Out-of-Area Network Summary of Benefits and Coverage

Document Information

The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services.

This is only a summary. For more information about your coverage, or to get a copy of the complete terms of coverage, call 1-866-882-2034 or at www.bcbstx.com/ut.