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 Stark County, Ohio.
Obamacare Providers, Plans and 2019 Rates for Stark County
Stark County is in “Rating Area 15” of Ohio.
Currently, there are 83 plans offered in Rating Area 15.
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 Massillon, OH area accept this insurance coverage as within the plan's "network".
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AultCare Insurance CompanyLocal: 1-330-363-6360 | Toll Free: 1-800-344-8858 TTY: 1-330-363-2393 |
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Plan: (PPO) AultCare Bronze 6000 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,000
: Family:
$12,000 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 |
$356.21 $404.30 $455.23 $636.19 $966.75 |
$712.42 $808.60 $910.46 $1,272.38 $1,933.50 |
$984.92 $1,081.10 $1,182.96 $1,544.88 |
$1,257.42 $1,353.60 $1,455.46 $1,817.38 |
$1,529.92 $1,626.10 $1,727.96 $2,089.88 |
$628.71 $676.80 $727.73 $908.69 |
$901.21 $949.30 $1,000.23 $1,181.19 |
$1,173.71 $1,221.80 $1,272.73 $1,453.69 |
$325.22 |
Plan: (PPO) AultCare Bronze 5000 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
Expanded Bronze | 21 30 40 50 60 |
$372.93 $423.27 $476.60 $666.05 $1,012.13 |
$745.86 $846.54 $953.20 $1,332.10 $2,024.26 |
$1,031.15 $1,131.83 $1,238.49 $1,617.39 |
$1,316.44 $1,417.12 $1,523.78 $1,902.68 |
$1,601.73 $1,702.41 $1,809.07 $2,187.97 |
$658.22 $708.56 $761.89 $951.34 |
$943.51 $993.85 $1,047.18 $1,236.63 |
$1,228.80 $1,279.14 $1,332.47 $1,521.92 |
$340.48 |
Plan: (PPO) AultCare Silver 5000 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
$521.75 $592.18 $666.79 $931.84 $1,416.02 |
$1,043.50 $1,184.36 $1,333.58 $1,863.68 $2,832.04 |
$1,442.64 $1,583.50 $1,732.72 $2,262.82 |
$1,841.78 $1,982.64 $2,131.86 $2,661.96 |
$2,240.92 $2,381.78 $2,531.00 $3,061.10 |
$920.89 $991.32 $1,065.93 $1,330.98 |
$1,320.03 $1,390.46 $1,465.07 $1,730.12 |
$1,719.17 $1,789.60 $1,864.21 $2,129.26 |
$476.35 |
Plan: (PPO) AultCare Gold 1200 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$1,200
: Family:
$2,400 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 |
Gold | 21 30 40 50 60 |
$576.58 $654.41 $736.86 $1,029.76 $1,564.83 |
$1,153.16 $1,308.82 $1,473.72 $2,059.52 $3,129.66 |
$1,594.24 $1,749.90 $1,914.80 $2,500.60 |
$2,035.32 $2,190.98 $2,355.88 $2,941.68 |
$2,476.40 $2,632.06 $2,796.96 $3,382.76 |
$1,017.66 $1,095.49 $1,177.94 $1,470.84 |
$1,458.74 $1,536.57 $1,619.02 $1,911.92 |
$1,899.82 $1,977.65 $2,060.10 $2,353.00 |
$526.41 |
Plan: (PPO) AultCare Gold 750 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$750
: Family:
$1,500 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 |
$576.18 $653.95 $736.35 $1,029.04 $1,563.73 |
$1,152.36 $1,307.90 $1,472.70 $2,058.08 $3,127.46 |
$1,593.13 $1,748.67 $1,913.47 $2,498.85 |
$2,033.90 $2,189.44 $2,354.24 $2,939.62 |
$2,474.67 $2,630.21 $2,795.01 $3,380.39 |
$1,016.95 $1,094.72 $1,177.12 $1,469.81 |
$1,457.72 $1,535.49 $1,617.89 $1,910.58 |
$1,898.49 $1,976.26 $2,058.66 $2,351.35 |
$526.04 |
Plan: (PPO) AultCare Gold 350 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$350
: Family:
$700 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 |
$587.38 $666.67 $750.67 $1,049.06 $1,594.14 |
$1,174.76 $1,333.34 $1,501.34 $2,098.12 $3,188.28 |
$1,624.10 $1,782.68 $1,950.68 $2,547.46 |
$2,073.44 $2,232.02 $2,400.02 $2,996.80 |
$2,522.78 $2,681.36 $2,849.36 $3,446.14 |
$1,036.72 $1,116.01 $1,200.01 $1,498.40 |
$1,486.06 $1,565.35 $1,649.35 $1,947.74 |
$1,935.40 $2,014.69 $2,098.69 $2,397.08 |
$536.28 |
Plan: (PPO) AultCare Catastrophic SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
$190.21 $215.88 $243.08 $339.70 $516.21 |
$380.42 $431.76 $486.16 $679.40 $1,032.42 |
$525.92 $577.26 $631.66 $824.90 |
$671.42 $722.76 $777.16 $970.40 |
$816.92 $868.26 $922.66 $1,115.90 |
$335.71 $361.38 $388.58 $485.20 |
$481.21 $506.88 $534.08 $630.70 |
$626.71 $652.38 $679.58 $776.20 |
$173.65 |
Plan: (PPO) AultCare Bronze 6000 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,000
: Family:
$12,000 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 |
$281.42 $319.40 $359.65 $502.60 $763.76 |
$562.84 $638.80 $719.30 $1,005.20 $1,527.52 |
$778.12 $854.08 $934.58 $1,220.48 |
$993.40 $1,069.36 $1,149.86 $1,435.76 |
$1,208.68 $1,284.64 $1,365.14 $1,651.04 |
$496.70 $534.68 $574.93 $717.88 |
$711.98 $749.96 $790.21 $933.16 |
$927.26 $965.24 $1,005.49 $1,148.44 |
$256.93 |
Plan: (PPO) AultCare Bronze 5000 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
Expanded Bronze | 21 30 40 50 60 |
$294.54 $334.29 $376.41 $526.03 $799.36 |
$589.08 $668.58 $752.82 $1,052.06 $1,598.72 |
$814.40 $893.90 $978.14 $1,277.38 |
$1,039.72 $1,119.22 $1,203.46 $1,502.70 |
$1,265.04 $1,344.54 $1,428.78 $1,728.02 |
$519.86 $559.61 $601.73 $751.35 |
$745.18 $784.93 $827.05 $976.67 |
$970.50 $1,010.25 $1,052.37 $1,201.99 |
$268.91 |
Plan: (PPO) AultCare Silver 5000 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
$411.12 $466.62 $525.41 $734.26 $1,115.78 |
$822.24 $933.24 $1,050.82 $1,468.52 $2,231.56 |
$1,136.75 $1,247.75 $1,365.33 $1,783.03 |
$1,451.26 $1,562.26 $1,679.84 $2,097.54 |
$1,765.77 $1,876.77 $1,994.35 $2,412.05 |
$725.63 $781.13 $839.92 $1,048.77 |
$1,040.14 $1,095.64 $1,154.43 $1,363.28 |
$1,354.65 $1,410.15 $1,468.94 $1,677.79 |
$375.35 |
Plan: (PPO) AultCare Gold 1200 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$1,200
: Family:
$2,400 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 |
Gold | 21 30 40 50 60 |
$455.00 $516.42 $581.48 $812.62 $1,234.85 |
$910.00 $1,032.84 $1,162.96 $1,625.24 $2,469.70 |
$1,258.07 $1,380.91 $1,511.03 $1,973.31 |
$1,606.14 $1,728.98 $1,859.10 $2,321.38 |
$1,954.21 $2,077.05 $2,207.17 $2,669.45 |
$803.07 $864.49 $929.55 $1,160.69 |
$1,151.14 $1,212.56 $1,277.62 $1,508.76 |
$1,499.21 $1,560.63 $1,625.69 $1,856.83 |
$415.41 |
Plan: (PPO) AultCare Gold 750 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$750
: Family:
$1,500 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 |
Gold | 21 30 40 50 60 |
$454.80 $516.20 $581.23 $812.27 $1,234.33 |
$909.60 $1,032.40 $1,162.46 $1,624.54 $2,468.66 |
$1,257.52 $1,380.32 $1,510.38 $1,972.46 |
$1,605.44 $1,728.24 $1,858.30 $2,320.38 |
$1,953.36 $2,076.16 $2,206.22 $2,668.30 |
$802.72 $864.12 $929.15 $1,160.19 |
$1,150.64 $1,212.04 $1,277.07 $1,508.11 |
$1,498.56 $1,559.96 $1,624.99 $1,856.03 |
$415.23 |
Plan: (PPO) AultCare Gold 350 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$350
: Family:
$700 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 |
$463.70 $526.30 $592.61 $828.17 $1,258.48 |
$927.40 $1,052.60 $1,185.22 $1,656.34 $2,516.96 |
$1,282.13 $1,407.33 $1,539.95 $2,011.07 |
$1,636.86 $1,762.06 $1,894.68 $2,365.80 |
$1,991.59 $2,116.79 $2,249.41 $2,720.53 |
$818.43 $881.03 $947.34 $1,182.90 |
$1,173.16 $1,235.76 $1,302.07 $1,537.63 |
$1,527.89 $1,590.49 $1,656.80 $1,892.36 |
$423.36 |
Plan: (PPO) AultCare CatastrophicSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
$243.46 $276.33 $311.14 $434.82 $660.75 |
$486.92 $552.66 $622.28 $869.64 $1,321.50 |
$673.17 $738.91 $808.53 $1,055.89 |
$859.42 $925.16 $994.78 $1,242.14 |
$1,045.67 $1,111.41 $1,181.03 $1,428.39 |
$429.71 $462.58 $497.39 $621.07 |
$615.96 $648.83 $683.64 $807.32 |
$802.21 $835.08 $869.89 $993.57 |
$222.28 |
Plan: (PPO) AultCare Bronze 6000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,000
: Family:
$12,000 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 |
$360.21 $408.84 $460.35 $643.33 $977.61 |
$720.42 $817.68 $920.70 $1,286.66 $1,955.22 |
$995.98 $1,093.24 $1,196.26 $1,562.22 |
$1,271.54 $1,368.80 $1,471.82 $1,837.78 |
$1,547.10 $1,644.36 $1,747.38 $2,113.34 |
$635.77 $684.40 $735.91 $918.89 |
$911.33 $959.96 $1,011.47 $1,194.45 |
$1,186.89 $1,235.52 $1,287.03 $1,470.01 |
$328.87 |
Plan: (PPO) AultCare Bronze 5000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
Expanded Bronze | 21 30 40 50 60 |
$377.00 $427.89 $481.80 $673.32 $1,023.17 |
$754.00 $855.78 $963.60 $1,346.64 $2,046.34 |
$1,042.40 $1,144.18 $1,252.00 $1,635.04 |
$1,330.80 $1,432.58 $1,540.40 $1,923.44 |
$1,619.20 $1,720.98 $1,828.80 $2,211.84 |
$665.40 $716.29 $770.20 $961.72 |
$953.80 $1,004.69 $1,058.60 $1,250.12 |
$1,242.20 $1,293.09 $1,347.00 $1,538.52 |
$344.20 |
Plan: (PPO) AultCare Silver 5000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
$526.24 $597.27 $672.52 $939.85 $1,428.19 |
$1,052.48 $1,194.54 $1,345.04 $1,879.70 $2,856.38 |
$1,455.05 $1,597.11 $1,747.61 $2,282.27 |
$1,857.62 $1,999.68 $2,150.18 $2,684.84 |
$2,260.19 $2,402.25 $2,552.75 $3,087.41 |
$928.81 $999.84 $1,075.09 $1,342.42 |
$1,331.38 $1,402.41 $1,477.66 $1,744.99 |
$1,733.95 $1,804.98 $1,880.23 $2,147.56 |
$480.45 |
Plan: (PPO) AultCare Gold 1200Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$1,200
: Family:
$2,400 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 |
$582.39 $661.01 $744.29 $1,040.15 $1,580.60 |
$1,164.78 $1,322.02 $1,488.58 $2,080.30 $3,161.20 |
$1,610.31 $1,767.55 $1,934.11 $2,525.83 |
$2,055.84 $2,213.08 $2,379.64 $2,971.36 |
$2,501.37 $2,658.61 $2,825.17 $3,416.89 |
$1,027.92 $1,106.54 $1,189.82 $1,485.68 |
$1,473.45 $1,552.07 $1,635.35 $1,931.21 |
$1,918.98 $1,997.60 $2,080.88 $2,376.74 |
$531.72 |
Plan: (PPO) AultCare Gold 750Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$750
: Family:
$1,500 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 |
$582.15 $660.73 $743.98 $1,039.71 $1,579.94 |
$1,164.30 $1,321.46 $1,487.96 $2,079.42 $3,159.88 |
$1,609.64 $1,766.80 $1,933.30 $2,524.76 |
$2,054.98 $2,212.14 $2,378.64 $2,970.10 |
$2,500.32 $2,657.48 $2,823.98 $3,415.44 |
$1,027.49 $1,106.07 $1,189.32 $1,485.05 |
$1,472.83 $1,551.41 $1,634.66 $1,930.39 |
$1,918.17 $1,996.75 $2,080.00 $2,375.73 |
$531.50 |
Plan: (PPO) AultCare Gold 350Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$350
: Family:
$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 |
Gold | 21 30 40 50 60 |
$593.54 $673.66 $758.54 $1,060.05 $1,610.85 |
$1,187.08 $1,347.32 $1,517.08 $2,120.10 $3,221.70 |
$1,641.13 $1,801.37 $1,971.13 $2,574.15 |
$2,095.18 $2,255.42 $2,425.18 $3,028.20 |
$2,549.23 $2,709.47 $2,879.23 $3,482.25 |
$1,047.59 $1,127.71 $1,212.59 $1,514.10 |
$1,501.64 $1,581.76 $1,666.64 $1,968.15 |
$1,955.69 $2,035.81 $2,120.69 $2,422.20 |
$541.90 |
Plan: (PPO) AultCare Catastrophic No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
$240.87 $273.38 $307.83 $430.19 $653.71 |
$481.74 $546.76 $615.66 $860.38 $1,307.42 |
$666.00 $731.02 $799.92 $1,044.64 |
$850.26 $915.28 $984.18 $1,228.90 |
$1,034.52 $1,099.54 $1,168.44 $1,413.16 |
$425.13 $457.64 $492.09 $614.45 |
$609.39 $641.90 $676.35 $798.71 |
$793.65 $826.16 $860.61 $982.97 |
$219.91 |
Plan: (PPO) AultCare Gold 350 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$350
: Family:
$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 |
Gold | 21 30 40 50 60 |
$458.89 $520.84 $586.46 $819.58 $1,245.42 |
$917.78 $1,041.68 $1,172.92 $1,639.16 $2,490.84 |
$1,268.83 $1,392.73 $1,523.97 $1,990.21 |
$1,619.88 $1,743.78 $1,875.02 $2,341.26 |
$1,970.93 $2,094.83 $2,226.07 $2,692.31 |
$809.94 $871.89 $937.51 $1,170.63 |
$1,160.99 $1,222.94 $1,288.56 $1,521.68 |
$1,512.04 $1,573.99 $1,639.61 $1,872.73 |
$418.97 |
Plan: (PPO) AultCare Gold 750 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$750
: Family:
$1,500 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 |
$450.14 $510.90 $575.27 $803.94 $1,221.66 |
$900.28 $1,021.80 $1,150.54 $1,607.88 $2,443.32 |
$1,244.63 $1,366.15 $1,494.89 $1,952.23 |
$1,588.98 $1,710.50 $1,839.24 $2,296.58 |
$1,933.33 $2,054.85 $2,183.59 $2,640.93 |
$794.49 $855.25 $919.62 $1,148.29 |
$1,138.84 $1,199.60 $1,263.97 $1,492.64 |
$1,483.19 $1,543.95 $1,608.32 $1,836.99 |
$410.97 |
Plan: (PPO) AultCare Gold 1200 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$1,200
: Family:
$2,400 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 |
$450.45 $511.26 $575.67 $804.50 $1,222.52 |
$900.90 $1,022.52 $1,151.34 $1,609.00 $2,445.04 |
$1,245.49 $1,367.11 $1,495.93 $1,953.59 |
$1,590.08 $1,711.70 $1,840.52 $2,298.18 |
$1,934.67 $2,056.29 $2,185.11 $2,642.77 |
$795.04 $855.85 $920.26 $1,149.09 |
$1,139.63 $1,200.44 $1,264.85 $1,493.68 |
$1,484.22 $1,545.03 $1,609.44 $1,838.27 |
$411.26 |
Plan: (PPO) AultCare Silver 5000 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
$407.62 $462.64 $520.93 $728.00 $1,106.26 |
$815.24 $925.28 $1,041.86 $1,456.00 $2,212.52 |
$1,127.06 $1,237.10 $1,353.68 $1,767.82 |
$1,438.88 $1,548.92 $1,665.50 $2,079.64 |
$1,750.70 $1,860.74 $1,977.32 $2,391.46 |
$719.44 $774.46 $832.75 $1,039.82 |
$1,031.26 $1,086.28 $1,144.57 $1,351.64 |
$1,343.08 $1,398.10 $1,456.39 $1,663.46 |
$372.15 |
Plan: (PPO) AultCare Bronze 5000 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
Expanded Bronze | 21 30 40 50 60 |
$291.35 $330.68 $372.34 $520.35 $790.72 |
$582.70 $661.36 $744.68 $1,040.70 $1,581.44 |
$805.58 $884.24 $967.56 $1,263.58 |
$1,028.46 $1,107.12 $1,190.44 $1,486.46 |
$1,251.34 $1,330.00 $1,413.32 $1,709.34 |
$514.23 $553.56 $595.22 $743.23 |
$737.11 $776.44 $818.10 $966.11 |
$959.99 $999.32 $1,040.98 $1,188.99 |
$266.00 |
Plan: (PPO) AultCare Bronze 6000 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
Expanded Bronze | 21 30 40 50 60 |
$278.29 $315.86 $355.65 $497.02 $755.27 |
$556.58 $631.72 $711.30 $994.04 $1,510.54 |
$769.47 $844.61 $924.19 $1,206.93 |
$982.36 $1,057.50 $1,137.08 $1,419.82 |
$1,195.25 $1,270.39 $1,349.97 $1,632.71 |
$491.18 $528.75 $568.54 $709.91 |
$704.07 $741.64 $781.43 $922.80 |
$916.96 $954.53 $994.32 $1,135.69 |
$254.08 |
Plan: (PPO) AultCare Catastrophic Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
$188.18 $213.58 $240.49 $336.08 $510.71 |
$376.36 $427.16 $480.98 $672.16 $1,021.42 |
$520.31 $571.11 $624.93 $816.11 |
$664.26 $715.06 $768.88 $960.06 |
$808.21 $859.01 $912.83 $1,104.01 |
$332.13 $357.53 $384.44 $480.03 |
$476.08 $501.48 $528.39 $623.98 |
$620.03 $645.43 $672.34 $767.93 |
$171.80 |
Plan: (PPO) AultCare Silver 6850Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,850
: Family:
$13,700 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 |
$453.18 $514.36 $579.16 $809.37 $1,229.92 |
$906.36 $1,028.72 $1,158.32 $1,618.74 $2,459.84 |
$1,253.04 $1,375.40 $1,505.00 $1,965.42 |
$1,599.72 $1,722.08 $1,851.68 $2,312.10 |
$1,946.40 $2,068.76 $2,198.36 $2,658.78 |
$799.86 $861.04 $925.84 $1,156.05 |
$1,146.54 $1,207.72 $1,272.52 $1,502.73 |
$1,493.22 $1,554.40 $1,619.20 $1,849.41 |
$413.75 |
Plan: (PPO) AultCare Silver 6850 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,850
: Family:
$13,700 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 |
$354.05 $401.84 $452.47 $632.32 $960.88 |
$708.10 $803.68 $904.94 $1,264.64 $1,921.76 |
$978.94 $1,074.52 $1,175.78 $1,535.48 |
$1,249.78 $1,345.36 $1,446.62 $1,806.32 |
$1,520.62 $1,616.20 $1,717.46 $2,077.16 |
$624.89 $672.68 $723.31 $903.16 |
$895.73 $943.52 $994.15 $1,174.00 |
$1,166.57 $1,214.36 $1,264.99 $1,444.84 |
$323.24 |
Plan: (PPO) AultCare Silver 6850 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,850
: Family:
$13,700 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 |
$448.37 $508.90 $573.02 $800.79 $1,216.87 |
$896.74 $1,017.80 $1,146.04 $1,601.58 $2,433.74 |
$1,239.74 $1,360.80 $1,489.04 $1,944.58 |
$1,582.74 $1,703.80 $1,832.04 $2,287.58 |
$1,925.74 $2,046.80 $2,175.04 $2,630.58 |
$791.37 $851.90 $916.02 $1,143.79 |
$1,134.37 $1,194.90 $1,259.02 $1,486.79 |
$1,477.37 $1,537.90 $1,602.02 $1,829.79 |
$409.36 |
Plan: (PPO) AultCare Silver 6850 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,850
: Family:
$13,700 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 |
$350.29 $397.58 $447.67 $625.61 $950.68 |
$700.58 $795.16 $895.34 $1,251.22 $1,901.36 |
$968.55 $1,063.13 $1,163.31 $1,519.19 |
$1,236.52 $1,331.10 $1,431.28 $1,787.16 |
$1,504.49 $1,599.07 $1,699.25 $2,055.13 |
$618.26 $665.55 $715.64 $893.58 |
$886.23 $933.52 $983.61 $1,161.55 |
$1,154.20 $1,201.49 $1,251.58 $1,429.52 |
$319.81 |
Plan: (PPO) AultCare Bronze 6550Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
Expanded Bronze | 21 30 40 50 60 |
$357.80 $406.10 $457.26 $639.02 $971.06 |
$715.60 $812.20 $914.52 $1,278.04 $1,942.12 |
$989.31 $1,085.91 $1,188.23 $1,551.75 |
$1,263.02 $1,359.62 $1,461.94 $1,825.46 |
$1,536.73 $1,633.33 $1,735.65 $2,099.17 |
$631.51 $679.81 $730.97 $912.73 |
$905.22 $953.52 $1,004.68 $1,186.44 |
$1,178.93 $1,227.23 $1,278.39 $1,460.15 |
$326.67 |
Plan: (PPO) AultCare Bronze 6550 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
Expanded Bronze | 21 30 40 50 60 |
$279.53 $317.26 $357.24 $499.24 $758.64 |
$559.06 $634.52 $714.48 $998.48 $1,517.28 |
$772.90 $848.36 $928.32 $1,212.32 |
$986.74 $1,062.20 $1,142.16 $1,426.16 |
$1,200.58 $1,276.04 $1,356.00 $1,640.00 |
$493.37 $531.10 $571.08 $713.08 |
$707.21 $744.94 $784.92 $926.92 |
$921.05 $958.78 $998.76 $1,140.76 |
$255.21 |
Plan: (PPO) AultCare Bronze 6550 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
Expanded Bronze | 21 30 40 50 60 |
$353.99 $401.77 $452.40 $632.22 $960.72 |
$707.98 $803.54 $904.80 $1,264.44 $1,921.44 |
$978.78 $1,074.34 $1,175.60 $1,535.24 |
$1,249.58 $1,345.14 $1,446.40 $1,806.04 |
$1,520.38 $1,615.94 $1,717.20 $2,076.84 |
$624.79 $672.57 $723.20 $903.02 |
$895.59 $943.37 $994.00 $1,173.82 |
$1,166.39 $1,214.17 $1,264.80 $1,444.62 |
$323.19 |
Plan: (PPO) AultCare Bronze 6550 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
Expanded Bronze | 21 30 40 50 60 |
$276.56 $313.89 $353.43 $493.92 $750.56 |
$553.12 $627.78 $706.86 $987.84 $1,501.12 |
$764.68 $839.34 $918.42 $1,199.40 |
$976.24 $1,050.90 $1,129.98 $1,410.96 |
$1,187.80 $1,262.46 $1,341.54 $1,622.52 |
$488.12 $525.45 $564.99 $705.48 |
$699.68 $737.01 $776.55 $917.04 |
$911.24 $948.57 $988.11 $1,128.60 |
$252.49 |
Plan: (PPO) AultCare Bronze Standard Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
Expanded Bronze | 21 30 40 50 60 |
$269.38 $305.74 $344.26 $481.10 $731.08 |
$538.76 $611.48 $688.52 $962.20 $1,462.16 |
$744.83 $817.55 $894.59 $1,168.27 |
$950.90 $1,023.62 $1,100.66 $1,374.34 |
$1,156.97 $1,229.69 $1,306.73 $1,580.41 |
$475.45 $511.81 $550.33 $687.17 |
$681.52 $717.88 $756.40 $893.24 |
$887.59 $923.95 $962.47 $1,099.31 |
$245.94 |
Plan: (PPO) AultCare Bronze 7350Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$7,350
: Family:
$14,700 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 |
Bronze | 21 30 40 50 60 |
$313.76 $356.12 $400.98 $560.37 $851.54 |
$627.52 $712.24 $801.96 $1,120.74 $1,703.08 |
$867.54 $952.26 $1,041.98 $1,360.76 |
$1,107.56 $1,192.28 $1,282.00 $1,600.78 |
$1,347.58 $1,432.30 $1,522.02 $1,840.80 |
$553.78 $596.14 $641.00 $800.39 |
$793.80 $836.16 $881.02 $1,040.41 |
$1,033.82 $1,076.18 $1,121.04 $1,280.43 |
$286.46 |
Plan: (PPO) AultCare Bronze 7350 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$7,350
: Family:
$14,700 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 |
Bronze | 21 30 40 50 60 |
$245.13 $278.21 $313.27 $437.79 $665.26 |
$490.26 $556.42 $626.54 $875.58 $1,330.52 |
$677.78 $743.94 $814.06 $1,063.10 |
$865.30 $931.46 $1,001.58 $1,250.62 |
$1,052.82 $1,118.98 $1,189.10 $1,438.14 |
$432.65 $465.73 $500.79 $625.31 |
$620.17 $653.25 $688.31 $812.83 |
$807.69 $840.77 $875.83 $1,000.35 |
$223.80 |
Plan: (PPO) AultCare Bronze 7350 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$7,350
: Family:
$14,700 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 |
Bronze | 21 30 40 50 60 |
$310.31 $352.20 $396.57 $554.21 $842.17 |
$620.62 $704.40 $793.14 $1,108.42 $1,684.34 |
$858.00 $941.78 $1,030.52 $1,345.80 |
$1,095.38 $1,179.16 $1,267.90 $1,583.18 |
$1,332.76 $1,416.54 $1,505.28 $1,820.56 |
$547.69 $589.58 $633.95 $791.59 |
$785.07 $826.96 $871.33 $1,028.97 |
$1,022.45 $1,064.34 $1,108.71 $1,266.35 |
$283.31 |
Plan: (PPO) AultCare Bronze 7350 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$7,350
: Family:
$14,700 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 |
Bronze | 21 30 40 50 60 |
$242.43 $275.15 $309.82 $432.97 $657.95 |
$484.86 $550.30 $619.64 $865.94 $1,315.90 |
$670.32 $735.76 $805.10 $1,051.40 |
$855.78 $921.22 $990.56 $1,236.86 |
$1,041.24 $1,106.68 $1,176.02 $1,422.32 |
$427.89 $460.61 $495.28 $618.43 |
$613.35 $646.07 $680.74 $803.89 |
$798.81 $831.53 $866.20 $989.35 |
$221.34 |
Plan: (PPO) AultCare Bronze 7900Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
$297.63 $337.80 $380.36 $531.56 $807.75 |
$595.26 $675.60 $760.72 $1,063.12 $1,615.50 |
$822.94 $903.28 $988.40 $1,290.80 |
$1,050.62 $1,130.96 $1,216.08 $1,518.48 |
$1,278.30 $1,358.64 $1,443.76 $1,746.16 |
$525.31 $565.48 $608.04 $759.24 |
$752.99 $793.16 $835.72 $986.92 |
$980.67 $1,020.84 $1,063.40 $1,214.60 |
$271.73 |
Plan: (PPO) AultCare Bronze 7900 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
$232.52 $263.91 $297.16 $415.28 $631.06 |
$465.04 $527.82 $594.32 $830.56 $1,262.12 |
$642.92 $705.70 $772.20 $1,008.44 |
$820.80 $883.58 $950.08 $1,186.32 |
$998.68 $1,061.46 $1,127.96 $1,364.20 |
$410.40 $441.79 $475.04 $593.16 |
$588.28 $619.67 $652.92 $771.04 |
$766.16 $797.55 $830.80 $948.92 |
$212.29 |
Plan: (PPO) AultCare Bronze 7900 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
$294.39 $334.13 $376.22 $525.77 $798.96 |
$588.78 $668.26 $752.44 $1,051.54 $1,597.92 |
$813.98 $893.46 $977.64 $1,276.74 |
$1,039.18 $1,118.66 $1,202.84 $1,501.94 |
$1,264.38 $1,343.86 $1,428.04 $1,727.14 |
$519.59 $559.33 $601.42 $750.97 |
$744.79 $784.53 $826.62 $976.17 |
$969.99 $1,009.73 $1,051.82 $1,201.37 |
$268.77 |
Plan: (PPO) AultCare Bronze 7900 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
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 |
$229.99 $261.04 $293.93 $410.76 $624.19 |
$459.98 $522.08 $587.86 $821.52 $1,248.38 |
$635.92 $698.02 $763.80 $997.46 |
$811.86 $873.96 $939.74 $1,173.40 |
$987.80 $1,049.90 $1,115.68 $1,349.34 |
$405.93 $436.98 $469.87 $586.70 |
$581.87 $612.92 $645.81 $762.64 |
$757.81 $788.86 $821.75 $938.58 |
$209.98 |
ADVERTISEMENT
|
||||||||||
Buckeye Community Health PlanLocal: 1-877-687-1189 | Toll Free: 1-877-687-1189 TTY: 1-877-941-9236 |
||||||||||
Plan: (HMO) Ambetter Secure Care 1 (2019) with 3 Free PCP VisitsSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community 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 |
$303.53 $344.49 $387.90 $542.08 $823.75 |
$607.06 $688.98 $775.80 $1,084.16 $1,647.50 |
$839.25 $921.17 $1,007.99 $1,316.35 |
$1,071.44 $1,153.36 $1,240.18 $1,548.54 |
$1,303.63 $1,385.55 $1,472.37 $1,780.73 |
$535.72 $576.68 $620.09 $774.27 |
$767.91 $808.87 $852.28 $1,006.46 |
$1,000.10 $1,041.06 $1,084.47 $1,238.65 |
$277.11 |
Plan: (HMO) Ambetter Balanced Care 1 (2019)Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)
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 |
$271.11 $307.70 $346.47 $484.19 $735.77 |
$542.22 $615.40 $692.94 $968.38 $1,471.54 |
$749.61 $822.79 $900.33 $1,175.77 |
$957.00 $1,030.18 $1,107.72 $1,383.16 |
$1,164.39 $1,237.57 $1,315.11 $1,590.55 |
$478.50 $515.09 $553.86 $691.58 |
$685.89 $722.48 $761.25 $898.97 |
$893.28 $929.87 $968.64 $1,106.36 |
$247.52 |
Plan: (HMO) Ambetter Balanced Care 2 (2019)Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community 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 |
Silver | 21 30 40 50 60 |
$267.90 $304.05 $342.36 $478.45 $727.05 |
$535.80 $608.10 $684.72 $956.90 $1,454.10 |
$740.73 $813.03 $889.65 $1,161.83 |
$945.66 $1,017.96 $1,094.58 $1,366.76 |
$1,150.59 $1,222.89 $1,299.51 $1,571.69 |
$472.83 $508.98 $547.29 $683.38 |
$677.76 $713.91 $752.22 $888.31 |
$882.69 $918.84 $957.15 $1,093.24 |
$244.58 |
Plan: (HMO) Ambetter Balanced Care 11 (2019)Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community 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 |
Silver | 21 30 40 50 60 |
$244.86 $277.90 $312.92 $437.30 $664.52 |
$489.72 $555.80 $625.84 $874.60 $1,329.04 |
$677.03 $743.11 $813.15 $1,061.91 |
$864.34 $930.42 $1,000.46 $1,249.22 |
$1,051.65 $1,117.73 $1,187.77 $1,436.53 |
$432.17 $465.21 $500.23 $624.61 |
$619.48 $652.52 $687.54 $811.92 |
$806.79 $839.83 $874.85 $999.23 |
$223.55 |
Plan: (HMO) Ambetter Balanced Care 5 (2019)Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)
Deductible: Individual:
$7,350
: Family:
$14,700 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 |
$248.07 $281.55 $317.03 $443.04 $673.25 |
$496.14 $563.10 $634.06 $886.08 $1,346.50 |
$685.91 $752.87 $823.83 $1,075.85 |
$875.68 $942.64 $1,013.60 $1,265.62 |
$1,065.45 $1,132.41 $1,203.37 $1,455.39 |
$437.84 $471.32 $506.80 $632.81 |
$627.61 $661.09 $696.57 $822.58 |
$817.38 $850.86 $886.34 $1,012.35 |
$226.48 |
Plan: (HMO) Ambetter Balanced Care 1 (2019) + VisionSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)
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 |
$274.15 $311.15 $350.35 $489.61 $744.01 |
$548.30 $622.30 $700.70 $979.22 $1,488.02 |
$758.02 $832.02 $910.42 $1,188.94 |
$967.74 $1,041.74 $1,120.14 $1,398.66 |
$1,177.46 $1,251.46 $1,329.86 $1,608.38 |
$483.87 $520.87 $560.07 $699.33 |
$693.59 $730.59 $769.79 $909.05 |
$903.31 $940.31 $979.51 $1,118.77 |
$250.29 |
Plan: (HMO) Ambetter Balanced Care 2 (2019) + VisionSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community 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 |
Silver | 21 30 40 50 60 |
$270.90 $307.46 $346.19 $483.80 $735.19 |
$541.80 $614.92 $692.38 $967.60 $1,470.38 |
$749.03 $822.15 $899.61 $1,174.83 |
$956.26 $1,029.38 $1,106.84 $1,382.06 |
$1,163.49 $1,236.61 $1,314.07 $1,589.29 |
$478.13 $514.69 $553.42 $691.03 |
$685.36 $721.92 $760.65 $898.26 |
$892.59 $929.15 $967.88 $1,105.49 |
$247.32 |
Plan: (HMO) Ambetter Balanced Care 1 (2019) + Vision + Adult DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)
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 |
$283.01 $321.21 $361.68 $505.44 $768.07 |
$566.02 $642.42 $723.36 $1,010.88 $1,536.14 |
$782.52 $858.92 $939.86 $1,227.38 |
$999.02 $1,075.42 $1,156.36 $1,443.88 |
$1,215.52 $1,291.92 $1,372.86 $1,660.38 |
$499.51 $537.71 $578.18 $721.94 |
$716.01 $754.21 $794.68 $938.44 |
$932.51 $970.71 $1,011.18 $1,154.94 |
$258.38 |
Plan: (HMO) Ambetter Balanced Care 2 (2019) + Vision + Adult DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community 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 |
Silver | 21 30 40 50 60 |
$279.66 $317.40 $357.39 $499.45 $758.96 |
$559.32 $634.80 $714.78 $998.90 $1,517.92 |
$773.25 $848.73 $928.71 $1,212.83 |
$987.18 $1,062.66 $1,142.64 $1,426.76 |
$1,201.11 $1,276.59 $1,356.57 $1,640.69 |
$493.59 $531.33 $571.32 $713.38 |
$707.52 $745.26 $785.25 $927.31 |
$921.45 $959.19 $999.18 $1,141.24 |
$255.32 |
ADVERTISEMENT
|
||||||||||
Summa Insurance Company, Inc.Local: 1-330-996-8675 | Toll Free: 1-888-996-8675 TTY: 1-800-750-0750 |
||||||||||
Plan: (HMO) SummaCare Value with SCConnect Network and 3 Free PCP VisitsSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-996-8675 - Provider Directory for This Plan: (Summa Insurance Company, Inc.)
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 |
$217.03 $246.31 $277.35 $387.59 $588.98 |
$434.06 $492.62 $554.70 $775.18 $1,177.96 |
$600.08 $658.64 $720.72 $941.20 |
$766.10 $824.66 $886.74 $1,107.22 |
$932.12 $990.68 $1,052.76 $1,273.24 |
$383.05 $412.33 $443.37 $553.61 |
$549.07 $578.35 $609.39 $719.63 |
$715.09 $744.37 $775.41 $885.65 |
$198.14 |
Plan: (HMO) SummaCare Bronze 7900 with SCConnect Network and 3 Free PCP VisitsSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-996-8675 - Provider Directory for This Plan: (Summa Insurance Company, Inc.)
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 |
$274.71 $311.79 $351.07 $490.62 $745.55 |
$549.42 $623.58 $702.14 $981.24 $1,491.10 |
$759.57 $833.73 $912.29 $1,191.39 |
$969.72 $1,043.88 $1,122.44 $1,401.54 |
$1,179.87 $1,254.03 $1,332.59 $1,611.69 |
$484.86 $521.94 $561.22 $700.77 |
$695.01 $732.09 $771.37 $910.92 |
$905.16 $942.24 $981.52 $1,121.07 |
$250.80 |
Plan: (HMO) SummaCare Silver 3500 with SCConnect Network and 3 Free PCP VisitsSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-996-8675 - Provider Directory for This Plan: (Summa Insurance Company, 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 |
$380.47 $431.83 $486.23 $679.51 $1,032.58 |
$760.94 $863.66 $972.46 $1,359.02 $2,065.16 |
$1,052.00 $1,154.72 $1,263.52 $1,650.08 |
$1,343.06 $1,445.78 $1,554.58 $1,941.14 |
$1,634.12 $1,736.84 $1,845.64 $2,232.20 |
$671.53 $722.89 $777.29 $970.57 |
$962.59 $1,013.95 $1,068.35 $1,261.63 |
$1,253.65 $1,305.01 $1,359.41 $1,552.69 |
$347.36 |
Plan: (HMO) SummaCare Silver 5000 with SCConnect Network and 3 Free PCP VisitsSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-996-8675 - Provider Directory for This Plan: (Summa Insurance Company, Inc.)
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 |
$379.65 $430.89 $485.18 $678.04 $1,030.34 |
$759.30 $861.78 $970.36 $1,356.08 $2,060.68 |
$1,049.72 $1,152.20 $1,260.78 $1,646.50 |
$1,340.14 $1,442.62 $1,551.20 $1,936.92 |
$1,630.56 $1,733.04 $1,841.62 $2,227.34 |
$670.07 $721.31 $775.60 $968.46 |
$960.49 $1,011.73 $1,066.02 $1,258.88 |
$1,250.91 $1,302.15 $1,356.44 $1,549.30 |
$346.61 |
Plan: (HMO) SummaCare Silver 5000 40 with SCConnect NetworkSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-996-8675 - Provider Directory for This Plan: (Summa Insurance Company, Inc.)
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 |
$337.35 $382.88 $431.12 $602.48 $915.53 |
$674.70 $765.76 $862.24 $1,204.96 $1,831.06 |
$932.76 $1,023.82 $1,120.30 $1,463.02 |
$1,190.82 $1,281.88 $1,378.36 $1,721.08 |
$1,448.88 $1,539.94 $1,636.42 $1,979.14 |
$595.41 $640.94 $689.18 $860.54 |
$853.47 $899.00 $947.24 $1,118.60 |
$1,111.53 $1,157.06 $1,205.30 $1,376.66 |
$307.99 |
Plan: (HMO) SummaCare Gold 750 with SCConnect and 3 Free PCP VisitsSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-996-8675 - Provider Directory for This Plan: (Summa Insurance Company, Inc.)
Deductible: Individual:
$750
: Family:
$1,500 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 |
$409.04 $464.25 $522.74 $730.53 $1,110.12 |
$818.08 $928.50 $1,045.48 $1,461.06 $2,220.24 |
$1,130.99 $1,241.41 $1,358.39 $1,773.97 |
$1,443.90 $1,554.32 $1,671.30 $2,086.88 |
$1,756.81 $1,867.23 $1,984.21 $2,399.79 |
$721.95 $777.16 $835.65 $1,043.44 |
$1,034.86 $1,090.07 $1,148.56 $1,356.35 |
$1,347.77 $1,402.98 $1,461.47 $1,669.26 |
$373.45 |
Plan: (HMO) SummaCare Bronze 6650 HSA with SCConnect NetworkSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-996-8675 - Provider Directory for This Plan: (Summa Insurance Company, 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 |
$296.96 $337.04 $379.51 $530.36 $805.93 |
$593.92 $674.08 $759.02 $1,060.72 $1,611.86 |
$821.09 $901.25 $986.19 $1,287.89 |
$1,048.26 $1,128.42 $1,213.36 $1,515.06 |
$1,275.43 $1,355.59 $1,440.53 $1,742.23 |
$524.13 $564.21 $606.68 $757.53 |
$751.30 $791.38 $833.85 $984.70 |
$978.47 $1,018.55 $1,061.02 $1,211.87 |
$271.12 |
ADVERTISEMENT
|
||||||||||
Molina Healthcare of Ohio, Inc.Local: 1-888-296-7677 | Toll Free: 1-888-296-7677 |
||||||||||
Plan: (HMO) Molina GoldSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-296-7677 - Provider Directory for This Plan: (Molina Healthcare of Ohio, 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 |
$354.73 $402.62 $453.35 $633.55 $962.74 |
$709.46 $805.24 $906.70 $1,267.10 $1,925.48 |
$980.83 $1,076.61 $1,178.07 $1,538.47 |
$1,252.20 $1,347.98 $1,449.44 $1,809.84 |
$1,523.57 $1,619.35 $1,720.81 $2,081.21 |
$626.10 $673.99 $724.72 $904.92 |
$897.47 $945.36 $996.09 $1,176.29 |
$1,168.84 $1,216.73 $1,267.46 $1,447.66 |
$323.87 |
Plan: (HMO) Molina SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-296-7677 - Provider Directory for This Plan: (Molina Healthcare of Ohio, 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 |
$315.43 $358.01 $403.12 $563.36 $856.08 |
$630.86 $716.02 $806.24 $1,126.72 $1,712.16 |
$872.16 $957.32 $1,047.54 $1,368.02 |
$1,113.46 $1,198.62 $1,288.84 $1,609.32 |
$1,354.76 $1,439.92 $1,530.14 $1,850.62 |
$556.73 $599.31 $644.42 $804.66 |
$798.03 $840.61 $885.72 $1,045.96 |
$1,039.33 $1,081.91 $1,127.02 $1,287.26 |
$287.99 |
ADVERTISEMENT
|
||||||||||
CareSourceLocal: 1-800-479-9502 | Toll Free: 1-800-479-9502 TTY: 1-800-750-0750 |
||||||||||
Plan: (HMO) CareSource Marketplace HSA Eligible BronzeSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)
Deductible: Individual:
$5,200
: Family:
$10,400 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 |
Bronze | 21 30 40 50 60 |
$252.31 $286.37 $322.45 $450.63 $684.77 |
$504.62 $572.74 $644.90 $901.26 $1,369.54 |
$697.64 $765.76 $837.92 $1,094.28 |
$890.66 $958.78 $1,030.94 $1,287.30 |
$1,083.68 $1,151.80 $1,223.96 $1,480.32 |
$445.33 $479.39 $515.47 $643.65 |
$638.35 $672.41 $708.49 $836.67 |
$831.37 $865.43 $901.51 $1,029.69 |
$230.36 |
Plan: (HMO) CareSource Marketplace Low Premium SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)
Deductible: Individual:
$6,400
: Family:
$12,800 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 |
Silver | 21 30 40 50 60 |
$332.59 $377.49 $425.05 $594.01 $902.65 |
$665.18 $754.98 $850.10 $1,188.02 $1,805.30 |
$919.61 $1,009.41 $1,104.53 $1,442.45 |
$1,174.04 $1,263.84 $1,358.96 $1,696.88 |
$1,428.47 $1,518.27 $1,613.39 $1,951.31 |
$587.02 $631.92 $679.48 $848.44 |
$841.45 $886.35 $933.91 $1,102.87 |
$1,095.88 $1,140.78 $1,188.34 $1,357.30 |
$303.66 |
Plan: (HMO) CareSource Marketplace GoldSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)
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 |
$395.12 $448.46 $504.96 $705.68 $1,072.35 |
$790.24 $896.92 $1,009.92 $1,411.36 $2,144.70 |
$1,092.50 $1,199.18 $1,312.18 $1,713.62 |
$1,394.76 $1,501.44 $1,614.44 $2,015.88 |
$1,697.02 $1,803.70 $1,916.70 $2,318.14 |
$697.38 $750.72 $807.22 $1,007.94 |
$999.64 $1,052.98 $1,109.48 $1,310.20 |
$1,301.90 $1,355.24 $1,411.74 $1,612.46 |
$360.74 |
Plan: (HMO) CareSource Marketplace Standard SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)
Deductible: Individual:
$5,700
: Family:
$11,400 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 |
$348.43 $395.46 $445.29 $622.29 $945.63 |
$696.86 $790.92 $890.58 $1,244.58 $1,891.26 |
$963.41 $1,057.47 $1,157.13 $1,511.13 |
$1,229.96 $1,324.02 $1,423.68 $1,777.68 |
$1,496.51 $1,590.57 $1,690.23 $2,044.23 |
$614.98 $662.01 $711.84 $888.84 |
$881.53 $928.56 $978.39 $1,155.39 |
$1,148.08 $1,195.11 $1,244.94 $1,421.94 |
$318.11 |
Plan: (HMO) CareSource Marketplace BronzeSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)
Deductible: Individual:
$7,400
: Family:
$14,800 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 |
$236.50 $268.42 $302.24 $422.38 $641.84 |
$473.00 $536.84 $604.48 $844.76 $1,283.68 |
$653.92 $717.76 $785.40 $1,025.68 |
$834.84 $898.68 $966.32 $1,206.60 |
$1,015.76 $1,079.60 $1,147.24 $1,387.52 |
$417.42 $449.34 $483.16 $603.30 |
$598.34 $630.26 $664.08 $784.22 |
$779.26 $811.18 $845.00 $965.14 |
$215.92 |
Plan: (HMO) CareSource Marketplace Low Deductible SilverSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)
Deductible: Individual:
$4,400
: Family:
$8,800 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 |
Silver | 21 30 40 50 60 |
$366.49 $415.96 $468.37 $654.55 $994.65 |
$732.98 $831.92 $936.74 $1,309.10 $1,989.30 |
$1,013.34 $1,112.28 $1,217.10 $1,589.46 |
$1,293.70 $1,392.64 $1,497.46 $1,869.82 |
$1,574.06 $1,673.00 $1,777.82 $2,150.18 |
$646.85 $696.32 $748.73 $934.91 |
$927.21 $976.68 $1,029.09 $1,215.27 |
$1,207.57 $1,257.04 $1,309.45 $1,495.63 |
$334.60 |
Plan: (HMO) CareSource Marketplace Low Premium Silver Dental and VisionSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)
Deductible: Individual:
$6,400
: Family:
$12,800 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 |
Silver | 21 30 40 50 60 |
$348.20 $395.20 $444.99 $621.87 $945.00 |
$696.40 $790.40 $889.98 $1,243.74 $1,890.00 |
$962.77 $1,056.77 $1,156.35 $1,510.11 |
$1,229.14 $1,323.14 $1,422.72 $1,776.48 |
$1,495.51 $1,589.51 $1,689.09 $2,042.85 |
$614.57 $661.57 $711.36 $888.24 |
$880.94 $927.94 $977.73 $1,154.61 |
$1,147.31 $1,194.31 $1,244.10 $1,420.98 |
$317.90 |
Plan: (HMO) CareSource Marketplace Gold Dental and VisionSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)
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 |
$410.72 $466.17 $524.90 $733.55 $1,114.69 |
$821.44 $932.34 $1,049.80 $1,467.10 $2,229.38 |
$1,135.64 $1,246.54 $1,364.00 $1,781.30 |
$1,449.84 $1,560.74 $1,678.20 $2,095.50 |
$1,764.04 $1,874.94 $1,992.40 $2,409.70 |
$724.92 $780.37 $839.10 $1,047.75 |
$1,039.12 $1,094.57 $1,153.30 $1,361.95 |
$1,353.32 $1,408.77 $1,467.50 $1,676.15 |
$374.99 |
Plan: (HMO) CareSource Marketplace Standard Silver Dental and VisionSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)
Deductible: Individual:
$5,700
: Family:
$11,400 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 |
$364.03 $413.17 $465.23 $650.16 $987.98 |
$728.06 $826.34 $930.46 $1,300.32 $1,975.96 |
$1,006.54 $1,104.82 $1,208.94 $1,578.80 |
$1,285.02 $1,383.30 $1,487.42 $1,857.28 |
$1,563.50 $1,661.78 $1,765.90 $2,135.76 |
$642.51 $691.65 $743.71 $928.64 |
$920.99 $970.13 $1,022.19 $1,207.12 |
$1,199.47 $1,248.61 $1,300.67 $1,485.60 |
$332.36 |
Plan: (HMO) CareSource Marketplace Bronze Dental and VisionSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)
Deductible: Individual:
$7,400
: Family:
$14,800 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 |
$252.09 $286.12 $322.17 $450.23 $684.16 |
$504.18 $572.24 $644.34 $900.46 $1,368.32 |
$697.03 $765.09 $837.19 $1,093.31 |
$889.88 $957.94 $1,030.04 $1,286.16 |
$1,082.73 $1,150.79 $1,222.89 $1,479.01 |
$444.94 $478.97 $515.02 $643.08 |
$637.79 $671.82 $707.87 $835.93 |
$830.64 $864.67 $900.72 $1,028.78 |
$230.16 |
Plan: (HMO) CareSource Marketplace Low Deductible Silver Dental and VisionSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)
Deductible: Individual:
$4,400
: Family:
$8,800 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 |
Silver | 21 30 40 50 60 |
$382.10 $433.67 $488.31 $682.42 $1,037.00 |
$764.20 $867.34 $976.62 $1,364.84 $2,074.00 |
$1,056.50 $1,159.64 $1,268.92 $1,657.14 |
$1,348.80 $1,451.94 $1,561.22 $1,949.44 |
$1,641.10 $1,744.24 $1,853.52 $2,241.74 |
$674.40 $725.97 $780.61 $974.72 |
$966.70 $1,018.27 $1,072.91 $1,267.02 |
$1,259.00 $1,310.57 $1,365.21 $1,559.32 |
$348.85 |
ADVERTISEMENT
|
||||||||||
Medical Health Insuring Corp. of OhioLocal: 1-888-308-0357 | Toll Free: 1-888-308-0357 |
||||||||||
Plan: (HMO) Market HMO 2000 - NE OhioSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-308-0357 - Provider Directory for This Plan: (Medical Health Insuring Corp. of Ohio)
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 |
$440.25 $499.68 $562.64 $786.29 $1,194.84 |
$880.50 $999.36 $1,125.28 $1,572.58 $2,389.68 |
$1,217.29 $1,336.15 $1,462.07 $1,909.37 |
$1,554.08 $1,672.94 $1,798.86 $2,246.16 |
$1,890.87 $2,009.73 $2,135.65 $2,582.95 |
$777.04 $836.47 $899.43 $1,123.08 |
$1,113.83 $1,173.26 $1,236.22 $1,459.87 |
$1,450.62 $1,510.05 $1,573.01 $1,796.66 |
$401.95 |
Plan: (HMO) Market HMO 2200 - NE OhioSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-308-0357 - Provider Directory for This Plan: (Medical Health Insuring Corp. of Ohio)
Deductible: Individual:
$2,200
: Family:
$4,400 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 |
$377.62 $428.59 $482.59 $674.42 $1,024.85 |
$755.24 $857.18 $965.18 $1,348.84 $2,049.70 |
$1,044.12 $1,146.06 $1,254.06 $1,637.72 |
$1,333.00 $1,434.94 $1,542.94 $1,926.60 |
$1,621.88 $1,723.82 $1,831.82 $2,215.48 |
$666.50 $717.47 $771.47 $963.30 |
$955.38 $1,006.35 $1,060.35 $1,252.18 |
$1,244.26 $1,295.23 $1,349.23 $1,541.06 |
$344.76 |
Plan: (HMO) Market HMO 3500 - NE OhioSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-308-0357 - Provider Directory for This Plan: (Medical Health Insuring Corp. of Ohio)
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 |
$370.63 $420.66 $473.66 $661.94 $1,005.88 |
$741.26 $841.32 $947.32 $1,323.88 $2,011.76 |
$1,024.79 $1,124.85 $1,230.85 $1,607.41 |
$1,308.32 $1,408.38 $1,514.38 $1,890.94 |
$1,591.85 $1,691.91 $1,797.91 $2,174.47 |
$654.16 $704.19 $757.19 $945.47 |
$937.69 $987.72 $1,040.72 $1,229.00 |
$1,221.22 $1,271.25 $1,324.25 $1,512.53 |
$338.38 |
Plan: (HMO) Market HMO 4000 HSA - NE OhioSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-308-0357 - Provider Directory for This Plan: (Medical Health Insuring Corp. of Ohio)
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 |
$386.93 $439.17 $494.50 $691.06 $1,050.14 |
$773.86 $878.34 $989.00 $1,382.12 $2,100.28 |
$1,069.86 $1,174.34 $1,285.00 $1,678.12 |
$1,365.86 $1,470.34 $1,581.00 $1,974.12 |
$1,661.86 $1,766.34 $1,877.00 $2,270.12 |
$682.93 $735.17 $790.50 $987.06 |
$978.93 $1,031.17 $1,086.50 $1,283.06 |
$1,274.93 $1,327.17 $1,382.50 $1,579.06 |
$353.27 |
Plan: (HMO) Market HMO 5250 HSA - NE OhioSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-308-0357 - Provider Directory for This Plan: (Medical Health Insuring Corp. of Ohio)
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 |
Expanded Bronze | 21 30 40 50 60 |
$279.52 $317.26 $357.23 $499.23 $758.63 |
$559.04 $634.52 $714.46 $998.46 $1,517.26 |
$772.88 $848.36 $928.30 $1,212.30 |
$986.72 $1,062.20 $1,142.14 $1,426.14 |
$1,200.56 $1,276.04 $1,355.98 $1,639.98 |
$493.36 $531.10 $571.07 $713.07 |
$707.20 $744.94 $784.91 $926.91 |
$921.04 $958.78 $998.75 $1,140.75 |
$255.21 |
Plan: (HMO) Market HMO 6750 HSA - NE OhioSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-308-0357 - Provider Directory for This Plan: (Medical Health Insuring Corp. of Ohio)
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 |
$248.98 $282.60 $318.20 $444.68 $675.74 |
$497.96 $565.20 $636.40 $889.36 $1,351.48 |
$688.43 $755.67 $826.87 $1,079.83 |
$878.90 $946.14 $1,017.34 $1,270.30 |
$1,069.37 $1,136.61 $1,207.81 $1,460.77 |
$439.45 $473.07 $508.67 $635.15 |
$629.92 $663.54 $699.14 $825.62 |
$820.39 $854.01 $889.61 $1,016.09 |
$227.32 |
Plan: (HMO) Market HMO 7900 - NE OhioSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-308-0357 - Provider Directory for This Plan: (Medical Health Insuring Corp. of Ohio)
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 |
$239.15 $271.43 $305.63 $427.12 $649.05 |
$478.30 $542.86 $611.26 $854.24 $1,298.10 |
$661.25 $725.81 $794.21 $1,037.19 |
$844.20 $908.76 $977.16 $1,220.14 |
$1,027.15 $1,091.71 $1,160.11 $1,403.09 |
$422.10 $454.38 $488.58 $610.07 |
$605.05 $637.33 $671.53 $793.02 |
$788.00 $820.28 $854.48 $975.97 |
$218.34 |
Plan: (HMO) Market HMO Young Adult Essentials - NE OhioSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-308-0357 - Provider Directory for This Plan: (Medical Health Insuring Corp. of Ohio)
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 |
$194.37 $220.61 $248.41 $347.15 $527.53 |
$388.74 $441.22 $496.82 $694.30 $1,055.06 |
$537.44 $589.92 $645.52 $843.00 |
$686.14 $738.62 $794.22 $991.70 |
$834.84 $887.32 $942.92 $1,140.40 |
$343.07 $369.31 $397.11 $495.85 |
$491.77 $518.01 $545.81 $644.55 |
$640.47 $666.71 $694.51 $793.25 |
$177.46 |
Plan: (HMO) Market HMO 6500 - NE OhioSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-308-0357 - Provider Directory for This Plan: (Medical Health Insuring Corp. of Ohio)
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 |
Silver | 21 30 40 50 60 |
$341.64 $387.76 $436.62 $610.17 $927.21 |
$683.28 $775.52 $873.24 $1,220.34 $1,854.42 |
$944.63 $1,036.87 $1,134.59 $1,481.69 |
$1,205.98 $1,298.22 $1,395.94 $1,743.04 |
$1,467.33 $1,559.57 $1,657.29 $2,004.39 |
$602.99 $649.11 $697.97 $871.52 |
$864.34 $910.46 $959.32 $1,132.87 |
$1,125.69 $1,171.81 $1,220.67 $1,394.22 |
$311.92 |
‡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 Stark County here.