ACA Basic High Deductible Health Plan Resources
This plan works the same as the Healthcare + Savings plan, with a deductible you must meet, but it has higher out-of-pocket costs. It is designed to meet meets the minimum essential coverage requirements under the federal Affordable Care Act (ACA).
2023 Plan Documents
An SBC is an overview of plan benefits, deductibles, copays and coverage levels for a variety of commonly-used medical treatments and services.
- ACA Basic HDHP Plan Summary of Benefits Coverage (short document)
An SPD or EOC is the official, detailed plan document for each plan outlining information about eligibility; costs and cost sharing; included and excluded services; claims process; procedures for filing grievances, complaints and appeals.
- ACA Basic HDHP Plan Summary Plan Description (long document)
Plan Forms & Resources
- High Deductible Plan Preventative Drug List 2021
- Blue Card Worldwide
- Blue Shield Claim Form - U.S.
- Blue Shield Claim Form - Prescriptions
- Blue Shield International Claim Form
Blue Shield website for Stanford participants
2024 Plan Documents
An SBC is an overview of plan benefits, deductibles, copays and coverage levels for a variety of commonly-used medical treatments and services.
- ACA Basic HDHP Plan Summary of Benefits Coverage (short document)