Obamacare Providers, Plans and 2017 Rates for Tuscarawas County
The health insurance rates listed below are for calendar year 2017.
2017 Rates and Providers
(click here for 2014)
(click here for 2015)
(click here for 2016)
This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for New Philadelphia, OH.
Currently, there are 66 plans offered in Tuscarawas County.
Below, you’ll find a summary of plans and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options. For detailed information on available subsidies to make your coverage affordable, you must complete an application at HealthCare.gov or contact the provider directly.
The table below shows premiums for the following scenarios:
- Individual
- Couple
- Couple with 1 2 or 3 children
- Individual with 1 2 or 3 children
- A child alone
Each scenario is covered for age
- Age 21, 30, 40, 50
- Age 60 (Individual and Couple only)
For each plan, there are links that go to the insurance provider's website in a new window. You can find links to:
- a summary of plan benefits and costs,
- a plan brochure, and
- a "Provider Directory" -- where you can find out which doctors and hospitals in the New Philadelphia, OH area accept this insurance coverage as within the plan's "network".
‡Source: HealthCare.gov has released sample rates for all counties in those states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Tuscarawas County here.
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AultCare Insurance CompanyLocal: 1-330-363-6360 | Toll Free: 1-800-344-8858 TTY: 1-330-363-2393 |
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Plan: (PPO) AultCare Bronze 6000 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,000
: Family:
$12,000 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$272.71 $309.52 $348.52 $487.06 $740.13 |
$545.42 $619.04 $697.04 $974.12 $1480.26 |
$718.59 $792.21 $870.21 $1147.29 |
$891.76 $965.38 $1043.38 $1320.46 |
$1064.93 $1138.55 $1216.55 $1493.63 |
$445.88 $482.69 $521.69 $660.23 |
$619.05 $655.86 $694.86 $833.40 |
$792.22 $829.03 $868.03 $1006.57 |
$173.17 |
Plan: (PPO) AultCare Bronze 5000 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$281.66 $319.68 $359.96 $503.04 $764.41 |
$563.32 $639.36 $719.92 $1006.08 $1528.82 |
$742.17 $818.21 $898.77 $1184.93 |
$921.02 $997.06 $1077.62 $1363.78 |
$1099.87 $1175.91 $1256.47 $1542.63 |
$460.51 $498.53 $538.81 $681.89 |
$639.36 $677.38 $717.66 $860.74 |
$818.21 $856.23 $896.51 $1039.59 |
$178.85 |
Plan: (PPO) AultCare Silver 5000 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$344.28 $390.76 $439.99 $614.88 $934.37 |
$688.56 $781.52 $879.98 $1229.76 $1868.74 |
$907.18 $1000.14 $1098.60 $1448.38 |
$1125.80 $1218.76 $1317.22 $1667.00 |
$1344.42 $1437.38 $1535.84 $1885.62 |
$562.90 $609.38 $658.61 $833.50 |
$781.52 $828.00 $877.23 $1052.12 |
$1000.14 $1046.62 $1095.85 $1270.74 |
$218.62 |
Plan: (PPO) AultCare Gold 750Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$750
: Family:
$1,500 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$470.81 $534.36 $601.69 $840.86 $1277.77 |
$941.62 $1068.72 $1203.38 $1681.72 $2555.54 |
$1240.58 $1367.68 $1502.34 $1980.68 |
$1539.54 $1666.64 $1801.30 $2279.64 |
$1838.50 $1965.60 $2100.26 $2578.60 |
$769.77 $833.32 $900.65 $1139.82 |
$1068.73 $1132.28 $1199.61 $1438.78 |
$1367.69 $1431.24 $1498.57 $1737.74 |
$298.96 |
Plan: (PPO) AultCare Silver 3000 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$3,000
: Family:
$6,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$373.27 $423.66 $477.04 $666.66 $1013.05 |
$746.54 $847.32 $954.08 $1333.32 $2026.10 |
$983.57 $1084.35 $1191.11 $1570.35 |
$1220.60 $1321.38 $1428.14 $1807.38 |
$1457.63 $1558.41 $1665.17 $2044.41 |
$610.30 $660.69 $714.07 $903.69 |
$847.33 $897.72 $951.10 $1140.72 |
$1084.36 $1134.75 $1188.13 $1377.75 |
$237.03 |
Plan: (PPO) AultCare Silver 2500 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$378.17 $429.23 $483.31 $675.42 $1026.37 |
$756.34 $858.46 $966.62 $1350.84 $2052.74 |
$996.48 $1098.60 $1206.76 $1590.98 |
$1236.62 $1338.74 $1446.90 $1831.12 |
$1476.76 $1578.88 $1687.04 $2071.26 |
$618.31 $669.37 $723.45 $915.56 |
$858.45 $909.51 $963.59 $1155.70 |
$1098.59 $1149.65 $1203.73 $1395.84 |
$240.14 |
Plan: (PPO) AultCare Gold 1200 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$1,200
: Family:
$2,400 Monthly Premiums: |
||||||||||
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 |
$464.92 $527.69 $594.17 $830.35 $1261.80 |
$929.84 $1055.38 $1188.34 $1660.70 $2523.60 |
$1225.07 $1350.61 $1483.57 $1955.93 |
$1520.30 $1645.84 $1778.80 $2251.16 |
$1815.53 $1941.07 $2074.03 $2546.39 |
$760.15 $822.92 $889.40 $1125.58 |
$1055.38 $1118.15 $1184.63 $1420.81 |
$1350.61 $1413.38 $1479.86 $1716.04 |
$295.23 |
Plan: (PPO) AultCare Gold 750 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$750
: Family:
$1,500 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$463.57 $526.15 $592.45 $827.94 $1258.14 |
$927.14 $1052.30 $1184.90 $1655.88 $2516.28 |
$1221.51 $1346.67 $1479.27 $1950.25 |
$1515.88 $1641.04 $1773.64 $2244.62 |
$1810.25 $1935.41 $2068.01 $2538.99 |
$757.94 $820.52 $886.82 $1122.31 |
$1052.31 $1114.89 $1181.19 $1416.68 |
$1346.68 $1409.26 $1475.56 $1711.05 |
$294.37 |
Plan: (PPO) AultCare Gold 350 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$350
: Family:
$700 Monthly Premiums: |
||||||||||
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 |
$480.89 $545.81 $614.57 $858.86 $1305.12 |
$961.78 $1091.62 $1229.14 $1717.72 $2610.24 |
$1267.14 $1396.98 $1534.50 $2023.08 |
$1572.50 $1702.34 $1839.86 $2328.44 |
$1877.86 $2007.70 $2145.22 $2633.80 |
$786.25 $851.17 $919.93 $1164.22 |
$1091.61 $1156.53 $1225.29 $1469.58 |
$1396.97 $1461.89 $1530.65 $1774.94 |
$305.36 |
Plan: (PPO) AultCare Gold 350Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$350
: Family:
$700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$488.75 $554.73 $624.62 $872.91 $1326.47 |
$977.50 $1109.46 $1249.24 $1745.82 $2652.94 |
$1287.86 $1419.82 $1559.60 $2056.18 |
$1598.22 $1730.18 $1869.96 $2366.54 |
$1908.58 $2040.54 $2180.32 $2676.90 |
$799.11 $865.09 $934.98 $1183.27 |
$1109.47 $1175.45 $1245.34 $1493.63 |
$1419.83 $1485.81 $1555.70 $1803.99 |
$310.36 |
Plan: (PPO) AultCare Catastrophic SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$7,150
: Family:
$14,300 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$170.68 $193.72 $218.13 $304.84 $463.23 |
$341.36 $387.44 $436.26 $609.68 $926.46 |
$449.74 $495.82 $544.64 $718.06 |
$558.12 $604.20 $653.02 $826.44 |
$666.50 $712.58 $761.40 $934.82 |
$279.06 $302.10 $326.51 $413.22 |
$387.44 $410.48 $434.89 $521.60 |
$495.82 $518.86 $543.27 $629.98 |
$108.38 |
Plan: (PPO) AultCare Bronze 6000 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,000
: Family:
$12,000 Monthly Premiums: |
||||||||||
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 |
$235.70 $267.52 $301.23 $420.97 $639.70 |
$471.40 $535.04 $602.46 $841.94 $1279.40 |
$621.07 $684.71 $752.13 $991.61 |
$770.74 $834.38 $901.80 $1141.28 |
$920.41 $984.05 $1051.47 $1290.95 |
$385.37 $417.19 $450.90 $570.64 |
$535.04 $566.86 $600.57 $720.31 |
$684.71 $716.53 $750.24 $869.98 |
$149.67 |
Plan: (PPO) AultCare Bronze 5000 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$243.85 $276.77 $311.64 $435.52 $661.82 |
$487.70 $553.54 $623.28 $871.04 $1323.64 |
$642.55 $708.39 $778.13 $1025.89 |
$797.40 $863.24 $932.98 $1180.74 |
$952.25 $1018.09 $1087.83 $1335.59 |
$398.70 $431.62 $466.49 $590.37 |
$553.55 $586.47 $621.34 $745.22 |
$708.40 $741.32 $776.19 $900.07 |
$154.85 |
Plan: (PPO) AultCare Silver 5000 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
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Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$297.85 $338.06 $380.65 $531.95 $808.35 |
$595.70 $676.12 $761.30 $1063.90 $1616.70 |
$784.83 $865.25 $950.43 $1253.03 |
$973.96 $1054.38 $1139.56 $1442.16 |
$1163.09 $1243.51 $1328.69 $1631.29 |
$486.98 $527.19 $569.78 $721.08 |
$676.11 $716.32 $758.91 $910.21 |
$865.24 $905.45 $948.04 $1099.34 |
$189.13 |
Plan: (PPO) AultCare Silver 3000 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$3,000
: Family:
$6,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$322.78 $366.36 $412.51 $576.49 $876.03 |
$645.56 $732.72 $825.02 $1152.98 $1752.06 |
$850.53 $937.69 $1029.99 $1357.95 |
$1055.50 $1142.66 $1234.96 $1562.92 |
$1260.47 $1347.63 $1439.93 $1767.89 |
$527.75 $571.33 $617.48 $781.46 |
$732.72 $776.30 $822.45 $986.43 |
$937.69 $981.27 $1027.42 $1191.40 |
$204.97 |
Plan: (PPO) AultCare Silver 2500 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$326.62 $370.72 $417.42 $583.35 $886.46 |
$653.24 $741.44 $834.84 $1166.70 $1772.92 |
$860.65 $948.85 $1042.25 $1374.11 |
$1068.06 $1156.26 $1249.66 $1581.52 |
$1275.47 $1363.67 $1457.07 $1788.93 |
$534.03 $578.13 $624.83 $790.76 |
$741.44 $785.54 $832.24 $998.17 |
$948.85 $992.95 $1039.65 $1205.58 |
$207.41 |
Plan: (PPO) AultCare Gold 1200 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$1,200
: Family:
$2,400 Monthly Premiums: |
||||||||||
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 |
$400.96 $455.08 $512.42 $716.11 $1088.19 |
$801.92 $910.16 $1024.84 $1432.22 $2176.38 |
$1056.53 $1164.77 $1279.45 $1686.83 |
$1311.14 $1419.38 $1534.06 $1941.44 |
$1565.75 $1673.99 $1788.67 $2196.05 |
$655.57 $709.69 $767.03 $970.72 |
$910.18 $964.30 $1021.64 $1225.33 |
$1164.79 $1218.91 $1276.25 $1479.94 |
$254.61 |
Plan: (PPO) AultCare Gold 750 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$750
: Family:
$1,500 Monthly Premiums: |
||||||||||
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 |
$400.18 $454.21 $511.44 $714.73 $1086.10 |
$800.36 $908.42 $1022.88 $1429.46 $2172.20 |
$1054.48 $1162.54 $1277.00 $1683.58 |
$1308.60 $1416.66 $1531.12 $1937.70 |
$1562.72 $1670.78 $1785.24 $2191.82 |
$654.30 $708.33 $765.56 $968.85 |
$908.42 $962.45 $1019.68 $1222.97 |
$1162.54 $1216.57 $1273.80 $1477.09 |
$254.12 |
Plan: (PPO) AultCare Gold 350 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$350
: Family:
$700 Monthly Premiums: |
||||||||||
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 |
$415.44 $471.52 $530.93 $741.97 $1127.50 |
$830.88 $943.04 $1061.86 $1483.94 $2255.00 |
$1094.68 $1206.84 $1325.66 $1747.74 |
$1358.48 $1470.64 $1589.46 $2011.54 |
$1622.28 $1734.44 $1853.26 $2275.34 |
$679.24 $735.32 $794.73 $1005.77 |
$943.04 $999.12 $1058.53 $1269.57 |
$1206.84 $1262.92 $1322.33 $1533.37 |
$263.80 |
Plan: (PPO) AultCare CatastrophicSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$7,150
: Family:
$14,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$200.80 $227.91 $256.63 $358.63 $544.98 |
$401.60 $455.82 $513.26 $717.26 $1089.96 |
$529.11 $583.33 $640.77 $844.77 |
$656.62 $710.84 $768.28 $972.28 |
$784.13 $838.35 $895.79 $1099.79 |
$328.31 $355.42 $384.14 $486.14 |
$455.82 $482.93 $511.65 $613.65 |
$583.33 $610.44 $639.16 $741.16 |
$127.51 |
Plan: (PPO) AultCare Bronze 6000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,000
: Family:
$12,000 Monthly Premiums: |
||||||||||
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 |
$277.30 $314.73 $354.39 $495.26 $752.59 |
$554.60 $629.46 $708.78 $990.52 $1505.18 |
$730.68 $805.54 $884.86 $1166.60 |
$906.76 $981.62 $1060.94 $1342.68 |
$1082.84 $1157.70 $1237.02 $1518.76 |
$453.38 $490.81 $530.47 $671.34 |
$629.46 $666.89 $706.55 $847.42 |
$805.54 $842.97 $882.63 $1023.50 |
$176.08 |
Plan: (PPO) AultCare Bronze 5000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
||||||||||
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 |
$286.89 $325.61 $366.64 $512.38 $778.61 |
$573.78 $651.22 $733.28 $1024.76 $1557.22 |
$755.95 $833.39 $915.45 $1206.93 |
$938.12 $1015.56 $1097.62 $1389.10 |
$1120.29 $1197.73 $1279.79 $1571.27 |
$469.06 $507.78 $548.81 $694.55 |
$651.23 $689.95 $730.98 $876.72 |
$833.40 $872.12 $913.15 $1058.89 |
$182.17 |
Plan: (PPO) AultCare Silver 5000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$350.41 $397.71 $447.82 $625.83 $951.00 |
$700.82 $795.42 $895.64 $1251.66 $1902.00 |
$923.33 $1017.93 $1118.15 $1474.17 |
$1145.84 $1240.44 $1340.66 $1696.68 |
$1368.35 $1462.95 $1563.17 $1919.19 |
$572.92 $620.22 $670.33 $848.34 |
$795.43 $842.73 $892.84 $1070.85 |
$1017.94 $1065.24 $1115.35 $1293.36 |
$222.51 |
Plan: (PPO) AultCare Silver 3000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$3,000
: Family:
$6,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$379.74 $431.01 $485.31 $678.22 $1030.62 |
$759.48 $862.02 $970.62 $1356.44 $2061.24 |
$1000.62 $1103.16 $1211.76 $1597.58 |
$1241.76 $1344.30 $1452.90 $1838.72 |
$1482.90 $1585.44 $1694.04 $2079.86 |
$620.88 $672.15 $726.45 $919.36 |
$862.02 $913.29 $967.59 $1160.50 |
$1103.16 $1154.43 $1208.73 $1401.64 |
$241.14 |
Plan: (PPO) AultCare Silver 2500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$384.26 $436.14 $491.09 $686.29 $1042.89 |
$768.52 $872.28 $982.18 $1372.58 $2085.78 |
$1012.53 $1116.29 $1226.19 $1616.59 |
$1256.54 $1360.30 $1470.20 $1860.60 |
$1500.55 $1604.31 $1714.21 $2104.61 |
$628.27 $680.15 $735.10 $930.30 |
$872.28 $924.16 $979.11 $1174.31 |
$1116.29 $1168.17 $1223.12 $1418.32 |
$244.01 |
Plan: (PPO) AultCare Gold 1200Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$1,200
: Family:
$2,400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$471.71 $535.39 $602.85 $842.48 $1280.23 |
$943.42 $1070.78 $1205.70 $1684.96 $2560.46 |
$1242.96 $1370.32 $1505.24 $1984.50 |
$1542.50 $1669.86 $1804.78 $2284.04 |
$1842.04 $1969.40 $2104.32 $2583.58 |
$771.25 $834.93 $902.39 $1142.02 |
$1070.79 $1134.47 $1201.93 $1441.56 |
$1370.33 $1434.01 $1501.47 $1741.10 |
$299.54 |
Plan: (PPO) AultCare Catastrophic No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$7,150
: Family:
$14,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$197.66 $224.35 $252.62 $353.03 $536.46 |
$395.32 $448.70 $505.24 $706.06 $1072.92 |
$520.84 $574.22 $630.76 $831.58 |
$646.36 $699.74 $756.28 $957.10 |
$771.88 $825.26 $881.80 $1082.62 |
$323.18 $349.87 $378.14 $478.55 |
$448.70 $475.39 $503.66 $604.07 |
$574.22 $600.91 $629.18 $729.59 |
$125.52 |
Plan: (PPO) AultCare Gold 350 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$350
: Family:
$700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$408.75 $463.93 $522.39 $730.03 $1109.36 |
$817.50 $927.86 $1044.78 $1460.06 $2218.72 |
$1077.06 $1187.42 $1304.34 $1719.62 |
$1336.62 $1446.98 $1563.90 $1979.18 |
$1596.18 $1706.54 $1823.46 $2238.74 |
$668.31 $723.49 $781.95 $989.59 |
$927.87 $983.05 $1041.51 $1249.15 |
$1187.43 $1242.61 $1301.07 $1508.71 |
$259.56 |
Plan: (PPO) AultCare Gold 750 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$750
: Family:
$1,500 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$394.04 $447.23 $503.58 $703.75 $1069.42 |
$788.08 $894.46 $1007.16 $1407.50 $2138.84 |
$1038.29 $1144.67 $1257.37 $1657.71 |
$1288.50 $1394.88 $1507.58 $1907.92 |
$1538.71 $1645.09 $1757.79 $2158.13 |
$644.25 $697.44 $753.79 $953.96 |
$894.46 $947.65 $1004.00 $1204.17 |
$1144.67 $1197.86 $1254.21 $1454.38 |
$250.21 |
Plan: (PPO) AultCare Gold 1200 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$1,200
: Family:
$2,400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Gold | 21 30 40 50 60 |
$395.18 $448.53 $505.04 $705.80 $1072.53 |
$790.36 $897.06 $1010.08 $1411.60 $2145.06 |
$1041.30 $1148.00 $1261.02 $1662.54 |
$1292.24 $1398.94 $1511.96 $1913.48 |
$1543.18 $1649.88 $1762.90 $2164.42 |
$646.12 $699.47 $755.98 $956.74 |
$897.06 $950.41 $1006.92 $1207.68 |
$1148.00 $1201.35 $1257.86 $1458.62 |
$250.94 |
Plan: (PPO) AultCare Silver 2500 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$321.45 $364.84 $410.81 $574.11 $872.41 |
$642.90 $729.68 $821.62 $1148.22 $1744.82 |
$847.02 $933.80 $1025.74 $1352.34 |
$1051.14 $1137.92 $1229.86 $1556.46 |
$1255.26 $1342.04 $1433.98 $1760.58 |
$525.57 $568.96 $614.93 $778.23 |
$729.69 $773.08 $819.05 $982.35 |
$933.81 $977.20 $1023.17 $1186.47 |
$204.12 |
Plan: (PPO) AultCare Bronze 6600Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,550
: Family:
$13,100 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$276.68 $314.03 $353.59 $494.14 $750.90 |
$553.36 $628.06 $707.18 $988.28 $1501.80 |
$729.05 $803.75 $882.87 $1163.97 |
$904.74 $979.44 $1058.56 $1339.66 |
$1080.43 $1155.13 $1234.25 $1515.35 |
$452.37 $489.72 $529.28 $669.83 |
$628.06 $665.41 $704.97 $845.52 |
$803.75 $841.10 $880.66 $1021.21 |
$175.69 |
Plan: (PPO) AultCare Silver 3000 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$3,000
: Family:
$6,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$317.28 $360.11 $405.48 $566.66 $861.10 |
$634.56 $720.22 $810.96 $1133.32 $1722.20 |
$836.03 $921.69 $1012.43 $1334.79 |
$1037.50 $1123.16 $1213.90 $1536.26 |
$1238.97 $1324.63 $1415.37 $1737.73 |
$518.75 $561.58 $606.95 $768.13 |
$720.22 $763.05 $808.42 $969.60 |
$921.69 $964.52 $1009.89 $1171.07 |
$201.47 |
Plan: (PPO) AultCare Silver 5000 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$292.64 $332.14 $373.99 $522.65 $794.22 |
$585.28 $664.28 $747.98 $1045.30 $1588.44 |
$771.10 $850.10 $933.80 $1231.12 |
$956.92 $1035.92 $1119.62 $1416.94 |
$1142.74 $1221.74 $1305.44 $1602.76 |
$478.46 $517.96 $559.81 $708.47 |
$664.28 $703.78 $745.63 $894.29 |
$850.10 $889.60 $931.45 $1080.11 |
$185.82 |
Plan: (PPO) AultCare Bronze 5000 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$239.41 $271.73 $305.96 $427.58 $649.75 |
$478.82 $543.46 $611.92 $855.16 $1299.50 |
$630.84 $695.48 $763.94 $1007.18 |
$782.86 $847.50 $915.96 $1159.20 |
$934.88 $999.52 $1067.98 $1311.22 |
$391.43 $423.75 $457.98 $579.60 |
$543.45 $575.77 $610.00 $731.62 |
$695.47 $727.79 $762.02 $883.64 |
$152.02 |
Plan: (PPO) AultCare Bronze 6000 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,000
: Family:
$12,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$231.80 $263.10 $296.24 $414.00 $629.11 |
$463.60 $526.20 $592.48 $828.00 $1258.22 |
$610.79 $673.39 $739.67 $975.19 |
$757.98 $820.58 $886.86 $1122.38 |
$905.17 $967.77 $1034.05 $1269.57 |
$378.99 $410.29 $443.43 $561.19 |
$526.18 $557.48 $590.62 $708.38 |
$673.37 $704.67 $737.81 $855.57 |
$147.19 |
Plan: (PPO) AultCare Catastrophic Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$7,150
: Family:
$14,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$168.01 $190.70 $214.72 $300.07 $455.99 |
$336.02 $381.40 $429.44 $600.14 $911.98 |
$442.71 $488.09 $536.13 $706.83 |
$549.40 $594.78 $642.82 $813.52 |
$656.09 $701.47 $749.51 $920.21 |
$274.70 $297.39 $321.41 $406.76 |
$381.39 $404.08 $428.10 $513.45 |
$488.08 $510.77 $534.79 $620.14 |
$106.69 |
Plan: (PPO) AultCare Silver 6850Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$308.47 $350.12 $394.23 $550.93 $837.19 |
$616.94 $700.24 $788.46 $1101.86 $1674.38 |
$812.82 $896.12 $984.34 $1297.74 |
$1008.70 $1092.00 $1180.22 $1493.62 |
$1204.58 $1287.88 $1376.10 $1689.50 |
$504.35 $546.00 $590.11 $746.81 |
$700.23 $741.88 $785.99 $942.69 |
$896.11 $937.76 $981.87 $1138.57 |
$195.88 |
Plan: (PPO) AultCare Silver 6850 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$262.20 $297.60 $335.09 $468.29 $711.61 |
$524.40 $595.20 $670.18 $936.58 $1423.22 |
$690.90 $761.70 $836.68 $1103.08 |
$857.40 $928.20 $1003.18 $1269.58 |
$1023.90 $1094.70 $1169.68 $1436.08 |
$428.70 $464.10 $501.59 $634.79 |
$595.20 $630.60 $668.09 $801.29 |
$761.70 $797.10 $834.59 $967.79 |
$166.50 |
Plan: (PPO) AultCare Silver 6850 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$303.55 $344.52 $387.93 $542.13 $823.82 |
$607.10 $689.04 $775.86 $1084.26 $1647.64 |
$799.85 $881.79 $968.61 $1277.01 |
$992.60 $1074.54 $1161.36 $1469.76 |
$1185.35 $1267.29 $1354.11 $1662.51 |
$496.30 $537.27 $580.68 $734.88 |
$689.05 $730.02 $773.43 $927.63 |
$881.80 $922.77 $966.18 $1120.38 |
$192.75 |
Plan: (PPO) AultCare Silver 6850 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,850
: Family:
$13,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$258.01 $292.85 $329.74 $460.81 $700.25 |
$516.02 $585.70 $659.48 $921.62 $1400.50 |
$679.86 $749.54 $823.32 $1085.46 |
$843.70 $913.38 $987.16 $1249.30 |
$1007.54 $1077.22 $1151.00 $1413.14 |
$421.85 $456.69 $493.58 $624.65 |
$585.69 $620.53 $657.42 $788.49 |
$749.53 $784.37 $821.26 $952.33 |
$163.84 |
Plan: (PPO) AultCare Bronze 6600 SelectSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,550
: Family:
$13,100 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$235.17 $266.92 $300.55 $420.02 $638.26 |
$470.34 $533.84 $601.10 $840.04 $1276.52 |
$619.68 $683.18 $750.44 $989.38 |
$769.02 $832.52 $899.78 $1138.72 |
$918.36 $981.86 $1049.12 $1288.06 |
$384.51 $416.26 $449.89 $569.36 |
$533.85 $565.60 $599.23 $718.70 |
$683.19 $714.94 $748.57 $868.04 |
$149.34 |
Plan: (PPO) AultCare Bronze 6600 No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,550
: Family:
$13,100 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$272.31 $309.07 $348.01 $486.34 $739.05 |
$544.62 $618.14 $696.02 $972.68 $1478.10 |
$717.54 $791.06 $868.94 $1145.60 |
$890.46 $963.98 $1041.86 $1318.52 |
$1063.38 $1136.90 $1214.78 $1491.44 |
$445.23 $481.99 $520.93 $659.26 |
$618.15 $654.91 $693.85 $832.18 |
$791.07 $827.83 $866.77 $1005.10 |
$172.92 |
Plan: (PPO) AultCare Bronze 6600 Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,550
: Family:
$13,100 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$231.46 $262.71 $295.81 $413.39 $628.19 |
$462.92 $525.42 $591.62 $826.78 $1256.38 |
$609.90 $672.40 $738.60 $973.76 |
$756.88 $819.38 $885.58 $1120.74 |
$903.86 $966.36 $1032.56 $1267.72 |
$378.44 $409.69 $442.79 $560.37 |
$525.42 $556.67 $589.77 $707.35 |
$672.40 $703.65 $736.75 $854.33 |
$146.98 |
Plan: (PPO) AultCare Bronze Standard Select No Pediatric DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)
Deductible: Individual:
$6,650
: Family:
$13,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$231.21 $262.43 $295.49 $412.95 $627.51 |
$462.42 $524.86 $590.98 $825.90 $1255.02 |
$609.24 $671.68 $737.80 $972.72 |
$756.06 $818.50 $884.62 $1119.54 |
$902.88 $965.32 $1031.44 $1266.36 |
$378.03 $409.25 $442.31 $559.77 |
$524.85 $556.07 $589.13 $706.59 |
$671.67 $702.89 $735.95 $853.41 |
$146.82 |
ADVERTISEMENT
|
||||||||||
Community Insurance Company(Anthem BCBS)Local: 1-855-748-1808 | Toll Free: 1-855-748-1808 |
||||||||||
Plan: (PPO) Anthem Catastrophic Pathway X PPO 7150Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$7,150
: Family:
$14,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Catastrophic | 21 30 40 50 60 |
$222.48 $252.51 $284.33 $397.35 $603.81 |
$444.96 $505.02 $568.66 $794.70 $1207.62 |
$586.23 $646.29 $709.93 $935.97 |
$727.50 $787.56 $851.20 $1077.24 |
$868.77 $928.83 $992.47 $1218.51 |
$363.75 $393.78 $425.60 $538.62 |
$505.02 $535.05 $566.87 $679.89 |
$646.29 $676.32 $708.14 $821.16 |
$141.27 |
Plan: (PPO) Anthem Bronze Pathway X PPO 0 for HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$6,550
: Family:
$13,100 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$277.29 $314.72 $354.38 $495.24 $752.57 |
$554.58 $629.44 $708.76 $990.48 $1505.14 |
$730.66 $805.52 $884.84 $1166.56 |
$906.74 $981.60 $1060.92 $1342.64 |
$1082.82 $1157.68 $1237.00 $1518.72 |
$453.37 $490.80 $530.46 $671.32 |
$629.45 $666.88 $706.54 $847.40 |
$805.53 $842.96 $882.62 $1023.48 |
$176.08 |
Plan: (PPO) Anthem Bronze Pathway X PPO 5150Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$5,150
: Family:
$10,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$276.90 $314.28 $353.88 $494.54 $751.51 |
$553.80 $628.56 $707.76 $989.08 $1503.02 |
$729.63 $804.39 $883.59 $1164.91 |
$905.46 $980.22 $1059.42 $1340.74 |
$1081.29 $1156.05 $1235.25 $1516.57 |
$452.73 $490.11 $529.71 $670.37 |
$628.56 $665.94 $705.54 $846.20 |
$804.39 $841.77 $881.37 $1022.03 |
$175.83 |
Plan: (PPO) Anthem Bronze Pathway X PPO 6800Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$6,800
: Family:
$13,600 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$279.79 $317.56 $357.57 $499.70 $759.35 |
$559.58 $635.12 $715.14 $999.40 $1518.70 |
$737.25 $812.79 $892.81 $1177.07 |
$914.92 $990.46 $1070.48 $1354.74 |
$1092.59 $1168.13 $1248.15 $1532.41 |
$457.46 $495.23 $535.24 $677.37 |
$635.13 $672.90 $712.91 $855.04 |
$812.80 $850.57 $890.58 $1032.71 |
$177.67 |
Plan: (PPO) Anthem Silver Pathway X PPO 3000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$3,000
: Family:
$6,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$329.49 $373.97 $421.09 $588.47 $894.24 |
$658.98 $747.94 $842.18 $1176.94 $1788.48 |
$868.21 $957.17 $1051.41 $1386.17 |
$1077.44 $1166.40 $1260.64 $1595.40 |
$1286.67 $1375.63 $1469.87 $1804.63 |
$538.72 $583.20 $630.32 $797.70 |
$747.95 $792.43 $839.55 $1006.93 |
$957.18 $1001.66 $1048.78 $1216.16 |
$209.23 |
Plan: (PPO) Anthem Silver Pathway X PPO 10 for HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$2,700
: Family:
$5,400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$333.13 $378.10 $425.74 $594.97 $904.11 |
$666.26 $756.20 $851.48 $1189.94 $1808.22 |
$877.80 $967.74 $1063.02 $1401.48 |
$1089.34 $1179.28 $1274.56 $1613.02 |
$1300.88 $1390.82 $1486.10 $1824.56 |
$544.67 $589.64 $637.28 $806.51 |
$756.21 $801.18 $848.82 $1018.05 |
$967.75 $1012.72 $1060.36 $1229.59 |
$211.54 |
Plan: (PPO) Anthem Bronze Pathway X PPO 5850Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$5,850
: Family:
$11,700 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 |
$270.49 $307.01 $345.69 $483.10 $734.11 |
$540.98 $614.02 $691.38 $966.20 $1468.22 |
$712.74 $785.78 $863.14 $1137.96 |
$884.50 $957.54 $1034.90 $1309.72 |
$1056.26 $1129.30 $1206.66 $1481.48 |
$442.25 $478.77 $517.45 $654.86 |
$614.01 $650.53 $689.21 $826.62 |
$785.77 $822.29 $860.97 $998.38 |
$171.76 |
Plan: (PPO) Anthem Silver Pathway X PPO 4050Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$4,050
: 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 |
Silver | 21 30 40 50 60 |
$332.16 $377.00 $424.50 $593.24 $901.48 |
$664.32 $754.00 $849.00 $1186.48 $1802.96 |
$875.24 $964.92 $1059.92 $1397.40 |
$1086.16 $1175.84 $1270.84 $1608.32 |
$1297.08 $1386.76 $1481.76 $1819.24 |
$543.08 $587.92 $635.42 $804.16 |
$754.00 $798.84 $846.34 $1015.08 |
$964.92 $1009.76 $1057.26 $1226.00 |
$210.92 |
Plan: (PPO) Anthem Silver Pathway X PPO 2000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$341.52 $387.63 $436.46 $609.95 $926.89 |
$683.04 $775.26 $872.92 $1219.90 $1853.78 |
$899.91 $992.13 $1089.79 $1436.77 |
$1116.78 $1209.00 $1306.66 $1653.64 |
$1333.65 $1425.87 $1523.53 $1870.51 |
$558.39 $604.50 $653.33 $826.82 |
$775.26 $821.37 $870.20 $1043.69 |
$992.13 $1038.24 $1087.07 $1260.56 |
$216.87 |
Plan: (PPO) Anthem Silver Pathway X PPO 2500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$2,500
: Family:
$5,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$339.47 $385.30 $433.84 $606.29 $921.32 |
$678.94 $770.60 $867.68 $1212.58 $1842.64 |
$894.50 $986.16 $1083.24 $1428.14 |
$1110.06 $1201.72 $1298.80 $1643.70 |
$1325.62 $1417.28 $1514.36 $1859.26 |
$555.03 $600.86 $649.40 $821.85 |
$770.59 $816.42 $864.96 $1037.41 |
$986.15 $1031.98 $1080.52 $1252.97 |
$215.56 |
Plan: (PPO) Anthem Silver Pathway X PPO 3500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$331.20 $375.91 $423.27 $591.52 $898.88 |
$662.40 $751.82 $846.54 $1183.04 $1797.76 |
$872.71 $962.13 $1056.85 $1393.35 |
$1083.02 $1172.44 $1267.16 $1603.66 |
$1293.33 $1382.75 $1477.47 $1813.97 |
$541.51 $586.22 $633.58 $801.83 |
$751.82 $796.53 $843.89 $1012.14 |
$962.13 $1006.84 $1054.20 $1222.45 |
$210.31 |
Plan: (HMO) Anthem Bronze Pathway X HMO 5000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$263.88 $299.50 $337.24 $471.29 $716.17 |
$527.76 $599.00 $674.48 $942.58 $1432.34 |
$695.32 $766.56 $842.04 $1110.14 |
$862.88 $934.12 $1009.60 $1277.70 |
$1030.44 $1101.68 $1177.16 $1445.26 |
$431.44 $467.06 $504.80 $638.85 |
$599.00 $634.62 $672.36 $806.41 |
$766.56 $802.18 $839.92 $973.97 |
$167.56 |
Plan: (HMO) Anthem Bronze Pathway X HMO 5200Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$5,200
: Family:
$10,400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$267.28 $303.36 $341.58 $477.36 $725.40 |
$534.56 $606.72 $683.16 $954.72 $1450.80 |
$704.28 $776.44 $852.88 $1124.44 |
$874.00 $946.16 $1022.60 $1294.16 |
$1043.72 $1115.88 $1192.32 $1463.88 |
$437.00 $473.08 $511.30 $647.08 |
$606.72 $642.80 $681.02 $816.80 |
$776.44 $812.52 $850.74 $986.52 |
$169.72 |
Plan: (HMO) Anthem Bronze Pathway X HMO 7150Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$7,150
: Family:
$14,300 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$260.21 $295.34 $332.55 $464.74 $706.21 |
$520.42 $590.68 $665.10 $929.48 $1412.42 |
$685.65 $755.91 $830.33 $1094.71 |
$850.88 $921.14 $995.56 $1259.94 |
$1016.11 $1086.37 $1160.79 $1425.17 |
$425.44 $460.57 $497.78 $629.97 |
$590.67 $625.80 $663.01 $795.20 |
$755.90 $791.03 $828.24 $960.43 |
$165.23 |
Plan: (HMO) Anthem Silver Pathway X HMO 4250Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$4,250
: 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 |
$312.77 $354.99 $399.72 $558.61 $848.86 |
$625.54 $709.98 $799.44 $1117.22 $1697.72 |
$824.15 $908.59 $998.05 $1315.83 |
$1022.76 $1107.20 $1196.66 $1514.44 |
$1221.37 $1305.81 $1395.27 $1713.05 |
$511.38 $553.60 $598.33 $757.22 |
$709.99 $752.21 $796.94 $955.83 |
$908.60 $950.82 $995.55 $1154.44 |
$198.61 |
Plan: (HMO) Anthem Silver Pathway X HMO 2850Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$2,850
: Family:
$5,700 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 |
$312.86 $355.10 $399.84 $558.77 $849.10 |
$625.72 $710.20 $799.68 $1117.54 $1698.20 |
$824.39 $908.87 $998.35 $1316.21 |
$1023.06 $1107.54 $1197.02 $1514.88 |
$1221.73 $1306.21 $1395.69 $1713.55 |
$511.53 $553.77 $598.51 $757.44 |
$710.20 $752.44 $797.18 $956.11 |
$908.87 $951.11 $995.85 $1154.78 |
$198.67 |
Plan: (HMO) Anthem Gold Pathway X HMO 1450Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$1,450
: Family:
$4,350 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 |
Gold | 21 30 40 50 60 |
$399.85 $453.83 $511.01 $714.13 $1085.19 |
$799.70 $907.66 $1022.02 $1428.26 $2170.38 |
$1053.60 $1161.56 $1275.92 $1682.16 |
$1307.50 $1415.46 $1529.82 $1936.06 |
$1561.40 $1669.36 $1783.72 $2189.96 |
$653.75 $707.73 $764.91 $968.03 |
$907.65 $961.63 $1018.81 $1221.93 |
$1161.55 $1215.53 $1272.71 $1475.83 |
$253.90 |
Plan: (HMO) Anthem Silver Core Pathway X HMO 5300Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$5,300
: Family:
$10,600 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$292.96 $332.51 $374.40 $523.23 $795.09 |
$585.92 $665.02 $748.80 $1046.46 $1590.18 |
$771.95 $851.05 $934.83 $1232.49 |
$957.98 $1037.08 $1120.86 $1418.52 |
$1144.01 $1223.11 $1306.89 $1604.55 |
$478.99 $518.54 $560.43 $709.26 |
$665.02 $704.57 $746.46 $895.29 |
$851.05 $890.60 $932.49 $1081.32 |
$186.03 |
Plan: (HMO) Anthem Bronze Pathway X HMO 0 for HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$6,550
: Family:
$13,100 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$269.17 $305.51 $344.00 $480.74 $730.53 |
$538.34 $611.02 $688.00 $961.48 $1461.06 |
$709.26 $781.94 $858.92 $1132.40 |
$880.18 $952.86 $1029.84 $1303.32 |
$1051.10 $1123.78 $1200.76 $1474.24 |
$440.09 $476.43 $514.92 $651.66 |
$611.01 $647.35 $685.84 $822.58 |
$781.93 $818.27 $856.76 $993.50 |
$170.92 |
Plan: (HMO) Anthem Silver Pathway X HMO 10 for HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$3,200
: Family:
$6,400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$316.56 $359.30 $404.56 $565.38 $859.14 |
$633.12 $718.60 $809.12 $1130.76 $1718.28 |
$834.14 $919.62 $1010.14 $1331.78 |
$1035.16 $1120.64 $1211.16 $1532.80 |
$1236.18 $1321.66 $1412.18 $1733.82 |
$517.58 $560.32 $605.58 $766.40 |
$718.60 $761.34 $806.60 $967.42 |
$919.62 $962.36 $1007.62 $1168.44 |
$201.02 |
Plan: (HMO) Anthem Silver Pathway X HMO 3500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1808 - Provider Directory for This Plan: (Community Insurance Company(Anthem BCBS))
Deductible: Individual:
$3,500
: Family:
$7,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$319.84 $363.02 $408.76 $571.23 $868.05 |
$639.68 $726.04 $817.52 $1142.46 $1736.10 |
$842.78 $929.14 $1020.62 $1345.56 |
$1045.88 $1132.24 $1223.72 $1548.66 |
$1248.98 $1335.34 $1426.82 $1751.76 |
$522.94 $566.12 $611.86 $774.33 |
$726.04 $769.22 $814.96 $977.43 |
$929.14 $972.32 $1018.06 $1180.53 |
$203.10 |