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summary of benefits and coverage (SBC)
for U.S.-payroll employees and expatriates in the U.S.
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Learn more about your health plans, including resources that may be available.
summary plan descriptions
Summary Plan Descriptions (SPDs) provide specific details about your Chevron benefits, such as eligibility, covered services and participation rules.
plan contacts
Summary of Benefits and Coverage (SBCs) provide summary information about your medical plans, such as benefits, copayments, deductibles, coinsurance and plan contact information. SBCs are not required for all health plans; only certain medical plans. You can open and print any of the SBCs on this page as desired. You can also call the HR Service Center and ask that an SBC be mailed to you free of charge.
For your reference, general benefit summaries are also included below for other health plans, such as dental, vision and other supplemental health plans.
2026
Medical PPO Plan (100)
High Deductible Health Plan (HDHP) (105)
High Deductible Health Plan Basic (HDHP Basic) (110)
Medical HMO: Kaiser Colorado (150)
Medical HMO: Kaiser Hawaii (155)
Medical HMO: Kaiser WA (160)
Medical HMO: Kaiser Northern California (165)
Medical HMO: Kaiser Southern California (170)
Medical HMO: Kaiser Northwest (185)
Medical HMO: Kaiser USW Local 5 $500 HMO Plan (180)
Medical HMO: Kaiser USW Local 5 $15 HMO Plan (175)
Global Choice Plan (U.S.-Payroll Expatriates)
Global Choice Plan (Expatriates in the U.S.)
Medical HMO: HMO Blue Texas - Plan discontinued effective January 1, 2026
2026 Prescription Drug Program Formulary
2026 List of Formulary Exclusions
List of Standard Preventive Medications (HDHP/HDHP Basic only)
SaveOnSP Drug List | About SaveOnSP (Medical PPO only)
Dental PPO Plan (U.S.-Payroll)
Dental PPO Plan (Expatriates in the U.S.)
Dental HMO Plan
Basic Vision (VSP) - Gray column
Vision Plus Program - Blue column
Basic Vision (HMO) - See your HMO benefit summary above
2025
HMO Blue Texas (135)
Kaiser Colorado (150)
Kaiser Hawaii (155)
Kaiser WA (160)
Kaiser Northern California (165)
Kaiser Southern California (170)
Kaiser Northwest (185)
Kaiser USW Local 5 $500 Deductible HMO Plan (180)
Kaiser USW Local 5 $15 HMO Plan (175)
For employees not enrolled in a Chevron medical plan option (050)
For employees enrolled in the Medical PPO plan (100)
For employees enrolled in the HDHP (105)
For employees enrolled in the HDHP Basic (110)
For employees enrolled in the Global Choice (U.S.-payroll expatriates) (115)
For employees enrolled in the Global Choice (Expatriates in the U.S.) (120)
For employees enrolled in these Medical HMOs (B130): Kaiser Hawaii, Kaiser USW
For employees enrolled in all other Medical HMO Plans (A125)
This communication provides only certain highlights about benefit provisions. It is not intended to be a complete explanation. If there are any discrepancies between this communication and the legal plan documents, the legal plan documents will prevail to the extent permitted by law. Oral statements about plan benefits are not binding on Chevron or the applicable plan. Chevron Corporation reserves all rights, for any reason and at any time, to amend, change or terminate these plans or to change or eliminate the company contribution toward the cost of such plans. Such amendments, changes, terminations or eliminations may be applicable without regard to whether someone previously terminated employment with Chevron or previously was subject to a grandfathering provision. Unless required by applicable law, there are no vested rights with respect to any Chevron health and welfare plan benefit or to any company contributions towards the cost of such health and welfare plan benefits. Some benefit plans and policies described in this document may be subject to collective bargaining and, therefore, may not apply to union-represented employees.
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