Obamacare 2023 Rates for Dane County
Obamacare > Rates > Wisconsin > Dane County
ADVERTISEMENT
Obamacare > Rates > Wisconsin > Dane County
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT
QuartzLocal: 1-608-644-3430 | Toll Free: 1-800-362-3310 | TTY: 1-800-877-8973 |
Toc - Plan #1 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I401 with Dental & Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$424.65 $481.98 $542.70 $758.42 $1,152.50 |
$749.51 $806.84 $867.56 $1,083.28 |
$1,074.37 $1,131.70 $1,192.42 $1,408.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$849.30 $963.96 $1,085.40 $1,516.84 $2,305.00 |
$1,174.16 $1,288.82 $1,410.26 $1,841.70 |
$1,499.02 $1,613.68 $1,735.12 $2,166.56 |
Toc - Plan #2 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I402 Maintenance with Dental & Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$420.67 $477.46 $537.61 $751.31 $1,141.69 |
$742.48 $799.27 $859.42 $1,073.12 |
$1,064.29 $1,121.08 $1,181.23 $1,394.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$841.34 $954.92 $1,075.22 $1,502.62 $2,283.38 |
$1,163.15 $1,276.73 $1,397.03 $1,824.43 |
$1,484.96 $1,598.54 $1,718.84 $2,146.24 |
Toc - Plan #3 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I405 with Dental & Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$424.17 $481.43 $542.08 $757.56 $1,151.18 |
$748.66 $805.92 $866.57 $1,082.05 |
$1,073.15 $1,130.41 $1,191.06 $1,406.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$848.34 $962.86 $1,084.16 $1,515.12 $2,302.36 |
$1,172.83 $1,287.35 $1,408.65 $1,839.61 |
$1,497.32 $1,611.84 $1,733.14 $2,164.10 |
Toc - Plan #4 Quartz | ||||||||||||||||||||
Gold
(HMO) Quartz One Gold I410 Standard with Dental & Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$435.03 $493.76 $555.96 $776.96 $1,180.66 |
$767.83 $826.56 $888.76 $1,109.76 |
$1,100.63 $1,159.36 $1,221.56 $1,442.56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$870.06 $987.52 $1,111.92 $1,553.92 $2,361.32 |
$1,202.86 $1,320.32 $1,444.72 $1,886.72 |
$1,535.66 $1,653.12 $1,777.52 $2,219.52 |
Toc - Plan #5 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I301 with Dental & Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$437.10 $496.10 $558.61 $780.65 $1,186.28 |
$771.48 $830.48 $892.99 $1,115.03 |
$1,105.86 $1,164.86 $1,227.37 $1,449.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$874.20 $992.20 $1,117.22 $1,561.30 $2,372.56 |
$1,208.58 $1,326.58 $1,451.60 $1,895.68 |
$1,542.96 $1,660.96 $1,785.98 $2,230.06 |
Toc - Plan #6 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I303 with Dental & Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$433.40 $491.90 $553.88 $774.04 $1,176.24 |
$764.95 $823.45 $885.43 $1,105.59 |
$1,096.50 $1,155.00 $1,216.98 $1,437.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$866.80 $983.80 $1,107.76 $1,548.08 $2,352.48 |
$1,198.35 $1,315.35 $1,439.31 $1,879.63 |
$1,529.90 $1,646.90 $1,770.86 $2,211.18 |
Toc - Plan #7 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I308 with Dental & Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$454.72 $516.10 $581.12 $812.12 $1,234.09 |
$802.57 $863.95 $928.97 $1,159.97 |
$1,150.42 $1,211.80 $1,276.82 $1,507.82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$909.44 $1,032.20 $1,162.24 $1,624.24 $2,468.18 |
$1,257.29 $1,380.05 $1,510.09 $1,972.09 |
$1,605.14 $1,727.90 $1,857.94 $2,319.94 |
Toc - Plan #8 Quartz | ||||||||||||||||||||
Silver
(HMO) Quartz One Silver I309 Standard with Dental & Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$476.25 $540.53 $608.64 $850.57 $1,292.52 |
$840.57 $904.85 $972.96 $1,214.89 |
$1,204.89 $1,269.17 $1,337.28 $1,579.21 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$952.50 $1,081.06 $1,217.28 $1,701.14 $2,585.04 |
$1,316.82 $1,445.38 $1,581.60 $2,065.46 |
$1,681.14 $1,809.70 $1,945.92 $2,429.78 |
Toc - Plan #9 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I201 with Dental & Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$322.34 $365.85 $411.95 $575.70 $874.83 |
$568.93 $612.44 $658.54 $822.29 |
$815.52 $859.03 $905.13 $1,068.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$644.68 $731.70 $823.90 $1,151.40 $1,749.66 |
$891.27 $978.29 $1,070.49 $1,397.99 |
$1,137.86 $1,224.88 $1,317.08 $1,644.58 |
Toc - Plan #10 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I202 with Dental & Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$325.53 $369.47 $416.03 $581.39 $883.48 |
$574.56 $618.50 $665.06 $830.42 |
$823.59 $867.53 $914.09 $1,079.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$651.06 $738.94 $832.06 $1,162.78 $1,766.96 |
$900.09 $987.97 $1,081.09 $1,411.81 |
$1,149.12 $1,237.00 $1,330.12 $1,660.84 |
Toc - Plan #11 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I204 with Dental & Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$341.23 $387.29 $436.08 $609.42 $926.08 |
$602.26 $648.32 $697.11 $870.45 |
$863.29 $909.35 $958.14 $1,131.48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$682.46 $774.58 $872.16 $1,218.84 $1,852.16 |
$943.49 $1,035.61 $1,133.19 $1,479.87 |
$1,204.52 $1,296.64 $1,394.22 $1,740.90 |
Toc - Plan #12 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I205 with Dental & Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$337.74 $383.33 $431.62 $603.19 $916.61 |
$596.11 $641.70 $689.99 $861.56 |
$854.48 $900.07 $948.36 $1,119.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$675.48 $766.66 $863.24 $1,206.38 $1,833.22 |
$933.85 $1,025.03 $1,121.61 $1,464.75 |
$1,192.22 $1,283.40 $1,379.98 $1,723.12 |
Toc - Plan #13 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) Quartz One Bronze I206 Standard with Dental & Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$351.64 $399.11 $449.39 $628.03 $954.35 |
$620.64 $668.11 $718.39 $897.03 |
$889.64 $937.11 $987.39 $1,166.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$703.28 $798.22 $898.78 $1,256.06 $1,908.70 |
$972.28 $1,067.22 $1,167.78 $1,525.06 |
$1,241.28 $1,336.22 $1,436.78 $1,794.06 |
Toc - Plan #14 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I401 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$405.83 $460.61 $518.64 $724.80 $1,101.40 |
$716.28 $771.06 $829.09 $1,035.25 |
$1,026.73 $1,081.51 $1,139.54 $1,345.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$811.66 $921.22 $1,037.28 $1,449.60 $2,202.80 |
$1,122.11 $1,231.67 $1,347.73 $1,760.05 |
$1,432.56 $1,542.12 $1,658.18 $2,070.50 |
Toc - Plan #15 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I402 Maintenance |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$402.02 $456.29 $513.78 $718.00 $1,091.07 |
$709.56 $763.83 $821.32 $1,025.54 |
$1,017.10 $1,071.37 $1,128.86 $1,333.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$804.04 $912.58 $1,027.56 $1,436.00 $2,182.14 |
$1,111.58 $1,220.12 $1,335.10 $1,743.54 |
$1,419.12 $1,527.66 $1,642.64 $2,051.08 |
Toc - Plan #16 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I405 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$405.36 $460.08 $518.05 $723.97 $1,100.14 |
$715.46 $770.18 $828.15 $1,034.07 |
$1,025.56 $1,080.28 $1,138.25 $1,344.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$810.72 $920.16 $1,036.10 $1,447.94 $2,200.28 |
$1,120.82 $1,230.26 $1,346.20 $1,758.04 |
$1,430.92 $1,540.36 $1,656.30 $2,068.14 |
Toc - Plan #17 Quartz | ||||||||||||||||||||
Gold
(HMO) Quartz One Gold I410 Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$415.74 $471.86 $531.31 $742.51 $1,128.32 |
$733.78 $789.90 $849.35 $1,060.55 |
$1,051.82 $1,107.94 $1,167.39 $1,378.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$831.48 $943.72 $1,062.62 $1,485.02 $2,256.64 |
$1,149.52 $1,261.76 $1,380.66 $1,803.06 |
$1,467.56 $1,579.80 $1,698.70 $2,121.10 |
Toc - Plan #18 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I301 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$417.72 $474.11 $533.84 $746.04 $1,133.68 |
$737.27 $793.66 $853.39 $1,065.59 |
$1,056.82 $1,113.21 $1,172.94 $1,385.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$835.44 $948.22 $1,067.68 $1,492.08 $2,267.36 |
$1,154.99 $1,267.77 $1,387.23 $1,811.63 |
$1,474.54 $1,587.32 $1,706.78 $2,131.18 |
Toc - Plan #19 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I303 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$414.19 $470.10 $529.32 $739.73 $1,124.09 |
$731.04 $786.95 $846.17 $1,056.58 |
$1,047.89 $1,103.80 $1,163.02 $1,373.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$828.38 $940.20 $1,058.64 $1,479.46 $2,248.18 |
$1,145.23 $1,257.05 $1,375.49 $1,796.31 |
$1,462.08 $1,573.90 $1,692.34 $2,113.16 |
Toc - Plan #20 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I308 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$434.56 $493.22 $555.36 $776.11 $1,179.37 |
$766.99 $825.65 $887.79 $1,108.54 |
$1,099.42 $1,158.08 $1,220.22 $1,440.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$869.12 $986.44 $1,110.72 $1,552.22 $2,358.74 |
$1,201.55 $1,318.87 $1,443.15 $1,884.65 |
$1,533.98 $1,651.30 $1,775.58 $2,217.08 |
Toc - Plan #21 Quartz | ||||||||||||||||||||
Silver
(HMO) Quartz One Silver I309 Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$455.13 $516.57 $581.65 $812.86 $1,235.21 |
$803.30 $864.74 $929.82 $1,161.03 |
$1,151.47 $1,212.91 $1,277.99 $1,509.20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$910.26 $1,033.14 $1,163.30 $1,625.72 $2,470.42 |
$1,258.43 $1,381.31 $1,511.47 $1,973.89 |
$1,606.60 $1,729.48 $1,859.64 $2,322.06 |
Toc - Plan #22 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I201 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$308.05 $349.63 $393.68 $550.17 $836.04 |
$543.71 $585.29 $629.34 $785.83 |
$779.37 $820.95 $865.00 $1,021.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$616.10 $699.26 $787.36 $1,100.34 $1,672.08 |
$851.76 $934.92 $1,023.02 $1,336.00 |
$1,087.42 $1,170.58 $1,258.68 $1,571.66 |
Toc - Plan #23 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I202 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$311.10 $353.09 $397.58 $555.62 $844.31 |
$549.09 $591.08 $635.57 $793.61 |
$787.08 $829.07 $873.56 $1,031.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$622.20 $706.18 $795.16 $1,111.24 $1,688.62 |
$860.19 $944.17 $1,033.15 $1,349.23 |
$1,098.18 $1,182.16 $1,271.14 $1,587.22 |
Toc - Plan #24 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I204 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$326.10 $370.12 $416.75 $582.40 $885.02 |
$575.56 $619.58 $666.21 $831.86 |
$825.02 $869.04 $915.67 $1,081.32 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$652.20 $740.24 $833.50 $1,164.80 $1,770.04 |
$901.66 $989.70 $1,082.96 $1,414.26 |
$1,151.12 $1,239.16 $1,332.42 $1,663.72 |
Toc - Plan #25 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I205 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$322.77 $366.33 $412.49 $576.45 $875.97 |
$569.68 $613.24 $659.40 $823.36 |
$816.59 $860.15 $906.31 $1,070.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$645.54 $732.66 $824.98 $1,152.90 $1,751.94 |
$892.45 $979.57 $1,071.89 $1,399.81 |
$1,139.36 $1,226.48 $1,318.80 $1,646.72 |
Toc - Plan #26 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) Quartz One Bronze I206 Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$336.05 $381.42 $429.47 $600.18 $912.04 |
$593.13 $638.50 $686.55 $857.26 |
$850.21 $895.58 $943.63 $1,114.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$672.10 $762.84 $858.94 $1,200.36 $1,824.08 |
$929.18 $1,019.92 $1,116.02 $1,457.44 |
$1,186.26 $1,277.00 $1,373.10 $1,714.52 |
Toc - Plan #27 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I203 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$323.73 $367.43 $413.72 $578.17 $878.59 |
$571.38 $615.08 $661.37 $825.82 |
$819.03 $862.73 $909.02 $1,073.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$647.46 $734.86 $827.44 $1,156.34 $1,757.18 |
$895.11 $982.51 $1,075.09 $1,403.99 |
$1,142.76 $1,230.16 $1,322.74 $1,651.64 |
Toc - Plan #28 Quartz | ||||||||||||||||||||
Catastrophic
(HMO) QUARTZ ONE CATASTROPHIC I101 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$238.65 $270.86 $304.99 $426.22 $647.68 |
$421.21 $453.42 $487.55 $608.78 |
$603.77 $635.98 $670.11 $791.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$477.30 $541.72 $609.98 $852.44 $1,295.36 |
$659.86 $724.28 $792.54 $1,035.00 |
$842.42 $906.84 $975.10 $1,217.56 |
Toc - Plan #29 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I304 HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$457.59 $519.36 $584.80 $817.25 $1,241.90 |
$807.65 $869.42 $934.86 $1,167.31 |
$1,157.71 $1,219.48 $1,284.92 $1,517.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$915.18 $1,038.72 $1,169.60 $1,634.50 $2,483.80 |
$1,265.24 $1,388.78 $1,519.66 $1,984.56 |
$1,615.30 $1,738.84 $1,869.72 $2,334.62 |
Toc - Plan #30 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I403 HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$430.70 $488.84 $550.43 $769.22 $1,168.90 |
$760.18 $818.32 $879.91 $1,098.70 |
$1,089.66 $1,147.80 $1,209.39 $1,428.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$861.40 $977.68 $1,100.86 $1,538.44 $2,337.80 |
$1,190.88 $1,307.16 $1,430.34 $1,867.92 |
$1,520.36 $1,636.64 $1,759.82 $2,197.40 |
Toc - Plan #31 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I307 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$459.59 $521.63 $587.35 $820.82 $1,247.31 |
$811.17 $873.21 $938.93 $1,172.40 |
$1,162.75 $1,224.79 $1,290.51 $1,523.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$919.18 $1,043.26 $1,174.70 $1,641.64 $2,494.62 |
$1,270.76 $1,394.84 $1,526.28 $1,993.22 |
$1,622.34 $1,746.42 $1,877.86 $2,344.80 |
Toc - Plan #32 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I401 with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$410.54 $465.96 $524.67 $733.22 $1,114.20 |
$724.60 $780.02 $838.73 $1,047.28 |
$1,038.66 $1,094.08 $1,152.79 $1,361.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$821.08 $931.92 $1,049.34 $1,466.44 $2,228.40 |
$1,135.14 $1,245.98 $1,363.40 $1,780.50 |
$1,449.20 $1,560.04 $1,677.46 $2,094.56 |
Toc - Plan #33 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I402 Maintenance with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$406.69 $461.59 $519.74 $726.34 $1,103.75 |
$717.80 $772.70 $830.85 $1,037.45 |
$1,028.91 $1,083.81 $1,141.96 $1,348.56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$813.38 $923.18 $1,039.48 $1,452.68 $2,207.50 |
$1,124.49 $1,234.29 $1,350.59 $1,763.79 |
$1,435.60 $1,545.40 $1,661.70 $2,074.90 |
Toc - Plan #34 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I405 with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$410.07 $465.43 $524.07 $732.38 $1,112.92 |
$723.77 $779.13 $837.77 $1,046.08 |
$1,037.47 $1,092.83 $1,151.47 $1,359.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$820.14 $930.86 $1,048.14 $1,464.76 $2,225.84 |
$1,133.84 $1,244.56 $1,361.84 $1,778.46 |
$1,447.54 $1,558.26 $1,675.54 $2,092.16 |
Toc - Plan #35 Quartz | ||||||||||||||||||||
Gold
(HMO) Quartz One Gold I410 Standard with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$420.57 $477.35 $537.49 $751.14 $1,141.42 |
$742.30 $799.08 $859.22 $1,072.87 |
$1,064.03 $1,120.81 $1,180.95 $1,394.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$841.14 $954.70 $1,074.98 $1,502.28 $2,282.84 |
$1,162.87 $1,276.43 $1,396.71 $1,824.01 |
$1,484.60 $1,598.16 $1,718.44 $2,145.74 |
Toc - Plan #36 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I301 with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$422.57 $479.61 $540.04 $754.71 $1,146.85 |
$745.83 $802.87 $863.30 $1,077.97 |
$1,069.09 $1,126.13 $1,186.56 $1,401.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$845.14 $959.22 $1,080.08 $1,509.42 $2,293.70 |
$1,168.40 $1,282.48 $1,403.34 $1,832.68 |
$1,491.66 $1,605.74 $1,726.60 $2,155.94 |
Toc - Plan #37 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I303 with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$419.00 $475.56 $535.47 $748.32 $1,137.14 |
$739.53 $796.09 $856.00 $1,068.85 |
$1,060.06 $1,116.62 $1,176.53 $1,389.38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$838.00 $951.12 $1,070.94 $1,496.64 $2,274.28 |
$1,158.53 $1,271.65 $1,391.47 $1,817.17 |
$1,479.06 $1,592.18 $1,712.00 $2,137.70 |
Toc - Plan #38 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I308 with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$439.61 $498.95 $561.81 $785.13 $1,193.07 |
$775.90 $835.24 $898.10 $1,121.42 |
$1,112.19 $1,171.53 $1,234.39 $1,457.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$879.22 $997.90 $1,123.62 $1,570.26 $2,386.14 |
$1,215.51 $1,334.19 $1,459.91 $1,906.55 |
$1,551.80 $1,670.48 $1,796.20 $2,242.84 |
Toc - Plan #39 Quartz | ||||||||||||||||||||
Silver
(HMO) Quartz One Silver I309 Standard with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$460.42 $522.57 $588.41 $822.30 $1,249.56 |
$812.64 $874.79 $940.63 $1,174.52 |
$1,164.86 $1,227.01 $1,292.85 $1,526.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$920.84 $1,045.14 $1,176.82 $1,644.60 $2,499.12 |
$1,273.06 $1,397.36 $1,529.04 $1,996.82 |
$1,625.28 $1,749.58 $1,881.26 $2,349.04 |
Toc - Plan #40 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I201 with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$311.63 $353.70 $398.26 $556.56 $845.75 |
$550.02 $592.09 $636.65 $794.95 |
$788.41 $830.48 $875.04 $1,033.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$623.26 $707.40 $796.52 $1,113.12 $1,691.50 |
$861.65 $945.79 $1,034.91 $1,351.51 |
$1,100.04 $1,184.18 $1,273.30 $1,589.90 |
Toc - Plan #41 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I202 with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$314.71 $357.20 $402.20 $562.07 $854.12 |
$555.46 $597.95 $642.95 $802.82 |
$796.21 $838.70 $883.70 $1,043.57 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$629.42 $714.40 $804.40 $1,124.14 $1,708.24 |
$870.17 $955.15 $1,045.15 $1,364.89 |
$1,110.92 $1,195.90 $1,285.90 $1,605.64 |
Toc - Plan #42 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I204 with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$329.89 $374.42 $421.59 $589.17 $895.30 |
$582.25 $626.78 $673.95 $841.53 |
$834.61 $879.14 $926.31 $1,093.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$659.78 $748.84 $843.18 $1,178.34 $1,790.60 |
$912.14 $1,001.20 $1,095.54 $1,430.70 |
$1,164.50 $1,253.56 $1,347.90 $1,683.06 |
Toc - Plan #43 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I205 with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$326.52 $370.59 $417.28 $583.15 $886.15 |
$576.30 $620.37 $667.06 $832.93 |
$826.08 $870.15 $916.84 $1,082.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$653.04 $741.18 $834.56 $1,166.30 $1,772.30 |
$902.82 $990.96 $1,084.34 $1,416.08 |
$1,152.60 $1,240.74 $1,334.12 $1,665.86 |
Toc - Plan #44 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) Quartz One Bronze I206 Standard with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$339.96 $385.85 $434.46 $607.15 $922.63 |
$600.02 $645.91 $694.52 $867.21 |
$860.08 $905.97 $954.58 $1,127.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$679.92 $771.70 $868.92 $1,214.30 $1,845.26 |
$939.98 $1,031.76 $1,128.98 $1,474.36 |
$1,200.04 $1,291.82 $1,389.04 $1,734.42 |
Toc - Plan #45 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I403 HSA with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$435.70 $494.52 $556.82 $778.15 $1,182.48 |
$769.01 $827.83 $890.13 $1,111.46 |
$1,102.32 $1,161.14 $1,223.44 $1,444.77 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$871.40 $989.04 $1,113.64 $1,556.30 $2,364.96 |
$1,204.71 $1,322.35 $1,446.95 $1,889.61 |
$1,538.02 $1,655.66 $1,780.26 $2,222.92 |
Toc - Plan #46 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I304 HSA with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$462.91 $525.40 $591.59 $826.75 $1,256.32 |
$817.03 $879.52 $945.71 $1,180.87 |
$1,171.15 $1,233.64 $1,299.83 $1,534.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$925.82 $1,050.80 $1,183.18 $1,653.50 $2,512.64 |
$1,279.94 $1,404.92 $1,537.30 $2,007.62 |
$1,634.06 $1,759.04 $1,891.42 $2,361.74 |
Toc - Plan #47 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I307 with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$464.93 $527.69 $594.17 $830.35 $1,261.80 |
$820.60 $883.36 $949.84 $1,186.02 |
$1,176.27 $1,239.03 $1,305.51 $1,541.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$929.86 $1,055.38 $1,188.34 $1,660.70 $2,523.60 |
$1,285.53 $1,411.05 $1,544.01 $2,016.37 |
$1,641.20 $1,766.72 $1,899.68 $2,372.04 |
Toc - Plan #48 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I203 with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$327.49 $371.70 $418.53 $584.89 $888.80 |
$578.02 $622.23 $669.06 $835.42 |
$828.55 $872.76 $919.59 $1,085.95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$654.98 $743.40 $837.06 $1,169.78 $1,777.60 |
$905.51 $993.93 $1,087.59 $1,420.31 |
$1,156.04 $1,244.46 $1,338.12 $1,670.84 |
ADVERTISEMENT
Dean Health PlanLocal: 1-800-279-1302 | Toll Free: 1-800-279-1302 | TTY: 1-800-279-1302 |
Toc - Plan #49 Dean Health Plan | ||||||||||||||||||||
Catastrophic
(HMO) Dean Catastrophic Safety Net (Free Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$183.23 $207.96 $234.17 $327.25 $497.28 |
$323.40 $348.13 $374.34 $467.42 |
$463.57 $488.30 $514.51 $607.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$366.46 $415.92 $468.34 $654.50 $994.56 |
$506.63 $556.09 $608.51 $794.67 |
$646.80 $696.26 $748.68 $934.84 |
Toc - Plan #50 Dean Health Plan | ||||||||||||||||||||
Silver
(HMO) Dean Silver Copay Plus 4800X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$361.71 $410.54 $462.26 $646.01 $981.67 |
$638.42 $687.25 $738.97 $922.72 |
$915.13 $963.96 $1,015.68 $1,199.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$723.42 $821.08 $924.52 $1,292.02 $1,963.34 |
$1,000.13 $1,097.79 $1,201.23 $1,568.73 |
$1,276.84 $1,374.50 $1,477.94 $1,845.44 |
Toc - Plan #51 Dean Health Plan | ||||||||||||||||||||
Silver
(HMO) Dean Silver Value Copay 4100X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$358.91 $407.36 $458.69 $641.01 $974.08 |
$633.48 $681.93 $733.26 $915.58 |
$908.05 $956.50 $1,007.83 $1,190.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$717.82 $814.72 $917.38 $1,282.02 $1,948.16 |
$992.39 $1,089.29 $1,191.95 $1,556.59 |
$1,266.96 $1,363.86 $1,466.52 $1,831.16 |
Toc - Plan #52 Dean Health Plan | ||||||||||||||||||||
Gold
(HMO) Dean Gold Value Copay 4000X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$344.63 $391.15 $440.44 $615.51 $935.32 |
$608.27 $654.79 $704.08 $879.15 |
$871.91 $918.43 $967.72 $1,142.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$689.26 $782.30 $880.88 $1,231.02 $1,870.64 |
$952.90 $1,045.94 $1,144.52 $1,494.66 |
$1,216.54 $1,309.58 $1,408.16 $1,758.30 |
Toc - Plan #53 Dean Health Plan | ||||||||||||||||||||
Bronze
(HMO) Dean Bronze Value Copay 9050X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$228.15 $258.95 $291.57 $407.47 $619.20 |
$402.68 $433.48 $466.10 $582.00 |
$577.21 $608.01 $640.63 $756.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$456.30 $517.90 $583.14 $814.94 $1,238.40 |
$630.83 $692.43 $757.67 $989.47 |
$805.36 $866.96 $932.20 $1,164.00 |
Toc - Plan #54 Dean Health Plan | ||||||||||||||||||||
Silver
(HMO) Dean Silver HSA-E HDHP 3550X (Free Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$344.21 $390.68 $439.90 $614.76 $934.18 |
$607.53 $654.00 $703.22 $878.08 |
$870.85 $917.32 $966.54 $1,141.40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$688.42 $781.36 $879.80 $1,229.52 $1,868.36 |
$951.74 $1,044.68 $1,143.12 $1,492.84 |
$1,215.06 $1,308.00 $1,406.44 $1,756.16 |
Toc - Plan #55 Dean Health Plan | ||||||||||||||||||||
Gold
(HMO) Dean Gold Copay Plus 1500X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$362.70 $411.66 $463.53 $647.78 $984.37 |
$640.16 $689.12 $740.99 $925.24 |
$917.62 $966.58 $1,018.45 $1,202.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$725.40 $823.32 $927.06 $1,295.56 $1,968.74 |
$1,002.86 $1,100.78 $1,204.52 $1,573.02 |
$1,280.32 $1,378.24 $1,481.98 $1,850.48 |
Toc - Plan #56 Dean Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Dean Bronze HSA-E HDHP 7000X (Free Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$245.62 $278.78 $313.90 $438.67 $666.61 |
$433.52 $466.68 $501.80 $626.57 |
$621.42 $654.58 $689.70 $814.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$491.24 $557.56 $627.80 $877.34 $1,333.22 |
$679.14 $745.46 $815.70 $1,065.24 |
$867.04 $933.36 $1,003.60 $1,253.14 |
Toc - Plan #57 Dean Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Dean Bronze Copay Plus 9050X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$238.88 $271.13 $305.29 $426.65 $648.33 |
$421.63 $453.88 $488.04 $609.40 |
$604.38 $636.63 $670.79 $792.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$477.76 $542.26 $610.58 $853.30 $1,296.66 |
$660.51 $725.01 $793.33 $1,036.05 |
$843.26 $907.76 $976.08 $1,218.80 |
Toc - Plan #58 Dean Health Plan | ||||||||||||||||||||
Gold
(HMO) Dean Gold HSA HDHP 2000X (Free Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$323.43 $367.09 $413.35 $577.65 $877.79 |
$570.86 $614.52 $660.78 $825.08 |
$818.29 $861.95 $908.21 $1,072.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$646.86 $734.18 $826.70 $1,155.30 $1,755.58 |
$894.29 $981.61 $1,074.13 $1,402.73 |
$1,141.72 $1,229.04 $1,321.56 $1,650.16 |
Toc - Plan #59 Dean Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Dean Bronze Copay PCP 8000X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$228.99 $259.90 $292.65 $408.98 $621.48 |
$404.17 $435.08 $467.83 $584.16 |
$579.35 $610.26 $643.01 $759.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$457.98 $519.80 $585.30 $817.96 $1,242.96 |
$633.16 $694.98 $760.48 $993.14 |
$808.34 $870.16 $935.66 $1,168.32 |
Toc - Plan #60 Dean Health Plan | ||||||||||||||||||||
Silver
(HMO) Dean Silver Copay PCP 4500X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$335.94 $381.29 $429.33 $599.99 $911.74 |
$592.93 $638.28 $686.32 $856.98 |
$849.92 $895.27 $943.31 $1,113.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$671.88 $762.58 $858.66 $1,199.98 $1,823.48 |
$928.87 $1,019.57 $1,115.65 $1,456.97 |
$1,185.86 $1,276.56 $1,372.64 $1,713.96 |
Toc - Plan #61 Dean Health Plan | ||||||||||||||||||||
Gold
(HMO) Dean Gold Copay PCP 2000X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$333.41 $378.42 $426.10 $595.48 $904.89 |
$588.47 $633.48 $681.16 $850.54 |
$843.53 $888.54 $936.22 $1,105.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$666.82 $756.84 $852.20 $1,190.96 $1,809.78 |
$921.88 $1,011.90 $1,107.26 $1,446.02 |
$1,176.94 $1,266.96 $1,362.32 $1,701.08 |
Toc - Plan #62 Dean Health Plan | ||||||||||||||||||||
Gold
(HMO) Dean Gold Standard 2000X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$347.49 $394.40 $444.09 $620.61 $943.08 |
$613.32 $660.23 $709.92 $886.44 |
$879.15 $926.06 $975.75 $1,152.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$694.98 $788.80 $888.18 $1,241.22 $1,886.16 |
$960.81 $1,054.63 $1,154.01 $1,507.05 |
$1,226.64 $1,320.46 $1,419.84 $1,772.88 |
Toc - Plan #63 Dean Health Plan | ||||||||||||||||||||
Silver
(HMO) Dean Silver Standard 5800X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$345.26 $391.87 $441.24 $616.63 $937.04 |
$609.38 $655.99 $705.36 $880.75 |
$873.50 $920.11 $969.48 $1,144.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$690.52 $783.74 $882.48 $1,233.26 $1,874.08 |
$954.64 $1,047.86 $1,146.60 $1,497.38 |
$1,218.76 $1,311.98 $1,410.72 $1,761.50 |
Toc - Plan #64 Dean Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Dean Bronze Standard 7500X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$235.79 $267.62 $301.33 $421.11 $639.92 |
$416.17 $448.00 $481.71 $601.49 |
$596.55 $628.38 $662.09 $781.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$471.58 $535.24 $602.66 $842.22 $1,279.84 |
$651.96 $715.62 $783.04 $1,022.60 |
$832.34 $896.00 $963.42 $1,202.98 |
Toc - Plan #65 Dean Health Plan | ||||||||||||||||||||
Bronze
(HMO) Dean Bronze Standard 9100X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$210.83 $239.29 $269.44 $376.54 $572.19 |
$372.12 $400.58 $430.73 $537.83 |
$533.41 $561.87 $592.02 $699.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$421.66 $478.58 $538.88 $753.08 $1,144.38 |
$582.95 $639.87 $700.17 $914.37 |
$744.24 $801.16 $861.46 $1,075.66 |
Toc - Plan #66 Dean Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) Dean Focus Network Bronze Copay Plus 9050X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$215.67 $244.79 $275.63 $385.19 $585.33 |
$380.66 $409.78 $440.62 $550.18 |
$545.65 $574.77 $605.61 $715.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$431.34 $489.58 $551.26 $770.38 $1,170.66 |
$596.33 $654.57 $716.25 $935.37 |
$761.32 $819.56 $881.24 $1,100.36 |
Toc - Plan #67 Dean Health Plan | ||||||||||||||||||||
Gold
(EPO) Dean Focus Network Gold Value Copay 4000X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$311.10 $353.10 $397.59 $555.63 $844.34 |
$549.09 $591.09 $635.58 $793.62 |
$787.08 $829.08 $873.57 $1,031.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$622.20 $706.20 $795.18 $1,111.26 $1,688.68 |
$860.19 $944.19 $1,033.17 $1,349.25 |
$1,098.18 $1,182.18 $1,271.16 $1,587.24 |
Toc - Plan #68 Dean Health Plan | ||||||||||||||||||||
Silver
(EPO) Dean Focus Network Silver Value Copay 4100X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$323.97 $367.71 $414.04 $578.62 $879.26 |
$571.81 $615.55 $661.88 $826.46 |
$819.65 $863.39 $909.72 $1,074.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$647.94 $735.42 $828.08 $1,157.24 $1,758.52 |
$895.78 $983.26 $1,075.92 $1,405.08 |
$1,143.62 $1,231.10 $1,323.76 $1,652.92 |
Toc - Plan #69 Dean Health Plan | ||||||||||||||||||||
Bronze
(EPO) Dean Focus Network Bronze Value Copay 9050X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$206.23 $234.07 $263.56 $368.33 $559.71 |
$364.00 $391.84 $421.33 $526.10 |
$521.77 $549.61 $579.10 $683.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$412.46 $468.14 $527.12 $736.66 $1,119.42 |
$570.23 $625.91 $684.89 $894.43 |
$728.00 $783.68 $842.66 $1,052.20 |
Toc - Plan #70 Dean Health Plan | ||||||||||||||||||||
Silver
(EPO) Dean Focus Network Silver HSA-E HDHP 3550X (Free Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$310.71 $352.66 $397.09 $554.93 $843.28 |
$548.41 $590.36 $634.79 $792.63 |
$786.11 $828.06 $872.49 $1,030.33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$621.42 $705.32 $794.18 $1,109.86 $1,686.56 |
$859.12 $943.02 $1,031.88 $1,347.56 |
$1,096.82 $1,180.72 $1,269.58 $1,585.26 |
Toc - Plan #71 Dean Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) Dean Focus Network Bronze HSA-E HDHP 7000X (Free Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$221.96 $251.92 $283.66 $396.41 $602.39 |
$391.76 $421.72 $453.46 $566.21 |
$561.56 $591.52 $623.26 $736.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$443.92 $503.84 $567.32 $792.82 $1,204.78 |
$613.72 $673.64 $737.12 $962.62 |
$783.52 $843.44 $906.92 $1,132.42 |
Toc - Plan #72 Dean Health Plan | ||||||||||||||||||||
Gold
(EPO) Dean Focus Network Gold Copay Plus 1500X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$327.01 $371.16 $417.92 $584.04 $887.50 |
$577.17 $621.32 $668.08 $834.20 |
$827.33 $871.48 $918.24 $1,084.36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$654.02 $742.32 $835.84 $1,168.08 $1,775.00 |
$904.18 $992.48 $1,086.00 $1,418.24 |
$1,154.34 $1,242.64 $1,336.16 $1,668.40 |
Toc - Plan #73 Dean Health Plan | ||||||||||||||||||||
Silver
(EPO) Dean Focus Network Silver Copay Plus 4800X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$326.11 $370.13 $416.77 $582.43 $885.06 |
$575.58 $619.60 $666.24 $831.90 |
$825.05 $869.07 $915.71 $1,081.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$652.22 $740.26 $833.54 $1,164.86 $1,770.12 |
$901.69 $989.73 $1,083.01 $1,414.33 |
$1,151.16 $1,239.20 $1,332.48 $1,663.80 |
Toc - Plan #74 Dean Health Plan | ||||||||||||||||||||
Gold
(EPO) Dean Focus Network Gold HSA HDHP 2000X (Free Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$292.01 $331.43 $373.19 $521.53 $792.52 |
$515.40 $554.82 $596.58 $744.92 |
$738.79 $778.21 $819.97 $968.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$584.02 $662.86 $746.38 $1,043.06 $1,585.04 |
$807.41 $886.25 $969.77 $1,266.45 |
$1,030.80 $1,109.64 $1,193.16 $1,489.84 |
Toc - Plan #75 Dean Health Plan | ||||||||||||||||||||
Catastrophic
(EPO) Dean Focus Network Catastrophic Safety Net (Free Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$165.79 $188.17 $211.88 $296.10 $449.95 |
$292.62 $315.00 $338.71 $422.93 |
$419.45 $441.83 $465.54 $549.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$331.58 $376.34 $423.76 $592.20 $899.90 |
$458.41 $503.17 $550.59 $719.03 |
$585.24 $630.00 $677.42 $845.86 |
Toc - Plan #76 Dean Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) Dean Focus Network Bronze Copay PCP 8000X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$206.98 $234.92 $264.52 $369.67 $561.75 |
$365.32 $393.26 $422.86 $528.01 |
$523.66 $551.60 $581.20 $686.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$413.96 $469.84 $529.04 $739.34 $1,123.50 |
$572.30 $628.18 $687.38 $897.68 |
$730.64 $786.52 $845.72 $1,056.02 |
Toc - Plan #77 Dean Health Plan | ||||||||||||||||||||
Silver
(EPO) Dean Focus Network Silver Copay PCP 4500X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$303.29 $344.23 $387.60 $541.67 $823.12 |
$535.30 $576.24 $619.61 $773.68 |
$767.31 $808.25 $851.62 $1,005.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$606.58 $688.46 $775.20 $1,083.34 $1,646.24 |
$838.59 $920.47 $1,007.21 $1,315.35 |
$1,070.60 $1,152.48 $1,239.22 $1,547.36 |
Toc - Plan #78 Dean Health Plan | ||||||||||||||||||||
Gold
(EPO) Dean Focus Network Gold Copay PCP 2000X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$301.00 $341.64 $384.68 $537.59 $816.92 |
$531.27 $571.91 $614.95 $767.86 |
$761.54 $802.18 $845.22 $998.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$602.00 $683.28 $769.36 $1,075.18 $1,633.84 |
$832.27 $913.55 $999.63 $1,305.45 |
$1,062.54 $1,143.82 $1,229.90 $1,535.72 |
Toc - Plan #79 Dean Health Plan | ||||||||||||||||||||
Gold
(EPO) Dean Focus Network Gold Standard 2000X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$313.66 $356.00 $400.86 $560.20 $851.27 |
$553.61 $595.95 $640.81 $800.15 |
$793.56 $835.90 $880.76 $1,040.10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$627.32 $712.00 $801.72 $1,120.40 $1,702.54 |
$867.27 $951.95 $1,041.67 $1,360.35 |
$1,107.22 $1,191.90 $1,281.62 $1,600.30 |
Toc - Plan #80 Dean Health Plan | ||||||||||||||||||||
Silver
(EPO) Dean Focus Network Silver Standard 5800X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$311.68 $353.75 $398.32 $556.65 $845.89 |
$550.11 $592.18 $636.75 $795.08 |
$788.54 $830.61 $875.18 $1,033.51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$623.36 $707.50 $796.64 $1,113.30 $1,691.78 |
$861.79 $945.93 $1,035.07 $1,351.73 |
$1,100.22 $1,184.36 $1,273.50 $1,590.16 |
Toc - Plan #81 Dean Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) Dean Focus Network Bronze Standard 7500X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$213.12 $241.89 $272.36 $380.62 $578.40 |
$376.15 $404.92 $435.39 $543.65 |
$539.18 $567.95 $598.42 $706.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$426.24 $483.78 $544.72 $761.24 $1,156.80 |
$589.27 $646.81 $707.75 $924.27 |
$752.30 $809.84 $870.78 $1,087.30 |
Toc - Plan #82 Dean Health Plan | ||||||||||||||||||||
Bronze
(EPO) Dean Focus Network Bronze Standard 9100X (Free Virtual Visits & Transportation) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$190.63 $216.36 $243.62 $340.46 $517.36 |
$336.46 $362.19 $389.45 $486.29 |
$482.29 $508.02 $535.28 $632.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$381.26 $432.72 $487.24 $680.92 $1,034.72 |
$527.09 $578.55 $633.07 $826.75 |
$672.92 $724.38 $778.90 $972.58 |
ADVERTISEMENT
Anthem Blue Cross and Blue ShieldLocal: 1-855-748-1813 | Toll Free: 1-855-748-1813 |
Toc - Plan #83 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Blue Preferred/Broad 0 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$291.65 $331.02 $372.73 $520.89 $791.54 |
$514.76 $554.13 $595.84 $744.00 |
$737.87 $777.24 $818.95 $967.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$583.30 $662.04 $745.46 $1,041.78 $1,583.08 |
$806.41 $885.15 $968.57 $1,264.89 |
$1,029.52 $1,108.26 $1,191.68 $1,488.00 |
Toc - Plan #84 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Blue Preferred/Broad 5000 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$282.78 $320.96 $361.39 $505.05 $767.46 |
$499.11 $537.29 $577.72 $721.38 |
$715.44 $753.62 $794.05 $937.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$565.56 $641.92 $722.78 $1,010.10 $1,534.92 |
$781.89 $858.25 $939.11 $1,226.43 |
$998.22 $1,074.58 $1,155.44 $1,442.76 |
Toc - Plan #85 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Blue Preferred/Broad 6550 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$277.72 $315.21 $354.93 $496.01 $753.73 |
$490.18 $527.67 $567.39 $708.47 |
$702.64 $740.13 $779.85 $920.93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$555.44 $630.42 $709.86 $992.02 $1,507.46 |
$767.90 $842.88 $922.32 $1,204.48 |
$980.36 $1,055.34 $1,134.78 $1,416.94 |
Toc - Plan #86 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Bronze
(HMO) Anthem Bronze Blue Preferred/Broad 9100 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$263.24 $298.78 $336.42 $470.15 $714.43 |
$464.62 $500.16 $537.80 $671.53 |
$666.00 $701.54 $739.18 $872.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$526.48 $597.56 $672.84 $940.30 $1,428.86 |
$727.86 $798.94 $874.22 $1,141.68 |
$929.24 $1,000.32 $1,075.60 $1,343.06 |
Toc - Plan #87 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Blue Preferred/Broad 0% for HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$277.14 $314.55 $354.18 $494.97 $752.16 |
$489.15 $526.56 $566.19 $706.98 |
$701.16 $738.57 $778.20 $918.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$554.28 $629.10 $708.36 $989.94 $1,504.32 |
$766.29 $841.11 $920.37 $1,201.95 |
$978.30 $1,053.12 $1,132.38 $1,413.96 |
Toc - Plan #88 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Gold
(HMO) Anthem Gold Blue Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$359.50 $408.03 $459.44 $642.07 $975.68 |
$634.52 $683.05 $734.46 $917.09 |
$909.54 $958.07 $1,009.48 $1,192.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$719.00 $816.06 $918.88 $1,284.14 $1,951.36 |
$994.02 $1,091.08 $1,193.90 $1,559.16 |
$1,269.04 $1,366.10 $1,468.92 $1,834.18 |
Toc - Plan #89 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Blue Preferred/Broad 4000 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$347.09 $393.95 $443.58 $619.90 $942.00 |
$612.61 $659.47 $709.10 $885.42 |
$878.13 $924.99 $974.62 $1,150.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$694.18 $787.90 $887.16 $1,239.80 $1,884.00 |
$959.70 $1,053.42 $1,152.68 $1,505.32 |
$1,225.22 $1,318.94 $1,418.20 $1,770.84 |
Toc - Plan #90 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Blue Preferred/Broad 4100 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$351.27 $398.69 $448.92 $627.37 $953.35 |
$619.99 $667.41 $717.64 $896.09 |
$888.71 $936.13 $986.36 $1,164.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$702.54 $797.38 $897.84 $1,254.74 $1,906.70 |
$971.26 $1,066.10 $1,166.56 $1,523.46 |
$1,239.98 $1,334.82 $1,435.28 $1,792.18 |
Toc - Plan #91 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Blue Preferred/Broad 5300 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$345.05 $391.63 $440.97 $616.26 $936.47 |
$609.01 $655.59 $704.93 $880.22 |
$872.97 $919.55 $968.89 $1,144.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$690.10 $783.26 $881.94 $1,232.52 $1,872.94 |
$954.06 $1,047.22 $1,145.90 $1,496.48 |
$1,218.02 $1,311.18 $1,409.86 $1,760.44 |
Toc - Plan #92 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Bronze
(HMO) Anthem Bronze Blue Preferred/Broad 9100/0% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$263.61 $299.20 $336.89 $470.81 $715.44 |
$465.27 $500.86 $538.55 $672.47 |
$666.93 $702.52 $740.21 $874.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$527.22 $598.40 $673.78 $941.62 $1,430.88 |
$728.88 $800.06 $875.44 $1,143.28 |
$930.54 $1,001.72 $1,077.10 $1,344.94 |
Toc - Plan #93 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(HMO) Anthem Bronze Blue Preferred/Broad 7500/50% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$286.53 $325.21 $366.19 $511.74 $777.64 |
$505.73 $544.41 $585.39 $730.94 |
$724.93 $763.61 $804.59 $950.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$573.06 $650.42 $732.38 $1,023.48 $1,555.28 |
$792.26 $869.62 $951.58 $1,242.68 |
$1,011.46 $1,088.82 $1,170.78 $1,461.88 |
Toc - Plan #94 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(HMO) Anthem Silver Blue Preferred/Broad 5800/40% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$342.11 $388.29 $437.22 $611.01 $928.49 |
$603.82 $650.00 $698.93 $872.72 |
$865.53 $911.71 $960.64 $1,134.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$684.22 $776.58 $874.44 $1,222.02 $1,856.98 |
$945.93 $1,038.29 $1,136.15 $1,483.73 |
$1,207.64 $1,300.00 $1,397.86 $1,745.44 |
Toc - Plan #95 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Gold
(HMO) Anthem Gold Blue Preferred/Broad 2000/25% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$359.76 $408.33 $459.77 $642.53 $976.39 |
$634.98 $683.55 $734.99 $917.75 |
$910.20 $958.77 $1,010.21 $1,192.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$719.52 $816.66 $919.54 $1,285.06 $1,952.78 |
$994.74 $1,091.88 $1,194.76 $1,560.28 |
$1,269.96 $1,367.10 $1,469.98 $1,835.50 |
ADVERTISEMENT
Group Health Cooperative-SCWLocal: 1-608-828-4831 | Toll Free: 1-855-344-2729 | TTY: 1-608-828-4815 |
Toc - Plan #96 Group Health Cooperative-SCW | ||||||||||||||||||||
Platinum
(HMO) Platinum 500 Ded/1500 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$421.29 $478.16 $538.40 $752.42 $1,143.37 |
$743.58 $800.45 $860.69 $1,074.71 |
$1,065.87 $1,122.74 $1,182.98 $1,397.00 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$842.58 $956.32 $1,076.80 $1,504.84 $2,286.74 |
$1,164.87 $1,278.61 $1,399.09 $1,827.13 |
$1,487.16 $1,600.90 $1,721.38 $2,149.42 |
Toc - Plan #97 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Gold 2600 Ded/2600 MOOP HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$351.26 $398.68 $448.91 $627.35 $953.31 |
$619.98 $667.40 $717.63 $896.07 |
$888.70 $936.12 $986.35 $1,164.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$702.52 $797.36 $897.82 $1,254.70 $1,906.62 |
$971.24 $1,066.08 $1,166.54 $1,523.42 |
$1,239.96 $1,334.80 $1,435.26 $1,792.14 |
Toc - Plan #98 Group Health Cooperative-SCW | ||||||||||||||||||||
Silver
(HMO) Silver 5400 Ded/5400 MOOP HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$411.27 $466.79 $525.60 $734.52 $1,116.18 |
$725.89 $781.41 $840.22 $1,049.14 |
$1,040.51 $1,096.03 $1,154.84 $1,363.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$822.54 $933.58 $1,051.20 $1,469.04 $2,232.36 |
$1,137.16 $1,248.20 $1,365.82 $1,783.66 |
$1,451.78 $1,562.82 $1,680.44 $2,098.28 |
Toc - Plan #99 Group Health Cooperative-SCW | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 4000 Ded/8500 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$286.49 $325.16 $366.13 $511.66 $777.52 |
$505.65 $544.32 $585.29 $730.82 |
$724.81 $763.48 $804.45 $949.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$572.98 $650.32 $732.26 $1,023.32 $1,555.04 |
$792.14 $869.48 $951.42 $1,242.48 |
$1,011.30 $1,088.64 $1,170.58 $1,461.64 |
Toc - Plan #100 Group Health Cooperative-SCW | ||||||||||||||||||||
Platinum
(HMO) Select Platinum 500 Ded/1500 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$401.32 $455.50 $512.89 $716.76 $1,089.18 |
$708.33 $762.51 $819.90 $1,023.77 |
$1,015.34 $1,069.52 $1,126.91 $1,330.78 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$802.64 $911.00 $1,025.78 $1,433.52 $2,178.36 |
$1,109.65 $1,218.01 $1,332.79 $1,740.53 |
$1,416.66 $1,525.02 $1,639.80 $2,047.54 |
Toc - Plan #101 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Select Gold 2600 Ded/2600 MOOP HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$334.63 $379.81 $427.66 $597.65 $908.18 |
$590.63 $635.81 $683.66 $853.65 |
$846.63 $891.81 $939.66 $1,109.65 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$669.26 $759.62 $855.32 $1,195.30 $1,816.36 |
$925.26 $1,015.62 $1,111.32 $1,451.30 |
$1,181.26 $1,271.62 $1,367.32 $1,707.30 |
Toc - Plan #102 Group Health Cooperative-SCW | ||||||||||||||||||||
Silver
(HMO) Select Silver 5400 Ded/5400 MOOP HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$382.06 $433.64 $488.27 $682.36 $1,036.91 |
$674.34 $725.92 $780.55 $974.64 |
$966.62 $1,018.20 $1,072.83 $1,266.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$764.12 $867.28 $976.54 $1,364.72 $2,073.82 |
$1,056.40 $1,159.56 $1,268.82 $1,657.00 |
$1,348.68 $1,451.84 $1,561.10 $1,949.28 |
Toc - Plan #103 Group Health Cooperative-SCW | ||||||||||||||||||||
Expanded Bronze
(HMO) Select Bronze 4000 Ded/8500 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$272.94 $309.79 $348.82 $487.47 $740.76 |
$481.74 $518.59 $557.62 $696.27 |
$690.54 $727.39 $766.42 $905.07 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$545.88 $619.58 $697.64 $974.94 $1,481.52 |
$754.68 $828.38 $906.44 $1,183.74 |
$963.48 $1,037.18 $1,115.24 $1,392.54 |
Toc - Plan #104 Group Health Cooperative-SCW | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 7500 Ded/7500 MOOP HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$278.60 $316.21 $356.04 $497.57 $756.10 |
$491.73 $529.34 $569.17 $710.70 |
$704.86 $742.47 $782.30 $923.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$557.20 $632.42 $712.08 $995.14 $1,512.20 |
$770.33 $845.55 $925.21 $1,208.27 |
$983.46 $1,058.68 $1,138.34 $1,421.40 |
Toc - Plan #105 Group Health Cooperative-SCW | ||||||||||||||||||||
Expanded Bronze
(HMO) Select Bronze 7500 Ded/7500 MOOP HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$265.43 $301.26 $339.22 $474.05 $720.36 |
$468.48 $504.31 $542.27 $677.10 |
$671.53 $707.36 $745.32 $880.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$530.86 $602.52 $678.44 $948.10 $1,440.72 |
$733.91 $805.57 $881.49 $1,151.15 |
$936.96 $1,008.62 $1,084.54 $1,354.20 |
Toc - Plan #106 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Gold 2500 Ded/6500 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$351.45 $398.90 $449.16 $627.69 $953.84 |
$620.31 $667.76 $718.02 $896.55 |
$889.17 $936.62 $986.88 $1,165.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$702.90 $797.80 $898.32 $1,255.38 $1,907.68 |
$971.76 $1,066.66 $1,167.18 $1,524.24 |
$1,240.62 $1,335.52 $1,436.04 $1,793.10 |
Toc - Plan #107 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Select Gold 2500 Ded/6500 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$334.81 $380.01 $427.89 $597.98 $908.68 |
$590.94 $636.14 $684.02 $854.11 |
$847.07 $892.27 $940.15 $1,110.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$669.62 $760.02 $855.78 $1,195.96 $1,817.36 |
$925.75 $1,016.15 $1,111.91 $1,452.09 |
$1,181.88 $1,272.28 $1,368.04 $1,708.22 |
Toc - Plan #108 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Select Gold 1800 Ded/5600 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$340.33 $386.27 $434.94 $607.82 $923.64 |
$600.68 $646.62 $695.29 $868.17 |
$861.03 $906.97 $955.64 $1,128.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$680.66 $772.54 $869.88 $1,215.64 $1,847.28 |
$941.01 $1,032.89 $1,130.23 $1,475.99 |
$1,201.36 $1,293.24 $1,390.58 $1,736.34 |
Toc - Plan #109 Group Health Cooperative-SCW | ||||||||||||||||||||
Expanded Bronze
(HMO) Select Bronze 6850 Ded/8200 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$280.69 $318.58 $358.72 $501.30 $761.78 |
$495.42 $533.31 $573.45 $716.03 |
$710.15 $748.04 $788.18 $930.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$561.38 $637.16 $717.44 $1,002.60 $1,523.56 |
$776.11 $851.89 $932.17 $1,217.33 |
$990.84 $1,066.62 $1,146.90 $1,432.06 |
Toc - Plan #110 Group Health Cooperative-SCW | ||||||||||||||||||||
Catastrophic
(HMO) Select Catastrophic 9100 Ded/9100 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$213.07 $241.83 $272.30 $380.54 $578.26 |
$376.07 $404.83 $435.30 $543.54 |
$539.07 $567.83 $598.30 $706.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$426.14 $483.66 $544.60 $761.08 $1,156.52 |
$589.14 $646.66 $707.60 $924.08 |
$752.14 $809.66 $870.60 $1,087.08 |
Toc - Plan #111 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Gold 1800 Ded/5600 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$357.24 $405.47 $456.55 $638.03 $969.55 |
$630.53 $678.76 $729.84 $911.32 |
$903.82 $952.05 $1,003.13 $1,184.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$714.48 $810.94 $913.10 $1,276.06 $1,939.10 |
$987.77 $1,084.23 $1,186.39 $1,549.35 |
$1,261.06 $1,357.52 $1,459.68 $1,822.64 |
Toc - Plan #112 Group Health Cooperative-SCW | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 6850 Ded/8200 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$294.62 $334.39 $376.52 $526.19 $799.59 |
$520.00 $559.77 $601.90 $751.57 |
$745.38 $785.15 $827.28 $976.95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$589.24 $668.78 $753.04 $1,052.38 $1,599.18 |
$814.62 $894.16 $978.42 $1,277.76 |
$1,040.00 $1,119.54 $1,203.80 $1,503.14 |
Toc - Plan #113 Group Health Cooperative-SCW | ||||||||||||||||||||
Platinum
(HMO) Platinum No Ded/2200 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$420.91 $477.73 $537.92 $751.74 $1,142.34 |
$742.91 $799.73 $859.92 $1,073.74 |
$1,064.91 $1,121.73 $1,181.92 $1,395.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$841.82 $955.46 $1,075.84 $1,503.48 $2,284.68 |
$1,163.82 $1,277.46 $1,397.84 $1,825.48 |
$1,485.82 $1,599.46 $1,719.84 $2,147.48 |
Toc - Plan #114 Group Health Cooperative-SCW | ||||||||||||||||||||
Platinum
(HMO) Select Platinum No Ded/2200 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$400.97 $455.10 $512.44 $716.13 $1,088.22 |
$707.71 $761.84 $819.18 $1,022.87 |
$1,014.45 $1,068.58 $1,125.92 $1,329.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$801.94 $910.20 $1,024.88 $1,432.26 $2,176.44 |
$1,108.68 $1,216.94 $1,331.62 $1,739.00 |
$1,415.42 $1,523.68 $1,638.36 $2,045.74 |
Toc - Plan #115 Group Health Cooperative-SCW | ||||||||||||||||||||
Bronze
(HMO) Bronze 9050 Ded/9050 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$273.13 $310.00 $349.06 $487.81 $741.27 |
$482.08 $518.95 $558.01 $696.76 |
$691.03 $727.90 $766.96 $905.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$546.26 $620.00 $698.12 $975.62 $1,482.54 |
$755.21 $828.95 $907.07 $1,184.57 |
$964.16 $1,037.90 $1,116.02 $1,393.52 |
Toc - Plan #116 Group Health Cooperative-SCW | ||||||||||||||||||||
Bronze
(HMO) Select Bronze 9050 Ded/9050 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$260.22 $295.35 $332.56 $464.75 $706.24 |
$459.29 $494.42 $531.63 $663.82 |
$658.36 $693.49 $730.70 $862.89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$520.44 $590.70 $665.12 $929.50 $1,412.48 |
$719.51 $789.77 $864.19 $1,128.57 |
$918.58 $988.84 $1,063.26 $1,327.64 |
Toc - Plan #117 Group Health Cooperative-SCW | ||||||||||||||||||||
Silver
(HMO) Silver 4900 Ded/7900 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$414.10 $470.00 $529.22 $739.58 $1,123.86 |
$730.89 $786.79 $846.01 $1,056.37 |
$1,047.68 $1,103.58 $1,162.80 $1,373.16 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$828.20 $940.00 $1,058.44 $1,479.16 $2,247.72 |
$1,144.99 $1,256.79 $1,375.23 $1,795.95 |
$1,461.78 $1,573.58 $1,692.02 $2,112.74 |
Toc - Plan #118 Group Health Cooperative-SCW | ||||||||||||||||||||
Silver
(HMO) Select Silver 4900 Ded/7900 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$390.18 $442.86 $498.65 $696.86 $1,058.94 |
$688.67 $741.35 $797.14 $995.35 |
$987.16 $1,039.84 $1,095.63 $1,293.84 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$780.36 $885.72 $997.30 $1,393.72 $2,117.88 |
$1,078.85 $1,184.21 $1,295.79 $1,692.21 |
$1,377.34 $1,482.70 $1,594.28 $1,990.70 |
Toc - Plan #119 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Gold 1500 Ded/8550 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$341.38 $387.47 $436.29 $609.71 $926.51 |
$602.54 $648.63 $697.45 $870.87 |
$863.70 $909.79 $958.61 $1,132.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$682.76 $774.94 $872.58 $1,219.42 $1,853.02 |
$943.92 $1,036.10 $1,133.74 $1,480.58 |
$1,205.08 $1,297.26 $1,394.90 $1,741.74 |
Toc - Plan #120 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Select Gold 1500 Ded/8550 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$325.23 $369.13 $415.64 $580.85 $882.65 |
$574.03 $617.93 $664.44 $829.65 |
$822.83 $866.73 $913.24 $1,078.45 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$650.46 $738.26 $831.28 $1,161.70 $1,765.30 |
$899.26 $987.06 $1,080.08 $1,410.50 |
$1,148.06 $1,235.86 $1,328.88 $1,659.30 |
Toc - Plan #121 Group Health Cooperative-SCW | ||||||||||||||||||||
Catastrophic
(HMO) Catastrophic 9100 Ded/9100 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$223.62 $253.81 $285.79 $399.39 $606.90 |
$394.69 $424.88 $456.86 $570.46 |
$565.76 $595.95 $627.93 $741.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$447.24 $507.62 $571.58 $798.78 $1,213.80 |
$618.31 $678.69 $742.65 $969.85 |
$789.38 $849.76 $913.72 $1,140.92 |
Toc - Plan #122 Group Health Cooperative-SCW | ||||||||||||||||||||
Platinum
(HMO) Platinum 1000 Ded/4000 MOOP Primary Care Preferred |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$396.89 $450.47 $507.23 $708.84 $1,077.15 |
$700.51 $754.09 $810.85 $1,012.46 |
$1,004.13 $1,057.71 $1,114.47 $1,316.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$793.78 $900.94 $1,014.46 $1,417.68 $2,154.30 |
$1,097.40 $1,204.56 $1,318.08 $1,721.30 |
$1,401.02 $1,508.18 $1,621.70 $2,024.92 |
Toc - Plan #123 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Gold 4450 Ded/7450 MOOP Primary Care Preferred |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$337.55 $383.11 $431.38 $602.85 $916.09 |
$595.77 $641.33 $689.60 $861.07 |
$853.99 $899.55 $947.82 $1,119.29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$675.10 $766.22 $862.76 $1,205.70 $1,832.18 |
$933.32 $1,024.44 $1,120.98 $1,463.92 |
$1,191.54 $1,282.66 $1,379.20 $1,722.14 |
Toc - Plan #124 Group Health Cooperative-SCW | ||||||||||||||||||||
Silver
(HMO) Silver 9050 Ded/9050 MOOP Primary Care Preferred |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$404.81 $459.46 $517.35 $722.99 $1,098.65 |
$714.49 $769.14 $827.03 $1,032.67 |
$1,024.17 $1,078.82 $1,136.71 $1,342.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$809.62 $918.92 $1,034.70 $1,445.98 $2,197.30 |
$1,119.30 $1,228.60 $1,344.38 $1,755.66 |
$1,428.98 $1,538.28 $1,654.06 $2,065.34 |
Toc - Plan #125 Group Health Cooperative-SCW | ||||||||||||||||||||
Platinum
(HMO) Select Platinum 1000 Ded/4000 MOOP Primary Care Preferred |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$378.09 $429.13 $483.20 $675.26 $1,026.13 |
$667.33 $718.37 $772.44 $964.50 |
$956.57 $1,007.61 $1,061.68 $1,253.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$756.18 $858.26 $966.40 $1,350.52 $2,052.26 |
$1,045.42 $1,147.50 $1,255.64 $1,639.76 |
$1,334.66 $1,436.74 $1,544.88 $1,929.00 |
Toc - Plan #126 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Select Gold 4450 Ded/7450 MOOP Primary Care Preferred |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$321.57 $364.98 $410.97 $574.32 $872.73 |
$567.57 $610.98 $656.97 $820.32 |
$813.57 $856.98 $902.97 $1,066.32 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$643.14 $729.96 $821.94 $1,148.64 $1,745.46 |
$889.14 $975.96 $1,067.94 $1,394.64 |
$1,135.14 $1,221.96 $1,313.94 $1,640.64 |
Toc - Plan #127 Group Health Cooperative-SCW | ||||||||||||||||||||
Silver
(HMO) Select Silver 9050 Ded/9050 MOOP Primary Care Preferred |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$392.91 $445.96 $502.14 $701.74 $1,066.36 |
$693.49 $746.54 $802.72 $1,002.32 |
$994.07 $1,047.12 $1,103.30 $1,302.90 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$785.82 $891.92 $1,004.28 $1,403.48 $2,132.72 |
$1,086.40 $1,192.50 $1,304.86 $1,704.06 |
$1,386.98 $1,493.08 $1,605.44 $2,004.64 |
Toc - Plan #128 Group Health Cooperative-SCW | ||||||||||||||||||||
Platinum
(HMO) Platinum No Ded/3000 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$436.42 $495.34 $557.75 $779.45 $1,184.44 |
$770.28 $829.20 $891.61 $1,113.31 |
$1,104.14 $1,163.06 $1,225.47 $1,447.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$872.84 $990.68 $1,115.50 $1,558.90 $2,368.88 |
$1,206.70 $1,324.54 $1,449.36 $1,892.76 |
$1,540.56 $1,658.40 $1,783.22 $2,226.62 |
Toc - Plan #129 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Gold 2000 Ded/8700 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$341.58 $387.69 $436.53 $610.05 $927.03 |
$602.89 $649.00 $697.84 $871.36 |
$864.20 $910.31 $959.15 $1,132.67 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$683.16 $775.38 $873.06 $1,220.10 $1,854.06 |
$944.47 $1,036.69 $1,134.37 $1,481.41 |
$1,205.78 $1,298.00 $1,395.68 $1,742.72 |
Toc - Plan #130 Group Health Cooperative-SCW | ||||||||||||||||||||
Silver
(HMO) Silver 5800 Ded/8900 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$398.39 $452.17 $509.14 $711.52 $1,081.22 |
$703.16 $756.94 $813.91 $1,016.29 |
$1,007.93 $1,061.71 $1,118.68 $1,321.06 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$796.78 $904.34 $1,018.28 $1,423.04 $2,162.44 |
$1,101.55 $1,209.11 $1,323.05 $1,727.81 |
$1,406.32 $1,513.88 $1,627.82 $2,032.58 |
Toc - Plan #131 Group Health Cooperative-SCW | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 7500 Ded/9000 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$291.66 $331.03 $372.74 $520.90 $791.55 |
$514.78 $554.15 $595.86 $744.02 |
$737.90 $777.27 $818.98 $967.14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$583.32 $662.06 $745.48 $1,041.80 $1,583.10 |
$806.44 $885.18 $968.60 $1,264.92 |
$1,029.56 $1,108.30 $1,191.72 $1,488.04 |
Toc - Plan #132 Group Health Cooperative-SCW | ||||||||||||||||||||
Bronze
(HMO) Bronze 9100 Ded/9100 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$259.64 $294.69 $331.82 $463.71 $704.66 |
$458.27 $493.32 $530.45 $662.34 |
$656.90 $691.95 $729.08 $860.97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$519.28 $589.38 $663.64 $927.42 $1,409.32 |
$717.91 $788.01 $862.27 $1,126.05 |
$916.54 $986.64 $1,060.90 $1,324.68 |
Toc - Plan #133 Group Health Cooperative-SCW | ||||||||||||||||||||
Platinum
(HMO) Select Platinum No Ded/3000 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$415.73 $471.86 $531.31 $742.50 $1,128.30 |
$733.77 $789.90 $849.35 $1,060.54 |
$1,051.81 $1,107.94 $1,167.39 $1,378.58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$831.46 $943.72 $1,062.62 $1,485.00 $2,256.60 |
$1,149.50 $1,261.76 $1,380.66 $1,803.04 |
$1,467.54 $1,579.80 $1,698.70 $2,121.08 |
Toc - Plan #134 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Select Gold 2000 Ded/8700 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$325.41 $369.34 $415.87 $581.17 $883.15 |
$574.35 $618.28 $664.81 $830.11 |
$823.29 $867.22 $913.75 $1,079.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$650.82 $738.68 $831.74 $1,162.34 $1,766.30 |
$899.76 $987.62 $1,080.68 $1,411.28 |
$1,148.70 $1,236.56 $1,329.62 $1,660.22 |
Toc - Plan #135 Group Health Cooperative-SCW | ||||||||||||||||||||
Silver
(HMO) Select Silver 5800 Ded/8900 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$380.67 $432.06 $486.50 $679.88 $1,033.14 |
$671.89 $723.28 $777.72 $971.10 |
$963.11 $1,014.50 $1,068.94 $1,262.32 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$761.34 $864.12 $973.00 $1,359.76 $2,066.28 |
$1,052.56 $1,155.34 $1,264.22 $1,650.98 |
$1,343.78 $1,446.56 $1,555.44 $1,942.20 |
Toc - Plan #136 Group Health Cooperative-SCW | ||||||||||||||||||||
Expanded Bronze
(HMO) Select Bronze 7500 Ded/9000 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$277.87 $315.38 $355.11 $496.27 $754.12 |
$490.44 $527.95 $567.68 $708.84 |
$703.01 $740.52 $780.25 $921.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$555.74 $630.76 $710.22 $992.54 $1,508.24 |
$768.31 $843.33 $922.79 $1,205.11 |
$980.88 $1,055.90 $1,135.36 $1,417.68 |
Toc - Plan #137 Group Health Cooperative-SCW | ||||||||||||||||||||
Bronze
(HMO) Select Bronze 9100 Ded/9100 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$247.37 $280.77 $316.14 $441.80 $671.36 |
$436.61 $470.01 $505.38 $631.04 |
$625.85 $659.25 $694.62 $820.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$494.74 $561.54 $632.28 $883.60 $1,342.72 |
$683.98 $750.78 $821.52 $1,072.84 |
$873.22 $940.02 $1,010.76 $1,262.08 |
‡Source: HealthCare.gov has released sample rates for all counties in the 36 states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Dane County here.
Dane County is in “Rating Area 2” of Wisconsin.
Currently, there are 137 plans offered in Rating Area 2.