Plan Documents | Baylor Scott & White Health Plan

Your Plan Documents

Quickly and easily view only the plan documents that apply to you in our Member Portal. Custom plan documents are not included on this page, but can also be found in the Member Portal.

More Information

2025 Plan Documents

Contact Support at 844.633.5325 (TTY: 711).

All Documents

Individual Plans

Small Group Plans

Primary Care Physician (PCP) referrals are not required for any of our plans.

Individual Plans

Gold Plans

BSW Elite Gold HMO 001
BSW Elite Gold HMO 001
BSW Elite Gold HMO 001 - Native American Zero
BSW Elite Gold HMO 001 - Native American Limited
BSW Elite Gold HMO 004
BSW Elite Gold HMO 004
BSW Elite Gold HMO 004 - Native American Zero
BSW Elite Gold HMO 004 - Native American Limited
BSW Elite Gold HMO 012
BSW Elite Gold HMO 012
BSW Elite Gold HMO 012 - Native American Zero
BSW Elite Gold HMO 012 - Native American Limited
BSW Diabetes Care Gold 014
BSW Diabetes Care Gold 014
BSW Diabetes Care Gold 014
BSW Diabetes Care Gold 014
BSW Elite Gold HMO 002

BSW Elite Gold HMO 001
BSW Elite Gold HMO 001
BSW Elite Gold HMO 001 - Native American Zero
BSW Elite Gold HMO 001 - Native American Limited
BSW Elite Gold HMO 004
BSW Elite Gold HMO 004
BSW Elite Gold HMO 004 - Native American Zero
BSW Elite Gold HMO 004 - Native American Limited
BSW Elite Gold HMO 012
BSW Elite Gold HMO 012
BSW Elite Gold HMO 012 - Native American Zero
BSW Elite Gold HMO 012 - Native American Limited
BSW Diabetes Care Gold 014
BSW Diabetes Care Gold 014
BSW Diabetes Care Gold 014
BSW Diabetes Care Gold 014

Coming soon...

Silver Plans

BSW Prime Silver HMO 008
BSW Prime Silver HMO 008
BSW Prime Silver HMO 008 - Native American Zero
BSW Prime Silver HMO 008 - Native American Limited
BSW Prime Silver HMO 008 - CSR 73% AV
BSW Prime Silver HMO 008 - CSR 87% AV
BSW Prime Silver HMO 008 - CSR 94% AV
BSW Prime Silver HMO 003
BSW Prime Silver HMO 003
BSW Prime Silver HMO 003 - Native American Zero
BSW Prime Silver HMO 003 - Native American Limited
BSW Prime Silver HMO 003 - CSR 73% AV
BSW Prime Silver HMO 003 - CSR 87% AV
BSW Prime Silver HMO 003 - CSR 94% AV
BSW Prime Silver HMO 005
BSW Prime Silver HMO 005
BSW Prime Silver HMO 005 - Native American Zero
BSW Prime Silver HMO 005 - Native American Limited
BSW Prime Silver HMO 005 - CSR 73% AV
BSW Prime Silver HMO 005 - CSR 87% AV
BSW Prime Silver HMO 005 - CSR 94% AV
BSW Prime Silver HMO 010
BSW Prime Silver HMO 011
BSW Prime Silver HMO 015

BSW Prime Silver HMO 008
BSW Prime Silver HMO 008
BSW Prime Silver HMO 008 - Native American Zero
BSW Prime Silver HMO 008 - Native American Limited
BSW Prime Silver HMO 008 - CSR 73% AV
BSW Prime Silver HMO 008 - CSR 87% AV
BSW Prime Silver HMO 008 - CSR 94% AV
BSW Prime Silver HMO 003
BSW Prime Silver HMO 003
BSW Prime Silver HMO 003 - Native American Zero
BSW Prime Silver HMO 003 - Native American Limited
BSW Prime Silver HMO 003 - CSR 73% AV
BSW Prime Silver HMO 003 - CSR 87% AV
BSW Prime Silver HMO 003 - CSR 94% AV
BSW Prime Silver HMO 005
BSW Prime Silver HMO 005
BSW Prime Silver HMO 005 - Native American Zero
BSW Prime Silver HMO 005 - Native American Limited
BSW Prime Silver HMO 005 - CSR 73% AV
BSW Prime Silver HMO 005 - CSR 87% AV
BSW Prime Silver HMO 005 - CSR 94% AV
BSW Prime Silver HMO 010
BSW Prime Silver HMO 011
BSW Prime Silver HMO 015

Coming soon...

Bronze Plans

BSW Savers Bronze HMO H S A 006
BSW Savers Bronze HMO H S A 006
BSW Savers Bronze HMO 006 - Native American Zero
BSW Savers Bronze HMO H S A 006 - Native American Limited
BSW Savers Bronze HMO H S A 007
BSW Savers Bronze HMO H S A 007
BSW Savers Bronze HMO H S A 007 - Native American Zero
BSW Savers Bronze HMO H S A 007 - Native American Limited
BSW Savers Bronze HMO H S A 009
BSW Savers Bronze HMO H S A 009
BSW Savers Bronze HMO H S A 009 - Native American Zero
BSW Savers Bronze HMO H S A 009 - Native American Limited
BSW Vital Bronze HMO 001
BSW Vital Bronze EPO 001

BSW Savers Bronze HMO H S A 006
BSW Savers Bronze HMO H S A 006
BSW Savers Bronze HMO 006 - Native American Zero
BSW Savers Bronze HMO H S A 006 - Native American Limited
BSW Savers Bronze HMO H S A 007
BSW Savers Bronze HMO H S A 007
BSW Savers Bronze HMO H S A 007 - Native American Zero
BSW Savers Bronze HMO H S A 007 - Native American Limited
BSW Savers Bronze HMO H S A 009
BSW Savers Bronze HMO H S A 009
BSW Savers Bronze HMO H S A 009 - Native American Zero
BSW Savers Bronze HMO H S A 009 - Native American Limited
BSW Vital Bronze HMO 001
BSW Vital Bronze EPO 001

Coming soon...

MyPlan PPO Transitional

Coming soon...

Coming soon...

Small Group Plans

Gold Plans

Coming soon...

Coming soon...

Coming soon...

Silver Plans

Coming soon...

Coming soon...

Coming soon...

Bronze Plans

Coming soon...

Coming soon...

Coming soon...

POS Transitional

Coming soon...

Coming soon...

Scroll To Top

Member Plan Documents

2026 Summary of Benefits and Coverage and Evidence of CoverageSBC and EOC documents

Your Plan Documents

More Information

All Documents

Individual Plans

Gold Plans

Silver Plans

Bronze Plans

MyPlan PPO Transitional

Small Group Plans

Gold Plans

Silver Plans

Bronze Plans

POS Transitional