Resources and Forms

Everything you need for your Oklahoma coverage.

2024 Individual & Family Plans

Summary of Benefits and Coverage (SBC)
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OffEx
Download PDF
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx
Download PDF
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx ZCS
Download PDF
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx LCS
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OffEx
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx ZCS
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx LCS
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 73%
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 87%
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 94%
Download PDF
Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OffEx
Download PDF
Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx
Download PDF
Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx ZCS
Download PDF
Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx LCS
Download PDF
Standard Bronze - OffEx
Download PDF
Standard Bronze - OnEx
Download PDF
Standard Bronze - OnEx ZCS
Download PDF
Standard Bronze - OnEx LCS
Download PDF
Standard Silver - OffEx
Download PDF
Standard Silver - OnEx
Download PDF
Standard Silver - OnEx ZCS
Download PDF
Standard Silver - OnEx LCS
Download PDF
Standard Silver - OnEx CSR 73%
Download PDF
Standard Silver - OnEx CSR 87%
Download PDF
Standard Silver - OnEx CSR 94%
Download PDF
Standard Gold - OffEx
Download PDF
Standard Gold - OnEx
Download PDF
Standard Gold - OnEx ZCS
Download PDF
Standard Gold - OnEx LCS
Download PDF
Schedule of Benefits (SOB)
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OffEx
Download PDF
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx
Download PDF
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx ZCS
Download PDF
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx LCS
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OffEx
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx ZCS
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx LCS
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 73%
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 87%
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 94%
Download PDF
Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OffEx
Download PDF
Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx
Download PDF
Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx ZCS
Download PDF
Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx LCS
Download PDF
Standard Bronze - OffEx
Download PDF
Standard Bronze - OnEx
Download PDF
Standard Bronze - OnEx ZCS
Download PDF
Standard Bronze - OnEx LCS
Download PDF
Standard Silver - OffEx
Download PDF
Standard Silver - OnEx
Download PDF
Standard Silver - OnEx ZCS
Download PDF
Standard Silver - OnEx LCS
Download PDF
Standard Silver - OnEx CSR 73%
Download PDF
Standard Silver - OnEx CSR 87%
Download PDF
Standard Silver - OnEx CSR 94%
Download PDF
Standard Gold - OffEx
Download PDF
Standard Gold - OnEx
Download PDF
Standard Gold - OnEx ZCS
Download PDF
Standard Gold - OnEx LCS
Download PDF
Evidence of Coverage (EOC)
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OffEx
Download PDF
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx
Download PDF
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx ZCS
Download PDF
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx LCS
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OffEx
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx ZCS
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx LCS
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 73%
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 87%
Download PDF
Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 94%
Download PDF
Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OffEx
Download PDF
Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx
Download PDF
Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx ZCS
Download PDF
Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx LCS
Download PDF
Standard Bronze - OffEx
Download PDF
Standard Bronze - OnEx
Download PDF
Standard Bronze - OnEx ZCS
Download PDF
Standard Bronze - OnEx LCS
Download PDF
Standard Silver - OffEx
Download PDF
Standard Silver - OnEx
Download PDF
Standard Silver - OnEx ZCS
Download PDF
Standard Silver - OnEx LCS
Download PDF
Standard Silver - OnEx CSR 73%
Download PDF
Standard Silver - OnEx CSR 87%
Download PDF
Standard Silver - OnEx CSR 94%
Download PDF
Standard Gold - OffEx
Download PDF
Standard Gold - OnEx
Download PDF
Standard Gold - OnEx ZCS
Download PDF
Standard Gold - OnEx LCS
Download PDF