Obamacare Providers, Plans and 2017 Rates for Langlade County
The health insurance rates listed below are for calendar year 2017.
2017 Rates and Providers
(click here for 2014)
(click here for 2015)
(click here for 2016)
This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for Langlade County, Wisconsin.
Currently, there are 51 plans offered in Langlade County.
Below, you’ll find a summary of plans and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options. For detailed information on available subsidies to make your coverage affordable, you must complete an application at HealthCare.gov or contact the provider directly.
The table below shows premiums for the following scenarios:
- Individual
- Couple
- Couple with 1 2 or 3 children
- Individual with 1 2 or 3 children
- A child alone
Each scenario is covered for age
- Age 21, 30, 40, 50
- Age 60 (Individual and Couple only)
For each plan, there are links that go to the insurance provider's website in a new window. You can find links to:
- a summary of plan benefits and costs,
- a plan brochure, and
- a "Provider Directory" -- where you can find out which doctors and hospitals in the Antigo, WI area accept this insurance coverage as within the plan's "network".
‡Source: HealthCare.gov has released sample rates for all counties in those states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Langlade County here.
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Security Health Plan of Wisconsin, Inc.Local: 1-715-221-9258 x19258 | Toll Free: 1-844-293-9624 TTY: 1-877-727-2232 |
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Plan: (HMO) Classic $5,500 HDHPSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$5,500
: Family:
$11,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$340.55 $386.52 $435.21 $608.21 $924.23 |
$681.10 $773.04 $870.42 $1216.42 $1848.46 |
$897.34 $989.28 $1086.66 $1432.66 |
$1113.58 $1205.52 $1302.90 $1648.90 |
$1329.82 $1421.76 $1519.14 $1865.14 |
$556.79 $602.76 $651.45 $824.45 |
$773.03 $819.00 $867.69 $1040.69 |
$989.27 $1035.24 $1083.93 $1256.93 |
$216.24 |
Plan: (HMO) Classic $1,500 - 20%Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$1,500
: Family:
$3,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$471.48 $535.12 $602.54 $842.05 $1279.57 |
$942.96 $1070.24 $1205.08 $1684.10 $2559.14 |
$1242.34 $1369.62 $1504.46 $1983.48 |
$1541.72 $1669.00 $1803.84 $2282.86 |
$1841.10 $1968.38 $2103.22 $2582.24 |
$770.86 $834.50 $901.92 $1141.43 |
$1070.24 $1133.88 $1201.30 $1440.81 |
$1369.62 $1433.26 $1500.68 $1740.19 |
$299.38 |
Plan: (HMO) Classic $3,750 HDHPSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$3,750
: Family:
$7,500 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$415.60 $471.70 $531.13 $742.25 $1127.92 |
$831.20 $943.40 $1062.26 $1484.50 $2255.84 |
$1095.10 $1207.30 $1326.16 $1748.40 |
$1359.00 $1471.20 $1590.06 $2012.30 |
$1622.90 $1735.10 $1853.96 $2276.20 |
$679.50 $735.60 $795.03 $1006.15 |
$943.40 $999.50 $1058.93 $1270.05 |
$1207.30 $1263.40 $1322.83 $1533.95 |
$263.90 |
Plan: (HMO) Classic $2,500 - 20%Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$390.81 $443.56 $499.44 $697.97 $1060.63 |
$781.62 $887.12 $998.88 $1395.94 $2121.26 |
$1029.78 $1135.28 $1247.04 $1644.10 |
$1277.94 $1383.44 $1495.20 $1892.26 |
$1526.10 $1631.60 $1743.36 $2140.42 |
$638.97 $691.72 $747.60 $946.13 |
$887.13 $939.88 $995.76 $1194.29 |
$1135.29 $1188.04 $1243.92 $1442.45 |
$248.16 |
Plan: (HMO) Classic $2,000 - 30%Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$390.15 $442.81 $498.59 $696.78 $1058.83 |
$780.30 $885.62 $997.18 $1393.56 $2117.66 |
$1028.04 $1133.36 $1244.92 $1641.30 |
$1275.78 $1381.10 $1492.66 $1889.04 |
$1523.52 $1628.84 $1740.40 $2136.78 |
$637.89 $690.55 $746.33 $944.52 |
$885.63 $938.29 $994.07 $1192.26 |
$1133.37 $1186.03 $1241.81 $1440.00 |
$247.74 |
Plan: (HMO) Classic $6,000 HDHPSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$6,000
: Family:
$12,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$330.63 $375.26 $422.54 $590.50 $897.31 |
$661.26 $750.52 $845.08 $1181.00 $1794.62 |
$871.21 $960.47 $1055.03 $1390.95 |
$1081.16 $1170.42 $1264.98 $1600.90 |
$1291.11 $1380.37 $1474.93 $1810.85 |
$540.58 $585.21 $632.49 $800.45 |
$750.53 $795.16 $842.44 $1010.40 |
$960.48 $1005.11 $1052.39 $1220.35 |
$209.95 |
Plan: (HMO) Classic ProtectionSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$7,150
: Family:
$14,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$224.83 $255.18 $287.33 $401.54 $610.17 |
$449.66 $510.36 $574.66 $803.08 $1220.34 |
$592.42 $653.12 $717.42 $945.84 |
$735.18 $795.88 $860.18 $1088.60 |
$877.94 $938.64 $1002.94 $1231.36 |
$367.59 $397.94 $430.09 $544.30 |
$510.35 $540.70 $572.85 $687.06 |
$653.11 $683.46 $715.61 $829.82 |
$142.76 |
Plan: (HMO) Classic $4,500 - 30%Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$4,500
: Family:
$9,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$387.17 $439.43 $494.79 $691.47 $1050.76 |
$774.34 $878.86 $989.58 $1382.94 $2101.52 |
$1020.19 $1124.71 $1235.43 $1628.79 |
$1266.04 $1370.56 $1481.28 $1874.64 |
$1511.89 $1616.41 $1727.13 $2120.49 |
$633.02 $685.28 $740.64 $937.32 |
$878.87 $931.13 $986.49 $1183.17 |
$1124.72 $1176.98 $1232.34 $1429.02 |
$245.85 |
Plan: (HMO) Classic $6,500 HDHPSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$6,500
: Family:
$13,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$316.42 $359.12 $404.37 $565.10 $858.73 |
$632.84 $718.24 $808.74 $1130.20 $1717.46 |
$833.76 $919.16 $1009.66 $1331.12 |
$1034.68 $1120.08 $1210.58 $1532.04 |
$1235.60 $1321.00 $1411.50 $1732.96 |
$517.34 $560.04 $605.29 $766.02 |
$718.26 $760.96 $806.21 $966.94 |
$919.18 $961.88 $1007.13 $1167.86 |
$200.92 |
Plan: (HMO) Classic $7,150Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$7,150
: Family:
$14,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$306.50 $347.86 $391.69 $547.39 $831.81 |
$613.00 $695.72 $783.38 $1094.78 $1663.62 |
$807.62 $890.34 $978.00 $1289.40 |
$1002.24 $1084.96 $1172.62 $1484.02 |
$1196.86 $1279.58 $1367.24 $1678.64 |
$501.12 $542.48 $586.31 $742.01 |
$695.74 $737.10 $780.93 $936.63 |
$890.36 $931.72 $975.55 $1131.25 |
$194.62 |
Plan: (HMO) Classic $5,500 - 30%Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$5,500
: Family:
$11,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$372.95 $423.29 $476.62 $666.08 $1012.17 |
$745.90 $846.58 $953.24 $1332.16 $2024.34 |
$982.72 $1083.40 $1190.06 $1568.98 |
$1219.54 $1320.22 $1426.88 $1805.80 |
$1456.36 $1557.04 $1663.70 $2042.62 |
$609.77 $660.11 $713.44 $902.90 |
$846.59 $896.93 $950.26 $1139.72 |
$1083.41 $1133.75 $1187.08 $1376.54 |
$236.82 |
Plan: (EPO) Select $1,500 - 20%Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$1,500
: Family:
$3,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$385.19 $437.18 $492.26 $687.93 $1045.37 |
$770.38 $874.36 $984.52 $1375.86 $2090.74 |
$1014.97 $1118.95 $1229.11 $1620.45 |
$1259.56 $1363.54 $1473.70 $1865.04 |
$1504.15 $1608.13 $1718.29 $2109.63 |
$629.78 $681.77 $736.85 $932.52 |
$874.37 $926.36 $981.44 $1177.11 |
$1118.96 $1170.95 $1226.03 $1421.70 |
$244.59 |
Plan: (EPO) Select $3,750 HDHPSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$3,750
: Family:
$7,500 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$339.56 $385.39 $433.95 $606.44 $921.54 |
$679.12 $770.78 $867.90 $1212.88 $1843.08 |
$894.74 $986.40 $1083.52 $1428.50 |
$1110.36 $1202.02 $1299.14 $1644.12 |
$1325.98 $1417.64 $1514.76 $1859.74 |
$555.18 $601.01 $649.57 $822.06 |
$770.80 $816.63 $865.19 $1037.68 |
$986.42 $1032.25 $1080.81 $1253.30 |
$215.62 |
Plan: (EPO) Select $2,500 - 20%Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$319.39 $362.50 $408.17 $570.42 $866.81 |
$638.78 $725.00 $816.34 $1140.84 $1733.62 |
$841.59 $927.81 $1019.15 $1343.65 |
$1044.40 $1130.62 $1221.96 $1546.46 |
$1247.21 $1333.43 $1424.77 $1749.27 |
$522.20 $565.31 $610.98 $773.23 |
$725.01 $768.12 $813.79 $976.04 |
$927.82 $970.93 $1016.60 $1178.85 |
$202.81 |
Plan: (EPO) Select $2,000 - 30%Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$318.73 $361.75 $407.33 $569.24 $865.01 |
$637.46 $723.50 $814.66 $1138.48 $1730.02 |
$839.85 $925.89 $1017.05 $1340.87 |
$1042.24 $1128.28 $1219.44 $1543.26 |
$1244.63 $1330.67 $1421.83 $1745.65 |
$521.12 $564.14 $609.72 $771.63 |
$723.51 $766.53 $812.11 $974.02 |
$925.90 $968.92 $1014.50 $1176.41 |
$202.39 |
Plan: (EPO) Select $6,000 HDHPSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$6,000
: Family:
$12,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$270.13 $306.59 $345.21 $482.43 $733.11 |
$540.26 $613.18 $690.42 $964.86 $1466.22 |
$711.79 $784.71 $861.95 $1136.39 |
$883.32 $956.24 $1033.48 $1307.92 |
$1054.85 $1127.77 $1205.01 $1479.45 |
$441.66 $478.12 $516.74 $653.96 |
$613.19 $649.65 $688.27 $825.49 |
$784.72 $821.18 $859.80 $997.02 |
$171.53 |
Plan: (EPO) Select $5,500 HDHPSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$5,500
: Family:
$11,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$278.40 $315.97 $355.78 $497.20 $755.54 |
$556.80 $631.94 $711.56 $994.40 $1511.08 |
$733.58 $808.72 $888.34 $1171.18 |
$910.36 $985.50 $1065.12 $1347.96 |
$1087.14 $1162.28 $1241.90 $1524.74 |
$455.18 $492.75 $532.56 $673.98 |
$631.96 $669.53 $709.34 $850.76 |
$808.74 $846.31 $886.12 $1027.54 |
$176.78 |
Plan: (EPO) Select ProtectionSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$7,150
: Family:
$14,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$183.51 $208.27 $234.51 $327.72 $498.01 |
$367.02 $416.54 $469.02 $655.44 $996.02 |
$483.54 $533.06 $585.54 $771.96 |
$600.06 $649.58 $702.06 $888.48 |
$716.58 $766.10 $818.58 $1005.00 |
$300.03 $324.79 $351.03 $444.24 |
$416.55 $441.31 $467.55 $560.76 |
$533.07 $557.83 $584.07 $677.28 |
$116.52 |
Plan: (EPO) Select $4,500 - 30%Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$4,500
: Family:
$9,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$316.42 $359.12 $404.37 $565.10 $858.73 |
$632.84 $718.24 $808.74 $1130.20 $1717.46 |
$833.76 $919.16 $1009.66 $1331.12 |
$1034.68 $1120.08 $1210.58 $1532.04 |
$1235.60 $1321.00 $1411.50 $1732.96 |
$517.34 $560.04 $605.29 $766.02 |
$718.26 $760.96 $806.21 $966.94 |
$919.18 $961.88 $1007.13 $1167.86 |
$200.92 |
Plan: (EPO) Select $6,500 HDHPSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$6,500
: Family:
$13,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$258.56 $293.45 $330.42 $461.77 $701.70 |
$517.12 $586.90 $660.84 $923.54 $1403.40 |
$681.30 $751.08 $825.02 $1087.72 |
$845.48 $915.26 $989.20 $1251.90 |
$1009.66 $1079.44 $1153.38 $1416.08 |
$422.74 $457.63 $494.60 $625.95 |
$586.92 $621.81 $658.78 $790.13 |
$751.10 $785.99 $822.96 $954.31 |
$164.18 |
Plan: (EPO) Select $7,150Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$7,150
: Family:
$14,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$250.62 $284.45 $320.28 $447.60 $680.16 |
$501.24 $568.90 $640.56 $895.20 $1360.32 |
$660.38 $728.04 $799.70 $1054.34 |
$819.52 $887.18 $958.84 $1213.48 |
$978.66 $1046.32 $1117.98 $1372.62 |
$409.76 $443.59 $479.42 $606.74 |
$568.90 $602.73 $638.56 $765.88 |
$728.04 $761.87 $797.70 $925.02 |
$159.14 |
Plan: (EPO) Select $5,500 - 30%Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-293-9624 - Provider Directory for This Plan: (Security Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$5,500
: Family:
$11,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$304.85 $345.99 $389.58 $544.44 $827.32 |
$609.70 $691.98 $779.16 $1088.88 $1654.64 |
$803.27 $885.55 $972.73 $1282.45 |
$996.84 $1079.12 $1166.30 $1476.02 |
$1190.41 $1272.69 $1359.87 $1669.59 |
$498.42 $539.56 $583.15 $738.01 |
$691.99 $733.13 $776.72 $931.58 |
$885.56 $926.70 $970.29 $1125.15 |
$193.57 |
ADVERTISEMENT
|
||||||||||
Compcare Health Serv Ins Co(Anthem BCBS)Local: 1-855-748-1813 | Toll Free: 1-855-748-1813 |
||||||||||
Plan: (HMO) Anthem Catastrophic Blue Priority WI 7150Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1813 - Provider Directory for This Plan: (Compcare Health Serv Ins Co(Anthem BCBS))
Deductible: Individual:
$7,150
: Family:
$14,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$271.71 $308.39 $347.25 $485.27 $737.42 |
$543.42 $616.78 $694.50 $970.54 $1474.84 |
$715.96 $789.32 $867.04 $1143.08 |
$888.50 $961.86 $1039.58 $1315.62 |
$1061.04 $1134.40 $1212.12 $1488.16 |
$444.25 $480.93 $519.79 $657.81 |
$616.79 $653.47 $692.33 $830.35 |
$789.33 $826.01 $864.87 $1002.89 |
$172.54 |
Plan: (HMO) Anthem Bronze Blue Priority WI 0 for HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1813 - Provider Directory for This Plan: (Compcare Health Serv Ins Co(Anthem BCBS))
Deductible: Individual:
$6,550
: Family:
$13,100 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$343.31 $389.66 $438.75 $613.15 $931.74 |
$686.62 $779.32 $877.50 $1226.30 $1863.48 |
$904.62 $997.32 $1095.50 $1444.30 |
$1122.62 $1215.32 $1313.50 $1662.30 |
$1340.62 $1433.32 $1531.50 $1880.30 |
$561.31 $607.66 $656.75 $831.15 |
$779.31 $825.66 $874.75 $1049.15 |
$997.31 $1043.66 $1092.75 $1267.15 |
$218.00 |
Plan: (HMO) Anthem Bronze Blue Priority WI 30 for HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1813 - Provider Directory for This Plan: (Compcare Health Serv Ins Co(Anthem BCBS))
Deductible: Individual:
$5,150
: Family:
$10,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$347.96 $394.93 $444.69 $621.46 $944.36 |
$695.92 $789.86 $889.38 $1242.92 $1888.72 |
$916.87 $1010.81 $1110.33 $1463.87 |
$1137.82 $1231.76 $1331.28 $1684.82 |
$1358.77 $1452.71 $1552.23 $1905.77 |
$568.91 $615.88 $665.64 $842.41 |
$789.86 $836.83 $886.59 $1063.36 |
$1010.81 $1057.78 $1107.54 $1284.31 |
$220.95 |
Plan: (HMO) Anthem Silver Blue Priority WI 3750Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1813 - Provider Directory for This Plan: (Compcare Health Serv Ins Co(Anthem BCBS))
Deductible: Individual:
$3,750
: Family:
$7,500 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$388.31 $440.73 $496.26 $693.52 $1053.87 |
$776.62 $881.46 $992.52 $1387.04 $2107.74 |
$1023.20 $1128.04 $1239.10 $1633.62 |
$1269.78 $1374.62 $1485.68 $1880.20 |
$1516.36 $1621.20 $1732.26 $2126.78 |
$634.89 $687.31 $742.84 $940.10 |
$881.47 $933.89 $989.42 $1186.68 |
$1128.05 $1180.47 $1236.00 $1433.26 |
$246.58 |
Plan: (HMO) Anthem Silver Blue Priority WI 2500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1813 - Provider Directory for This Plan: (Compcare Health Serv Ins Co(Anthem BCBS))
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$397.01 $450.61 $507.38 $709.06 $1077.49 |
$794.02 $901.22 $1014.76 $1418.12 $2154.98 |
$1046.12 $1153.32 $1266.86 $1670.22 |
$1298.22 $1405.42 $1518.96 $1922.32 |
$1550.32 $1657.52 $1771.06 $2174.42 |
$649.11 $702.71 $759.48 $961.16 |
$901.21 $954.81 $1011.58 $1213.26 |
$1153.31 $1206.91 $1263.68 $1465.36 |
$252.10 |
Plan: (HMO) Anthem Silver Blue Priority WI for HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1813 - Provider Directory for This Plan: (Compcare Health Serv Ins Co(Anthem BCBS))
Deductible: Individual:
$3,000
: Family:
$6,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$392.92 $445.96 $502.15 $701.76 $1066.38 |
$785.84 $891.92 $1004.30 $1403.52 $2132.76 |
$1035.34 $1141.42 $1253.80 $1653.02 |
$1284.84 $1390.92 $1503.30 $1902.52 |
$1534.34 $1640.42 $1752.80 $2152.02 |
$642.42 $695.46 $751.65 $951.26 |
$891.92 $944.96 $1001.15 $1200.76 |
$1141.42 $1194.46 $1250.65 $1450.26 |
$249.50 |
Plan: (HMO) Anthem Bronze Blue Priority WI 40 for HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1813 - Provider Directory for This Plan: (Compcare Health Serv Ins Co(Anthem BCBS))
Deductible: Individual:
$5,500
: Family:
$11,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$345.13 $391.72 $441.08 $616.40 $936.68 |
$690.26 $783.44 $882.16 $1232.80 $1873.36 |
$909.42 $1002.60 $1101.32 $1451.96 |
$1128.58 $1221.76 $1320.48 $1671.12 |
$1347.74 $1440.92 $1539.64 $1890.28 |
$564.29 $610.88 $660.24 $835.56 |
$783.45 $830.04 $879.40 $1054.72 |
$1002.61 $1049.20 $1098.56 $1273.88 |
$219.16 |
Plan: (HMO) Anthem Bronze Blue Priority WI 5450Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1813 - Provider Directory for This Plan: (Compcare Health Serv Ins Co(Anthem BCBS))
Deductible: Individual:
$5,450
: Family:
$10,900 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$339.18 $384.97 $433.47 $605.78 $920.53 |
$678.36 $769.94 $866.94 $1211.56 $1841.06 |
$893.74 $985.32 $1082.32 $1426.94 |
$1109.12 $1200.70 $1297.70 $1642.32 |
$1324.50 $1416.08 $1513.08 $1857.70 |
$554.56 $600.35 $648.85 $821.16 |
$769.94 $815.73 $864.23 $1036.54 |
$985.32 $1031.11 $1079.61 $1251.92 |
$215.38 |
Plan: (HMO) Anthem Blue Cross and Blue Shield Gold DirectAccess, a Multi-State PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1813 - Provider Directory for This Plan: (Compcare Health Serv Ins Co(Anthem BCBS))
Deductible: Individual:
$1,000
: Family:
$3,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$560.28 $635.92 $716.04 $1000.66 $1520.60 |
$1120.56 $1271.84 $1432.08 $2001.32 $3041.20 |
$1476.34 $1627.62 $1787.86 $2357.10 |
$1832.12 $1983.40 $2143.64 $2712.88 |
$2187.90 $2339.18 $2499.42 $3068.66 |
$916.06 $991.70 $1071.82 $1356.44 |
$1271.84 $1347.48 $1427.60 $1712.22 |
$1627.62 $1703.26 $1783.38 $2068.00 |
$355.78 |
Plan: (HMO) Anthem Silver Blue Priority WI 4000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1813 - Provider Directory for This Plan: (Compcare Health Serv Ins Co(Anthem BCBS))
Deductible: Individual:
$4,000
: Family:
$8,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$379.46 $430.69 $484.95 $677.72 $1029.85 |
$758.92 $861.38 $969.90 $1355.44 $2059.70 |
$999.88 $1102.34 $1210.86 $1596.40 |
$1240.84 $1343.30 $1451.82 $1837.36 |
$1481.80 $1584.26 $1692.78 $2078.32 |
$620.42 $671.65 $725.91 $918.68 |
$861.38 $912.61 $966.87 $1159.64 |
$1102.34 $1153.57 $1207.83 $1400.60 |
$240.96 |
Plan: (HMO) Anthem Silver Blue Priority WI 5300Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1813 - Provider Directory for This Plan: (Compcare Health Serv Ins Co(Anthem BCBS))
Deductible: Individual:
$5,300
: Family:
$10,600 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$359.63 $408.18 $459.61 $642.30 $976.04 |
$719.26 $816.36 $919.22 $1284.60 $1952.08 |
$947.63 $1044.73 $1147.59 $1512.97 |
$1176.00 $1273.10 $1375.96 $1741.34 |
$1404.37 $1501.47 $1604.33 $1969.71 |
$588.00 $636.55 $687.98 $870.67 |
$816.37 $864.92 $916.35 $1099.04 |
$1044.74 $1093.29 $1144.72 $1327.41 |
$228.37 |
Plan: (HMO) Anthem Silver Blue Priority WI 3200Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1813 - Provider Directory for This Plan: (Compcare Health Serv Ins Co(Anthem BCBS))
Deductible: Individual:
$3,200
: Family:
$6,400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$374.51 $425.07 $478.62 $668.87 $1016.42 |
$749.02 $850.14 $957.24 $1337.74 $2032.84 |
$986.83 $1087.95 $1195.05 $1575.55 |
$1224.64 $1325.76 $1432.86 $1813.36 |
$1462.45 $1563.57 $1670.67 $2051.17 |
$612.32 $662.88 $716.43 $906.68 |
$850.13 $900.69 $954.24 $1144.49 |
$1087.94 $1138.50 $1192.05 $1382.30 |
$237.81 |
Plan: (HMO) Anthem Blue Cross and Blue Shield Silver DirectAccess, a Multi-State PlanSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1813 - Provider Directory for This Plan: (Compcare Health Serv Ins Co(Anthem BCBS))
Deductible: Individual:
$1,850
: Family:
$3,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$404.37 $458.96 $516.78 $722.20 $1097.46 |
$808.74 $917.92 $1033.56 $1444.40 $2194.92 |
$1065.51 $1174.69 $1290.33 $1701.17 |
$1322.28 $1431.46 $1547.10 $1957.94 |
$1579.05 $1688.23 $1803.87 $2214.71 |
$661.14 $715.73 $773.55 $978.97 |
$917.91 $972.50 $1030.32 $1235.74 |
$1174.68 $1229.27 $1287.09 $1492.51 |
$256.77 |
ADVERTISEMENT
|
||||||||||
Aspirus Arise Health Plan of Wisconsin, Inc.Local: 1-715-972-8140 | Toll Free: 1-800-332-6290 TTY: 1-888-332-0144 |
||||||||||
Plan: (HMO) HMO Silver 7000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-332-6290 - Provider Directory for This Plan: (Aspirus Arise Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$7,000
: Family:
$14,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$331.95 $376.76 $424.23 $592.86 $900.91 |
$663.90 $753.52 $848.46 $1185.72 $1801.82 |
$874.69 $964.31 $1059.25 $1396.51 |
$1085.48 $1175.10 $1270.04 $1607.30 |
$1296.27 $1385.89 $1480.83 $1818.09 |
$542.74 $587.55 $635.02 $803.65 |
$753.53 $798.34 $845.81 $1014.44 |
$964.32 $1009.13 $1056.60 $1225.23 |
$210.79 |
Plan: (HMO) HMO Silver 4500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-332-6290 - Provider Directory for This Plan: (Aspirus Arise Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$4,500
: Family:
$9,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$344.78 $391.33 $440.63 $615.78 $935.73 |
$689.56 $782.66 $881.26 $1231.56 $1871.46 |
$908.50 $1001.60 $1100.20 $1450.50 |
$1127.44 $1220.54 $1319.14 $1669.44 |
$1346.38 $1439.48 $1538.08 $1888.38 |
$563.72 $610.27 $659.57 $834.72 |
$782.66 $829.21 $878.51 $1053.66 |
$1001.60 $1048.15 $1097.45 $1272.60 |
$218.94 |
Plan: (HMO) HMO HDHP Bronze 5500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-332-6290 - Provider Directory for This Plan: (Aspirus Arise Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$5,500
: Family:
$11,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$280.31 $318.15 $358.24 $500.63 $760.76 |
$560.62 $636.30 $716.48 $1001.26 $1521.52 |
$738.62 $814.30 $894.48 $1179.26 |
$916.62 $992.30 $1072.48 $1357.26 |
$1094.62 $1170.30 $1250.48 $1535.26 |
$458.31 $496.15 $536.24 $678.63 |
$636.31 $674.15 $714.24 $856.63 |
$814.31 $852.15 $892.24 $1034.63 |
$178.00 |
Plan: (HMO) HMO HDHP Silver 2700Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-332-6290 - Provider Directory for This Plan: (Aspirus Arise Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$2,700
: Family:
$5,400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$339.62 $385.47 $434.03 $606.56 $921.73 |
$679.24 $770.94 $868.06 $1213.12 $1843.46 |
$894.90 $986.60 $1083.72 $1428.78 |
$1110.56 $1202.26 $1299.38 $1644.44 |
$1326.22 $1417.92 $1515.04 $1860.10 |
$555.28 $601.13 $649.69 $822.22 |
$770.94 $816.79 $865.35 $1037.88 |
$986.60 $1032.45 $1081.01 $1253.54 |
$215.66 |
Plan: (HMO) HMO Bronze 7150Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-332-6290 - Provider Directory for This Plan: (Aspirus Arise Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$7,150
: Family:
$14,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$269.68 $306.09 $344.65 $481.65 $731.91 |
$539.36 $612.18 $689.30 $963.30 $1463.82 |
$710.61 $783.43 $860.55 $1134.55 |
$881.86 $954.68 $1031.80 $1305.80 |
$1053.11 $1125.93 $1203.05 $1477.05 |
$440.93 $477.34 $515.90 $652.90 |
$612.18 $648.59 $687.15 $824.15 |
$783.43 $819.84 $858.40 $995.40 |
$171.25 |
Plan: (HMO) HMO Bronze 6250Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-332-6290 - Provider Directory for This Plan: (Aspirus Arise Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$6,250
: Family:
$12,500 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$275.08 $312.22 $351.55 $491.29 $746.57 |
$550.16 $624.44 $703.10 $982.58 $1493.14 |
$724.84 $799.12 $877.78 $1157.26 |
$899.52 $973.80 $1052.46 $1331.94 |
$1074.20 $1148.48 $1227.14 $1506.62 |
$449.76 $486.90 $526.23 $665.97 |
$624.44 $661.58 $700.91 $840.65 |
$799.12 $836.26 $875.59 $1015.33 |
$174.68 |
Plan: (HMO) HMO Gold 2000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-332-6290 - Provider Directory for This Plan: (Aspirus Arise Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$517.24 $587.07 $661.03 $923.79 $1403.79 |
$1034.48 $1174.14 $1322.06 $1847.58 $2807.58 |
$1362.93 $1502.59 $1650.51 $2176.03 |
$1691.38 $1831.04 $1978.96 $2504.48 |
$2019.83 $2159.49 $2307.41 $2832.93 |
$845.69 $915.52 $989.48 $1252.24 |
$1174.14 $1243.97 $1317.93 $1580.69 |
$1502.59 $1572.42 $1646.38 $1909.14 |
$328.45 |
Plan: (HMO) HMO Catastrophic 7150Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-332-6290 - Provider Directory for This Plan: (Aspirus Arise Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$7,150
: Family:
$14,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$236.57 $268.51 $302.34 $422.51 $642.05 |
$473.14 $537.02 $604.68 $845.02 $1284.10 |
$623.36 $687.24 $754.90 $995.24 |
$773.58 $837.46 $905.12 $1145.46 |
$923.80 $987.68 $1055.34 $1295.68 |
$386.79 $418.73 $452.56 $572.73 |
$537.01 $568.95 $602.78 $722.95 |
$687.23 $719.17 $753.00 $873.17 |
$150.22 |
Plan: (HMO) HMO HDHP Bronze 6550Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-332-6290 - Provider Directory for This Plan: (Aspirus Arise Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$6,550
: Family:
$13,100 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$274.27 $311.30 $350.52 $489.85 $744.37 |
$548.54 $622.60 $701.04 $979.70 $1488.74 |
$722.70 $796.76 $875.20 $1153.86 |
$896.86 $970.92 $1049.36 $1328.02 |
$1071.02 $1145.08 $1223.52 $1502.18 |
$448.43 $485.46 $524.68 $664.01 |
$622.59 $659.62 $698.84 $838.17 |
$796.75 $833.78 $873.00 $1012.33 |
$174.16 |
Plan: (HMO) HMO HDHP Silver 4000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-332-6290 - Provider Directory for This Plan: (Aspirus Arise Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$4,000
: Family:
$8,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$343.04 $389.35 $438.41 $612.67 $931.01 |
$686.08 $778.70 $876.82 $1225.34 $1862.02 |
$903.91 $996.53 $1094.65 $1443.17 |
$1121.74 $1214.36 $1312.48 $1661.00 |
$1339.57 $1432.19 $1530.31 $1878.83 |
$560.87 $607.18 $656.24 $830.50 |
$778.70 $825.01 $874.07 $1048.33 |
$996.53 $1042.84 $1091.90 $1266.16 |
$217.83 |
Plan: (HMO) HMO STANDARD Bronze 6650Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-332-6290 - Provider Directory for This Plan: (Aspirus Arise Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$6,650
: Family:
$13,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$279.33 $317.04 $356.98 $498.88 $758.10 |
$558.66 $634.08 $713.96 $997.76 $1516.20 |
$736.03 $811.45 $891.33 $1175.13 |
$913.40 $988.82 $1068.70 $1352.50 |
$1090.77 $1166.19 $1246.07 $1529.87 |
$456.70 $494.41 $534.35 $676.25 |
$634.07 $671.78 $711.72 $853.62 |
$811.44 $849.15 $889.09 $1030.99 |
$177.37 |
Plan: (HMO) HMO STANDARD Silver 3500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-332-6290 - Provider Directory for This Plan: (Aspirus Arise Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$340.95 $386.98 $435.73 $608.94 $925.34 |
$681.90 $773.96 $871.46 $1217.88 $1850.68 |
$898.40 $990.46 $1087.96 $1434.38 |
$1114.90 $1206.96 $1304.46 $1650.88 |
$1331.40 $1423.46 $1520.96 $1867.38 |
$557.45 $603.48 $652.23 $825.44 |
$773.95 $819.98 $868.73 $1041.94 |
$990.45 $1036.48 $1085.23 $1258.44 |
$216.50 |
Plan: (POS) POS Silver 7000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-332-6290 - Provider Directory for This Plan: (Aspirus Arise Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$7,000
: Family:
$14,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$365.17 $414.47 $466.69 $652.19 $991.07 |
$730.34 $828.94 $933.38 $1304.38 $1982.14 |
$962.22 $1060.82 $1165.26 $1536.26 |
$1194.10 $1292.70 $1397.14 $1768.14 |
$1425.98 $1524.58 $1629.02 $2000.02 |
$597.05 $646.35 $698.57 $884.07 |
$828.93 $878.23 $930.45 $1115.95 |
$1060.81 $1110.11 $1162.33 $1347.83 |
$231.88 |
Plan: (POS) POS Silver 4500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-332-6290 - Provider Directory for This Plan: (Aspirus Arise Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$4,500
: Family:
$9,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$379.28 $430.48 $484.72 $677.39 $1029.37 |
$758.56 $860.96 $969.44 $1354.78 $2058.74 |
$999.40 $1101.80 $1210.28 $1595.62 |
$1240.24 $1342.64 $1451.12 $1836.46 |
$1481.08 $1583.48 $1691.96 $2077.30 |
$620.12 $671.32 $725.56 $918.23 |
$860.96 $912.16 $966.40 $1159.07 |
$1101.80 $1153.00 $1207.24 $1399.91 |
$240.84 |
Plan: (POS) POS HDHP Bronze 5500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-332-6290 - Provider Directory for This Plan: (Aspirus Arise Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$5,500
: Family:
$11,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$308.37 $350.00 $394.10 $550.75 $836.92 |
$616.74 $700.00 $788.20 $1101.50 $1673.84 |
$812.55 $895.81 $984.01 $1297.31 |
$1008.36 $1091.62 $1179.82 $1493.12 |
$1204.17 $1287.43 $1375.63 $1688.93 |
$504.18 $545.81 $589.91 $746.56 |
$699.99 $741.62 $785.72 $942.37 |
$895.80 $937.43 $981.53 $1138.18 |
$195.81 |
Plan: (POS) POS HDHP Silver 2700Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-332-6290 - Provider Directory for This Plan: (Aspirus Arise Health Plan of Wisconsin, Inc.)
Deductible: Individual:
$2,700
: Family:
$5,400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$375.86 $426.60 $480.35 $671.29 $1020.08 |
$751.72 $853.20 $960.70 $1342.58 $2040.16 |
$990.39 $1091.87 $1199.37 $1581.25 |
$1229.06 $1330.54 $1438.04 $1819.92 |
$1467.73 $1569.21 $1676.71 $2058.59 |
$614.53 $665.27 $719.02 $909.96 |
$853.20 $903.94 $957.69 $1148.63 |
$1091.87 $1142.61 $1196.36 $1387.30 |
$238.67 |