Providers for Zip Code 29646

Obamacare 2015 Marketplace Rates For Greenwood County, South Carolina

Thursday, November 27th, 2014

Click for Greenwood, South Carolina Forecast

The health insurance rates listed below are for calendar year 2015.

2015 Rates and Providers

(click here for 2014)

This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for Greenwood County, South Carolina.

Obamacare Providers, Plans and 2015 Rates for Greenwood County

Greenwood County is in “Rating Area 1” of South Carolina.

Currently, there are 3 providers offering 27 plans to Rating Area 1.

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, including deductible amounts, annual limits on out-of-pocket costs, and possible subsidies, 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 Greenwood, SC area accept this insurance coverage as within the plan's "network".

BlueCross BlueShield of South Carolina

Local: 1-803-264-1426 | Toll Free: 1-800-550-6322

Plan: (EPO) BlueEssentials Gold 1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $1,200 : Family: $2,350
Out of Pocket Maximum per year: Individual: $4,200 : Family: $8,250

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
$291.85
$331.25
$372.99
$521.25
$792.09
$583.70
$662.50
$745.98
$1042.50
$1584.18
$769.03
$847.83
$931.31
$1227.83
$954.36
$1033.16
$1116.64
$1413.16
$1139.69
$1218.49
$1301.97
$1598.49
$477.18
$516.58
$558.32
$706.58
$662.51
$701.91
$743.65
$891.91
$847.84
$887.24
$928.98
$1077.24
$185.33

Plan: (EPO) BlueEssentials Silver 1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $6,000 : Family: $9,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$269.81
$306.24
$344.82
$481.89
$732.28
$539.62
$612.48
$689.64
$963.78
$1464.56
$710.95
$783.81
$860.97
$1135.11
$882.28
$955.14
$1032.30
$1306.44
$1053.61
$1126.47
$1203.63
$1477.77
$441.14
$477.57
$516.15
$653.22
$612.47
$648.90
$687.48
$824.55
$783.80
$820.23
$858.81
$995.88
$171.33

Plan: (EPO) BlueEssentials Silver 2

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $2,000 : Family: $3,650
Out of Pocket Maximum per year: Individual: $6,350 : Family: $11,600

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$246.73
$280.04
$315.33
$440.67
$669.64
$493.46
$560.08
$630.66
$881.34
$1339.28
$650.14
$716.76
$787.34
$1038.02
$806.82
$873.44
$944.02
$1194.70
$963.50
$1030.12
$1100.70
$1351.38
$403.41
$436.72
$472.01
$597.35
$560.09
$593.40
$628.69
$754.03
$716.77
$750.08
$785.37
$910.71
$156.68

Plan: (EPO) BlueEssentials Silver 3

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $3,000 : Family: $5,700
Out of Pocket Maximum per year: Individual: $5,200 : Family: $9,850

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
Silver 21
30
40
50
60
$255.16
$289.60
$326.09
$455.71
$692.50
$510.32
$579.20
$652.18
$911.42
$1385.00
$672.34
$741.22
$814.20
$1073.44
$834.36
$903.24
$976.22
$1235.46
$996.38
$1065.26
$1138.24
$1397.48
$417.18
$451.62
$488.11
$617.73
$579.20
$613.64
$650.13
$779.75
$741.22
$775.66
$812.15
$941.77
$162.02

Plan: (EPO) BlueEssentials Bronze 1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $5,000 : Family: $9,050
Out of Pocket Maximum per year: Individual: $6,250 : Family: $11,300

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
$224.04
$254.29
$286.33
$400.14
$608.05
$448.08
$508.58
$572.66
$800.28
$1216.10
$590.35
$650.85
$714.93
$942.55
$732.62
$793.12
$857.20
$1084.82
$874.89
$935.39
$999.47
$1227.09
$366.31
$396.56
$428.60
$542.41
$508.58
$538.83
$570.87
$684.68
$650.85
$681.10
$713.14
$826.95
$142.27

Plan: (EPO) BlueEssentials HD Bronze 2

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $5,000 : Family: $8,650
Out of Pocket Maximum per year: Individual: $6,350 : Family: $11,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$220.36
$250.11
$281.62
$393.57
$598.06
$440.72
$500.22
$563.24
$787.14
$1196.12
$580.65
$640.15
$703.17
$927.07
$720.58
$780.08
$843.10
$1067.00
$860.51
$920.01
$983.03
$1206.93
$360.29
$390.04
$421.55
$533.50
$500.22
$529.97
$561.48
$673.43
$640.15
$669.90
$701.41
$813.36
$139.93

Plan: (EPO) BlueEssentials Gold 2

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $800 : Family: $1,450
Out of Pocket Maximum per year: Individual: $4,000 : Family: $7,450

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
$295.12
$334.97
$377.17
$527.09
$800.97
$590.24
$669.94
$754.34
$1054.18
$1601.94
$777.64
$857.34
$941.74
$1241.58
$965.04
$1044.74
$1129.14
$1428.98
$1152.44
$1232.14
$1316.54
$1616.38
$482.52
$522.37
$564.57
$714.49
$669.92
$709.77
$751.97
$901.89
$857.32
$897.17
$939.37
$1089.29
$187.40

Plan: (EPO) BlueEssentials HD Gold 3

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $2,000 : Family: $4,250
Out of Pocket Maximum per year: Individual: $2,000 : Family: $4,250

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
$299.88
$340.36
$383.24
$535.58
$813.87
$599.76
$680.72
$766.48
$1071.16
$1627.74
$790.18
$871.14
$956.90
$1261.58
$980.60
$1061.56
$1147.32
$1452.00
$1171.02
$1251.98
$1337.74
$1642.42
$490.30
$530.78
$573.66
$726.00
$680.72
$721.20
$764.08
$916.42
$871.14
$911.62
$954.50
$1106.84
$190.42

Plan: (EPO) BlueEssentials Silver 4

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $1,900 : Family: $3,450
Out of Pocket Maximum per year: Individual: $6,600 : Family: $12,050

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
$254.74
$289.13
$325.55
$454.96
$691.35
$509.48
$578.26
$651.10
$909.92
$1382.70
$671.24
$740.02
$812.86
$1071.68
$833.00
$901.78
$974.62
$1233.44
$994.76
$1063.54
$1136.38
$1395.20
$416.50
$450.89
$487.31
$616.72
$578.26
$612.65
$649.07
$778.48
$740.02
$774.41
$810.83
$940.24
$161.76

Plan: (EPO) BlueEssentials HD Silver 5

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $2,300 : Family: $4,300
Out of Pocket Maximum per year: Individual: $5,000 : Family: $9,400

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
$257.68
$292.47
$329.32
$460.22
$699.35
$515.36
$584.94
$658.64
$920.44
$1398.70
$678.99
$748.57
$822.27
$1084.07
$842.62
$912.20
$985.90
$1247.70
$1006.25
$1075.83
$1149.53
$1411.33
$421.31
$456.10
$492.95
$623.85
$584.94
$619.73
$656.58
$787.48
$748.57
$783.36
$820.21
$951.11
$163.63

Plan: (EPO) BlueEssentials HD Silver 6

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $3,600 : Family: $6,900
Out of Pocket Maximum per year: Individual: $3,600 : Family: $6,900

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$258.54
$293.45
$330.42
$461.76
$701.69
$517.08
$586.90
$660.84
$923.52
$1403.38
$681.25
$751.07
$825.01
$1087.69
$845.42
$915.24
$989.18
$1251.86
$1009.59
$1079.41
$1153.35
$1416.03
$422.71
$457.62
$494.59
$625.93
$586.88
$621.79
$658.76
$790.10
$751.05
$785.96
$822.93
$954.27
$164.17

Plan: (EPO) BlueEssentials HD Bronze 3

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $4,000 : Family: $7,100
Out of Pocket Maximum per year: Individual: $6,350 : Family: $11,300

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
$228.80
$259.68
$292.40
$408.63
$620.95
$457.60
$519.36
$584.80
$817.26
$1241.90
$602.89
$664.65
$730.09
$962.55
$748.18
$809.94
$875.38
$1107.84
$893.47
$955.23
$1020.67
$1253.13
$374.09
$404.97
$437.69
$553.92
$519.38
$550.26
$582.98
$699.21
$664.67
$695.55
$728.27
$844.50
$145.29

Plan: (EPO) BlueEssentials HD Bronze 4

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $5,200 : Family: $9,000
Out of Pocket Maximum per year: Individual: $6,450 : Family: $11,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$220.39
$250.15
$281.66
$393.62
$598.15
$440.78
$500.30
$563.32
$787.24
$1196.30
$580.73
$640.25
$703.27
$927.19
$720.68
$780.20
$843.22
$1067.14
$860.63
$920.15
$983.17
$1207.09
$360.34
$390.10
$421.61
$533.57
$500.29
$530.05
$561.56
$673.52
$640.24
$670.00
$701.51
$813.47
$139.95

Plan: (EPO) BlueEssentials HD Bronze 5

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $6,300 : Family: $10,950
Out of Pocket Maximum per year: Individual: $6,300 : Family: $10,950

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
$220.46
$250.22
$281.74
$393.74
$598.32
$440.92
$500.44
$563.48
$787.48
$1196.64
$580.91
$640.43
$703.47
$927.47
$720.90
$780.42
$843.46
$1067.46
$860.89
$920.41
$983.45
$1207.45
$360.45
$390.21
$421.73
$533.73
$500.44
$530.20
$561.72
$673.72
$640.43
$670.19
$701.71
$813.71
$139.99

Plan: (EPO) BlueEssentials Silver 7

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $6,000 : Family: $11,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $11,900

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$237.33
$269.37
$303.31
$423.88
$644.12
$474.66
$538.74
$606.62
$847.76
$1288.24
$625.37
$689.45
$757.33
$998.47
$776.08
$840.16
$908.04
$1149.18
$926.79
$990.87
$1058.75
$1299.89
$388.04
$420.08
$454.02
$574.59
$538.75
$570.79
$604.73
$725.30
$689.46
$721.50
$755.44
$876.01
$150.71

Plan: (EPO) BlueEssentials Catastrophic 1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $6,600 : Family: $13,200
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Catastrophic 21
30
40
50
60
$201.03
$228.16
$256.91
$359.03
$545.58
$402.06
$456.32
$513.82
$718.06
$1091.16
$529.71
$583.97
$641.47
$845.71
$657.36
$711.62
$769.12
$973.36
$785.01
$839.27
$896.77
$1101.01
$328.68
$355.81
$384.56
$486.68
$456.33
$483.46
$512.21
$614.33
$583.98
$611.11
$639.86
$741.98
$127.65

Plan: (EPO) Blue Cross Blue Shield Gold 1, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $1,000 : Family: $1,900
Out of Pocket Maximum per year: Individual: $4,200 : Family: $8,100

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
Gold 21
30
40
50
60
$294.54
$334.30
$376.42
$526.04
$799.37
$589.08
$668.60
$752.84
$1052.08
$1598.74
$776.11
$855.63
$939.87
$1239.11
$963.14
$1042.66
$1126.90
$1426.14
$1150.17
$1229.69
$1313.93
$1613.17
$481.57
$521.33
$563.45
$713.07
$668.60
$708.36
$750.48
$900.10
$855.63
$895.39
$937.51
$1087.13
$187.03

Plan: (EPO) Blue Cross Blue Shield Silver 1, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-550-6322 - Provider Directory for This Plan: (BlueCross BlueShield of South Carolina)

Deductible: Individual: $2,500 : Family: $4,550
Out of Pocket Maximum per year: Individual: $6,000 : 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
$252.39
$286.46
$322.56
$450.77
$684.99
$504.78
$572.92
$645.12
$901.54
$1369.98
$665.05
$733.19
$805.39
$1061.81
$825.32
$893.46
$965.66
$1222.08
$985.59
$1053.73
$1125.93
$1382.35
$412.66
$446.73
$482.83
$611.04
$572.93
$607.00
$643.10
$771.31
$733.20
$767.27
$803.37
$931.58
$160.27

Assurant Health

Local: 1-414-271-3011 | Toll Free: 1-800-800-1212

Plan: (PPO) Assurant Health Bronze Plan 001

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-1212 - Provider Directory for This Plan: (Assurant Health)

Deductible: Individual: $6,000 : Family: $12,000
Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$311.97
$354.09
$398.70
$557.18
$846.69
$623.94
$708.18
$797.40
$1114.36
$1693.38
$822.04
$906.28
$995.50
$1312.46
$1020.14
$1104.38
$1193.60
$1510.56
$1218.24
$1302.48
$1391.70
$1708.66
$510.07
$552.19
$596.80
$755.28
$708.17
$750.29
$794.90
$953.38
$906.27
$948.39
$993.00
$1151.48
$198.10

Plan: (PPO) Assurant Health Silver Plan 001

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-1212 - Provider Directory for This Plan: (Assurant Health)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: 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
$371.57
$421.73
$474.87
$663.62
$1008.44
$743.14
$843.46
$949.74
$1327.24
$2016.88
$979.09
$1079.41
$1185.69
$1563.19
$1215.04
$1315.36
$1421.64
$1799.14
$1450.99
$1551.31
$1657.59
$2035.09
$607.52
$657.68
$710.82
$899.57
$843.47
$893.63
$946.77
$1135.52
$1079.42
$1129.58
$1182.72
$1371.47
$235.95

Plan: (PPO) Assurant Health Bronze Plan 002

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-1212 - Provider Directory for This Plan: (Assurant Health)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

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
$323.01
$366.62
$412.81
$576.90
$876.65
$646.02
$733.24
$825.62
$1153.80
$1753.30
$851.13
$938.35
$1030.73
$1358.91
$1056.24
$1143.46
$1235.84
$1564.02
$1261.35
$1348.57
$1440.95
$1769.13
$528.12
$571.73
$617.92
$782.01
$733.23
$776.84
$823.03
$987.12
$938.34
$981.95
$1028.14
$1192.23
$205.11

Plan: (PPO) Assurant Health Silver Plan 002

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-1212 - Provider Directory for This Plan: (Assurant Health)

Deductible: Individual: $2,000 : Family: $4,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

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
$378.56
$429.67
$483.80
$676.11
$1027.41
$757.12
$859.34
$967.60
$1352.22
$2054.82
$997.51
$1099.73
$1207.99
$1592.61
$1237.90
$1340.12
$1448.38
$1833.00
$1478.29
$1580.51
$1688.77
$2073.39
$618.95
$670.06
$724.19
$916.50
$859.34
$910.45
$964.58
$1156.89
$1099.73
$1150.84
$1204.97
$1397.28
$240.39

Plan: (PPO) Assurant Health Gold Plan 002

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-1212 - Provider Directory for This Plan: (Assurant Health)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

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
$455.82
$517.36
$582.54
$814.09
$1237.10
$911.64
$1034.72
$1165.08
$1628.18
$2474.20
$1201.09
$1324.17
$1454.53
$1917.63
$1490.54
$1613.62
$1743.98
$2207.08
$1779.99
$1903.07
$2033.43
$2496.53
$745.27
$806.81
$871.99
$1103.54
$1034.72
$1096.26
$1161.44
$1392.99
$1324.17
$1385.71
$1450.89
$1682.44
$289.45

Plan: (PPO) Assurant Health Platinum Plan 002

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-1212 - Provider Directory for This Plan: (Assurant Health)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: 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
Platinum 21
30
40
50
60
$520.93
$591.26
$665.75
$930.38
$1413.80
$1041.86
$1182.52
$1331.50
$1860.76
$2827.60
$1372.65
$1513.31
$1662.29
$2191.55
$1703.44
$1844.10
$1993.08
$2522.34
$2034.23
$2174.89
$2323.87
$2853.13
$851.72
$922.05
$996.54
$1261.17
$1182.51
$1252.84
$1327.33
$1591.96
$1513.30
$1583.63
$1658.12
$1922.75
$330.79

BlueChoice HealthPlan

Local: 1-855-433-2132 | Toll Free: 1-855-433-2132

Plan: (EPO) Blue Option Bronze 5001 HD

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $5,000 : Family: $8,650
Out of Pocket Maximum per year: Individual: $6,350 : Family: $11,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$217.68
$247.07
$278.20
$388.78
$590.79
$435.36
$494.14
$556.40
$777.56
$1181.58
$573.59
$632.37
$694.63
$915.79
$711.82
$770.60
$832.86
$1054.02
$850.05
$908.83
$971.09
$1192.25
$355.91
$385.30
$416.43
$527.01
$494.14
$523.53
$554.66
$665.24
$632.37
$661.76
$692.89
$803.47
$138.23

Plan: (EPO) Blue Option Bronze 5002

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $5,000 : Family: $8,900
Out of Pocket Maximum per year: Individual: $6,250 : Family: $11,100

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$230.43
$261.53
$294.48
$411.54
$625.38
$460.86
$523.06
$588.96
$823.08
$1250.76
$607.18
$669.38
$735.28
$969.40
$753.50
$815.70
$881.60
$1115.72
$899.82
$962.02
$1027.92
$1262.04
$376.75
$407.85
$440.80
$557.86
$523.07
$554.17
$587.12
$704.18
$669.39
$700.49
$733.44
$850.50
$146.32

Plan: (EPO) Blue Option Bronze 6350

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $6,350 : Family: $10,950
Out of Pocket Maximum per year: Individual: $6,350 : Family: $10,950

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
$218.87
$248.42
$279.72
$390.90
$594.01
$437.74
$496.84
$559.44
$781.80
$1188.02
$576.72
$635.82
$698.42
$920.78
$715.70
$774.80
$837.40
$1059.76
$854.68
$913.78
$976.38
$1198.74
$357.85
$387.40
$418.70
$529.88
$496.83
$526.38
$557.68
$668.86
$635.81
$665.36
$696.66
$807.84
$138.98

Plan: (EPO) Blue Option Catastrophic

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $6,600 : Family: $13,200
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Catastrophic 21
30
40
50
60
$198.69
$225.51
$253.93
$354.86
$539.25
$397.38
$451.02
$507.86
$709.72
$1078.50
$523.55
$577.19
$634.03
$835.89
$649.72
$703.36
$760.20
$962.06
$775.89
$829.53
$886.37
$1088.23
$324.86
$351.68
$380.10
$481.03
$451.03
$477.85
$506.27
$607.20
$577.20
$604.02
$632.44
$733.37
$126.17

Plan: (EPO) Blue Option Silver 400

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $400 : Family: $650
Out of Pocket Maximum per year: Individual: $6,350 : Family: $10,500

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$255.36
$289.83
$326.35
$456.07
$693.04
$510.72
$579.66
$652.70
$912.14
$1386.08
$672.87
$741.81
$814.85
$1074.29
$835.02
$903.96
$977.00
$1236.44
$997.17
$1066.11
$1139.15
$1398.59
$417.51
$451.98
$488.50
$618.22
$579.66
$614.13
$650.65
$780.37
$741.81
$776.28
$812.80
$942.52
$162.15

Plan: (EPO) Blue Option Silver 2501 HD

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $2,500 : Family: $4,700
Out of Pocket Maximum per year: Individual: $5,650 : 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
$252.72
$286.83
$322.97
$451.35
$685.88
$505.44
$573.66
$645.94
$902.70
$1371.76
$665.92
$734.14
$806.42
$1063.18
$826.40
$894.62
$966.90
$1223.66
$986.88
$1055.10
$1127.38
$1384.14
$413.20
$447.31
$483.45
$611.83
$573.68
$607.79
$643.93
$772.31
$734.16
$768.27
$804.41
$932.79
$160.48

Plan: (EPO) Blue Option Silver 2500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $2,500 : Family: $4,500
Out of Pocket Maximum per year: Individual: $6,350 : Family: $11,500

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$246.39
$279.65
$314.88
$440.05
$668.70
$492.78
$559.30
$629.76
$880.10
$1337.40
$649.24
$715.76
$786.22
$1036.56
$805.70
$872.22
$942.68
$1193.02
$962.16
$1028.68
$1099.14
$1349.48
$402.85
$436.11
$471.34
$596.51
$559.31
$592.57
$627.80
$752.97
$715.77
$749.03
$784.26
$909.43
$156.46

Plan: (EPO) Blue Option Silver 1750

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $1,750 : Family: $3,150
Out of Pocket Maximum per year: Individual: $6,350 : Family: $11,450

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
$250.88
$284.75
$320.62
$448.07
$680.88
$501.76
$569.50
$641.24
$896.14
$1361.76
$661.07
$728.81
$800.55
$1055.45
$820.38
$888.12
$959.86
$1214.76
$979.69
$1047.43
$1119.17
$1374.07
$410.19
$444.06
$479.93
$607.38
$569.50
$603.37
$639.24
$766.69
$728.81
$762.68
$798.55
$926.00
$159.31

Plan: (EPO) Blue Option Silver 1500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $1,500 : Family: $2,600
Out of Pocket Maximum per year: Individual: $6,350 : Family: $11,050

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
$245.39
$278.52
$313.61
$438.26
$665.98
$490.78
$557.04
$627.22
$876.52
$1331.96
$646.60
$712.86
$783.04
$1032.34
$802.42
$868.68
$938.86
$1188.16
$958.24
$1024.50
$1094.68
$1343.98
$401.21
$434.34
$469.43
$594.08
$557.03
$590.16
$625.25
$749.90
$712.85
$745.98
$781.07
$905.72
$155.82

Plan: (EPO) Blue Option Gold 1000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $1,000 : Family: $2,400
Out of Pocket Maximum per year: Individual: $6,350 : Family: $13,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$298.17
$338.43
$381.07
$532.54
$809.24
$596.34
$676.86
$762.14
$1065.08
$1618.48
$785.68
$866.20
$951.48
$1254.42
$975.02
$1055.54
$1140.82
$1443.76
$1164.36
$1244.88
$1330.16
$1633.10
$487.51
$527.77
$570.41
$721.88
$676.85
$717.11
$759.75
$911.22
$866.19
$906.45
$949.09
$1100.56
$189.34

Plan: (EPO) Blue Option Silver 3000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $3,000 : Family: $5,400
Out of Pocket Maximum per year: Individual: $5,500 : Family: $9,950

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
$243.09
$275.90
$310.66
$434.15
$659.73
$486.18
$551.80
$621.32
$868.30
$1319.46
$640.54
$706.16
$775.68
$1022.66
$794.90
$860.52
$930.04
$1177.02
$949.26
$1014.88
$1084.40
$1331.38
$397.45
$430.26
$465.02
$588.51
$551.81
$584.62
$619.38
$742.87
$706.17
$738.98
$773.74
$897.23
$154.36

Plan: (EPO) Blue Option Silver 3500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $3,500 : Family: $6,850
Out of Pocket Maximum per year: Individual: $4,500 : 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
$248.89
$282.49
$318.08
$444.52
$675.49
$497.78
$564.98
$636.16
$889.04
$1350.98
$655.83
$723.03
$794.21
$1047.09
$813.88
$881.08
$952.26
$1205.14
$971.93
$1039.13
$1110.31
$1363.19
$406.94
$440.54
$476.13
$602.57
$564.99
$598.59
$634.18
$760.62
$723.04
$756.64
$792.23
$918.67
$158.05

Plan: (EPO) Blue Option Silver 4000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $4,000 : Family: $7,500
Out of Pocket Maximum per year: Individual: $5,000 : Family: $9,400

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
$245.22
$278.33
$313.39
$437.96
$665.53
$490.44
$556.66
$626.78
$875.92
$1331.06
$646.15
$712.37
$782.49
$1031.63
$801.86
$868.08
$938.20
$1187.34
$957.57
$1023.79
$1093.91
$1343.05
$400.93
$434.04
$469.10
$593.67
$556.64
$589.75
$624.81
$749.38
$712.35
$745.46
$780.52
$905.09
$155.71

Plan: (EPO) Blue Option Silver 6000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $6,000 : Family: $11,100
Out of Pocket Maximum per year: Individual: $6,350 : Family: $11,750

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
$234.52
$266.18
$299.71
$418.85
$636.48
$469.04
$532.36
$599.42
$837.70
$1272.96
$617.96
$681.28
$748.34
$986.62
$766.88
$830.20
$897.26
$1135.54
$915.80
$979.12
$1046.18
$1284.46
$383.44
$415.10
$448.63
$567.77
$532.36
$564.02
$597.55
$716.69
$681.28
$712.94
$746.47
$865.61
$148.92

Plan: (EPO) Blue Option Gold 1100

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $1,100 : Family: $2,250
Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,150

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
$294.70
$334.49
$376.63
$526.34
$799.83
$589.40
$668.98
$753.26
$1052.68
$1599.66
$776.54
$856.12
$940.40
$1239.82
$963.68
$1043.26
$1127.54
$1426.96
$1150.82
$1230.40
$1314.68
$1614.10
$481.84
$521.63
$563.77
$713.48
$668.98
$708.77
$750.91
$900.62
$856.12
$895.91
$938.05
$1087.76
$187.14

Plan: (EPO) Blue Option Gold 800

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $800 : Family: $1,500
Out of Pocket Maximum per year: Individual: $3,500 : Family: $6,700

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
$292.44
$331.92
$373.74
$522.30
$793.69
$584.88
$663.84
$747.48
$1044.60
$1587.38
$770.58
$849.54
$933.18
$1230.30
$956.28
$1035.24
$1118.88
$1416.00
$1141.98
$1220.94
$1304.58
$1601.70
$478.14
$517.62
$559.44
$708.00
$663.84
$703.32
$745.14
$893.70
$849.54
$889.02
$930.84
$1079.40
$185.70

Plan: (EPO) Blue Option Gold 2000 HD

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $2,000 : Family: $4,250
Out of Pocket Maximum per year: Individual: $2,000 : Family: $4,250

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
$295.76
$335.68
$377.98
$528.22
$802.68
$591.52
$671.36
$755.96
$1056.44
$1605.36
$779.32
$859.16
$943.76
$1244.24
$967.12
$1046.96
$1131.56
$1432.04
$1154.92
$1234.76
$1319.36
$1619.84
$483.56
$523.48
$565.78
$716.02
$671.36
$711.28
$753.58
$903.82
$859.16
$899.08
$941.38
$1091.62
$187.80

Plan: (EPO) Blue Option Bronze 4500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $4,500 : Family: $8,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $11,550

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
$220.21
$249.93
$281.42
$393.29
$597.64
$440.42
$499.86
$562.84
$786.58
$1195.28
$580.25
$639.69
$702.67
$926.41
$720.08
$779.52
$842.50
$1066.24
$859.91
$919.35
$982.33
$1206.07
$360.04
$389.76
$421.25
$533.12
$499.87
$529.59
$561.08
$672.95
$639.70
$669.42
$700.91
$812.78
$139.83

Plan: (EPO) Blue Option Bronze 6250 HD

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $6,250 : Family: $10,850
Out of Pocket Maximum per year: Individual: $6,250 : Family: $10,850

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
Bronze 21
30
40
50
60
$218.26
$247.72
$278.94
$389.81
$592.36
$436.52
$495.44
$557.88
$779.62
$1184.72
$575.12
$634.04
$696.48
$918.22
$713.72
$772.64
$835.08
$1056.82
$852.32
$911.24
$973.68
$1195.42
$356.86
$386.32
$417.54
$528.41
$495.46
$524.92
$556.14
$667.01
$634.06
$663.52
$694.74
$805.61
$138.60

Plan: (EPO) Blue Option Bronze 6500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $6,500 : Family: $11,100
Out of Pocket Maximum per year: Individual: $6,500 : Family: $11,100

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$219.34
$248.95
$280.32
$391.75
$595.30
$438.68
$497.90
$560.64
$783.50
$1190.60
$577.96
$637.18
$699.92
$922.78
$717.24
$776.46
$839.20
$1062.06
$856.52
$915.74
$978.48
$1201.34
$358.62
$388.23
$419.60
$531.03
$497.90
$527.51
$558.88
$670.31
$637.18
$666.79
$698.16
$809.59
$139.28

Plan: (EPO) Blue Option Silver 2000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $2,000 : Family: $3,750
Out of Pocket Maximum per year: Individual: $4,500 : Family: $8,500

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$253.51
$287.73
$323.98
$452.76
$688.02
$507.02
$575.46
$647.96
$905.52
$1376.04
$668.00
$736.44
$808.94
$1066.50
$828.98
$897.42
$969.92
$1227.48
$989.96
$1058.40
$1130.90
$1388.46
$414.49
$448.71
$484.96
$613.74
$575.47
$609.69
$645.94
$774.72
$736.45
$770.67
$806.92
$935.70
$160.98

Plan: (EPO) Blue Option Silver 3250 HD

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $3,250 : Family: $6,350
Out of Pocket Maximum per year: Individual: $3,250 : Family: $6,350

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
$260.58
$295.76
$333.02
$465.40
$707.22
$521.16
$591.52
$666.04
$930.80
$1414.44
$686.63
$756.99
$831.51
$1096.27
$852.10
$922.46
$996.98
$1261.74
$1017.57
$1087.93
$1162.45
$1427.21
$426.05
$461.23
$498.49
$630.87
$591.52
$626.70
$663.96
$796.34
$756.99
$792.17
$829.43
$961.81
$165.47

Plan: (EPO) Blue Option Silver 3650 HD

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-433-2132 - Provider Directory for This Plan: (BlueChoice HealthPlan)

Deductible: Individual: $3,650 : Family: $7,000
Out of Pocket Maximum per year: Individual: $3,650 : 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
$254.39
$288.73
$325.11
$454.34
$690.41
$508.78
$577.46
$650.22
$908.68
$1380.82
$670.32
$739.00
$811.76
$1070.22
$831.86
$900.54
$973.30
$1231.76
$993.40
$1062.08
$1134.84
$1393.30
$415.93
$450.27
$486.65
$615.88
$577.47
$611.81
$648.19
$777.42
$739.01
$773.35
$809.73
$938.96
$161.54

Consumers' Choice Health Plan

Local: 1-800-580-8736 | Toll Free: 1-800-580-8736

TTY: 1-800-545-8279

Plan: (EPO) Consumers' Choice Gold 1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-580-8736 - Provider Directory for This Plan: (Consumers' Choice Health Plan)

Deductible: Individual: $600 : Family: $1,200
Out of Pocket Maximum per year: Individual: $4,500 : Family: $9,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$441.91
$501.55
$564.74
$789.23
$1199.31
$883.82
$1003.10
$1129.48
$1578.46
$2398.62
$1164.42
$1283.70
$1410.08
$1859.06
$1445.02
$1564.30
$1690.68
$2139.66
$1725.62
$1844.90
$1971.28
$2420.26
$722.51
$782.15
$845.34
$1069.83
$1003.11
$1062.75
$1125.94
$1350.43
$1283.71
$1343.35
$1406.54
$1631.03
$280.60

Plan: (EPO) Consumers' Choice Gold 2

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-580-8736 - Provider Directory for This Plan: (Consumers' Choice Health Plan)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: 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
Gold 21
30
40
50
60
$425.61
$483.06
$543.92
$760.12
$1155.08
$851.22
$966.12
$1087.84
$1520.24
$2310.16
$1121.48
$1236.38
$1358.10
$1790.50
$1391.74
$1506.64
$1628.36
$2060.76
$1662.00
$1776.90
$1898.62
$2331.02
$695.87
$753.32
$814.18
$1030.38
$966.13
$1023.58
$1084.44
$1300.64
$1236.39
$1293.84
$1354.70
$1570.90
$270.26

Plan: (EPO) Consumers' Choice Silver 1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-580-8736 - Provider Directory for This Plan: (Consumers' Choice Health Plan)

Deductible: Individual: $2,000 : Family: $4,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

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
$370.42
$420.41
$473.38
$661.55
$1005.29
$740.84
$840.82
$946.76
$1323.10
$2010.58
$976.05
$1076.03
$1181.97
$1558.31
$1211.26
$1311.24
$1417.18
$1793.52
$1446.47
$1546.45
$1652.39
$2028.73
$605.63
$655.62
$708.59
$896.76
$840.84
$890.83
$943.80
$1131.97
$1076.05
$1126.04
$1179.01
$1367.18
$235.21

Plan: (EPO) Consumers' Choice Silver 2

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-580-8736 - Provider Directory for This Plan: (Consumers' Choice Health Plan)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

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
$362.27
$411.16
$462.97
$647.00
$983.17
$724.54
$822.32
$925.94
$1294.00
$1966.34
$954.57
$1052.35
$1155.97
$1524.03
$1184.60
$1282.38
$1386.00
$1754.06
$1414.63
$1512.41
$1616.03
$1984.09
$592.30
$641.19
$693.00
$877.03
$822.33
$871.22
$923.03
$1107.06
$1052.36
$1101.25
$1153.06
$1337.09
$230.03

Plan: (EPO) Consumers' Choice Silver HDP 1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-580-8736 - Provider Directory for This Plan: (Consumers' Choice Health Plan)

Deductible: Individual: $2,900 : Family: $5,800
Out of Pocket Maximum per year: Individual: $2,900 : Family: $5,800

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
$366.34
$415.79
$468.17
$654.27
$994.23
$732.68
$831.58
$936.34
$1308.54
$1988.46
$965.30
$1064.20
$1168.96
$1541.16
$1197.92
$1296.82
$1401.58
$1773.78
$1430.54
$1529.44
$1634.20
$2006.40
$598.96
$648.41
$700.79
$886.89
$831.58
$881.03
$933.41
$1119.51
$1064.20
$1113.65
$1166.03
$1352.13
$232.62

Plan: (EPO) Consumers' Choice Bronze 1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-580-8736 - Provider Directory for This Plan: (Consumers' Choice Health Plan)

Deductible: Individual: $4,400 : Family: $8,800
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$278.93
$316.57
$356.46
$498.15
$756.98
$557.86
$633.14
$712.92
$996.30
$1513.96
$734.97
$810.25
$890.03
$1173.41
$912.08
$987.36
$1067.14
$1350.52
$1089.19
$1164.47
$1244.25
$1527.63
$456.04
$493.68
$533.57
$675.26
$633.15
$670.79
$710.68
$852.37
$810.26
$847.90
$887.79
$1029.48
$177.11

Plan: (EPO) Consumers' Choice Bronze HDP 1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-580-8736 - Provider Directory for This Plan: (Consumers' Choice Health Plan)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: Individual: $5,500 : Family: $11,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$264.48
$300.18
$337.99
$472.35
$717.78
$528.96
$600.36
$675.98
$944.70
$1435.56
$696.90
$768.30
$843.92
$1112.64
$864.84
$936.24
$1011.86
$1280.58
$1032.78
$1104.18
$1179.80
$1448.52
$432.42
$468.12
$505.93
$640.29
$600.36
$636.06
$673.87
$808.23
$768.30
$804.00
$841.81
$976.17
$167.94

Plan: (EPO) Consumers' Choice Value Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-580-8736 - Provider Directory for This Plan: (Consumers' Choice Health Plan)

Deductible: Individual: $6,600 : Family: $13,200
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Catastrophic 21
30
40
50
60
$240.78
$273.27
$307.70
$430.01
$653.44
$481.56
$546.54
$615.40
$860.02
$1306.88
$634.45
$699.43
$768.29
$1012.91
$787.34
$852.32
$921.18
$1165.80
$940.23
$1005.21
$1074.07
$1318.69
$393.67
$426.16
$460.59
$582.90
$546.56
$579.05
$613.48
$735.79
$699.45
$731.94
$766.37
$888.68
$152.89

Plan: (EPO) Consumers' Choice Silver 10

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-580-8736 - Provider Directory for This Plan: (Consumers' Choice Health Plan)

Deductible: Individual: $4,000 : Family: $8,000
Out of Pocket Maximum per year: 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
$347.82
$394.77
$444.51
$621.19
$943.97
$695.64
$789.54
$889.02
$1242.38
$1887.94
$916.50
$1010.40
$1109.88
$1463.24
$1137.36
$1231.26
$1330.74
$1684.10
$1358.22
$1452.12
$1551.60
$1904.96
$568.68
$615.63
$665.37
$842.05
$789.54
$836.49
$886.23
$1062.91
$1010.40
$1057.35
$1107.09
$1283.77
$220.86

Plan: (EPO) Consumers' Choice Silver 11

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-580-8736 - Provider Directory for This Plan: (Consumers' Choice Health Plan)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$386.35
$438.49
$493.74
$690.00
$1048.52
$772.70
$876.98
$987.48
$1380.00
$2097.04
$1018.02
$1122.30
$1232.80
$1625.32
$1263.34
$1367.62
$1478.12
$1870.64
$1508.66
$1612.94
$1723.44
$2115.96
$631.67
$683.81
$739.06
$935.32
$876.99
$929.13
$984.38
$1180.64
$1122.31
$1174.45
$1229.70
$1425.96
$245.32

Plan: (EPO) Consumers' Choice Bronze 10

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-580-8736 - Provider Directory for This Plan: (Consumers' Choice Health Plan)

Deductible: Individual: $6,300 : Family: $12,600
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$273.00
$309.84
$348.88
$487.56
$740.90
$546.00
$619.68
$697.76
$975.12
$1481.80
$719.35
$793.03
$871.11
$1148.47
$892.70
$966.38
$1044.46
$1321.82
$1066.05
$1139.73
$1217.81
$1495.17
$446.35
$483.19
$522.23
$660.91
$619.70
$656.54
$695.58
$834.26
$793.05
$829.89
$868.93
$1007.61
$173.35

Plan: (EPO) CO-OPtions Consumers' Choice Silver 12, A Multistate Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-580-8736 - Provider Directory for This Plan: (Consumers' Choice Health Plan)

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

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
$368.57
$418.31
$471.02
$658.24
$1000.26
$737.14
$836.62
$942.04
$1316.48
$2000.52
$971.17
$1070.65
$1176.07
$1550.51
$1205.20
$1304.68
$1410.10
$1784.54
$1439.23
$1538.71
$1644.13
$2018.57
$602.60
$652.34
$705.05
$892.27
$836.63
$886.37
$939.08
$1126.30
$1070.66
$1120.40
$1173.11
$1360.33
$234.03

Plan: (EPO) CO-OPtions Consumers Choice' Gold 4, A Multistate Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-580-8736 - Provider Directory for This Plan: (Consumers' Choice Health Plan)

Deductible: Individual: $1,500 : Family: $3,000
Out of Pocket Maximum per year: Individual: $3,500 : Family: $7,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$410.42
$465.82
$524.51
$733.00
$1113.86
$820.84
$931.64
$1049.02
$1466.00
$2227.72
$1081.45
$1192.25
$1309.63
$1726.61
$1342.06
$1452.86
$1570.24
$1987.22
$1602.67
$1713.47
$1830.85
$2247.83
$671.03
$726.43
$785.12
$993.61
$931.64
$987.04
$1045.73
$1254.22
$1192.25
$1247.65
$1306.34
$1514.83
$260.61

†Source: Our summary of lowest costs and numbers of providers is based on a government report released September 25, 2013. For more detailed information about specific plans and providers, see HealthCare.gov.

‡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 Greenwood County here.

 

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