Obamacare 2022 Rates for Rockingham County

Obamacare > Rates > North Carolina > Rockingham County

Obamacare is also known as the Affordable Care Act. This page gives you an overview of the rates for individual and family health insurance plans available from , the marketplace for Rockingham County, NC.

The health insurance rates listed below are for calendar year 2022.

For information on subsidies to make your coverage affordable, you must take one of the following actions:

  • Contact a licensed health insurance agent
  • Complete an application at Healthcare.gov
  • Contact the provider directly

Obamacare Providers, 54 Plans and 2022 Rates for Rockingham County, North Carolina

Below, you’ll find a summary of the 54 plans for Rockingham County, North Carolina and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options.

You may also be interested in:

Obamacare Rates and Providers for Other Years

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Blue Cross and Blue Shield of NC

Local: 1-800-324-4973 | Toll Free: 1-800-324-4973

Toc - Plan #1 Blue Cross and Blue Shield of NC
Silver

(PPO) Blue Advantage Silver $0 Deductible

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$504.88
$573.04
$645.24
$901.72
$1,370.24 		$891.11
$959.27
$1,031.47
$1,287.95 		$1,277.34
$1,345.50
$1,417.70
$1,674.18 		$1,663.57
$1,731.73
$1,803.93
$2,060.41 		$386.23
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,009.76
$1,146.08
$1,290.48
$1,803.44
$2,740.48 		$1,395.99
$1,532.31
$1,676.71
$2,189.67 		$1,782.22
$1,918.54
$2,062.94
$2,575.90 		$2,168.45
$2,304.77
$2,449.17
$2,962.13 		$386.23
Toc - Plan #2 Blue Cross and Blue Shield of NC
Silver

(PPO) Blue Advantage Silver 5300 + 3 Free PCP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$5,300 $10,600 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$467.55
$530.67
$597.53
$835.04
$1,268.93 		$825.23
$888.35
$955.21
$1,192.72 		$1,182.91
$1,246.03
$1,312.89
$1,550.40 		$1,540.59
$1,603.71
$1,670.57
$1,908.08 		$357.68
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$935.10
$1,061.34
$1,195.06
$1,670.08
$2,537.86 		$1,292.78
$1,419.02
$1,552.74
$2,027.76 		$1,650.46
$1,776.70
$1,910.42
$2,385.44 		$2,008.14
$2,134.38
$2,268.10
$2,743.12 		$357.68
Toc - Plan #3 Blue Cross and Blue Shield of NC
Silver

(PPO) Blue Advantage Silver 2800 + $15 PCP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$2,800 $5,600 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$488.06
$553.95
$623.74
$871.68
$1,324.59 		$861.43
$927.32
$997.11
$1,245.05 		$1,234.80
$1,300.69
$1,370.48
$1,618.42 		$1,608.17
$1,674.06
$1,743.85
$1,991.79 		$373.37
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$976.12
$1,107.90
$1,247.48
$1,743.36
$2,649.18 		$1,349.49
$1,481.27
$1,620.85
$2,116.73 		$1,722.86
$1,854.64
$1,994.22
$2,490.10 		$2,096.23
$2,228.01
$2,367.59
$2,863.47 		$373.37
Toc - Plan #4 Blue Cross and Blue Shield of NC
Expanded Bronze

(PPO) Blue Advantage Bronze 7000 + 3 Free PCP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$7,000 $14,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$342.07
$388.25
$437.17
$610.94
$928.38 		$603.75
$649.93
$698.85
$872.62 		$865.43
$911.61
$960.53
$1,134.30 		$1,127.11
$1,173.29
$1,222.21
$1,395.98 		$261.68
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$684.14
$776.50
$874.34
$1,221.88
$1,856.76 		$945.82
$1,038.18
$1,136.02
$1,483.56 		$1,207.50
$1,299.86
$1,397.70
$1,745.24 		$1,469.18
$1,561.54
$1,659.38
$2,006.92 		$261.68
Toc - Plan #5 Blue Cross and Blue Shield of NC
Gold

(PPO) Blue Advantage Gold 2500 + 3 Free PCP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$2,500 $5,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$489.73
$555.84
$625.87
$874.66
$1,329.13 		$864.37
$930.48
$1,000.51
$1,249.30 		$1,239.01
$1,305.12
$1,375.15
$1,623.94 		$1,613.65
$1,679.76
$1,749.79
$1,998.58 		$374.64
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$979.46
$1,111.68
$1,251.74
$1,749.32
$2,658.26 		$1,354.10
$1,486.32
$1,626.38
$2,123.96 		$1,728.74
$1,860.96
$2,001.02
$2,498.60 		$2,103.38
$2,235.60
$2,375.66
$2,873.24 		$374.64
Toc - Plan #6 Blue Cross and Blue Shield of NC
Silver

(PPO) Blue Advantage Silver 3800 + 3 Free PCP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$3,800 $7,600 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$506.02
$574.33
$646.69
$903.75
$1,373.34 		$893.13
$961.44
$1,033.80
$1,290.86 		$1,280.24
$1,348.55
$1,420.91
$1,677.97 		$1,667.35
$1,735.66
$1,808.02
$2,065.08 		$387.11
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,012.04
$1,148.66
$1,293.38
$1,807.50
$2,746.68 		$1,399.15
$1,535.77
$1,680.49
$2,194.61 		$1,786.26
$1,922.88
$2,067.60
$2,581.72 		$2,173.37
$2,309.99
$2,454.71
$2,968.83 		$387.11
Toc - Plan #7 Blue Cross and Blue Shield of NC
Expanded Bronze

(PPO) Blue Advantage Bronze 7000 HSA Eligible

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$7,000 $14,000 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$354.43
$402.28
$452.96
$633.01
$961.92 		$625.57
$673.42
$724.10
$904.15 		$896.71
$944.56
$995.24
$1,175.29 		$1,167.85
$1,215.70
$1,266.38
$1,446.43 		$271.14
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$708.86
$804.56
$905.92
$1,266.02
$1,923.84 		$980.00
$1,075.70
$1,177.06
$1,537.16 		$1,251.14
$1,346.84
$1,448.20
$1,808.30 		$1,522.28
$1,617.98
$1,719.34
$2,079.44 		$271.14
Toc - Plan #8 Blue Cross and Blue Shield of NC
Catastrophic

(PPO) Blue Advantage Catastrophic

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$8,700 $17,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$241.15
$273.71
$308.19
$430.69
$654.48 		$425.63
$458.19
$492.67
$615.17 		$610.11
$642.67
$677.15
$799.65 		$794.59
$827.15
$861.63
$984.13 		$184.48
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$482.30
$547.42
$616.38
$861.38
$1,308.96 		$666.78
$731.90
$800.86
$1,045.86 		$851.26
$916.38
$985.34
$1,230.34 		$1,035.74
$1,100.86
$1,169.82
$1,414.82 		$184.48
Toc - Plan #9 Blue Cross and Blue Shield of NC
Silver

(PPO) Blue Advantage Silver 6000 + 3 Free PCP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$485.19
$550.69
$620.07
$866.55
$1,316.81 		$856.36
$921.86
$991.24
$1,237.72 		$1,227.53
$1,293.03
$1,362.41
$1,608.89 		$1,598.70
$1,664.20
$1,733.58
$1,980.06 		$371.17
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$970.38
$1,101.38
$1,240.14
$1,733.10
$2,633.62 		$1,341.55
$1,472.55
$1,611.31
$2,104.27 		$1,712.72
$1,843.72
$1,982.48
$2,475.44 		$2,083.89
$2,214.89
$2,353.65
$2,846.61 		$371.17
Toc - Plan #10 Blue Cross and Blue Shield of NC
Expanded Bronze

(PPO) Blue Advantage Bronze 7000 Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$7,000 $14,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$364.51
$413.72
$465.84
$651.01
$989.28 		$643.36
$692.57
$744.69
$929.86 		$922.21
$971.42
$1,023.54
$1,208.71 		$1,201.06
$1,250.27
$1,302.39
$1,487.56 		$278.85
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$729.02
$827.44
$931.68
$1,302.02
$1,978.56 		$1,007.87
$1,106.29
$1,210.53
$1,580.87 		$1,286.72
$1,385.14
$1,489.38
$1,859.72 		$1,565.57
$1,663.99
$1,768.23
$2,138.57 		$278.85
Toc - Plan #11 Blue Cross and Blue Shield of NC
Bronze

(PPO) Blue Advantage Bronze 8700

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$8,700 $17,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$338.41
$384.10
$432.49
$604.40
$918.44 		$597.29
$642.98
$691.37
$863.28 		$856.17
$901.86
$950.25
$1,122.16 		$1,115.05
$1,160.74
$1,209.13
$1,381.04 		$258.88
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$676.82
$768.20
$864.98
$1,208.80
$1,836.88 		$935.70
$1,027.08
$1,123.86
$1,467.68 		$1,194.58
$1,285.96
$1,382.74
$1,726.56 		$1,453.46
$1,544.84
$1,641.62
$1,985.44 		$258.88

ADVERTISEMENT

Bright HealthCare

Local: 1-855-521-9349 | Toll Free: 1-855-521-9349

Toc - Plan #12 Bright HealthCare
Gold

(HMO) Gold 1000 ($0 Telehealth + $0 Primary Care + $0 Specialist + $0 Mental Health + $0 Prescription List)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-521-9349

Annual Out of Pocket Expenses:

Individual Family
$1,000 $2,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$438.20
$497.36
$560.02
$782.63
$1,189.28 		$773.43
$832.59
$895.25
$1,117.86 		$1,108.66
$1,167.82
$1,230.48
$1,453.09 		$1,443.89
$1,503.05
$1,565.71
$1,788.32 		$335.23
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$876.40
$994.72
$1,120.04
$1,565.26
$2,378.56 		$1,211.63
$1,329.95
$1,455.27
$1,900.49 		$1,546.86
$1,665.18
$1,790.50
$2,235.72 		$1,882.09
$2,000.41
$2,125.73
$2,570.95 		$335.23
Toc - Plan #13 Bright HealthCare
Silver

(HMO) Silver 5000 ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription List)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-521-9349

Annual Out of Pocket Expenses:

Individual Family
$5,000 $10,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$341.64
$387.77
$436.62
$610.18
$927.22 		$603.00
$649.13
$697.98
$871.54 		$864.36
$910.49
$959.34
$1,132.90 		$1,125.72
$1,171.85
$1,220.70
$1,394.26 		$261.36
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$683.28
$775.54
$873.24
$1,220.36
$1,854.44 		$944.64
$1,036.90
$1,134.60
$1,481.72 		$1,206.00
$1,298.26
$1,395.96
$1,743.08 		$1,467.36
$1,559.62
$1,657.32
$2,004.44 		$261.36
Toc - Plan #14 Bright HealthCare
Silver

(HMO) Silver 3000 ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription List)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-521-9349

Annual Out of Pocket Expenses:

Individual Family
$3,000 $6,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$344.28
$390.76
$439.99
$614.88
$934.37 		$607.65
$654.13
$703.36
$878.25 		$871.02
$917.50
$966.73
$1,141.62 		$1,134.39
$1,180.87
$1,230.10
$1,404.99 		$263.37
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$688.56
$781.52
$879.98
$1,229.76
$1,868.74 		$951.93
$1,044.89
$1,143.35
$1,493.13 		$1,215.30
$1,308.26
$1,406.72
$1,756.50 		$1,478.67
$1,571.63
$1,670.09
$2,019.87 		$263.37
Toc - Plan #15 Bright HealthCare
Silver

(HMO) Silver $0 Deductible ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription List)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-521-9349

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$355.86
$403.90
$454.78
$635.56
$965.79 		$628.09
$676.13
$727.01
$907.79 		$900.32
$948.36
$999.24
$1,180.02 		$1,172.55
$1,220.59
$1,271.47
$1,452.25 		$272.23
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$711.72
$807.80
$909.56
$1,271.12
$1,931.58 		$983.95
$1,080.03
$1,181.79
$1,543.35 		$1,256.18
$1,352.26
$1,454.02
$1,815.58 		$1,528.41
$1,624.49
$1,726.25
$2,087.81 		$272.23
Toc - Plan #16 Bright HealthCare
Expanded Bronze

(HMO) Bronze 8700 + $0 Mental Health ($0 Telehealth + $0 Primary Care + $0 Prescription List)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-521-9349

Annual Out of Pocket Expenses:

Individual Family
$8,700 $17,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$234.43
$266.08
$299.61
$418.70
$636.25 		$413.77
$445.42
$478.95
$598.04 		$593.11
$624.76
$658.29
$777.38 		$772.45
$804.10
$837.63
$956.72 		$179.34
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$468.86
$532.16
$599.22
$837.40
$1,272.50 		$648.20
$711.50
$778.56
$1,016.74 		$827.54
$890.84
$957.90
$1,196.08 		$1,006.88
$1,070.18
$1,137.24
$1,375.42 		$179.34
Toc - Plan #17 Bright HealthCare
Expanded Bronze

(HMO) Bronze 7200 ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription List)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-521-9349

Annual Out of Pocket Expenses:

Individual Family
$7,200 $14,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$242.50
$275.24
$309.92
$433.11
$658.15 		$428.01
$460.75
$495.43
$618.62 		$613.52
$646.26
$680.94
$804.13 		$799.03
$831.77
$866.45
$989.64 		$185.51
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$485.00
$550.48
$619.84
$866.22
$1,316.30 		$670.51
$735.99
$805.35
$1,051.73 		$856.02
$921.50
$990.86
$1,237.24 		$1,041.53
$1,107.01
$1,176.37
$1,422.75 		$185.51
Toc - Plan #18 Bright HealthCare
Expanded Bronze

(HMO) Bronze 5300 HSA

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-521-9349

Annual Out of Pocket Expenses:

Individual Family
$5,300 $10,600 Annual Deductible
$7,050 $14,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$254.52
$288.88
$325.28
$454.57
$690.77 		$449.23
$483.59
$519.99
$649.28 		$643.94
$678.30
$714.70
$843.99 		$838.65
$873.01
$909.41
$1,038.70 		$194.71
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$509.04
$577.76
$650.56
$909.14
$1,381.54 		$703.75
$772.47
$845.27
$1,103.85 		$898.46
$967.18
$1,039.98
$1,298.56 		$1,093.17
$1,161.89
$1,234.69
$1,493.27 		$194.71
Toc - Plan #19 Bright HealthCare
Catastrophic

(HMO) Catastrophic 8700 ($0 Primary Care)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-521-9349

Annual Out of Pocket Expenses:

Individual Family
$8,700 $17,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$168.79
$191.58
$215.71
$301.46
$458.09 		$297.91
$320.70
$344.83
$430.58 		$427.03
$449.82
$473.95
$559.70 		$556.15
$578.94
$603.07
$688.82 		$129.12
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$337.58
$383.16
$431.42
$602.92
$916.18 		$466.70
$512.28
$560.54
$732.04 		$595.82
$641.40
$689.66
$861.16 		$724.94
$770.52
$818.78
$990.28 		$129.12
Toc - Plan #20 Bright HealthCare
Expanded Bronze

(HMO) Bronze $0 Medical Deductible ($0 Telehealth + $0 Primary Care + $0 Specialist + $0 Mental Health + $0 Prescription

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-521-9349

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$270.58
$307.10
$345.80
$483.25
$734.34 		$477.57
$514.09
$552.79
$690.24 		$684.56
$721.08
$759.78
$897.23 		$891.55
$928.07
$966.77
$1,104.22 		$206.99
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$541.16
$614.20
$691.60
$966.50
$1,468.68 		$748.15
$821.19
$898.59
$1,173.49 		$955.14
$1,028.18
$1,105.58
$1,380.48 		$1,162.13
$1,235.17
$1,312.57
$1,587.47 		$206.99
Toc - Plan #21 Bright HealthCare
Silver

(HMO) Silver 6700 ($0 Telehealth + $0 Primary Care + $0 Specialist + $0 Mental Health + $0 Prescription List)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-521-9349

Annual Out of Pocket Expenses:

Individual Family
$6,700 $13,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$347.58
$394.51
$444.21
$620.78
$943.34 		$613.48
$660.41
$710.11
$886.68 		$879.38
$926.31
$976.01
$1,152.58 		$1,145.28
$1,192.21
$1,241.91
$1,418.48 		$265.90
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$695.16
$789.02
$888.42
$1,241.56
$1,886.68 		$961.06
$1,054.92
$1,154.32
$1,507.46 		$1,226.96
$1,320.82
$1,420.22
$1,773.36 		$1,492.86
$1,586.72
$1,686.12
$2,039.26 		$265.90
Toc - Plan #22 Bright HealthCare
Expanded Bronze

(HMO) Bronze 7200 + Adult Dental & Vision ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription List)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-521-9349

Annual Out of Pocket Expenses:

Individual Family
$7,200 $14,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$253.24
$287.43
$323.64
$452.29
$687.29 		$446.97
$481.16
$517.37
$646.02 		$640.70
$674.89
$711.10
$839.75 		$834.43
$868.62
$904.83
$1,033.48 		$193.73
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$506.48
$574.86
$647.28
$904.58
$1,374.58 		$700.21
$768.59
$841.01
$1,098.31 		$893.94
$962.32
$1,034.74
$1,292.04 		$1,087.67
$1,156.05
$1,228.47
$1,485.77 		$193.73
Toc - Plan #23 Bright HealthCare
Silver

(HMO) Silver 6700 + Adult Dental & Vision ($0 Telehealth + $0 Primary Care + $0 Specialist + $0 Mental Health + $0 Presc

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-521-9349

Annual Out of Pocket Expenses:

Individual Family
$6,700 $13,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$358.22
$406.58
$457.81
$639.78
$972.21 		$632.26
$680.62
$731.85
$913.82 		$906.30
$954.66
$1,005.89
$1,187.86 		$1,180.34
$1,228.70
$1,279.93
$1,461.90 		$274.04
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$716.44
$813.16
$915.62
$1,279.56
$1,944.42 		$990.48
$1,087.20
$1,189.66
$1,553.60 		$1,264.52
$1,361.24
$1,463.70
$1,827.64 		$1,538.56
$1,635.28
$1,737.74
$2,101.68 		$274.04
Toc - Plan #24 Bright HealthCare
Gold

(HMO) Gold $0 Ded + Adult Dental & Vision ($0 Telehealth + $0 Primary Care + $0 Mental Health + $0 Prescription List)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-521-9349

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$484.59
$550.01
$619.30
$865.48
$1,315.17 		$855.30
$920.72
$990.01
$1,236.19 		$1,226.01
$1,291.43
$1,360.72
$1,606.90 		$1,596.72
$1,662.14
$1,731.43
$1,977.61 		$370.71
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$969.18
$1,100.02
$1,238.60
$1,730.96
$2,630.34 		$1,339.89
$1,470.73
$1,609.31
$2,101.67 		$1,710.60
$1,841.44
$1,980.02
$2,472.38 		$2,081.31
$2,212.15
$2,350.73
$2,843.09 		$370.71
Toc - Plan #25 Bright HealthCare
Expanded Bronze

(HMO) Bronze 8700 ($25 Generic)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-521-9349

Annual Out of Pocket Expenses:

Individual Family
$8,700 $17,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$226.85
$257.48
$289.92
$405.16
$615.68 		$400.39
$431.02
$463.46
$578.70 		$573.93
$604.56
$637.00
$752.24 		$747.47
$778.10
$810.54
$925.78 		$173.54
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$453.70
$514.96
$579.84
$810.32
$1,231.36 		$627.24
$688.50
$753.38
$983.86 		$800.78
$862.04
$926.92
$1,157.40 		$974.32
$1,035.58
$1,100.46
$1,330.94 		$173.54
Toc - Plan #26 Bright HealthCare
Silver

(HMO) Silver 4000 ($35 Primary Care + $15 Generic)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-521-9349

Annual Out of Pocket Expenses:

Individual Family
$4,000 $8,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$337.16
$382.67
$430.89
$602.16
$915.04 		$595.09
$640.60
$688.82
$860.09 		$853.02
$898.53
$946.75
$1,118.02 		$1,110.95
$1,156.46
$1,204.68
$1,375.95 		$257.93
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$674.32
$765.34
$861.78
$1,204.32
$1,830.08 		$932.25
$1,023.27
$1,119.71
$1,462.25 		$1,190.18
$1,281.20
$1,377.64
$1,720.18 		$1,448.11
$1,539.13
$1,635.57
$1,978.11 		$257.93

ADVERTISEMENT

WellCare of North Carolina

Local: 1-312-332-5401 | Toll Free: 1-800-779-7989

Toc - Plan #27 WellCare of North Carolina
Expanded Bronze

(PPO) WellCare Secure Health Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-779-7989

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$552.82
$627.44
$706.50
$987.33
$1,500.34 		$975.72
$1,050.34
$1,129.40
$1,410.23 		$1,398.62
$1,473.24
$1,552.30
$1,833.13 		$1,821.52
$1,896.14
$1,975.20
$2,256.03 		$422.90
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,105.64
$1,254.88
$1,413.00
$1,974.66
$3,000.68 		$1,528.54
$1,677.78
$1,835.90
$2,397.56 		$1,951.44
$2,100.68
$2,258.80
$2,820.46 		$2,374.34
$2,523.58
$2,681.70
$3,243.36 		$422.90
Toc - Plan #28 WellCare of North Carolina
Silver

(PPO) WellCare Secure Health Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-779-7989

Annual Out of Pocket Expenses:

Individual Family
$7,200 $14,400 Annual Deductible
$7,200 $14,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$789.48
$896.05
$1,008.95
$1,410.00
$2,142.63 		$1,393.43
$1,500.00
$1,612.90
$2,013.95 		$1,997.38
$2,103.95
$2,216.85
$2,617.90 		$2,601.33
$2,707.90
$2,820.80
$3,221.85 		$603.95
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,578.96
$1,792.10
$2,017.90
$2,820.00
$4,285.26 		$2,182.91
$2,396.05
$2,621.85
$3,423.95 		$2,786.86
$3,000.00
$3,225.80
$4,027.90 		$3,390.81
$3,603.95
$3,829.75
$4,631.85 		$603.95
Toc - Plan #29 WellCare of North Carolina
Gold

(PPO) WellCare Secure Health Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-779-7989

Annual Out of Pocket Expenses:

Individual Family
$1,350 $2,700 Annual Deductible
$5,850 $11,700 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$782.73
$888.39
$1,000.32
$1,397.94
$2,124.30 		$1,381.51
$1,487.17
$1,599.10
$1,996.72 		$1,980.29
$2,085.95
$2,197.88
$2,595.50 		$2,579.07
$2,684.73
$2,796.66
$3,194.28 		$598.78
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,565.46
$1,776.78
$2,000.64
$2,795.88
$4,248.60 		$2,164.24
$2,375.56
$2,599.42
$3,394.66 		$2,763.02
$2,974.34
$3,198.20
$3,993.44 		$3,361.80
$3,573.12
$3,796.98
$4,592.22 		$598.78

ADVERTISEMENT

UnitedHealthcare

Local: 1-800-980-5357 | Toll Free: 1-800-980-5357 | TTY: 1-800-980-5357
Toc - Plan #30 UnitedHealthcare
Gold

(HMO) UHC Gold Value+ ($2 Rx + 3 Free Primary Care & 6 Free Virtual Visits)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$3,000 $6,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$522.59
$593.14
$667.87
$933.35
$1,418.31 		$922.37
$992.92
$1,067.65
$1,333.13 		$1,322.15
$1,392.70
$1,467.43
$1,732.91 		$1,721.93
$1,792.48
$1,867.21
$2,132.69 		$399.78
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,045.18
$1,186.28
$1,335.74
$1,866.70
$2,836.62 		$1,444.96
$1,586.06
$1,735.52
$2,266.48 		$1,844.74
$1,985.84
$2,135.30
$2,666.26 		$2,244.52
$2,385.62
$2,535.08
$3,066.04 		$399.78
Toc - Plan #31 UnitedHealthcare
Silver

(HMO) UHC Silver Value+ Saver ($3 Rx + 3 Free Primary Care & 6 Free Virtual Visits)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$4,500 $9,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$547.65
$621.59
$699.90
$978.11
$1,486.33 		$966.61
$1,040.55
$1,118.86
$1,397.07 		$1,385.57
$1,459.51
$1,537.82
$1,816.03 		$1,804.53
$1,878.47
$1,956.78
$2,234.99 		$418.96
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,095.30
$1,243.18
$1,399.80
$1,956.22
$2,972.66 		$1,514.26
$1,662.14
$1,818.76
$2,375.18 		$1,933.22
$2,081.10
$2,237.72
$2,794.14 		$2,352.18
$2,500.06
$2,656.68
$3,213.10 		$418.96
Toc - Plan #32 UnitedHealthcare
Silver

(HMO) UHC Silver Value+ ($3 Rx + Unlimited Free Primary Care & Virtual Visits)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$4,500 $9,000 Annual Deductible
$7,950 $15,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$549.15
$623.29
$701.81
$980.78
$1,490.39 		$969.25
$1,043.39
$1,121.91
$1,400.88 		$1,389.35
$1,463.49
$1,542.01
$1,820.98 		$1,809.45
$1,883.59
$1,962.11
$2,241.08 		$420.10
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,098.30
$1,246.58
$1,403.62
$1,961.56
$2,980.78 		$1,518.40
$1,666.68
$1,823.72
$2,381.66 		$1,938.50
$2,086.78
$2,243.82
$2,801.76 		$2,358.60
$2,506.88
$2,663.92
$3,221.86 		$420.10
Toc - Plan #33 UnitedHealthcare
Expanded Bronze

(HMO) UHC Bronze Value+ ($3 Rx)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$7,900 $15,800 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$388.67
$441.14
$496.72
$694.16
$1,054.85 		$686.00
$738.47
$794.05
$991.49 		$983.33
$1,035.80
$1,091.38
$1,288.82 		$1,280.66
$1,333.13
$1,388.71
$1,586.15 		$297.33
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$777.34
$882.28
$993.44
$1,388.32
$2,109.70 		$1,074.67
$1,179.61
$1,290.77
$1,685.65 		$1,372.00
$1,476.94
$1,588.10
$1,982.98 		$1,669.33
$1,774.27
$1,885.43
$2,280.31 		$297.33
Toc - Plan #34 UnitedHealthcare
Gold

(HMO) UHC Gold Advantage+ ($2 Rx + 3 Free Primary Care & 6 Free Virtual Visits)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$1,200 $2,400 Annual Deductible
$7,250 $14,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$521.47
$591.87
$666.44
$931.34
$1,415.26 		$920.39
$990.79
$1,065.36
$1,330.26 		$1,319.31
$1,389.71
$1,464.28
$1,729.18 		$1,718.23
$1,788.63
$1,863.20
$2,128.10 		$398.92
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,042.94
$1,183.74
$1,332.88
$1,862.68
$2,830.52 		$1,441.86
$1,582.66
$1,731.80
$2,261.60 		$1,840.78
$1,981.58
$2,130.72
$2,660.52 		$2,239.70
$2,380.50
$2,529.64
$3,059.44 		$398.92
Toc - Plan #35 UnitedHealthcare
Gold

(HMO) UHC Gold Advantage+ Extra ($2 Rx + Dental + Vision + 3 Free Primary Care & 6 Free Virtual Visits)ays)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$1,700 $3,400 Annual Deductible
$8,000 $16,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$529.70
$601.21
$676.95
$946.04
$1,437.60 		$934.92
$1,006.43
$1,082.17
$1,351.26 		$1,340.14
$1,411.65
$1,487.39
$1,756.48 		$1,745.36
$1,816.87
$1,892.61
$2,161.70 		$405.22
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,059.40
$1,202.42
$1,353.90
$1,892.08
$2,875.20 		$1,464.62
$1,607.64
$1,759.12
$2,297.30 		$1,869.84
$2,012.86
$2,164.34
$2,702.52 		$2,275.06
$2,418.08
$2,569.56
$3,107.74 		$405.22
Toc - Plan #36 UnitedHealthcare
Silver

(HMO) UHC Silver Advantage+ ($3 Rx + 3 Free Primary Care & 6 Free Virtual Visits)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$3,500 $7,000 Annual Deductible
$8,000 $16,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$545.41
$619.04
$697.03
$974.10
$1,480.24 		$962.65
$1,036.28
$1,114.27
$1,391.34 		$1,379.89
$1,453.52
$1,531.51
$1,808.58 		$1,797.13
$1,870.76
$1,948.75
$2,225.82 		$417.24
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,090.82
$1,238.08
$1,394.06
$1,948.20
$2,960.48 		$1,508.06
$1,655.32
$1,811.30
$2,365.44 		$1,925.30
$2,072.56
$2,228.54
$2,782.68 		$2,342.54
$2,489.80
$2,645.78
$3,199.92 		$417.24
Toc - Plan #37 UnitedHealthcare
Expanded Bronze

(HMO) UHC Bronze Value+ (HSA)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$6,700 $13,400 Annual Deductible
$7,050 $14,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$394.65
$447.93
$504.37
$704.85
$1,071.09 		$696.56
$749.84
$806.28
$1,006.76 		$998.47
$1,051.75
$1,108.19
$1,308.67 		$1,300.38
$1,353.66
$1,410.10
$1,610.58 		$301.91
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$789.30
$895.86
$1,008.74
$1,409.70
$2,142.18 		$1,091.21
$1,197.77
$1,310.65
$1,711.61 		$1,393.12
$1,499.68
$1,612.56
$2,013.52 		$1,695.03
$1,801.59
$1,914.47
$2,315.43 		$301.91
Toc - Plan #38 UnitedHealthcare
Bronze

(HMO) UHC Bronze Essential+ (Low Premium)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$8,700 $17,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$374.08
$424.58
$478.07
$668.11
$1,015.25 		$660.25
$710.75
$764.24
$954.28 		$946.42
$996.92
$1,050.41
$1,240.45 		$1,232.59
$1,283.09
$1,336.58
$1,526.62 		$286.17
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$748.16
$849.16
$956.14
$1,336.22
$2,030.50 		$1,034.33
$1,135.33
$1,242.31
$1,622.39 		$1,320.50
$1,421.50
$1,528.48
$1,908.56 		$1,606.67
$1,707.67
$1,814.65
$2,194.73 		$286.17
Toc - Plan #39 UnitedHealthcare
Silver

(HMO) UHC Silver Value+ ($3 Rx + 3 Free Primary Care & 6 Free Virtual Visits)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$6,800 $13,600 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$543.91
$617.34
$695.12
$971.43
$1,476.18 		$960.00
$1,033.43
$1,111.21
$1,387.52 		$1,376.09
$1,449.52
$1,527.30
$1,803.61 		$1,792.18
$1,865.61
$1,943.39
$2,219.70 		$416.09
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,087.82
$1,234.68
$1,390.24
$1,942.86
$2,952.36 		$1,503.91
$1,650.77
$1,806.33
$2,358.95 		$1,920.00
$2,066.86
$2,222.42
$2,775.04 		$2,336.09
$2,482.95
$2,638.51
$3,191.13 		$416.09
Toc - Plan #40 UnitedHealthcare
Expanded Bronze

(HMO) UHC Bronze Value+ ($3 Rx + 3 Free Primary Care & 6 Free Virtual Visits)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-980-5357

Annual Out of Pocket Expenses:

Individual Family
$7,600 $15,200 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$389.42
$441.99
$497.68
$695.50
$1,056.88 		$687.32
$739.89
$795.58
$993.40 		$985.22
$1,037.79
$1,093.48
$1,291.30 		$1,283.12
$1,335.69
$1,391.38
$1,589.20 		$297.90
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$778.84
$883.98
$995.36
$1,391.00
$2,113.76 		$1,076.74
$1,181.88
$1,293.26
$1,688.90 		$1,374.64
$1,479.78
$1,591.16
$1,986.80 		$1,672.54
$1,777.68
$1,889.06
$2,284.70 		$297.90

ADVERTISEMENT

Aetna CVS Health

Local: 1-877-336-3915 | Toll Free: 1-877-336-3915

Toc - Plan #41 Aetna CVS Health
Expanded Bronze

(HMO) Aetna CVS Bronze: Low-Cost MinuteClinic Visits, Telehealth, Store Discounts

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-336-3915

Annual Out of Pocket Expenses:

Individual Family
$5,500 $11,000 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$313.78
$356.14
$401.01
$560.42
$851.61 		$553.82
$596.18
$641.05
$800.46 		$793.86
$836.22
$881.09
$1,040.50 		$1,033.90
$1,076.26
$1,121.13
$1,280.54 		$240.04
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$627.56
$712.28
$802.02
$1,120.84
$1,703.22 		$867.60
$952.32
$1,042.06
$1,360.88 		$1,107.64
$1,192.36
$1,282.10
$1,600.92 		$1,347.68
$1,432.40
$1,522.14
$1,840.96 		$240.04
Toc - Plan #42 Aetna CVS Health
Bronze

(HMO) Aetna CVS Bronze: $0 MinuteClinic Visits, Telehealth, Store Discounts

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-336-3915

Annual Out of Pocket Expenses:

Individual Family
$8,700 $17,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$271.75
$308.43
$347.29
$485.34
$737.52 		$479.64
$516.32
$555.18
$693.23 		$687.53
$724.21
$763.07
$901.12 		$895.42
$932.10
$970.96
$1,109.01 		$207.89
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$543.50
$616.86
$694.58
$970.68
$1,475.04 		$751.39
$824.75
$902.47
$1,178.57 		$959.28
$1,032.64
$1,110.36
$1,386.46 		$1,167.17
$1,240.53
$1,318.25
$1,594.35 		$207.89
Toc - Plan #43 Aetna CVS Health
Gold

(HMO) Aetna CVS Gold: $0 MinuteClinic Visits, Telehealth, Store Discounts

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-336-3915

Annual Out of Pocket Expenses:

Individual Family
$1,450 $2,900 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$453.26
$514.45
$579.27
$809.53
$1,230.15 		$800.01
$861.20
$926.02
$1,156.28 		$1,146.76
$1,207.95
$1,272.77
$1,503.03 		$1,493.51
$1,554.70
$1,619.52
$1,849.78 		$346.75
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$906.52
$1,028.90
$1,158.54
$1,619.06
$2,460.30 		$1,253.27
$1,375.65
$1,505.29
$1,965.81 		$1,600.02
$1,722.40
$1,852.04
$2,312.56 		$1,946.77
$2,069.15
$2,198.79
$2,659.31 		$346.75
Toc - Plan #44 Aetna CVS Health
Silver

(HMO) Aetna CVS Silver 1: $0 MinuteClinic Visits, Telehealth, Store Discounts

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-336-3915

Annual Out of Pocket Expenses:

Individual Family
$4,000 $8,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$434.04
$492.63
$554.70
$775.19
$1,177.98 		$766.08
$824.67
$886.74
$1,107.23 		$1,098.12
$1,156.71
$1,218.78
$1,439.27 		$1,430.16
$1,488.75
$1,550.82
$1,771.31 		$332.04
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$868.08
$985.26
$1,109.40
$1,550.38
$2,355.96 		$1,200.12
$1,317.30
$1,441.44
$1,882.42 		$1,532.16
$1,649.34
$1,773.48
$2,214.46 		$1,864.20
$1,981.38
$2,105.52
$2,546.50 		$332.04
Toc - Plan #45 Aetna CVS Health
Silver

(HMO) Aetna CVS Silver 2: $0 MinuteClinic Visits, Telehealth, Store Discounts

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-336-3915

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$377.92
$428.93
$482.98
$674.96
$1,025.66 		$667.02
$718.03
$772.08
$964.06 		$956.12
$1,007.13
$1,061.18
$1,253.16 		$1,245.22
$1,296.23
$1,350.28
$1,542.26 		$289.10
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$755.84
$857.86
$965.96
$1,349.92
$2,051.32 		$1,044.94
$1,146.96
$1,255.06
$1,639.02 		$1,334.04
$1,436.06
$1,544.16
$1,928.12 		$1,623.14
$1,725.16
$1,833.26
$2,217.22 		$289.10

ADVERTISEMENT

Friday Health Plans

Local: 1-844-465-5500 | Toll Free: 1-844-465-5500 | TTY: 1-800-659-2656
Toc - Plan #46 Friday Health Plans
Catastrophic

(HMO) Friday Catastrophic

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-465-5500

Annual Out of Pocket Expenses:

Individual Family
$8,700 $17,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$167.77
$190.41
$214.41
$299.63
$455.32 		$296.11
$318.75
$342.75
$427.97 		$424.45
$447.09
$471.09
$556.31 		$552.79
$575.43
$599.43
$684.65 		$128.34
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$335.54
$380.82
$428.82
$599.26
$910.64 		$463.88
$509.16
$557.16
$727.60 		$592.22
$637.50
$685.50
$855.94 		$720.56
$765.84
$813.84
$984.28 		$128.34
Toc - Plan #47 Friday Health Plans
Bronze

(HMO) Friday Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-465-5500

Annual Out of Pocket Expenses:

Individual Family
$8,700 $17,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$217.94
$247.36
$278.53
$389.24
$591.49 		$384.66
$414.08
$445.25
$555.96 		$551.38
$580.80
$611.97
$722.68 		$718.10
$747.52
$778.69
$889.40 		$166.72
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$435.88
$494.72
$557.06
$778.48
$1,182.98 		$602.60
$661.44
$723.78
$945.20 		$769.32
$828.16
$890.50
$1,111.92 		$936.04
$994.88
$1,057.22
$1,278.64 		$166.72
Toc - Plan #48 Friday Health Plans
Expanded Bronze

(HMO) Friday Bronze Plus

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-465-5500

Annual Out of Pocket Expenses:

Individual Family
$8,700 $17,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$223.99
$254.23
$286.26
$400.05
$607.92 		$395.34
$425.58
$457.61
$571.40 		$566.69
$596.93
$628.96
$742.75 		$738.04
$768.28
$800.31
$914.10 		$171.35
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$447.98
$508.46
$572.52
$800.10
$1,215.84 		$619.33
$679.81
$743.87
$971.45 		$790.68
$851.16
$915.22
$1,142.80 		$962.03
$1,022.51
$1,086.57
$1,314.15 		$171.35
Toc - Plan #49 Friday Health Plans
Expanded Bronze

(HMO) Friday Bronze HSA

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-465-5500

Annual Out of Pocket Expenses:

Individual Family
$7,000 $14,000 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$230.66
$261.79
$294.78
$411.95
$626.00 		$407.11
$438.24
$471.23
$588.40 		$583.56
$614.69
$647.68
$764.85 		$760.01
$791.14
$824.13
$941.30 		$176.45
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$461.32
$523.58
$589.56
$823.90
$1,252.00 		$637.77
$700.03
$766.01
$1,000.35 		$814.22
$876.48
$942.46
$1,176.80 		$990.67
$1,052.93
$1,118.91
$1,353.25 		$176.45
Toc - Plan #50 Friday Health Plans
Silver

(HMO) Friday Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-465-5500

Annual Out of Pocket Expenses:

Individual Family
$5,500 $11,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$323.25
$366.89
$413.12
$577.33
$877.31 		$570.54
$614.18
$660.41
$824.62 		$817.83
$861.47
$907.70
$1,071.91 		$1,065.12
$1,108.76
$1,154.99
$1,319.20 		$247.29
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$646.50
$733.78
$826.24
$1,154.66
$1,754.62 		$893.79
$981.07
$1,073.53
$1,401.95 		$1,141.08
$1,228.36
$1,320.82
$1,649.24 		$1,388.37
$1,475.65
$1,568.11
$1,896.53 		$247.29
Toc - Plan #51 Friday Health Plans
Gold

(HMO) Friday Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-465-5500

Annual Out of Pocket Expenses:

Individual Family
$2,300 $4,600 Annual Deductible
$8,250 $16,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$281.02
$318.96
$359.14
$501.90
$762.68 		$496.00
$533.94
$574.12
$716.88 		$710.98
$748.92
$789.10
$931.86 		$925.96
$963.90
$1,004.08
$1,146.84 		$214.98
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$562.04
$637.92
$718.28
$1,003.80
$1,525.36 		$777.02
$852.90
$933.26
$1,218.78 		$992.00
$1,067.88
$1,148.24
$1,433.76 		$1,206.98
$1,282.86
$1,363.22
$1,648.74 		$214.98
Toc - Plan #52 Friday Health Plans
Expanded Bronze

(HMO) Friday Bronze Plus Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-465-5500

Annual Out of Pocket Expenses:

Individual Family
$8,700 $17,400 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$226.50
$257.07
$289.46
$404.52
$614.71 		$399.77
$430.34
$462.73
$577.79 		$573.04
$603.61
$636.00
$751.06 		$746.31
$776.88
$809.27
$924.33 		$173.27
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$453.00
$514.14
$578.92
$809.04
$1,229.42 		$626.27
$687.41
$752.19
$982.31 		$799.54
$860.68
$925.46
$1,155.58 		$972.81
$1,033.95
$1,098.73
$1,328.85 		$173.27
Toc - Plan #53 Friday Health Plans
Silver

(HMO) Friday Silver Plus Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-465-5500

Annual Out of Pocket Expenses:

Individual Family
$5,500 $11,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$326.94
$371.08
$417.83
$583.91
$887.31 		$577.05
$621.19
$667.94
$834.02 		$827.16
$871.30
$918.05
$1,084.13 		$1,077.27
$1,121.41
$1,168.16
$1,334.24 		$250.11
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$653.88
$742.16
$835.66
$1,167.82
$1,774.62 		$903.99
$992.27
$1,085.77
$1,417.93 		$1,154.10
$1,242.38
$1,335.88
$1,668.04 		$1,404.21
$1,492.49
$1,585.99
$1,918.15 		$250.11
Toc - Plan #54 Friday Health Plans
Gold

(HMO) Friday Gold Plus Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-465-5500

Annual Out of Pocket Expenses:

Individual Family
$2,300 $4,600 Annual Deductible
$8,250 $16,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$295.74
$335.67
$377.96
$528.19
$802.64 		$521.98
$561.91
$604.20
$754.43 		$748.22
$788.15
$830.44
$980.67 		$974.46
$1,014.39
$1,056.68
$1,206.91 		$226.24
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$591.48
$671.34
$755.92
$1,056.38
$1,605.28 		$817.72
$897.58
$982.16
$1,282.62 		$1,043.96
$1,123.82
$1,208.40
$1,508.86 		$1,270.20
$1,350.06
$1,434.64
$1,735.10 		$226.24

‡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 Rockingham County here.

Rockingham County is in “Rating Area 11” of North Carolina.

Currently, there are 54 plans offered in Rating Area 11.

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2022 Obamacare Plans for Rockingham County, NC

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