2023 Plan Information

Small Group Health Maintenance Organization (HMO)

Aspirus Health Plan believes in giving you all the information you need to make a sound decision. Whether you are choosing a plan and need to see the fine details, requesting information on behalf of a family member, or filing a claim, we are your resource. The plan options below will connect to your insurance plan documents.

What you will find in the charts

Certificate/Contract – This is the legal contract between you and Aspirus Health Plan. It includes the details about your insurance plan.

Plan Summary – High level chart that shows the deductible, coinsurance, out-of-pocket and much more for all plan offerings.

Summary of Benefits (SBC) – An easy-to-read version of your plan that can be used to compare plans. The Certificate/Contract and Plan Summary will give a “detailed version” of same information.

Questions? Contact member services at 866.631.5404

2023 Small Group HMO Plans

Health Maintenance Organization (HMO) plans

Plan Name Summary of Benefits (SBC) Plan Summary Contract
HMO Gold 1150 86584WI0040002-00.pdf 29989 AHP SG Plan Summary.pdf 86584WI0040002 HMO Gold 1150 2023.pdf
HMO Gold 1700 86584WI0040003-00.pdf 29989 AHP SG Plan Summary.pdf 86584WI0040003 HMO Gold 1700 2023.pdf
HMO Gold 2100 86584WI0040005-00.pdf 29989 AHP SG Plan Summary.pdf 86584WI0040005 HMO Gold 2100 2023.pdf
HMO Gold 2600 86584WI0040006-00.pdf 29989 AHP SG Plan Summary.pdf 86584WI0040006 HMO Gold 2600 2023.pdf
HMO Silver 3700 86584WI0040009-00.pdf 29989 AHP SG Plan Summary.pdf 86584WI0040009 HMO Silver 3700 2023.pdf
HMO Silver 4500 86584WI0040010-00.pdf 29989 AHP SG Plan Summary.pdf 86584WI0040010 HMO Silver 4500 2023.pdf
HMO Silver 5000 86584WI0040011-00.pdf 29989 AHP SG Plan Summary.pdf 86584WI0040011 HMO Silver 5000 2023.pdf
HMO HDHP-HSA Gold 2600 86584WI0040012-00.pdf 29989 AHP SG Plan Summary.pdf 86584WI0040012 HMO HDHP-HSA Gold 2600 2023.pdf
HMO HDHP-HSA Silver 2200 86584WI0040013-00.pdf 29989 AHP SG Plan Summary.pdf 86584WI0040013 HMO HDHP-HSA Silver 2200 2023.pdf
HMO HDHP-HSA Silver 3250 86584WI0040015-00.pdf 29989 AHP SG Plan Summary.pdf 86584WI0040015 HMO HDHP-HSA Silver 3250 2023.pdf
HMO HDHP-HSA Silver 5000 86584WI0040016-00.pdf 29989 AHP SG Plan Summary.pdf 86584WI0040016 HMO HDHP-HSA Silver 5000 2023.pdf
HMO HDHP-HSA Bronze 6000 86584WI0040017-00.pdf 29989 AHP SG Plan Summary.pdf 86584WI0040017 HMO HDHP-HSA Bronze 6000 2023.pdf
HMO HDHP-HSA Bronze 7000 86584WI0040018-00.pdf 29989 AHP SG Plan Summary.pdf 86584WI0040018 HMO HDHP-HSA Bronze 7000 2023.pdf
HMO Silver 7000 86584WI0040020-00.pdf 29989 AHP SG Plan Summary.pdf 86584WI0040020 HMO Silver 7000 2023.pdf
HMO HDHP-HSA Gold 3150 86584WI0040021-00.pdf 29989 AHP SG Plan Summary.pdf 86584WI0040021 HMO HDHP-HSA Gold 3150 2023.pdf
HMO HDHP-HSA Silver 4050 86584WI0040022-00.pdf 29989 AHP SG Plan Summary.pdf 86584WI0040022 HMO HDHP-HSA Silver 4050 2023.pdf