Plan Documents - Individual & Family Plan - by CHPW

Plan Documents

The plan documents below explain what CHPW Individual & Family Cascade Select health insurance plans do and do not cover, how much you’ll pay for care, options to access benefits, and much more.

Access the documents online, or call Customer Service to request a hard copy by mail: 1-866-907-1906.

Evidence of Coverage

The Evidence of Coverage (EOC) is also known as the Health Care Coverage Agreement. It is a binding contract that describes the health care benefits available to you, and your rights and responsibilities, under your plan.

➔ 2023 EOC (for all plans)

Schedule of Benefits

The Schedule of Benefits (SB) details the fees associated with each type of health care service covered by your plan. This includes your deductible and out-of-pocket maximum amounts.

2023 Schedule of Benefits:

Summary of Benefits and Coverage

The Summary of Benefits and Coverage (SBC) gives a snapshot, in plain language, of your health plan’s costs, benefits, covered health care services, and other features.

2023 Summary of Benefits and Coverage:

Online Payment Portal

Our secure E-Bill Express payment portal allows members to pay their monthly premiums and medical bills online.

➔ E-Bill Express

Member Rights

Standard Consumer Notice

Know your rights under the Balance Billing Protection Act. Beginning January 1, 2020, Washington state law protects you from ‘surprise billing’ or ‘balance billing’ if you receive emergency care or are treated at an in-network hospital or outpatient surgical facility.

Member Rights Forms

As a CHPW Individual & Family plan member, you have certain rights designed to protect you when you get health care.



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