Summary of Benefits and Coverage

This document is about a summary of benefits and coverage for an insurance plan provided by Insurance Company 1. It covers the key details of the plan, including the overall deductible, whether there are other deductibles for specific services, the out-of-pocket limit, annual limits, network of providers, and the need for referrals to see specialists. The document aims to provide an overview of the plan's coverage and costs to help the reader understand the plan's features and limitations.