2023 HMO SOB's
2023 SG HMO HSA Silver 0090017
2023 SG HMO HSA Silver 0090016
2023 SG HMO HSA Bronze 0090019
2023 POS SOB's
2023 SG Choice POS Platinum 0040032
2023 SG Choice POS Gold 0040029
2023 SG Choice POS Gold 0040003
2023 SG Choice POS Gold 0040031
2023 SG Choice POS Gold 0040005
2023 SG Choice POS Gold 0040030
2023 SG Choice POS Gold 0040023
2023 SG Choice POS Gold 0040024
2023 SG Choice POS Gold 0040025
2023 SG Choice POS Silver 0040022
2023 SG Choice POS Silver 0040013
2023 SG Choice POS Silver 0040026
2023 SG Choice POS Silver 0040015
2023 SG Choice POS Silver 0040027
2023 SG Choice POS Bronze 0040028
2023 SG Choice POS HSA Silver 0040017
2023 SG Choice POS HSA Silver 0040016
2023 SG Choice POS HSA Bronze 0040019
2023 PPO SOB's
2023 SG PPO HSA Silver 0170017
2023 SG PPO HSA Silver 0170016
2023 SG PPO HSA Bronze 0170019
RX Option
HMO
RxLGHMO_HSA_01-23 Final 10AD-40AD-70AD-20%AD $300max 2.5x Retail
RxLGHMO_HSA_Rx Option 10.30.50.125.AD 01.23
RxLGHMO_HSA_Rx Option 15_40_55_125 AD 01.23
RxLGHMO_Rx Option 15_40_55_125_150 Ded 01.23
RxLGHMO_Rx Option_10-40-70-20%_$300max 2.5x Retail
RxLGHMO_Rx Option_10.30.50.125 150Ded 01-23
RxLGHMO_Rx Option_10.30.50.125ND 01-23
RxLGHMO_Rx Option_15_50_85-20%_$300max 2.5x Retail
RxLGHMO_Rx Option_15.40.55.125ND 01-23
PPO
RxLGPPO_10-40-70-20%_$300max_2.5xRetail_01-23
RxLGPPO_10.30.50_125_150 Ded_01-23
RxLGPPO_15-50-85-20%_$300max_2.5xRetail_01-23
RxLGPPO_15.40.55.125_150 Ded_01-23
RxLGPPO_HSA_10.30.50.125.AD_01-23
RxLGPPO_HSA_10AD-40AD-70AD-20%AD_$300max_2.5xRetail_01-23
RxLGPPO_HSA_15.40.55_125 AD_01-23
RxLGPPO_HSA_15AD-50AD-85AD-20%AD_$300max_2.5xRetail-01-23
RIDERS
HMO
HMO_HSA_PreventiveDrugList_Rx_Rider_1_$0_GenericListOnly_01-23
HMO_HSA_PreventiveDrugList_Rx_Rider_2_$0_Generic-Brand_List_01-23
HMO_HSA_PreventiveDrugList_Rx_Rider_3_$10_GenericListOnly_01-23
HMO_HSA_PreventiveDrugList_Rx_Rider_4_$10-Generic_$30-Brand_GenBrandList_01-23
HMO_HSA_PreventiveDrugList_Rx_Rider_5_Template_4TierBD_01-23
PPO
PPO_HSA_PreventiveDrugList_Rx_Rider_1_$0_GenericListOnly_01-23
PPO_HSA_PreventiveDrugList_Rx_Rider_2_$0_Generic-Brand_List_01-23
PPO_HSA_PreventiveDrugList_Rx_Rider_3_$10_GenericListOnly_01-23
PPO_HSA_PreventiveDrugList_Rx_Rider_4_$10-Generic_$30-Brand_GenBrandList_01-23
PPO_HSA_PreventiveDrugList_Rx_Rider_5_Template_4TierBD_01-23
2023 LG HMO Centra Community HMO SOB
Basic
2023 LG HMO Basic Centra Community 17
2023 LG HMO Basic Centra Community 18
2023 LG HMO Basic Centra Community 19
2023 LG HMO Basic Centra Community 20
2023 LG HMO Basic Centra Community 21
2023 LG HMO Basic Centra Community 22
2023 LG HMO Basic Centra Community 23
2023 LG HMO Basic Centra Community 24
2023 LG HMO Basic Centra Community 25
2023 LG HMO Basic Centra Community 26
Complete
2023 LG HMO Complete Centra Community 01
2023 LG HMO Complete Centra Community 02
2023 LG HMO Complete Centra Community 03
2023 LG HMO Complete Centra Community 04
2023 LG HMO Complete Centra Community 05
2023 LG HMO HSA Complete Centra Community 27
2023 LG HMO HSA Complete Centra Community 28
2023 LG HMO HSA Complete Centra Community 29
2023 LG HMO HSA Complete Centra Community 30
2023 LG HMO HSA Complete Centra Community 31
2023 LG HMO HSA Complete Centra Community C01
Preferred
2023 LG HMO Preferred Centra Community 06
2023 LG HMO Preferred Centra Community 07
2023 LG HMO Preferred Centra Community 08
2023 LG HMO Preferred Centra Community 09
2023 LG HMO Preferred Centra Community 10
2023 LG HMO Preferred Centra Community 11
2023 LG HMO Preferred Centra Community 12
2023 LG HMO Preferred Centra Community 13
2023 LG HMO Preferred Centra Community 14
2023 LG HMO Preferred Centra Community 15
2023 LG HMO Preferred Centra Community 16
2023 LG HMO Preferred Centra Community C02
2023 LG HMO Preferred Centra Community C03
2023 LG HMO HSA Preferred Centra Community 32
2023 LG HMO HSA Preferred Centra Community 33
2023 LG HMO HSA Preferred Centra Community 34
2023 LG HMO HSA Preferred Centra Community 35
2023 LG HMO HSA Preferred Centra Community 36
2023 LG Virginia Expanded SOB's
Basic
2023 LG PPO Basic VA Expanded 17
2023 LG PPO Basic VA Expanded 18
2023 LG PPO Basic VA Expanded 19
2023 LG PPO Basic VA Expanded 20
2023 LG PPO Basic VA Expanded 21
2023 LG PPO Basic VA Expanded 22
2023 LG PPO Basic VA Expanded 23
2023 LG PPO Basic VA Expanded 24
2023 LG PPO Basic VA Expanded 25
2023 LG PPO Basic VA Expanded 26
2023 LG PPO Basic VA Expanded C07
2023 LG PPO Basic VA Expanded C11
Complete
2023 LG PPO Complete VA Expanded 01
2023 LG PPO Complete VA Expanded 02
2023 LG PPO Complete VA Expanded 03
2023 LG PPO Complete VA Expanded 04
2023 LG PPO Complete VA Expanded 05
2023 LG PPO Preferred VA Expanded C07
2023 LG PPO HSA Complete VA Expanded 27
2023 LG PPO HSA Complete VA Expanded 28
2023 LG PPO HSA Complete VA Expanded 29
2023 LG PPO HSA Complete VA Expanded 30
2023 LG PPO HSA Complete VA Expanded 31
2023 LG PPO HSA Complete VA Expanded C09
2023 LG PPO HSA Complete VA Expanded C10
Preferred
2023 LG PPO Preferred VA Expanded 06
2023 LG PPO Preferred VA Expanded 07
2023 LG PPO Preferred VA Expanded 08
2023 LG PPO Preferred VA Expanded 09
2023 LG PPO Preferred VA Expanded 10
2023 LG PPO Preferred VA Expanded 11
2023 LG PPO Preferred VA Expanded 12
2023 LG PPO Preferred VA Expanded 13
2023 LG PPO Preferred VA Expanded 14
2023 LG PPO Preferred VA Expanded 15
2023 LG PPO Preferred VA Expanded 16
2023 LG PPO Preferred VA Expanded C01
2023 LG PPO Preferred VA Expanded C02
2023 LG PPO Preferred VA Expanded C03
2023 LG PPO Preferred VA Expanded C04
2023 LG PPO Preferred VA Expanded C05
2023 LG PPO Preferred VA Expanded C06
2023 LG PPO HSA Preferred VA Expanded 32
2023 LG PPO HSA Preferred VA Expanded 33
2023 LG PPO HSA Preferred VA Expanded 34
2023 LG PPO HSA Preferred VA Expanded 35
2023 LG PPO HSA Preferred VA Expanded 36
2023 LG Coast to Coast SOB
Basic
2023 LG PPO Basic National Network 17
2023 LG PPO Basic National Network 18
2023 LG PPO Basic National Network 19
2023 LG PPO Basic National Network 20
2023 LG PPO Basic National Network 21
2023 LG PPO Basic National Network 22
2023 LG PPO Basic National Network 23
2023 LG PPO Basic National Network 24
2023 LG PPO Basic National Network 25
2023 LG PPO Basic National Network 26
Complete
2023 LG PPO Complete National Network 01
2023 LG PPO Complete National Network 02
2023 LG PPO Complete National Network 03
2023 LG PPO Complete National Network 04
2023 LG PPO Complete National Network 05
2023 LG PPO HSA Complete National Network 27
2023 LG PPO HSA Complete National Network 28
2023 LG PPO HSA Complete National Network 29
2023 LG PPO HSA Complete National Network 30
2023 LG PPO HSA Complete National Network 31
Preferred
2023 LG PPO Preferred National Network 06
2023 LG PPO Preferred National Network 07
2023 LG PPO Preferred National Network 08
2023 LG PPO Preferred National Network 09
2023 LG PPO Preferred National Network 10
2023 LG PPO Preferred National Network 11
2023 LG PPO Preferred National Network 12
2023 LG PPO Preferred National Network 13
2023 LG PPO Preferred National Network 14
2023 LG PPO Preferred National Network 15
2023 LG PPO Preferred National Network 16
2023 LG PPO HSA Preferred National Network 32
2023 LG PPO HSA Preferred National Network 33
2023 LG PPO HSA Preferred National Network 34
2023 LG PPO HSA Preferred National Network 35
2023 LG PPO HSA Preferred National Network 36
Custom Plans
23LGPPOVENPreC13-Piedmont PPO Preferred 1000-25-40 VA Expanded-C
23LGPPOC2CPreC13-Piedmont PPO Preferred 1000-25-40 National Network-C
23LGPPOVENPreC14-Piedmont PPO Preferred 3000-5000 HSA VA Expanded-C
23LGPPOC2CPreC14-Piedmont PPO Preferred 3000-5000 HSA National Network-C
RxLGPPO_Template_10.30.45.55 ND_01.23 - C Appomattox
RxLGPPO_HSA_Template_20%.20%.20%.20% AD - C Appomattox_01-23