Medical Plan:
Summary of Benefits and Coverage

Blue Shield of California is pleased to provide you with the following Medical Plan documents:

• Evidence of Coverage (EOC) 
  This pdf contains a complete coverage description of the Medical Plan, in an easy to understand format. This is your plan document that explains in full all the terms of your plan coverage, the benefits, copays or coinsurance, exclusions, limitations and how to access coverage.
• Summary of Benefits and Coverage (SBC) 
  An easy to read, plain English summary of the CCPOA Medical Plan. It is in a standardized format that allows you to easily compare the Blue Shield health plans to other carriers’ health plans.
• Summary of Benefits (SOB)
  This document highlights some benefits covered under the plan and how much it costs, helping you make an informed decision. This document has fewer details than the Evidence of Coverage.

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