Group
HMO Plans

Benefits

SBCs

In compliance with new requirements of the Affordable Care Act, AdventHealth Advantage Plans has made available a Summary of Benefits and Coverage (SBC) for our group plans. All SBCs are available at myAHplan.com/mySBC.

2021 Drug Lists (Formularies):

• 5 Tier Commercial Metal:
  Annual Notice of Change
  Online Search | PDF
  Prior Authorization and Step Therapy Criteria
• 5 Tier Commercial:
  Annual Notice of Change
  Online Search | PDF
  Prior Authorization and Step Therapy Criteria
• 3 Tier Commercial:
  Annual Notice of Change
  Online Search | PDF
  Prior Authorization and Step Therapy Criteria

Participating Providers:

• Provider Directory and Search

Dental Benefits

• Pediatric dental coverage

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Last Updated: 12/13/2021