| PLANS | CSR VARIATION TYPE | DOCUMENTS | DRUG COSTS |
|---|---|---|---|
| Sendero Original Silver | |||
| Sendero Health Original Silver Off Exchange | Off Exchange | English | Lookup Cost |
| Sendero Health Original Silver On Exchange | On Exchange | English | Lookup Cost |
| Sendero Health Original Silver ZCS | AI/AN Zero Cost Sharing | English | Lookup Cost |
| Sendero Health Original Silver LCS | AI/AN Limited Cost Sharing | English | Lookup Cost |
| Sendero Health Original Silver 73 AV | 73% AV | English | Lookup Cost |
| Sendero Health Original Silver 87 AV | 87% AV | English | Lookup Cost |
| Sendero Health Original Silver 94 AV | 94% AV | English | Lookup Cost |
| Sendero Real Gold | |||
| Sendero Health Real Gold Off Exchange | Off Exchange | English | Lookup Cost |
| Sendero Health Real Gold On Exchange | On Exchange | English | Lookup Cost |
| Sendero Health Real Gold ZCS | AI/AN Zero Cost Sharing | English | Lookup Cost |
| Sendero Health Real Gold LCS | AI/AN Limited Cost Sharing | English | Lookup Cost |
| Sendero Central Platinum | |||
| Sendero Health Central Platinum | Off Exchange | English | Lookup Cost |
| Sendero Preferred Bronze | |||
| Sendero Health Preferred Bronze Off Exchange | Off Exchange | English | Lookup Cost |
| Sendero Health Preferred Bronze On Exchange | On Exchange | English | Lookup Cost |
| Sendero Health Preferred Bronze ZCS | AI/AN Zero Cost Sharing | English | Lookup Cost |
| Sendero Health Preferred Bronze LCS | AI/AN Limited Cost Sharing | English | Lookup Cost |
| Sendero Capital Silver | |||
| Sendero Health Capital Silver Off Exchange | Off Exchange | English | Lookup Cost |
| Sendero Health Capital Silver On Exchange | On Exchange | English | Lookup Cost |
| Sendero Health Capital Silver ZCS | AI/AN Zero Cost Sharing | English | Lookup Cost |
| Sendero Health Capital Silver LCS | AI/AN Limited Cost Sharing | English | Lookup Cost |
| Sendero Health Capital Silver 73 AV | 73% AV | English | Lookup Cost |
| Sendero Health Capital Silver 87 AV | 87% AV | English | Lookup Cost |
| Sendero Health Capital Silver 94 AV | 94% AV | English | Lookup Cost |
| Sendero Hill Country Gold | |||
| Sendero Health Hill Country Gold Off Exchange | Off Exchange | English | Lookup Cost |
| Sendero Health Hill Country Gold On Exchange | On Exchange | English | Lookup Cost |
| Sendero Health Hill Country Gold ZCS | AI/AN Zero Cost Sharing | English | Lookup Cost |
| Sendero Health Hill Country Gold LCS | AI/AN Limited Cost Sharing | English | Lookup Cost |
| Sendero Quality Care Bronze High Deductible | |||
| Sendero Health Quality Care Bronze High Deductible Off Exchange | Off Exchange | English | Lookup Cost |
| Sendero Health Quality Care Bronze High Deductible On Exchange | On Exchange | English | Lookup Cost |
| Sendero Health Quality Care Bronze High Deductible ZCS | AI/AN Zero Cost Sharing | English | Lookup Cost |
| Sendero Health Quality Care Bronze High Deductible LCS | AI/AN Limited Cost Sharing | English | Lookup Cost |
| Sendero Austin 512 Silver | |||
| Sendero Health Austin512 Silver Off Exchange | Off Exchange | English | Lookup Cost |
| Sendero Health Austin512 Silver On Exchange | On Exchange | English | Lookup Cost |
| Sendero Health Austin512 Silver ZCS | AI/AN Zero Cost Sharing | English | Lookup Cost |
| Sendero Health Austin512 Silver LCS | AI/AN Limited Cost Sharing | English | Lookup Cost |
| Sendero Health Austin512 Silver 73 AV | 73% AV | English | Lookup Cost |
| Sendero Health Austin512 Silver 87 AV | 87% AV | English | Lookup Cost |
| Sendero Health Austin512 Silver 94 AV | 94% AV | English | Lookup Cost |
| PLANS | Medical-Surgical and Behavioral Health Substance Abuse Disorder Schedule of Coverage | Pharmacy Benefits Schedule of Coverage |
|---|---|---|
| Sendero Health Original Silver | ||
| Sendero Health Original Silver Off Exchange | English | English |
| Sendero Health Original Silver On Exchange | English | English |
| Sendero Health Original Silver ZCS | English | English |
| Sendero Health Original Silver LCS | English | English |
| Sendero Health Original Silver 73 AV | English | English |
| Sendero Health Original Silver 87 AV | English | English |
| Sendero Health Original Silver 94 AV | English | English |
| Sendero Health Real Gold | ||
| Sendero Health Real Gold Off Exchange | English | English |
| Sendero Health Real Gold On Exchange | English | English |
| Sendero Health Real Gold ZCS | English | English |
| Sendero Health Real Gold LCS | English | English |
| Sendero Central Platinum | ||
| Sendero Health Central Platinum | English | English |
| Sendero Health Preferred Bronze | ||
| Sendero Health Preferred Bronze Off Exchange | English | English |
| Sendero Health Preferred Bronze On Exchange | English | English |
| Sendero Health Preferred Bronze ZCS | English | English |
| Sendero Health Preferred Bronze LCS | English | English |
| Sendero Health Capital Silver | ||
| Sendero Health Capital Silver Off Exchange | English | English |
| Sendero Health Capital Silver On Exchange | English | English |
| Sendero Health Capital Silver ZCS | English | English |
| Sendero Health Capital Silver LCS | English | English |
| Sendero Health Capital Silver 73 AV | English | English |
| Sendero Health Capital Silver 87 AV | English | English |
| Sendero Health Capital Silver 94 AV | English | English |
| Sendero Health Hill Country Gold | ||
| Sendero Health Hill Country Gold Off Exchange | English | English |
| Sendero Health Hill Country Gold On Exchange | English | English |
| Sendero Health Hill Country Gold ZCS | English | English |
| Sendero Health Hill Country Gold LCS | English | English |
| Sendero Health Quality Care Bronze High Deductible | ||
| Sendero Health Quality Care Bronze High Deductible Off Exchange | English | English |
| Sendero Health Quality Care Bronze High Deductible On Exchange | English | English |
| Sendero Health Quality Care Bronze High Deductible ZCS | English | English |
| Sendero Health Quality Care Bronze High Deductible LCS | English | English |
| Sendero Health Austin512 Silver | ||
| Sendero Health Austin512 Silver Off Exchange | English | English |
| Sendero Health Austin512 Silver On Exchange | English | English |
| Sendero Health Austin512 Silver ZCS | English | English |
| Sendero Health Austin512 Silver LCS | English | English |
| Sendero Health Austin512 Silver 73 AV | English | English |
| Sendero Health Austin512 Silver 87 AV | English | English |
| Sendero Health Austin512 Silver 94 AV | English | English |