Plan Documents
Rate Grids, Individual and Family Plan Documents, AHP Plan Documents, Small Group Plan Documents
Hometown Health Plan Documents
Below are Plan Documents for all Hometown Health Plans. If you are looking for Senior Care Plus Plan documents please visit: www.seniorcareplus.com/documents
Note: To view the organization’s benefits and operating procedures including:
Covered benefits., Noncovered benefits., Practitioner and provider availability., Key UM procedures the organization uses., Potential network, service or benefit restrictions., Pharmaceutical management procedures., view the Evidence of Coverage.
Rate Grids
Please review the rate grid instruction on the excel tab after opening the rate grid document.
- Please review the rate grid instruction on the excel tab after opening the rate grid document.
- 2024 Individual & Family Rate Grid
- 2024 Small Group Rate Grid
- 2024 Association Health Plans Rate Grid is not available here. Reach out to your Account Specialist for a quote.
- Please review the rate grid instruction on the excel tab after opening the rate grid document.
- 2025 Individual & Family Rate Grid
- 2025 Small Group Rate Grid
- 2025 Association Health Plans Rate Grid is not available here. Reach out to your Account Specialist for a quote.
Individual and Family Plan Documents
Please click below for IFP Plan Documents
- 2025 Renown Gold HMO Plus
- 2025 Renown Gold HMO
- 2025 Renown Silver HMO Plus
- 2025 Renown Silver HMO $20 PCP
- 2025 Renown Silver HMO $10 PCP
- 2025 Renown Silver HMO $5 PCP
- 2025 Renown Silver 70 HMO HSA
- 2025 Renown Silver 68 HMO HSA
- 2025 Renown Silver 70 HMO
- 2025 Renown Silver 68 HMO
- 2025 Renown Bronze HMO Plus
- 2025 Renown Bronze HMO HSA
- 2025 Renown Bronze HMO
- 2025 Renown Catastrophic HMO
- 2024 Renown Gold HMO Plus
- 2024 Renown Gold HMO
- 2024 Renown Silver HMO $20 PCP
- 2024 Renown Silver HMO $10 PCP
- 2024 Renown Silver HMO $5 PCP
- 2024 Renown Silver HMO $0 PCP
- 2024 Renown Silver 70 HMO HSA
- 2024 Renown Silver 68 HMO HSA
- 2024 Renown Silver 70 HMO
- 2024 Renown Silver 68 HMO
- 2024 Renown Bronze HMO Plus
- 2024 Renown Bronze HMO HSA
- 2024 Renown Bronze HMO
- 2024 Renown Catastrophic HMO
AHP Plan Documents
Please click below for AHP Plan Documents
- 2025 AHP Renown Platinum HMO
- 2025 AHP Renown Gold HMO Plus
- 2025 AHP Renown Gold HMO
- 2025 AHP Renown Value Gold HMO
- 2025 AHP Renown Silver HMO Plus
- 2025 AHP Renown Silver HMO HSA
- 2025 AHP Renown Value Silver HMO
- 2025 AHP Renown Bronze HMO Plus
- 2025 AHP Renown Bronze HMO HSA
- 2025 AHP Renown Value Bronze HMO
- 2024 AHP Renown Battle Born Gold HMO SOB
- 2024 AHP Hometown Battle Born Gold PPO SOB
- 2024 AHP Renown Bronze HMO Plus
- 2024 AHP Renown Bronze HMO
- 2024 AHP Renown Gold HMO
- 2024 AHP Renown Silver HMO HSA
- 2024 AHP Renown Silver HMO Plus
- 2024 AHP Renown Silver HMO
- 2024 AHP Renown Battle Born Gold HMO
- 2024 AHP Renown Bronze HMO HSA
- 2025 AHP Hometown Gold PPO Plus National
- 2025 AHP Hometown Gold PPO Plus
- 2025 AHP Hometown Gold PPO
- 2025 AHP Hometown Value Gold PPO
- 2025 AHP Hometown Silver HSA PPO Plus
- 2025 AHP Hometown Silver PPO HSA
- 2025 AHP Hometown Silver PPO Plus
- 2025 AHP Hometown Value Silver PPO
- 2025 AHP Hometown Bronze PPO Plus
- 2025 AHP Hometown Bronze PPO HSA
- 2025 AHP Hometown Value Bronze PPO
- 2023 Association Health Plan (AHP) Evidence Of Coverage (HMO + EPO + PPO)
- 2023 AHP Hometown Gold X PPO SOB
- 2023 AHP Hometown Gold PPO SOB
- 2023 AHP Hometown Silver HDHP PPO SOB
- 2023 23_AHP Hometown Silver PPO SOB
- 2023 AHP Hometown Bronze D9100 PPO SOB
- 2023 AHP Hometown Bronze HDHP PPO SOB
- 2023 AHP Hometown Bronze PPO SOB
Small Group Plan Documents
Please click below for Small Group Plan Documents
- 2024 SG Renown Bronze HMO
- 2024 SG Renown Gold HMO
- 2024 SG Renown Silver HMO HSA
- 2024 SG Renown Silver HMO Plus
- 2024 SG Renown Silver HMO
- 2024 SG Renown Battle Born Gold HMO
- 2024 SG Renown Bronze HMO HSA
- 2024 SG Renown Bronze HMO Plus
- 2023 Renown Gold HMO 0020053-00 SOB
- 2023 Renown Gold X HMO 0020079-00 SOB
- 2023 Renown Silver HMO HDHP 0020058-00 SOB
- 2023 Renown Silver HMO 0020055-00 SOB
- 2023 Renown Bronze D9100 HMO 0020081-00 SOB
- 2023 Renown Bronze HMO HDHP 0020064-00 SOB
- 2023 Renown Bronze HMO_0020080-00 SOB
- 2024 SG Hometown Bronze EPO Plus
- 2024 SG Hometown Bronze EPO
- 2024 SG Hometown Bronze EPO HSA
- 2024 SG Hometown Silver EPO HSA
- 2024 SG Hometown Silver EPO Plus
- 2024 SG Hometown Silver EPO
- 2024 SG Hometown Battle Born Gold EPO
- 2024 SG Hometown Gold EPO
- 2024 SG Hometown Gold EPO
- 2023 Hometown Gold EPO 0050001-00 SOB
- 2023 Hometown Gold X EPO 0050004-00 SOB
- 2023 Hometown Silver EPO HDHP 0050005-00 SOB
- 2023 Hometown Silver EPO 0050002-00 SOB
- 2023 Hometown Bronze D9100 EPO 0050007-00 SOB
- 2023 Hometown Bronze EPO HDHP 0050003-00 SOB
- 2023 Hometown Bronze EPO 0050006-00 SOB
- 2025 SG Hometown Gold PPO Plus National
- 2025 SG Hometown Gold PPO Plus
- 2025 SG Hometown Gold PPO
- 2025 SG Hometown Value Gold PPO
- 2025 SG Hometown Silver HSA PPO
- 2025 SG Hometown Silver PPO Plus
- 2025 SG Hometown Value Silver PPO
- 2025 SG Hometown Bronze PPO Plus
- 2025 SG Hometown Bronze PPO HSA
- 2025 SG Hometown Value Bronze PPO
- 2024 SG Hometown Bronze PPO
- 2024 SG Hometown Gold PPO
- 2024 SG Hometown Silver PPO HSA
- 2024 SG Hometown Silver PPO Plus
- 2024 SG Hometown Silver PPO
- 2024 SG Hometown Battle Born Gold PPO
- 2024 SG Hometown Bronze PPO HSA
- 2024 SG Hometown Bronze PPO Plus
- 2023 Hometown Silver PPO HDHP 0020114-00 SOB
- 2023 Hometown Silver PPO 0020112-00 SOB
- 2023 Hometown Bronze D9100 PPO 0020136-00 SOB
- 2023 Hometown Bronze PPO HDHP 0020120-00 SOB
- 2023 Hometown Bronze PPO 0020135-00 SOB
- 2023 Hometown Gold PPO 0020109-00 SOB
- 2023 Hometown Gold X PPO_0020108-00 SOB
2025 EOC Amendments
Please click below for 2025 EOC Amendments.
- 2025 Care After Hours DMR Appeal Response TAT Times Amendment
- 2025 Foreign Claims Language Amendment V1
- 2025 Travel Benefit Language Amendment
