Obamacare 2021 Rates for Washington County

Obamacare > Rates > Utah > Washington County

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

The health insurance rates listed below are for calendar year 2021.

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

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

Obamacare Providers, 31 Plans and 2021 Rates for Washington County, Utah

Below, you’ll find a summary of the 31 plans for Washington County, Utah and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options.

You may also be interested in:

Obamacare Rates and Providers for Other Years

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Molina Healthcare

Local: 1-801-858-0400 | Toll Free: 1-888-858-3973

Toc - Plan #1 Molina Healthcare
Gold

(HMO) Confident Care Gold 1

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-858-3973

Annual Out of Pocket Expenses:

Individual Family
$2,925 $5,850 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$364,62
$506,83
$539,28
$775,55
$1 093,86 		$653,77
$795,98
$828,43
$1 064,70 		$942,92
$1 085,13
$1 117,58
$1 353,85 		$1 232,07
$1 374,28
$1 406,73
$1 643,00 		$289,15
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$729,24
$1 013,66
$1 078,56
$1 551,10
$2 187,72 		$1 018,39
$1 302,81
$1 367,71
$1 840,25 		$1 307,54
$1 591,96
$1 656,86
$2 129,40 		$1 596,69
$1 881,11
$1 946,01
$2 418,55 		$289,15
Toc - Plan #2 Molina Healthcare
Silver

(HMO) Constant Care Silver 1

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-858-3973

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$375,93
$522,54
$556,00
$799,60
$1 127,79 		$674,04
$820,65
$854,11
$1 097,71 		$972,15
$1 118,76
$1 152,22
$1 395,82 		$1 270,26
$1 416,87
$1 450,33
$1 693,93 		$298,11
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$751,86
$1 045,08
$1 112,00
$1 599,20
$2 255,58 		$1 049,97
$1 343,19
$1 410,11
$1 897,31 		$1 348,08
$1 641,30
$1 708,22
$2 195,42 		$1 646,19
$1 939,41
$2 006,33
$2 493,53 		$298,11
Toc - Plan #3 Molina Healthcare
Bronze

(HMO) Core Care Bronze 1

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-858-3973

Annual Out of Pocket Expenses:

Individual Family
$6,100 $12,200 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$258,28
$359,01
$382,00
$549,37
$774,84 		$463,10
$563,83
$586,82
$754,19 		$667,92
$768,65
$791,64
$959,01 		$872,74
$973,47
$996,46
$1 163,83 		$204,82
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$516,56
$718,02
$764,00
$1 098,74
$1 549,68 		$721,38
$922,84
$968,82
$1 303,56 		$926,20
$1 127,66
$1 173,64
$1 508,38 		$1 131,02
$1 332,48
$1 378,46
$1 713,20 		$204,82
Toc - Plan #4 Molina Healthcare
Silver

(HMO) Constant Care Silver 4

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-858-3973

Annual Out of Pocket Expenses:

Individual Family
$7,450 $14,900 Annual Deductible
$7,450 $14,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$361,43
$502,38
$534,55
$768,75
$1 084,28 		$648,04
$788,99
$821,16
$1 055,36 		$934,65
$1 075,60
$1 107,77
$1 341,97 		$1 221,26
$1 362,21
$1 394,38
$1 628,58 		$286,61
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$722,86
$1 004,76
$1 069,10
$1 537,50
$2 168,56 		$1 009,47
$1 291,37
$1 355,71
$1 824,11 		$1 296,08
$1 577,98
$1 642,32
$2 110,72 		$1 582,69
$1 864,59
$1 928,93
$2 397,33 		$286,61
Toc - Plan #5 Molina Healthcare
Expanded Bronze

(HMO) Core Care Bronze 4

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-858-3973

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$270,20
$375,57
$399,62
$574,71
$810,59 		$484,47
$589,84
$613,89
$788,98 		$698,74
$804,11
$828,16
$1 003,25 		$913,01
$1 018,38
$1 042,43
$1 217,52 		$214,27
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$540,40
$751,14
$799,24
$1 149,42
$1 621,18 		$754,67
$965,41
$1 013,51
$1 363,69 		$968,94
$1 179,68
$1 227,78
$1 577,96 		$1 183,21
$1 393,95
$1 442,05
$1 792,23 		$214,27
Toc - Plan #6 Molina Healthcare
Expanded Bronze

(HMO) Core Care Bronze 5

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-858-3973

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$262,91
$365,45
$388,85
$559,22
$788,73 		$471,40
$573,94
$597,34
$767,71 		$679,89
$782,43
$805,83
$976,20 		$888,38
$990,92
$1 014,32
$1 184,69 		$208,49
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$525,82
$730,90
$777,70
$1 118,44
$1 577,46 		$734,31
$939,39
$986,19
$1 326,93 		$942,80
$1 147,88
$1 194,68
$1 535,42 		$1 151,29
$1 356,37
$1 403,17
$1 743,91 		$208,49
Toc - Plan #7 Molina Healthcare
Gold

(HMO) Confident Care Gold 1 + Vision

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-858-3973

Annual Out of Pocket Expenses:

Individual Family
$2,925 $5,850 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$368,98
$512,88
$545,71
$784,81
$1 106,93 		$661,58
$805,48
$838,31
$1 077,41 		$954,18
$1 098,08
$1 130,91
$1 370,01 		$1 246,78
$1 390,68
$1 423,51
$1 662,61 		$292,60
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$737,96
$1 025,76
$1 091,42
$1 569,62
$2 213,86 		$1 030,56
$1 318,36
$1 384,02
$1 862,22 		$1 323,16
$1 610,96
$1 676,62
$2 154,82 		$1 615,76
$1 903,56
$1 969,22
$2 447,42 		$292,60
Toc - Plan #8 Molina Healthcare
Silver

(HMO) Constant Care Silver 1 + Vision

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-858-3973

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,500 $17,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$380,28
$528,59
$562,44
$808,86
$1 140,84 		$681,84
$830,15
$864,00
$1 110,42 		$983,40
$1 131,71
$1 165,56
$1 411,98 		$1 284,96
$1 433,27
$1 467,12
$1 713,54 		$301,56
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$760,56
$1 057,18
$1 124,88
$1 617,72
$2 281,68 		$1 062,12
$1 358,74
$1 426,44
$1 919,28 		$1 363,68
$1 660,30
$1 728,00
$2 220,84 		$1 665,24
$1 961,86
$2 029,56
$2 522,40 		$301,56
Toc - Plan #9 Molina Healthcare
Bronze

(HMO) Core Care Bronze 1 + Vision

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-858-3973

Annual Out of Pocket Expenses:

Individual Family
$6,100 $12,200 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$262,63
$365,06
$388,44
$558,62
$787,89 		$470,90
$573,33
$596,71
$766,89 		$679,17
$781,60
$804,98
$975,16 		$887,44
$989,87
$1 013,25
$1 183,43 		$208,27
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$525,26
$730,12
$776,88
$1 117,24
$1 575,78 		$733,53
$938,39
$985,15
$1 325,51 		$941,80
$1 146,66
$1 193,42
$1 533,78 		$1 150,07
$1 354,93
$1 401,69
$1 742,05 		$208,27
Toc - Plan #10 Molina Healthcare
Silver

(HMO) Constant Care Silver 2

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-858-3973

Annual Out of Pocket Expenses:

Individual Family
$5,200 $10,400 Annual Deductible
$8,150 $16,300 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$372,05
$517,15
$550,26
$791,35
$1 116,15 		$667,09
$812,19
$845,30
$1 086,39 		$962,13
$1 107,23
$1 140,34
$1 381,43 		$1 257,17
$1 402,27
$1 435,38
$1 676,47 		$295,04
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$744,10
$1 034,30
$1 100,52
$1 582,70
$2 232,30 		$1 039,14
$1 329,34
$1 395,56
$1 877,74 		$1 334,18
$1 624,38
$1 690,60
$2 172,78 		$1 629,22
$1 919,42
$1 985,64
$2 467,82 		$295,04
Toc - Plan #11 Molina Healthcare
Bronze

(HMO) Core Care Bronze 2

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-858-3973

Annual Out of Pocket Expenses:

Individual Family
$8,000 $16,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$256,07
$355,93
$378,72
$544,65
$768,20 		$459,13
$558,99
$581,78
$747,71 		$662,19
$762,05
$784,84
$950,77 		$865,25
$965,11
$987,90
$1 153,83 		$203,06
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$512,14
$711,86
$757,44
$1 089,30
$1 536,40 		$715,20
$914,92
$960,50
$1 292,36 		$918,26
$1 117,98
$1 163,56
$1 495,42 		$1 121,32
$1 321,04
$1 366,62
$1 698,48 		$203,06

ADVERTISEMENT

University of Utah Health Plans

Local: 1-801-587-6480x1 | Toll Free: 1-888-271-5870 | TTY: 1-800-346-4128
Toc - Plan #12 University of Utah Health Plans
Gold

(EPO) Healthy Premier Gold Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-271-5870

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$662,51
$920,89
$979,85
$1 409,16
$1 987,52 		$1 187,88
$1 446,26
$1 505,22
$1 934,53 		$1 713,25
$1 971,63
$2 030,59
$2 459,90 		$2 238,62
$2 497,00
$2 555,96
$2 985,27 		$525,37
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1 325,02
$1 841,78
$1 959,70
$2 818,32
$3 975,04 		$1 850,39
$2 367,15
$2 485,07
$3 343,69 		$2 375,76
$2 892,52
$3 010,44
$3 869,06 		$2 901,13
$3 417,89
$3 535,81
$4 394,43 		$525,37
Toc - Plan #13 University of Utah Health Plans
Silver

(EPO) Healthy Premier Silver Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-271-5870

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$508,57
$706,91
$752,17
$1 081,72
$1 525,70 		$911,86
$1 110,20
$1 155,46
$1 485,01 		$1 315,15
$1 513,49
$1 558,75
$1 888,30 		$1 718,44
$1 916,78
$1 962,04
$2 291,59 		$403,29
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1 017,14
$1 413,82
$1 504,34
$2 163,44
$3 051,40 		$1 420,43
$1 817,11
$1 907,63
$2 566,73 		$1 823,72
$2 220,40
$2 310,92
$2 970,02 		$2 227,01
$2 623,69
$2 714,21
$3 373,31 		$403,29
Toc - Plan #14 University of Utah Health Plans
Expanded Bronze

(EPO) Healthy Premier Bronze HSA

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-271-5870

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$314,87
$437,67
$465,70
$669,73
$944,61 		$564,56
$687,36
$715,39
$919,42 		$814,25
$937,05
$965,08
$1 169,11 		$1 063,94
$1 186,74
$1 214,77
$1 418,80 		$249,69
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$629,74
$875,34
$931,40
$1 339,46
$1 889,22 		$879,43
$1 125,03
$1 181,09
$1 589,15 		$1 129,12
$1 374,72
$1 430,78
$1 838,84 		$1 378,81
$1 624,41
$1 680,47
$2 088,53 		$249,69
Toc - Plan #15 University of Utah Health Plans
Expanded Bronze

(EPO) Healthy Premier Expanded Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-271-5870

Annual Out of Pocket Expenses:

Individual Family
$5,650 $11,300 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$378,49
$526,10
$559,79
$805,05
$1 135,47 		$678,63
$826,24
$859,93
$1 105,19 		$978,77
$1 126,38
$1 160,07
$1 405,33 		$1 278,91
$1 426,52
$1 460,21
$1 705,47 		$300,14
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$756,98
$1 052,20
$1 119,58
$1 610,10
$2 270,94 		$1 057,12
$1 352,34
$1 419,72
$1 910,24 		$1 357,26
$1 652,48
$1 719,86
$2 210,38 		$1 657,40
$1 952,62
$2 020,00
$2 510,52 		$300,14
Toc - Plan #16 University of Utah Health Plans
Expanded Bronze

(EPO) Healthy Premier Expanded Bronze HSA

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-271-5870

Annual Out of Pocket Expenses:

Individual Family
$5,750 $11,500 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$378,49
$526,10
$559,79
$805,05
$1 135,47 		$678,63
$826,24
$859,93
$1 105,19 		$978,77
$1 126,38
$1 160,07
$1 405,33 		$1 278,91
$1 426,52
$1 460,21
$1 705,47 		$300,14
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$756,98
$1 052,20
$1 119,58
$1 610,10
$2 270,94 		$1 057,12
$1 352,34
$1 419,72
$1 910,24 		$1 357,26
$1 652,48
$1 719,86
$2 210,38 		$1 657,40
$1 952,62
$2 020,00
$2 510,52 		$300,14
Toc - Plan #17 University of Utah Health Plans
Silver

(EPO) Healthy Premier Silver 2300

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-271-5870

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$509,27
$707,88
$753,21
$1 083,21
$1 527,80 		$913,12
$1 111,73
$1 157,06
$1 487,06 		$1 316,97
$1 515,58
$1 560,91
$1 890,91 		$1 720,82
$1 919,43
$1 964,76
$2 294,76 		$403,85
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1 018,54
$1 415,76
$1 506,42
$2 166,42
$3 055,60 		$1 422,39
$1 819,61
$1 910,27
$2 570,27 		$1 826,24
$2 223,46
$2 314,12
$2 974,12 		$2 230,09
$2 627,31
$2 717,97
$3 377,97 		$403,85
Toc - Plan #18 University of Utah Health Plans
Expanded Bronze

(EPO) Healthy Premier Bronze w.3 Copays Before Deductible

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-271-5870

Annual Out of Pocket Expenses:

Individual Family
$7,800 $15,600 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$316,97
$440,59
$468,80
$674,19
$950,91 		$568,33
$691,95
$720,16
$925,55 		$819,69
$943,31
$971,52
$1 176,91 		$1 071,05
$1 194,67
$1 222,88
$1 428,27 		$251,36
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$633,94
$881,18
$937,60
$1 348,38
$1 901,82 		$885,30
$1 132,54
$1 188,96
$1 599,74 		$1 136,66
$1 383,90
$1 440,32
$1 851,10 		$1 388,02
$1 635,26
$1 691,68
$2 102,46 		$251,36

ADVERTISEMENT

SelectHealth

Local: 1-801-442-5038 | Toll Free: 1-800-538-5038

Toc - Plan #19 SelectHealth
Silver

(HMO) Med Silver 2500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-5038

Annual Out of Pocket Expenses:

Individual Family
$2,500 $5,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$376,53
$523,37
$556,88
$800,87
$1 129,58 		$675,12
$821,96
$855,47
$1 099,46 		$973,71
$1 120,55
$1 154,06
$1 398,05 		$1 272,30
$1 419,14
$1 452,65
$1 696,64 		$298,59
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$753,06
$1 046,74
$1 113,76
$1 601,74
$2 259,16 		$1 051,65
$1 345,33
$1 412,35
$1 900,33 		$1 350,24
$1 643,92
$1 710,94
$2 198,92 		$1 648,83
$1 942,51
$2 009,53
$2 497,51 		$298,59
Toc - Plan #20 SelectHealth
Gold

(HMO) Med Gold 1500 - no deductible for office visits

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-5038

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$6,000 $12,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$464,32
$645,41
$686,73
$987,61
$1 392,96 		$832,53
$1 013,62
$1 054,94
$1 355,82 		$1 200,74
$1 381,83
$1 423,15
$1 724,03 		$1 568,95
$1 750,04
$1 791,36
$2 092,24 		$368,21
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$928,64
$1 290,82
$1 373,46
$1 975,22
$2 785,92 		$1 296,85
$1 659,03
$1 741,67
$2 343,43 		$1 665,06
$2 027,24
$2 109,88
$2 711,64 		$2 033,27
$2 395,45
$2 478,09
$3 079,85 		$368,21
Toc - Plan #21 SelectHealth
Expanded Bronze

(HMO) Med Expanded Bronze 7800 - no deductible for one urgent care and all PCP visits

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-5038

Annual Out of Pocket Expenses:

Individual Family
$7,800 $15,600 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$236,62
$328,90
$349,96
$503,29
$709,86 		$424,26
$516,54
$537,60
$690,93 		$611,90
$704,18
$725,24
$878,57 		$799,54
$891,82
$912,88
$1 066,21 		$187,64
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$473,24
$657,80
$699,92
$1 006,58
$1 419,72 		$660,88
$845,44
$887,56
$1 194,22 		$848,52
$1 033,08
$1 075,20
$1 381,86 		$1 036,16
$1 220,72
$1 262,84
$1 569,50 		$187,64
Toc - Plan #22 SelectHealth
Expanded Bronze

(HMO) Med Expanded Bronze 6900 HSA Qualified

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-5038

Annual Out of Pocket Expenses:

Individual Family
$6,900 $13,800 Annual Deductible
$6,900 $13,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$238,50
$331,51
$352,74
$507,29
$715,50 		$427,63
$520,64
$541,87
$696,42 		$616,76
$709,77
$731,00
$885,55 		$805,89
$898,90
$920,13
$1 074,68 		$189,13
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$477,00
$663,02
$705,48
$1 014,58
$1 431,00 		$666,13
$852,15
$894,61
$1 203,71 		$855,26
$1 041,28
$1 083,74
$1 392,84 		$1 044,39
$1 230,41
$1 272,87
$1 581,97 		$189,13
Toc - Plan #23 SelectHealth
Catastrophic

(HMO) Med Catastrophic 8550

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-5038

Annual Out of Pocket Expenses:

Individual Family
$8,550 $17,100 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$197,65
$274,74
$292,33
$420,41
$592,95 		$354,39
$431,48
$449,07
$577,15 		$511,13
$588,22
$605,81
$733,89 		$667,87
$744,96
$762,55
$890,63 		$156,74
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$395,30
$549,48
$584,66
$840,82
$1 185,90 		$552,04
$706,22
$741,40
$997,56 		$708,78
$862,96
$898,14
$1 154,30 		$865,52
$1 019,70
$1 054,88
$1 311,04 		$156,74
Toc - Plan #24 SelectHealth
Silver

(HMO) Med Silver 3000 - no deductible for office visits

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-5038

Annual Out of Pocket Expenses:

Individual Family
$3,000 $6,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$405,64
$563,83
$599,94
$862,79
$1 216,91 		$727,31
$885,50
$921,61
$1 184,46 		$1 048,98
$1 207,17
$1 243,28
$1 506,13 		$1 370,65
$1 528,84
$1 564,95
$1 827,80 		$321,67
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$811,28
$1 127,66
$1 199,88
$1 725,58
$2 433,82 		$1 132,95
$1 449,33
$1 521,55
$2 047,25 		$1 454,62
$1 771,00
$1 843,22
$2 368,92 		$1 776,29
$2 092,67
$2 164,89
$2 690,59 		$321,67
Toc - Plan #25 SelectHealth
Expanded Bronze

(HMO) Med Expanded Bronze 5900 HSA Qualified

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-5038

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$300,00
$417,00
$443,70
$638,10
$900,00 		$537,90
$654,90
$681,60
$876,00 		$775,80
$892,80
$919,50
$1 113,90 		$1 013,70
$1 130,70
$1 157,40
$1 351,80 		$237,90
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$600,00
$834,00
$887,40
$1 276,20
$1 800,00 		$837,90
$1 071,90
$1 125,30
$1 514,10 		$1 075,80
$1 309,80
$1 363,20
$1 752,00 		$1 313,70
$1 547,70
$1 601,10
$1 989,90 		$237,90
Toc - Plan #26 SelectHealth
Expanded Bronze

(HMO) Med Expanded Bronze 5300 Copay Plan - no deductible for one urgent care and all PCP visits

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-5038

Annual Out of Pocket Expenses:

Individual Family
$5,300 $10,600 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$292,49
$406,56
$432,59
$622,13
$877,47 		$524,43
$638,50
$664,53
$854,07 		$756,37
$870,44
$896,47
$1 086,01 		$988,31
$1 102,38
$1 128,41
$1 317,95 		$231,94
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$584,98
$813,12
$865,18
$1 244,26
$1 754,94 		$816,92
$1 045,06
$1 097,12
$1 476,20 		$1 048,86
$1 277,00
$1 329,06
$1 708,14 		$1 280,80
$1 508,94
$1 561,00
$1 940,08 		$231,94
Toc - Plan #27 SelectHealth
Expanded Bronze

(HMO) Med Expanded Bronze 8550 - no deductible for office visits

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-5038

Annual Out of Pocket Expenses:

Individual Family
$8,550 $17,100 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$290,61
$403,95
$429,82
$618,13
$871,83 		$521,07
$634,41
$660,28
$848,59 		$751,53
$864,87
$890,74
$1 079,05 		$981,99
$1 095,33
$1 121,20
$1 309,51 		$230,46
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$581,22
$807,90
$859,64
$1 236,26
$1 743,66 		$811,68
$1 038,36
$1 090,10
$1 466,72 		$1 042,14
$1 268,82
$1 320,56
$1 697,18 		$1 272,60
$1 499,28
$1 551,02
$1 927,64 		$230,46
Toc - Plan #28 SelectHealth
Expanded Bronze

(HMO) Med Benchmark Expanded Bronze 6800

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-5038

Annual Out of Pocket Expenses:

Individual Family
$6,800 $13,600 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$226,80
$315,25
$335,44
$482,40
$680,40 		$406,65
$495,10
$515,29
$662,25 		$586,50
$674,95
$695,14
$842,10 		$766,35
$854,80
$874,99
$1 021,95 		$179,85
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$453,60
$630,50
$670,88
$964,80
$1 360,80 		$633,45
$810,35
$850,73
$1 144,65 		$813,30
$990,20
$1 030,58
$1 324,50 		$993,15
$1 170,05
$1 210,43
$1 504,35 		$179,85
Toc - Plan #29 SelectHealth
Expanded Bronze

(HMO) Med Benchmark Expanded Bronze 3800

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-5038

Annual Out of Pocket Expenses:

Individual Family
$3,800 $7,600 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$268,09
$372,65
$396,51
$570,23
$804,27 		$480,69
$585,25
$609,11
$782,83 		$693,29
$797,85
$821,71
$995,43 		$905,89
$1 010,45
$1 034,31
$1 208,03 		$212,60
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$536,18
$745,30
$793,02
$1 140,46
$1 608,54 		$748,78
$957,90
$1 005,62
$1 353,06 		$961,38
$1 170,50
$1 218,22
$1 565,66 		$1 173,98
$1 383,10
$1 430,82
$1 778,26 		$212,60
Toc - Plan #30 SelectHealth
Bronze

(HMO) Med Benchmark Bronze 8550

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-5038

Annual Out of Pocket Expenses:

Individual Family
$8,550 $17,100 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$219,28
$304,79
$324,31
$466,40
$657,83 		$393,17
$478,68
$498,20
$640,29 		$567,06
$652,57
$672,09
$814,18 		$740,95
$826,46
$845,98
$988,07 		$173,89
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$438,56
$609,58
$648,62
$932,80
$1 315,66 		$612,45
$783,47
$822,51
$1 106,69 		$786,34
$957,36
$996,40
$1 280,58 		$960,23
$1 131,25
$1 170,29
$1 454,47 		$173,89
Toc - Plan #31 SelectHealth
Silver

(HMO) Med Benchmark Silver 6500 - no deductible for office visits

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-5038

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$363,91
$505,84
$538,23
$774,04
$1 091,73 		$652,49
$794,42
$826,81
$1 062,62 		$941,07
$1 083,00
$1 115,39
$1 351,20 		$1 229,65
$1 371,58
$1 403,97
$1 639,78 		$288,58
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$727,82
$1 011,68
$1 076,46
$1 548,08
$2 183,46 		$1 016,40
$1 300,26
$1 365,04
$1 836,66 		$1 304,98
$1 588,84
$1 653,62
$2 125,24 		$1 593,56
$1 877,42
$1 942,20
$2 413,82 		$288,58

‡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 Washington County here.

Washington County is in “Rating Area 5” of Utah.

Currently, there are 31 plans offered in Rating Area 5.

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2021 Obamacare Plans for Washington County, UT

Plan Browser: 31 Plans
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