Use this summary to compare costs and coverage between health plans based on price, benefits, network providers and other features. The Summary of Benefits and Coverage (SBC) is helpful to understand new coverage, renewals or change in coverage.

2024 Intel HMO Summary of Benefits and Coverage (SBC) 

2024 Intel HDHP Summary of Benefits and Coverage (SBC) 

2024 Intel Copay Summary of Benefits and Coverage (SBC) 

2025 Intel HDHP Summary of Benefits and Coverage (SBC)

2025 Intel Copay Summary of Benefits and Coverage (SBC)

Commercial 4-Tier Drug Formulary - By Drug Class

Drug Formulary Changes

Explanation of Prior Authorization requirements as well as a list of drugs that require prior authorization.

Drugs Requiring Prior Authorization

Specialty Pharmacy & Medical Drugs Coverage 

Form for a member, prescriber or a pharmacy to request authorization for  a drug listed on the Drugs Requiring Prior Authorization List.

Prior Authorization Request Form

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