The health insurance rates listed below are for calendar year 2019.
2019 Rates and Providers
(click here for 2014)
(click here for 2015)
(click here for 2016)
(click here for 2017)
(click here for 2018)
This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for Brookfield, WI.
Obamacare Providers, Plans and 2019 Rates for Waukesha County
Waukesha County is in “Rating Area 12” of Wisconsin.
Currently, there are 54 plans offered in Rating Area 12.
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 for:
- 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 Brookfield, WI area accept this insurance coverage as within the plan's "network".
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Children's Community Health PlanLocal: 1-844-201-4672 | Toll Free: 1-844-201-4672 TTY: 1-844-531-4856 |
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Plan: (EPO) Together BronzeSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-201-4672 - Provider Directory for This Plan: (Children's Community Health Plan)
Deductible: Individual:
$7,000
: Family:
$14,000 Monthly Premiums: |
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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 |
$370.97 $421.04 $474.09 $662.54 $1,006.80 |
$741.94 $842.08 $948.18 $1,325.08 $2,013.60 |
$1,025.73 $1,125.87 $1,231.97 $1,608.87 |
$1,309.52 $1,409.66 $1,515.76 $1,892.66 |
$1,593.31 $1,693.45 $1,799.55 $2,176.45 |
$654.76 $704.83 $757.88 $946.33 |
$938.55 $988.62 $1,041.67 $1,230.12 |
$1,222.34 $1,272.41 $1,325.46 $1,513.91 |
$338.69 |
Plan: (EPO) Together Standard SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-201-4672 - Provider Directory for This Plan: (Children's Community Health Plan)
Deductible: Individual:
$4,000
: Family:
$8,000 Monthly Premiums: |
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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 |
$514.52 $583.97 $657.55 $918.92 $1,396.39 |
$1,029.04 $1,167.94 $1,315.10 $1,837.84 $2,792.78 |
$1,422.64 $1,561.54 $1,708.70 $2,231.44 |
$1,816.24 $1,955.14 $2,102.30 $2,625.04 |
$2,209.84 $2,348.74 $2,495.90 $3,018.64 |
$908.12 $977.57 $1,051.15 $1,312.52 |
$1,301.72 $1,371.17 $1,444.75 $1,706.12 |
$1,695.32 $1,764.77 $1,838.35 $2,099.72 |
$469.75 |
Plan: (EPO) Together SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-201-4672 - Provider Directory for This Plan: (Children's Community Health Plan)
Deductible: Individual:
$4,700
: Family:
$9,400 Monthly Premiums: |
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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 |
$477.99 $542.51 $610.86 $853.68 $1,297.25 |
$955.98 $1,085.02 $1,221.72 $1,707.36 $2,594.50 |
$1,321.64 $1,450.68 $1,587.38 $2,073.02 |
$1,687.30 $1,816.34 $1,953.04 $2,438.68 |
$2,052.96 $2,182.00 $2,318.70 $2,804.34 |
$843.65 $908.17 $976.52 $1,219.34 |
$1,209.31 $1,273.83 $1,342.18 $1,585.00 |
$1,574.97 $1,639.49 $1,707.84 $1,950.66 |
$436.40 |
Plan: (EPO) Together GoldSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-201-4672 - Provider Directory for This Plan: (Children's Community Health Plan)
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
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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 |
$508.35 $576.97 $649.66 $907.89 $1,379.63 |
$1,016.70 $1,153.94 $1,299.32 $1,815.78 $2,759.26 |
$1,405.58 $1,542.82 $1,688.20 $2,204.66 |
$1,794.46 $1,931.70 $2,077.08 $2,593.54 |
$2,183.34 $2,320.58 $2,465.96 $2,982.42 |
$897.23 $965.85 $1,038.54 $1,296.77 |
$1,286.11 $1,354.73 $1,427.42 $1,685.65 |
$1,674.99 $1,743.61 $1,816.30 $2,074.53 |
$464.11 |
Plan: (EPO) Together Bronze HDHPSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-201-4672 - Provider Directory for This Plan: (Children's Community Health Plan)
Deductible: Individual:
$6,750
: Family:
$13,500 Monthly Premiums: |
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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 |
$395.16 $448.49 $505.00 $705.73 $1,072.43 |
$790.32 $896.98 $1,010.00 $1,411.46 $2,144.86 |
$1,092.61 $1,199.27 $1,312.29 $1,713.75 |
$1,394.90 $1,501.56 $1,614.58 $2,016.04 |
$1,697.19 $1,803.85 $1,916.87 $2,318.33 |
$697.45 $750.78 $807.29 $1,008.02 |
$999.74 $1,053.07 $1,109.58 $1,310.31 |
$1,302.03 $1,355.36 $1,411.87 $1,612.60 |
$360.77 |
Plan: (EPO) Together Silver SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-201-4672 - Provider Directory for This Plan: (Children's Community Health Plan)
Deductible: Individual:
$3,250
: Family:
$6,500 Monthly Premiums: |
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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 |
$498.57 $565.87 $637.16 $890.43 $1,353.10 |
$997.14 $1,131.74 $1,274.32 $1,780.86 $2,706.20 |
$1,378.54 $1,513.14 $1,655.72 $2,162.26 |
$1,759.94 $1,894.54 $2,037.12 $2,543.66 |
$2,141.34 $2,275.94 $2,418.52 $2,925.06 |
$879.97 $947.27 $1,018.56 $1,271.83 |
$1,261.37 $1,328.67 $1,399.96 $1,653.23 |
$1,642.77 $1,710.07 $1,781.36 $2,034.63 |
$455.19 |
Plan: (EPO) Together CatastrophicSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-844-201-4672 - Provider Directory for This Plan: (Children's Community Health Plan)
Deductible: Individual:
$7,900
: Family:
$15,800 Monthly Premiums: |
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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 |
$304.60 $345.71 $389.27 $544.00 $826.66 |
$609.20 $691.42 $778.54 $1,088.00 $1,653.32 |
$842.21 $924.43 $1,011.55 $1,321.01 |
$1,075.22 $1,157.44 $1,244.56 $1,554.02 |
$1,308.23 $1,390.45 $1,477.57 $1,787.03 |
$537.61 $578.72 $622.28 $777.01 |
$770.62 $811.73 $855.29 $1,010.02 |
$1,003.63 $1,044.74 $1,088.30 $1,243.03 |
$278.09 |
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Unity Health Plans Insurance CorporationLocal: 1-608-644-3430 | Toll Free: 1-800-362-3310 TTY: 1-800-877-8973 |
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Plan: (HMO) ProHealth Silver 5000 - Copay $50/$100 with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
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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 |
$496.14 $563.12 $634.06 $886.10 $1,346.52 |
$992.28 $1,126.24 $1,268.12 $1,772.20 $2,693.04 |
$1,371.83 $1,505.79 $1,647.67 $2,151.75 |
$1,751.38 $1,885.34 $2,027.22 $2,531.30 |
$2,130.93 $2,264.89 $2,406.77 $2,910.85 |
$875.69 $942.67 $1,013.61 $1,265.65 |
$1,255.24 $1,322.22 $1,393.16 $1,645.20 |
$1,634.79 $1,701.77 $1,772.71 $2,024.75 |
$452.97 |
Plan: (HMO) ProHealth Silver 7900 - Copay $80/$160 with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$7,900
: Family:
$15,800 Monthly Premiums: |
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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 |
$479.98 $544.77 $613.41 $857.24 $1,302.66 |
$959.96 $1,089.54 $1,226.82 $1,714.48 $2,605.32 |
$1,327.14 $1,456.72 $1,594.00 $2,081.66 |
$1,694.32 $1,823.90 $1,961.18 $2,448.84 |
$2,061.50 $2,191.08 $2,328.36 $2,816.02 |
$847.16 $911.95 $980.59 $1,224.42 |
$1,214.34 $1,279.13 $1,347.77 $1,591.60 |
$1,581.52 $1,646.31 $1,714.95 $1,958.78 |
$438.22 |
Plan: (HMO) ProHealth Gold Maintenance - Copay $40/$90 with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$1,500
: Family:
$3,000 Monthly Premiums: |
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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 |
$419.53 $476.16 $536.15 $749.26 $1,138.58 |
$839.06 $952.32 $1,072.30 $1,498.52 $2,277.16 |
$1,159.99 $1,273.25 $1,393.23 $1,819.45 |
$1,480.92 $1,594.18 $1,714.16 $2,140.38 |
$1,801.85 $1,915.11 $2,035.09 $2,461.31 |
$740.46 $797.09 $857.08 $1,070.19 |
$1,061.39 $1,118.02 $1,178.01 $1,391.12 |
$1,382.32 $1,438.95 $1,498.94 $1,712.05 |
$383.02 |
Plan: (HMO) ProHealth Gold 2000 - Copay $30/$70 with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
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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 |
$409.38 $464.64 $523.18 $731.15 $1,111.05 |
$818.76 $929.28 $1,046.36 $1,462.30 $2,222.10 |
$1,131.93 $1,242.45 $1,359.53 $1,775.47 |
$1,445.10 $1,555.62 $1,672.70 $2,088.64 |
$1,758.27 $1,868.79 $1,985.87 $2,401.81 |
$722.55 $777.81 $836.35 $1,044.32 |
$1,035.72 $1,090.98 $1,149.52 $1,357.49 |
$1,348.89 $1,404.15 $1,462.69 $1,670.66 |
$373.76 |
Plan: (HMO) ProHealth Silver 4000 - Copay $45/$90 with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$4,000
: Family:
$8,000 Monthly Premiums: |
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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 |
$501.65 $569.37 $641.10 $895.94 $1,361.47 |
$1,003.30 $1,138.74 $1,282.20 $1,791.88 $2,722.94 |
$1,387.06 $1,522.50 $1,665.96 $2,175.64 |
$1,770.82 $1,906.26 $2,049.72 $2,559.40 |
$2,154.58 $2,290.02 $2,433.48 $2,943.16 |
$885.41 $953.13 $1,024.86 $1,279.70 |
$1,269.17 $1,336.89 $1,408.62 $1,663.46 |
$1,652.93 $1,720.65 $1,792.38 $2,047.22 |
$458.00 |
Plan: (HMO) ProHealth Bronze 7500 - Copay $80/$160 with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$7,500
: Family:
$15,000 Monthly Premiums: |
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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 |
Expanded Bronze | 21 30 40 50 60 |
$311.02 $353.00 $397.47 $555.47 $844.09 |
$622.04 $706.00 $794.94 $1,110.94 $1,688.18 |
$859.96 $943.92 $1,032.86 $1,348.86 |
$1,097.88 $1,181.84 $1,270.78 $1,586.78 |
$1,335.80 $1,419.76 $1,508.70 $1,824.70 |
$548.94 $590.92 $635.39 $793.39 |
$786.86 $828.84 $873.31 $1,031.31 |
$1,024.78 $1,066.76 $1,111.23 $1,269.23 |
$283.95 |
Plan: (HMO) ProHealth Bronze 7900 - Copay $50/$100 with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$7,900
: Family:
$15,800 Monthly Premiums: |
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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 |
$303.18 $344.11 $387.46 $541.48 $822.83 |
$606.36 $688.22 $774.92 $1,082.96 $1,645.66 |
$838.29 $920.15 $1,006.85 $1,314.89 |
$1,070.22 $1,152.08 $1,238.78 $1,546.82 |
$1,302.15 $1,384.01 $1,470.71 $1,778.75 |
$535.11 $576.04 $619.39 $773.41 |
$767.04 $807.97 $851.32 $1,005.34 |
$998.97 $1,039.90 $1,083.25 $1,237.27 |
$276.80 |
Plan: (HMO) ProHealth Silver 5000 - Copay $50/$100Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
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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 |
$472.68 $536.48 $604.08 $844.20 $1,282.84 |
$945.36 $1,072.96 $1,208.16 $1,688.40 $2,565.68 |
$1,306.96 $1,434.56 $1,569.76 $2,050.00 |
$1,668.56 $1,796.16 $1,931.36 $2,411.60 |
$2,030.16 $2,157.76 $2,292.96 $2,773.20 |
$834.28 $898.08 $965.68 $1,205.80 |
$1,195.88 $1,259.68 $1,327.28 $1,567.40 |
$1,557.48 $1,621.28 $1,688.88 $1,929.00 |
$431.55 |
Plan: (HMO) ProHealth Silver 7900 - Copay $80/$160Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$7,900
: Family:
$15,800 Monthly Premiums: |
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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 |
$457.28 $519.01 $584.40 $816.70 $1,241.05 |
$914.56 $1,038.02 $1,168.80 $1,633.40 $2,482.10 |
$1,264.38 $1,387.84 $1,518.62 $1,983.22 |
$1,614.20 $1,737.66 $1,868.44 $2,333.04 |
$1,964.02 $2,087.48 $2,218.26 $2,682.86 |
$807.10 $868.83 $934.22 $1,166.52 |
$1,156.92 $1,218.65 $1,284.04 $1,516.34 |
$1,506.74 $1,568.47 $1,633.86 $1,866.16 |
$417.49 |
Plan: (HMO) ProHealth Gold Maintenance - Copay $40/$90Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$1,500
: Family:
$3,000 Monthly Premiums: |
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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 |
$399.69 $453.64 $510.79 $713.83 $1,084.73 |
$799.38 $907.28 $1,021.58 $1,427.66 $2,169.46 |
$1,105.14 $1,213.04 $1,327.34 $1,733.42 |
$1,410.90 $1,518.80 $1,633.10 $2,039.18 |
$1,716.66 $1,824.56 $1,938.86 $2,344.94 |
$705.45 $759.40 $816.55 $1,019.59 |
$1,011.21 $1,065.16 $1,122.31 $1,325.35 |
$1,316.97 $1,370.92 $1,428.07 $1,631.11 |
$364.91 |
Plan: (HMO) ProHealth Gold 2000 - Copay $30/$70Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
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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 |
$390.02 $442.67 $498.44 $696.57 $1,058.50 |
$780.04 $885.34 $996.88 $1,393.14 $2,117.00 |
$1,078.40 $1,183.70 $1,295.24 $1,691.50 |
$1,376.76 $1,482.06 $1,593.60 $1,989.86 |
$1,675.12 $1,780.42 $1,891.96 $2,288.22 |
$688.38 $741.03 $796.80 $994.93 |
$986.74 $1,039.39 $1,095.16 $1,293.29 |
$1,285.10 $1,337.75 $1,393.52 $1,591.65 |
$356.08 |
Plan: (HMO) ProHealth Silver 4000 - Copay $45/$90Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$4,000
: Family:
$8,000 Monthly Premiums: |
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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 |
$477.93 $542.44 $610.78 $853.57 $1,297.08 |
$955.86 $1,084.88 $1,221.56 $1,707.14 $2,594.16 |
$1,321.47 $1,450.49 $1,587.17 $2,072.75 |
$1,687.08 $1,816.10 $1,952.78 $2,438.36 |
$2,052.69 $2,181.71 $2,318.39 $2,803.97 |
$843.54 $908.05 $976.39 $1,219.18 |
$1,209.15 $1,273.66 $1,342.00 $1,584.79 |
$1,574.76 $1,639.27 $1,707.61 $1,950.40 |
$436.34 |
Plan: (HMO) ProHealth Bronze 7500 - Copay $80/$160Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$7,500
: Family:
$15,000 Monthly Premiums: |
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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 |
Expanded Bronze | 21 30 40 50 60 |
$296.31 $336.31 $378.68 $529.20 $804.17 |
$592.62 $672.62 $757.36 $1,058.40 $1,608.34 |
$819.29 $899.29 $984.03 $1,285.07 |
$1,045.96 $1,125.96 $1,210.70 $1,511.74 |
$1,272.63 $1,352.63 $1,437.37 $1,738.41 |
$522.98 $562.98 $605.35 $755.87 |
$749.65 $789.65 $832.02 $982.54 |
$976.32 $1,016.32 $1,058.69 $1,209.21 |
$270.53 |
Plan: (HMO) ProHealth Bronze 7900 - Copay $50/$100Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$7,900
: Family:
$15,800 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 |
$288.85 $327.83 $369.14 $515.87 $783.92 |
$577.70 $655.66 $738.28 $1,031.74 $1,567.84 |
$798.66 $876.62 $959.24 $1,252.70 |
$1,019.62 $1,097.58 $1,180.20 $1,473.66 |
$1,240.58 $1,318.54 $1,401.16 $1,694.62 |
$509.81 $548.79 $590.10 $736.83 |
$730.77 $769.75 $811.06 $957.79 |
$951.73 $990.71 $1,032.02 $1,178.75 |
$263.71 |
Plan: (HMO) ProHealth Gold HSA 2000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
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 |
$408.49 $463.63 $522.05 $729.56 $1,108.64 |
$816.98 $927.26 $1,044.10 $1,459.12 $2,217.28 |
$1,129.47 $1,239.75 $1,356.59 $1,771.61 |
$1,441.96 $1,552.24 $1,669.08 $2,084.10 |
$1,754.45 $1,864.73 $1,981.57 $2,396.59 |
$720.98 $776.12 $834.54 $1,042.05 |
$1,033.47 $1,088.61 $1,147.03 $1,354.54 |
$1,345.96 $1,401.10 $1,459.52 $1,667.03 |
$372.95 |
Plan: (HMO) ProHealth Bronze HSA 6750Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$6,750
: Family:
$13,500 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 |
$301.88 $342.62 $385.79 $539.14 $819.28 |
$603.76 $685.24 $771.58 $1,078.28 $1,638.56 |
$834.69 $916.17 $1,002.51 $1,309.21 |
$1,065.62 $1,147.10 $1,233.44 $1,540.14 |
$1,296.55 $1,378.03 $1,464.37 $1,771.07 |
$532.81 $573.55 $616.72 $770.07 |
$763.74 $804.48 $847.65 $1,001.00 |
$994.67 $1,035.41 $1,078.58 $1,231.93 |
$275.61 |
Plan: (HMO) ProHealth CatastrophicSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$7,900
: Family:
$15,800 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 |
$224.13 $254.38 $286.43 $400.29 $608.27 |
$448.26 $508.76 $572.86 $800.58 $1,216.54 |
$619.72 $680.22 $744.32 $972.04 |
$791.18 $851.68 $915.78 $1,143.50 |
$962.64 $1,023.14 $1,087.24 $1,314.96 |
$395.59 $425.84 $457.89 $571.75 |
$567.05 $597.30 $629.35 $743.21 |
$738.51 $768.76 $800.81 $914.67 |
$204.63 |
Plan: (HMO) ProHealth Silver HSA 5250Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$5,250
: Family:
$10,500 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 |
$489.28 $555.33 $625.29 $873.85 $1,327.89 |
$978.56 $1,110.66 $1,250.58 $1,747.70 $2,655.78 |
$1,352.86 $1,484.96 $1,624.88 $2,122.00 |
$1,727.16 $1,859.26 $1,999.18 $2,496.30 |
$2,101.46 $2,233.56 $2,373.48 $2,870.60 |
$863.58 $929.63 $999.59 $1,248.15 |
$1,237.88 $1,303.93 $1,373.89 $1,622.45 |
$1,612.18 $1,678.23 $1,748.19 $1,996.75 |
$446.71 |
Plan: (HMO) ProHealth Gold HSA 3000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
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 |
Gold | 21 30 40 50 60 |
$412.84 $468.56 $527.60 $737.32 $1,120.42 |
$825.68 $937.12 $1,055.20 $1,474.64 $2,240.84 |
$1,141.50 $1,252.94 $1,371.02 $1,790.46 |
$1,457.32 $1,568.76 $1,686.84 $2,106.28 |
$1,773.14 $1,884.58 $2,002.66 $2,422.10 |
$728.66 $784.38 $843.42 $1,053.14 |
$1,044.48 $1,100.20 $1,159.24 $1,368.96 |
$1,360.30 $1,416.02 $1,475.06 $1,684.78 |
$376.92 |
ADVERTISEMENT
|
||||||||||
Dean Health PlanLocal: 1-608-828-1302 | Toll Free: 1-800-279-1302 TTY: 1-608-827-4086 |
||||||||||
Plan: (HMO) Dean Catastrophic Safety NetSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1302 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: Individual:
$7,900
: Family:
$15,800 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 |
$216.71 $245.97 $276.95 $387.04 $588.15 |
$433.42 $491.94 $553.90 $774.08 $1,176.30 |
$599.20 $657.72 $719.68 $939.86 |
$764.98 $823.50 $885.46 $1,105.64 |
$930.76 $989.28 $1,051.24 $1,271.42 |
$382.49 $411.75 $442.73 $552.82 |
$548.27 $577.53 $608.51 $718.60 |
$714.05 $743.31 $774.29 $884.38 |
$197.86 |
Plan: (HMO) Dean Silver Copay Plus 3600XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1302 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: Individual:
$3,600
: Family:
$7,200 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 |
$474.70 $538.78 $606.66 $847.81 $1,288.33 |
$949.40 $1,077.56 $1,213.32 $1,695.62 $2,576.66 |
$1,312.54 $1,440.70 $1,576.46 $2,058.76 |
$1,675.68 $1,803.84 $1,939.60 $2,421.90 |
$2,038.82 $2,166.98 $2,302.74 $2,785.04 |
$837.84 $901.92 $969.80 $1,210.95 |
$1,200.98 $1,265.06 $1,332.94 $1,574.09 |
$1,564.12 $1,628.20 $1,696.08 $1,937.23 |
$433.40 |
Plan: (HMO) Dean Silver Classic 4750XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1302 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: Individual:
$4,750
: Family:
$9,500 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 |
$461.15 $523.40 $589.34 $823.61 $1,251.55 |
$922.30 $1,046.80 $1,178.68 $1,647.22 $2,503.10 |
$1,275.08 $1,399.58 $1,531.46 $2,000.00 |
$1,627.86 $1,752.36 $1,884.24 $2,352.78 |
$1,980.64 $2,105.14 $2,237.02 $2,705.56 |
$813.93 $876.18 $942.12 $1,176.39 |
$1,166.71 $1,228.96 $1,294.90 $1,529.17 |
$1,519.49 $1,581.74 $1,647.68 $1,881.95 |
$421.03 |
Plan: (HMO) Dean Silver Value Copay 5000XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1302 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: Individual:
$5,000
: Family:
$10,000 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 |
$470.06 $533.52 $600.74 $839.53 $1,275.75 |
$940.12 $1,067.04 $1,201.48 $1,679.06 $2,551.50 |
$1,299.72 $1,426.64 $1,561.08 $2,038.66 |
$1,659.32 $1,786.24 $1,920.68 $2,398.26 |
$2,018.92 $2,145.84 $2,280.28 $2,757.86 |
$829.66 $893.12 $960.34 $1,199.13 |
$1,189.26 $1,252.72 $1,319.94 $1,558.73 |
$1,548.86 $1,612.32 $1,679.54 $1,918.33 |
$429.17 |
Plan: (HMO) Dean Gold Value Copay 3500XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1302 - Provider Directory for This Plan: (Dean Health Plan)
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 |
Gold | 21 30 40 50 60 |
$449.11 $509.74 $573.97 $802.12 $1,218.89 |
$898.22 $1,019.48 $1,147.94 $1,604.24 $2,437.78 |
$1,241.79 $1,363.05 $1,491.51 $1,947.81 |
$1,585.36 $1,706.62 $1,835.08 $2,291.38 |
$1,928.93 $2,050.19 $2,178.65 $2,634.95 |
$792.68 $853.31 $917.54 $1,145.69 |
$1,136.25 $1,196.88 $1,261.11 $1,489.26 |
$1,479.82 $1,540.45 $1,604.68 $1,832.83 |
$410.04 |
Plan: (HMO) Dean Bronze Value Copay 7800XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1302 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: Individual:
$7,800
: Family:
$15,600 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 |
Bronze | 21 30 40 50 60 |
$314.41 $356.86 $401.82 $561.54 $853.32 |
$628.82 $713.72 $803.64 $1,123.08 $1,706.64 |
$869.35 $954.25 $1,044.17 $1,363.61 |
$1,109.88 $1,194.78 $1,284.70 $1,604.14 |
$1,350.41 $1,435.31 $1,525.23 $1,844.67 |
$554.94 $597.39 $642.35 $802.07 |
$795.47 $837.92 $882.88 $1,042.60 |
$1,036.00 $1,078.45 $1,123.41 $1,283.13 |
$287.06 |
Plan: (HMO) Dean Silver HSA-E 3500XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1302 - Provider Directory for This Plan: (Dean Health Plan)
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 |
$452.27 $513.32 $578.00 $807.75 $1,227.45 |
$904.54 $1,026.64 $1,156.00 $1,615.50 $2,454.90 |
$1,250.52 $1,372.62 $1,501.98 $1,961.48 |
$1,596.50 $1,718.60 $1,847.96 $2,307.46 |
$1,942.48 $2,064.58 $2,193.94 $2,653.44 |
$798.25 $859.30 $923.98 $1,153.73 |
$1,144.23 $1,205.28 $1,269.96 $1,499.71 |
$1,490.21 $1,551.26 $1,615.94 $1,845.69 |
$412.92 |
Plan: (HMO) Dean Gold Copay Plus 1500XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1302 - Provider Directory for This Plan: (Dean Health Plan)
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 |
$466.95 $529.99 $596.76 $833.97 $1,267.30 |
$933.90 $1,059.98 $1,193.52 $1,667.94 $2,534.60 |
$1,291.12 $1,417.20 $1,550.74 $2,025.16 |
$1,648.34 $1,774.42 $1,907.96 $2,382.38 |
$2,005.56 $2,131.64 $2,265.18 $2,739.60 |
$824.17 $887.21 $953.98 $1,191.19 |
$1,181.39 $1,244.43 $1,311.20 $1,548.41 |
$1,538.61 $1,601.65 $1,668.42 $1,905.63 |
$426.32 |
Plan: (HMO) Dean Bronze HSA-E 6550XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1302 - Provider Directory for This Plan: (Dean Health Plan)
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 |
$310.25 $352.13 $396.50 $554.10 $842.01 |
$620.50 $704.26 $793.00 $1,108.20 $1,684.02 |
$857.84 $941.60 $1,030.34 $1,345.54 |
$1,095.18 $1,178.94 $1,267.68 $1,582.88 |
$1,332.52 $1,416.28 $1,505.02 $1,820.22 |
$547.59 $589.47 $633.84 $791.44 |
$784.93 $826.81 $871.18 $1,028.78 |
$1,022.27 $1,064.15 $1,108.52 $1,266.12 |
$283.26 |
ADVERTISEMENT
|
||||||||||
Molina Healthcare of Wisconsin, Inc.Local: 1-888-560-2043 | Toll Free: 1-888-560-2043 |
||||||||||
Plan: (HMO) Molina GoldSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-560-2043 - Provider Directory for This Plan: (Molina Healthcare of Wisconsin, Inc.)
Deductible: Individual:
$2,925
: Family:
$5,850 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 |
$498.02 $565.25 $636.47 $889.46 $1,351.62 |
$996.04 $1,130.50 $1,272.94 $1,778.92 $2,703.24 |
$1,377.02 $1,511.48 $1,653.92 $2,159.90 |
$1,758.00 $1,892.46 $2,034.90 $2,540.88 |
$2,138.98 $2,273.44 $2,415.88 $2,921.86 |
$879.00 $946.23 $1,017.45 $1,270.44 |
$1,259.98 $1,327.21 $1,398.43 $1,651.42 |
$1,640.96 $1,708.19 $1,779.41 $2,032.40 |
$454.69 |
Plan: (HMO) Molina SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-560-2043 - Provider Directory for This Plan: (Molina Healthcare of Wisconsin, Inc.)
Deductible: Individual:
$5,350
: Family:
$10,700 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 |
$439.94 $499.33 $562.25 $785.74 $1,194.00 |
$879.88 $998.66 $1,124.50 $1,571.48 $2,388.00 |
$1,216.44 $1,335.22 $1,461.06 $1,908.04 |
$1,553.00 $1,671.78 $1,797.62 $2,244.60 |
$1,889.56 $2,008.34 $2,134.18 $2,581.16 |
$776.50 $835.89 $898.81 $1,122.30 |
$1,113.06 $1,172.45 $1,235.37 $1,458.86 |
$1,449.62 $1,509.01 $1,571.93 $1,795.42 |
$401.67 |
ADVERTISEMENT
|
||||||||||
Network Health PlanLocal: 1-920-720-1400x1400 | Toll Free: 1-855-275-1400 TTY: 1-800-947-3529 |
||||||||||
Plan: (HMO) Prestige Bronze 20 HDHPSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-275-1400 - Provider Directory for This Plan: (Network Health Plan)
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 |
$392.21 $445.16 $501.24 $700.48 $1,064.45 |
$784.42 $890.32 $1,002.48 $1,400.96 $2,128.90 |
$1,084.46 $1,190.36 $1,302.52 $1,701.00 |
$1,384.50 $1,490.40 $1,602.56 $2,001.04 |
$1,684.54 $1,790.44 $1,902.60 $2,301.08 |
$692.25 $745.20 $801.28 $1,000.52 |
$992.29 $1,045.24 $1,101.32 $1,300.56 |
$1,292.33 $1,345.28 $1,401.36 $1,600.60 |
$358.09 |
Plan: (HMO) Prestige Silver 20 HDHPSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-275-1400 - Provider Directory for This Plan: (Network Health Plan)
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 |
$565.71 $642.08 $722.97 $1,010.35 $1,535.32 |
$1,131.42 $1,284.16 $1,445.94 $2,020.70 $3,070.64 |
$1,564.19 $1,716.93 $1,878.71 $2,453.47 |
$1,996.96 $2,149.70 $2,311.48 $2,886.24 |
$2,429.73 $2,582.47 $2,744.25 $3,319.01 |
$998.48 $1,074.85 $1,155.74 $1,443.12 |
$1,431.25 $1,507.62 $1,588.51 $1,875.89 |
$1,864.02 $1,940.39 $2,021.28 $2,308.66 |
$516.49 |
Plan: (HMO) Prestige Bronze EssentialSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-275-1400 - Provider Directory for This Plan: (Network Health Plan)
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 |
Expanded Bronze | 21 30 40 50 60 |
$381.40 $432.89 $487.43 $681.18 $1,035.12 |
$762.80 $865.78 $974.86 $1,362.36 $2,070.24 |
$1,054.57 $1,157.55 $1,266.63 $1,654.13 |
$1,346.34 $1,449.32 $1,558.40 $1,945.90 |
$1,638.11 $1,741.09 $1,850.17 $2,237.67 |
$673.17 $724.66 $779.20 $972.95 |
$964.94 $1,016.43 $1,070.97 $1,264.72 |
$1,256.71 $1,308.20 $1,362.74 $1,556.49 |
$348.22 |
Plan: (HMO) Prestige Silver EssentialSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-275-1400 - Provider Directory for This Plan: (Network Health Plan)
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 |
$549.35 $623.51 $702.07 $981.13 $1,490.92 |
$1,098.70 $1,247.02 $1,404.14 $1,962.26 $2,981.84 |
$1,518.95 $1,667.27 $1,824.39 $2,382.51 |
$1,939.20 $2,087.52 $2,244.64 $2,802.76 |
$2,359.45 $2,507.77 $2,664.89 $3,223.01 |
$969.60 $1,043.76 $1,122.32 $1,401.38 |
$1,389.85 $1,464.01 $1,542.57 $1,821.63 |
$1,810.10 $1,884.26 $1,962.82 $2,241.88 |
$501.56 |
Plan: (HMO) Prestige Gold EssentialSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-275-1400 - Provider Directory for This Plan: (Network Health Plan)
Deductible: Individual:
$1,750
: Family:
$3,500 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 |
Gold | 21 30 40 50 60 |
$566.85 $643.37 $724.43 $1,012.38 $1,538.41 |
$1,133.70 $1,286.74 $1,448.86 $2,024.76 $3,076.82 |
$1,567.34 $1,720.38 $1,882.50 $2,458.40 |
$2,000.98 $2,154.02 $2,316.14 $2,892.04 |
$2,434.62 $2,587.66 $2,749.78 $3,325.68 |
$1,000.49 $1,077.01 $1,158.07 $1,446.02 |
$1,434.13 $1,510.65 $1,591.71 $1,879.66 |
$1,867.77 $1,944.29 $2,025.35 $2,313.30 |
$517.53 |
Plan: (HMO) Prestige Bronze 0Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-275-1400 - Provider Directory for This Plan: (Network Health Plan)
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 |
$401.88 $456.13 $513.59 $717.74 $1,090.68 |
$803.76 $912.26 $1,027.18 $1,435.48 $2,181.36 |
$1,111.20 $1,219.70 $1,334.62 $1,742.92 |
$1,418.64 $1,527.14 $1,642.06 $2,050.36 |
$1,726.08 $1,834.58 $1,949.50 $2,357.80 |
$709.32 $763.57 $821.03 $1,025.18 |
$1,016.76 $1,071.01 $1,128.47 $1,332.62 |
$1,324.20 $1,378.45 $1,435.91 $1,640.06 |
$366.91 |
Plan: (HMO) Prestige Bronze 50 HDHPSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-275-1400 - Provider Directory for This Plan: (Network Health Plan)
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 |
Expanded Bronze | 21 30 40 50 60 |
$413.47 $469.29 $528.42 $738.46 $1,122.16 |
$826.94 $938.58 $1,056.84 $1,476.92 $2,244.32 |
$1,143.25 $1,254.89 $1,373.15 $1,793.23 |
$1,459.56 $1,571.20 $1,689.46 $2,109.54 |
$1,775.87 $1,887.51 $2,005.77 $2,425.85 |
$729.78 $785.60 $844.73 $1,054.77 |
$1,046.09 $1,101.91 $1,161.04 $1,371.08 |
$1,362.40 $1,418.22 $1,477.35 $1,687.39 |
$377.50 |
Plan: (HMO) Prestige Gold 50Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-275-1400 - Provider Directory for This Plan: (Network Health Plan)
Deductible: Individual:
$1,000
: Family:
$2,000 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 |
$588.16 $667.56 $751.67 $1,050.45 $1,596.26 |
$1,176.32 $1,335.12 $1,503.34 $2,100.90 $3,192.52 |
$1,626.27 $1,785.07 $1,953.29 $2,550.85 |
$2,076.22 $2,235.02 $2,403.24 $3,000.80 |
$2,526.17 $2,684.97 $2,853.19 $3,450.75 |
$1,038.11 $1,117.51 $1,201.62 $1,500.40 |
$1,488.06 $1,567.46 $1,651.57 $1,950.35 |
$1,938.01 $2,017.41 $2,101.52 $2,400.30 |
$536.99 |
Plan: (HMO) Prestige Gold 0 HDHPSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-275-1400 - Provider Directory for This Plan: (Network Health Plan)
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 |
Gold | 21 30 40 50 60 |
$603.88 $685.40 $771.75 $1,078.52 $1,638.91 |
$1,207.76 $1,370.80 $1,543.50 $2,157.04 $3,277.82 |
$1,669.73 $1,832.77 $2,005.47 $2,619.01 |
$2,131.70 $2,294.74 $2,467.44 $3,080.98 |
$2,593.67 $2,756.71 $2,929.41 $3,542.95 |
$1,065.85 $1,147.37 $1,233.72 $1,540.49 |
$1,527.82 $1,609.34 $1,695.69 $2,002.46 |
$1,989.79 $2,071.31 $2,157.66 $2,464.43 |
$551.34 |
ADVERTISEMENT
|
||||||||||
Common Ground Healthcare CooperativeLocal: 1-877-514-2442 | Toll Free: 1-877-514-2442 TTY: 1-855-643-5001 |
||||||||||
Plan: (EPO) Envision Aurora Bellin ThedaCare CHHS - Gold 2000/80Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-514-2442 - Provider Directory for This Plan: (Common Ground Healthcare Cooperative)
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 |
$454.39 $515.72 $580.69 $811.52 $1,233.18 |
$908.78 $1,031.44 $1,161.38 $1,623.04 $2,466.36 |
$1,256.38 $1,379.04 $1,508.98 $1,970.64 |
$1,603.98 $1,726.64 $1,856.58 $2,318.24 |
$1,951.58 $2,074.24 $2,204.18 $2,665.84 |
$801.99 $863.32 $928.29 $1,159.12 |
$1,149.59 $1,210.92 $1,275.89 $1,506.72 |
$1,497.19 $1,558.52 $1,623.49 $1,854.32 |
$414.85 |
Plan: (EPO) Envision Aurora Bellin ThedaCare CHHS - Silver 4000/75Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-514-2442 - Provider Directory for This Plan: (Common Ground Healthcare Cooperative)
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 |
$453.02 $514.17 $578.95 $809.08 $1,229.48 |
$906.04 $1,028.34 $1,157.90 $1,618.16 $2,458.96 |
$1,252.60 $1,374.90 $1,504.46 $1,964.72 |
$1,599.16 $1,721.46 $1,851.02 $2,311.28 |
$1,945.72 $2,068.02 $2,197.58 $2,657.84 |
$799.58 $860.73 $925.51 $1,155.64 |
$1,146.14 $1,207.29 $1,272.07 $1,502.20 |
$1,492.70 $1,553.85 $1,618.63 $1,848.76 |
$413.60 |
Plan: (EPO) Envision Aurora Bellin ThedaCare CHHS - Silver 3000/75/Copay40Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-514-2442 - Provider Directory for This Plan: (Common Ground Healthcare Cooperative)
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 |
$467.07 $530.12 $596.91 $834.17 $1,267.61 |
$934.14 $1,060.24 $1,193.82 $1,668.34 $2,535.22 |
$1,291.44 $1,417.54 $1,551.12 $2,025.64 |
$1,648.74 $1,774.84 $1,908.42 $2,382.94 |
$2,006.04 $2,132.14 $2,265.72 $2,740.24 |
$824.37 $887.42 $954.21 $1,191.47 |
$1,181.67 $1,244.72 $1,311.51 $1,548.77 |
$1,538.97 $1,602.02 $1,668.81 $1,906.07 |
$426.43 |
Plan: (EPO) Envision Aurora Bellin ThedaCare CHHS - Catastrophic 7900/100Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-514-2442 - Provider Directory for This Plan: (Common Ground Healthcare Cooperative)
Deductible: Individual:
$7,900
: Family:
$15,800 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 |
$228.64 $259.49 $292.18 $408.33 $620.49 |
$457.28 $518.98 $584.36 $816.66 $1,240.98 |
$632.18 $693.88 $759.26 $991.56 |
$807.08 $868.78 $934.16 $1,166.46 |
$981.98 $1,043.68 $1,109.06 $1,341.36 |
$403.54 $434.39 $467.08 $583.23 |
$578.44 $609.29 $641.98 $758.13 |
$753.34 $784.19 $816.88 $933.03 |
$208.74 |
Plan: (EPO) Envision Aurora Bellin ThedaCare CHHS - Bronze 7900/100Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-514-2442 - Provider Directory for This Plan: (Common Ground Healthcare Cooperative)
Deductible: Individual:
$7,900
: Family:
$15,800 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 |
$296.66 $336.70 $379.12 $529.82 $805.11 |
$593.32 $673.40 $758.24 $1,059.64 $1,610.22 |
$820.26 $900.34 $985.18 $1,286.58 |
$1,047.20 $1,127.28 $1,212.12 $1,513.52 |
$1,274.14 $1,354.22 $1,439.06 $1,740.46 |
$523.60 $563.64 $606.06 $756.76 |
$750.54 $790.58 $833.00 $983.70 |
$977.48 $1,017.52 $1,059.94 $1,210.64 |
$270.84 |
Plan: (EPO) Envision Aurora Bellin ThedaCare CHHS - HSA Silver 3500/75Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-514-2442 - Provider Directory for This Plan: (Common Ground Healthcare Cooperative)
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 |
$483.61 $548.88 $618.03 $863.70 $1,312.48 |
$967.22 $1,097.76 $1,236.06 $1,727.40 $2,624.96 |
$1,337.17 $1,467.71 $1,606.01 $2,097.35 |
$1,707.12 $1,837.66 $1,975.96 $2,467.30 |
$2,077.07 $2,207.61 $2,345.91 $2,837.25 |
$853.56 $918.83 $987.98 $1,233.65 |
$1,223.51 $1,288.78 $1,357.93 $1,603.60 |
$1,593.46 $1,658.73 $1,727.88 $1,973.55 |
$441.52 |
Plan: (EPO) Envision Aurora Bellin ThedaCare CHHS - HSA Bronze 6650/100Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-514-2442 - Provider Directory for This Plan: (Common Ground Healthcare Cooperative)
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 |
$318.67 $361.67 $407.24 $569.12 $864.83 |
$637.34 $723.34 $814.48 $1,138.24 $1,729.66 |
$881.11 $967.11 $1,058.25 $1,382.01 |
$1,124.88 $1,210.88 $1,302.02 $1,625.78 |
$1,368.65 $1,454.65 $1,545.79 $1,869.55 |
$562.44 $605.44 $651.01 $812.89 |
$806.21 $849.21 $894.78 $1,056.66 |
$1,049.98 $1,092.98 $1,138.55 $1,300.43 |
$290.93 |
Plan: (EPO) Envision Aurora Bellin ThedaCare CHHS - Silver 6000/75Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-514-2442 - Provider Directory for This Plan: (Common Ground Healthcare Cooperative)
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 |
Silver | 21 30 40 50 60 |
$380.75 $432.14 $486.59 $680.00 $1,033.33 |
$761.50 $864.28 $973.18 $1,360.00 $2,066.66 |
$1,052.77 $1,155.55 $1,264.45 $1,651.27 |
$1,344.04 $1,446.82 $1,555.72 $1,942.54 |
$1,635.31 $1,738.09 $1,846.99 $2,233.81 |
$672.02 $723.41 $777.86 $971.27 |
$963.29 $1,014.68 $1,069.13 $1,262.54 |
$1,254.56 $1,305.95 $1,360.40 $1,553.81 |
$347.62 |
‡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 Waukesha County here.