2026 CODAC Benefit Summaries and Carrier Flyers

Table of Contents

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

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

QUALIFIED HIGH DEDUCTIBLE HEALTH PLAN MEDICAL SCHEDULE OF BENEFITS.......................4

TRANSPLANT SCHEDULE OF BENEFITS .............................................................................................. 12

GENERATIONYOU PROGRAM ................................................................................................................ 13

OUT-OF-POCKET EXPENSES AND MAXIMUMS.................................................................................... 14

ELIGIBILITY AND ENROLLMENT ............................................................................................................ 16

SPECIAL ENROLLMENT PROVISION ..................................................................................................... 20

TERMINATION ........................................................................................................................................... 22

COBRA CONTINUATION OF COVERAGE............................................................................................... 24

UNIFORMED SERVICES EMPLOYMENT AND REEMPLOYMENT RIGHTS ACT OF 1994..................32

PROTECTION FROM BALANCE BILLING............................................................................................... 33

PROVIDER NETWORK .............................................................................................................................. 35

COVERED MEDICAL BENEFITS .............................................................................................................. 38

TELADOC HEALTH SERVICES ................................................................................................................ 50

VIRTA.......................................................................................................................................................... 53

ENVITA ....................................................................................................................................................... 54

HINGE HEALTH ......................................................................................................................................... 55

CARRUM HEALTH..................................................................................................................................... 56

HOME HEALTH CARE BENEFITS............................................................................................................ 68

TRANSPLANT BENEFITS ......................................................................................................................... 69

VISION CARE BENEFITS .......................................................................................................................... 72

HEARING AID BENEFITS.......................................................................................................................... 73

BEHAVIORAL HEALTH BENEFITS.......................................................................................................... 74

UMR CARE: CLINICAL ADVOCACY RELATIONSHIPS TO EMPOWER .............................................. 76

CENTERS OF EXCELLENCE.................................................................................................................... 80

COORDINATION OF BENEFITS ............................................................................................................... 81