Find all the documents and details for your plan
The documents below provide up-to-date details about your plan:
- Summary of Benefits and Coverage (SBC) – Your SBC gives you general information about your plan, such as what’s covered, your out-of-pocket limits, prescription drug coverage, where to find in-network providers and more. This document is often the easiest-to-read summary of your plan.
- Your legal contract with HealthPartners – Your contract contains all of the details about your insurance plan, including terms and conditions of your plan, your rights and responsibilities, and more.
- Benefit chart – Your benefit chart includes the exact legal definition of coverage-related terms used in your plan documents. It also contains complete and comprehensive information about what your plan does and doesn’t cover.
- Pediatric dental amendment – Some of our plans have dental benefits that only apply to people younger than 19. Those benefits are explained in this amendment.
2024 Wisconsin plan documents
Atlas plans
Plan name | Summary of Benefits and Coverage | Contract | Benefit charts | Amendments/pediatric dental |
---|---|---|---|---|
Atlas $1,000 w/Copay P-S Gold | ||||
Atlas $1,500 w/Copay P-S Gold | ||||
Atlas $3,200 Plus Silver | ||||
Atlas $4,900 Plus Silver | ||||
Atlas $6,350 Plus Bronze | ||||
Atlas $9,450 Catastrophic | ||||
Atlas $3,000 w/Copay P-S Silver | ||||
Atlas $7,500 w/Copay P-S Bronze | ||||
Atlas $3,800 HSA Silver | ||||
Atlas $8,000 HSA Bronze |
Plan name | Summary of Benefits and Coverage | Contract | Benefit charts |
---|---|---|---|
Atlas $1,000 w/Copay P-S Gold | |||
Atlas Zero Cost Share Gold (IW602) | |||
Atlas $1,000 w/Copay P-S Limited Cost Share Gold | |||
Atlas $1,500 w/Copay Gold | |||
Atlas Zero Cost Share Gold (IW656) | |||
Atlas $1,500 w/Copay Limited Cost Share Gold | |||
Atlas $3,200 Plus Silver | |||
Atlas Zero Cost Share Silver (IW605) | |||
Atlas $3,200 Plus Limited Cost Share Silver | |||
Atlas $50 Plus Cost Share Silver | |||
Atlas $650 Plus Cost Share Silver | |||
Atlas $3,000 Plus Cost Share Silver | |||
Atlas $5,900 w/Copay P-S Silver | |||
Atlas Zero Cost Share Silver (IW659) | |||
Atlas $5,900 w/Copay P-S Limited Cost Share Silver | |||
Atlas $0 w/Copay P-S Cost Share Silver | |||
Atlas $700 w/Copay P-S Cost Share Silver | |||
Atlas $5,700 w/Copay P-S Cost Share Silver | |||
Atlas $6,350 Plus Bronze | |||
Atlas Zero Cost Share Bronze (IW617) | |||
Atlas $6,350 Plus Limited Cost Share Bronze | |||
Atlas $7,500 w/Copay P-S Bronze | |||
Atlas Zero Cost Share Bronze (IW665) | |||
Atlas $7,500 w/Copay P-S Limited Cost Share Bronze | |||
Atlas $9,450 Catastrophic | |||
Atlas $3,000 w/Copay P-S Silver | |||
Atlas Zero Cost Share Silver (IW639) | |||
Atlas $3,000 w/Copay P-S Limited Cost Share Silver | |||
Atlas $50 Cost Share Reduction Silver | |||
Atlas $850 Cost Share Reduction Silver | |||
Atlas $2,800 Cost Share Reduction Silver | |||
Atlas $3,800 HSA Silver | |||
Atlas Zero Cost Share Silver (IW624) | |||
Atlas $3,800 Limited Cost Share Silver | |||
Atlas $200 Cost Share Silver | |||
Atlas $1,200 Cost Share Silver | |||
Atlas $3,000 Cost Share Silver | |||
Atlas $8,000 HSA Bronze | |||
Atlas Zero Cost Share Bronze (IW630) | |||
Atlas $8,000 Limited Cost Share Bronze |
Robin Oak plans
Plan name | Summary of Benefits and Coverage | Contract | Benefit charts | Amendments/pediatric dental |
---|---|---|---|---|
Robin Oak $1,000 w/Copay P-S Gold | ||||
Robin Oak $1,500 w/Copay P-S Gold |
Plan name | Summary of Benefits and Coverage | Contract | Benefit charts |
---|---|---|---|
Robin Oak $1,000 w/Copay P-S Gold | |||
Robin Oak Zero Cost Share Gold (IR602) | |||
Robin Oak $1,000 w/Copay P-S Limited Cost Share Gold | |||
Robin Oak $1,500 w/Copay P-S Gold | |||
Robin Oak Zero Cost Share Gold (IR643) | |||
Robin Oak $1,500 w/Copay P-S Limited Cost Share Gold |
Robin Select plans
Plan name | Summary of Benefits and Coverage | Contract | Benefit charts | Amendments/pediatric dental |
---|---|---|---|---|
Robin Select $4,500 Plus Silver | ||||
Robin Select $6,350 Plus Bronze | ||||
Robin Select $7,500 w/Copay P-S Bronze | ||||
Robin Select $9,450 Catastrophic | ||||
Robin Select $3,800 HSA Silver | ||||
Robin Select $8,000 HSA Bronze |
Plan name | Summary of Benefits and Coverage | Contract | Benefit charts |
---|---|---|---|
Robin Select $3,600 Plus Silver | |||
Robin Select Zero Cost Share Silver (IR661) | |||
Robin Select $3,600 Plus Limited Cost Share Silver | |||
Robin Select $50 Cost Share Reduction Silver | |||
Robin Select $750 Cost Share Reduction Silver | |||
Robin Select $3,100 Cost Share Reduction Silver | |||
Robin Select $5,900 w/Copay P-S Silver | |||
Robin Select Zero Cost Share Silver (IR667) | |||
Robin Select $5,900 w/Copay P-S Limited Cost Share Silver | |||
Robin Select $0 w/Copay P-S Cost Share Reduction Silver | |||
Robin Select $700 w/Copay P-S Cost Share Reduction Silver | |||
Robin Select $5,700 w/Copay P-S Cost Share Reduction Silver | |||
Robin Select $6,350 Plus Bronze | |||
Robin Select Zero Cost Share Bronze (IR673) | |||
Robin Select $6,350 Plus Limited Cost Share Bronze | |||
Robin Select $7,500 w/Copay P-S Bronze | |||
Robin Select Zero Cost Share Bronze (IR676) | |||
Robin Select $7,500 w/Copay P-S Limited Cost Share Bronze | |||
Robin Select $9,450 Catastrophic | |||
Robin Select $3,800 HSA Silver | |||
Robin Select Zero Cost Share Silver (IR679) | |||
Robin Select $3,800 HSA Limited Cost Share Silver | |||
Robin Select $200 Cost Share Reduction Silver | |||
Robin Select $1,200 Cost Share Reduction Silver | |||
Robin Select $3,000 Cost Share Reduction Silver | |||
Robin Select $8,000 HSA Bronze | |||
Robin Select Zero Cost Share Bronze (IR685) | |||
Robin Select $8,000 HSA Limited Cost Share Bronze |