2026 CODAC Benefit Summaries and Carrier Flyers

Table of Contents

INTRODUCTION........................................................................................................................................... 1

PLAN INFORMATION .................................................................................................................................. 2

MEDICAL SCHEDULE OF BENEFITS ........................................................................................................ 4

TRANSPLANT SCHEDULE OF BENEFITS .............................................................................................. 15

OUT-OF-POCKET EXPENSES AND MAXIMUMS.................................................................................... 16

ELIGIBILITY AND ENROLLMENT ............................................................................................................ 18

SPECIAL ENROLLMENT PROVISION ..................................................................................................... 22

TERMINATION ........................................................................................................................................... 24

COBRA CONTINUATION OF COVERAGE............................................................................................... 26

UNIFORMED SERVICES EMPLOYMENT AND REEMPLOYMENT RIGHTS ACT OF 1994 ..................34

PROTECTION FROM BALANCE BILLING ............................................................................................... 35

PROVIDER NETWORK .............................................................................................................................. 37

TRANSITIONAL CARE .............................................................................................................................. 40

CONTINUITY OF CARE ............................................................................................................................. 41

COVERED MEDICAL BENEFITS .............................................................................................................. 42

TELADOC HEALTH SERVICES ................................................................................................................ 53

HOME HEALTH CARE BENEFITS............................................................................................................ 56

TRANSPLANT BENEFITS ......................................................................................................................... 57

VIRTA.......................................................................................................................................................... 60

ENVITA ....................................................................................................................................................... 61

HINGE HEALTH ......................................................................................................................................... 62

CARRUM HEALTH..................................................................................................................................... 63

VISION CARE BENEFITS .......................................................................................................................... 75

HEARING AID BENEFITS.......................................................................................................................... 76

BEHAVIORAL HEALTH BENEFITS .......................................................................................................... 77

COST MANAGEMENT ............................................................................................................................... 79

COORDINATION OF BENEFITS ............................................................................................................... 83