Florida

Obamacare 2018 Rates

Obamacare 2018 Rates and Health Insurance Providers for Indian River County,Sebastian,FL


The health insurance rates listed below are for calendar year 2018.

2018 Rates and Providers

(click here for 2014)

(click here for 2015)

(click here for 2016)

(click here for 2017)

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

Obamacare Providers, Plans and 2018 Rates for Indian River County

Indian River County is in “Rating Area 30” of Florida.

Currently, there are 58 plans offered in Rating Area 30.

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 either

  • contact a licensed health insurance agent (by contacting one of the advertisers you see on this website)
  • 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 Sebastian, FL area accept this insurance coverage as within the plan's "network".

2018 Obamacare Rates Providers, Plans for Indian River County

Blue Cross and Blue Shield of Florida

Local: 1-800-352-2583 | Toll Free: 1-800-352-2583

TTY: 1-800-955-8771

Silver

Plan: (EPO) BlueOptions Silver 1423

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $5,950 : Family: $11,900
Out of Pocket Maximum per year: 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
0-14
Silver 21
30
40
50
60
$580.13
$658.45
$741.41
$1,036.11
$1,574.47
$1,160.26
$1,316.90
$1,482.82
$2,072.22
$3,148.94
$1,604.06
$1,760.70
$1,926.62
$2,516.02
$2,047.86
$2,204.50
$2,370.42
$2,959.82
$2,491.66
$2,648.30
$2,814.22
$3,403.62
$1,023.93
$1,102.25
$1,185.21
$1,479.91
$1,467.73
$1,546.05
$1,629.01
$1,923.71
$1,911.53
$1,989.85
$2,072.81
$2,367.51
$443.80

Bronze

Plan: (EPO) BlueOptions Bronze 1419

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $7,350 : Family: $14,700
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Bronze 21
30
40
50
60
$325.76
$369.74
$416.32
$581.81
$884.11
$651.52
$739.48
$832.64
$1,163.62
$1,768.22
$900.73
$988.69
$1,081.85
$1,412.83
$1,149.94
$1,237.90
$1,331.06
$1,662.04
$1,399.15
$1,487.11
$1,580.27
$1,911.25
$574.97
$618.95
$665.53
$831.02
$824.18
$868.16
$914.74
$1,080.23
$1,073.39
$1,117.37
$1,163.95
$1,329.44
$249.21

Silver

Plan: (EPO) BlueOptions Silver 1431

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $5,450 : Family: $10,900
Out of Pocket Maximum per year: 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
0-14
Silver 21
30
40
50
60
$601.07
$682.21
$768.17
$1,073.51
$1,631.30
$1,202.14
$1,364.42
$1,536.34
$2,147.02
$3,262.60
$1,661.96
$1,824.24
$1,996.16
$2,606.84
$2,121.78
$2,284.06
$2,455.98
$3,066.66
$2,581.60
$2,743.88
$2,915.80
$3,526.48
$1,060.89
$1,142.03
$1,227.99
$1,533.33
$1,520.71
$1,601.85
$1,687.81
$1,993.15
$1,980.53
$2,061.67
$2,147.63
$2,452.97
$459.82

Platinum

Plan: (EPO) BlueOptions Platinum 1418

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $800 : Family: $1,600
Out of Pocket Maximum per year: 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
0-14
Platinum 21
30
40
50
60
$738.58
$838.29
$943.91
$1,319.10
$2,004.51
$1,477.16
$1,676.58
$1,887.82
$2,638.20
$4,009.02
$2,042.17
$2,241.59
$2,452.83
$3,203.21
$2,607.18
$2,806.60
$3,017.84
$3,768.22
$3,172.19
$3,371.61
$3,582.85
$4,333.23
$1,303.59
$1,403.30
$1,508.92
$1,884.11
$1,868.60
$1,968.31
$2,073.93
$2,449.12
$2,433.61
$2,533.32
$2,638.94
$3,014.13
$565.01

Expanded Bronze

Plan: (EPO) BlueOptions Bronze 1416

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $6,400 : Family: $12,800
Out of Pocket Maximum per year: Individual: $6,900 : Family: $13,800

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
0-14
Expanded Bronze 21
30
40
50
60
$354.47
$402.32
$453.01
$633.08
$962.03
$708.94
$804.64
$906.02
$1,266.16
$1,924.06
$980.11
$1,075.81
$1,177.19
$1,537.33
$1,251.28
$1,346.98
$1,448.36
$1,808.50
$1,522.45
$1,618.15
$1,719.53
$2,079.67
$625.64
$673.49
$724.18
$904.25
$896.81
$944.66
$995.35
$1,175.42
$1,167.98
$1,215.83
$1,266.52
$1,446.59
$271.17

Platinum

Plan: (EPO) BlueOptions Platinum 1424

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

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
0-14
Platinum 21
30
40
50
60
$757.09
$859.30
$967.56
$1,352.16
$2,054.74
$1,514.18
$1,718.60
$1,935.12
$2,704.32
$4,109.48
$2,093.35
$2,297.77
$2,514.29
$3,283.49
$2,672.52
$2,876.94
$3,093.46
$3,862.66
$3,251.69
$3,456.11
$3,672.63
$4,441.83
$1,336.26
$1,438.47
$1,546.73
$1,931.33
$1,915.43
$2,017.64
$2,125.90
$2,510.50
$2,494.60
$2,596.81
$2,705.07
$3,089.67
$579.17

Silver

Plan: (EPO) BlueOptions Silver 1410

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $6,050 : Family: $12,100
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Silver 21
30
40
50
60
$539.11
$611.89
$688.98
$962.85
$1,463.14
$1,078.22
$1,223.78
$1,377.96
$1,925.70
$2,926.28
$1,490.64
$1,636.20
$1,790.38
$2,338.12
$1,903.06
$2,048.62
$2,202.80
$2,750.54
$2,315.48
$2,461.04
$2,615.22
$3,162.96
$951.53
$1,024.31
$1,101.40
$1,375.27
$1,363.95
$1,436.73
$1,513.82
$1,787.69
$1,776.37
$1,849.15
$1,926.24
$2,200.11
$412.42

Gold

Plan: (EPO) BlueOptions Gold 1505

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $0 : Family: $0
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
0-14
Gold 21
30
40
50
60
$586.76
$665.97
$749.88
$1,047.95
$1,592.47
$1,173.52
$1,331.94
$1,499.76
$2,095.90
$3,184.94
$1,622.39
$1,780.81
$1,948.63
$2,544.77
$2,071.26
$2,229.68
$2,397.50
$2,993.64
$2,520.13
$2,678.55
$2,846.37
$3,442.51
$1,035.63
$1,114.84
$1,198.75
$1,496.82
$1,484.50
$1,563.71
$1,647.62
$1,945.69
$1,933.37
$2,012.58
$2,096.49
$2,394.56
$448.87

Bronze

Plan: (EPO) BlueOptions Bronze (HSA) 1705

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

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
0-14
Bronze 21
30
40
50
60
$339.01
$384.78
$433.25
$605.47
$920.07
$678.02
$769.56
$866.50
$1,210.94
$1,840.14
$937.36
$1,028.90
$1,125.84
$1,470.28
$1,196.70
$1,288.24
$1,385.18
$1,729.62
$1,456.04
$1,547.58
$1,644.52
$1,988.96
$598.35
$644.12
$692.59
$864.81
$857.69
$903.46
$951.93
$1,124.15
$1,117.03
$1,162.80
$1,211.27
$1,383.49
$259.34

Silver

Plan: (EPO) BlueOptions Silver 1706S

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Silver 21
30
40
50
60
$597.41
$678.06
$763.49
$1,066.97
$1,621.37
$1,194.82
$1,356.12
$1,526.98
$2,133.94
$3,242.74
$1,651.84
$1,813.14
$1,984.00
$2,590.96
$2,108.86
$2,270.16
$2,441.02
$3,047.98
$2,565.88
$2,727.18
$2,898.04
$3,505.00
$1,054.43
$1,135.08
$1,220.51
$1,523.99
$1,511.45
$1,592.10
$1,677.53
$1,981.01
$1,968.47
$2,049.12
$2,134.55
$2,438.03
$457.02

Expanded Bronze

Plan: (EPO) BlueOptions Bronze 1707S

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Expanded Bronze 21
30
40
50
60
$341.91
$388.07
$436.96
$610.65
$927.94
$683.82
$776.14
$873.92
$1,221.30
$1,855.88
$945.38
$1,037.70
$1,135.48
$1,482.86
$1,206.94
$1,299.26
$1,397.04
$1,744.42
$1,468.50
$1,560.82
$1,658.60
$2,005.98
$603.47
$649.63
$698.52
$872.21
$865.03
$911.19
$960.08
$1,133.77
$1,126.59
$1,172.75
$1,221.64
$1,395.33
$261.56

Gold

Plan: (EPO) BlueOptions Gold 1805

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $2,000 : Family: $4,000
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
0-14
Gold 21
30
40
50
60
$560.65
$636.34
$716.51
$1,001.32
$1,521.60
$1,121.30
$1,272.68
$1,433.02
$2,002.64
$3,043.20
$1,550.20
$1,701.58
$1,861.92
$2,431.54
$1,979.10
$2,130.48
$2,290.82
$2,860.44
$2,408.00
$2,559.38
$2,719.72
$3,289.34
$989.55
$1,065.24
$1,145.41
$1,430.22
$1,418.45
$1,494.14
$1,574.31
$1,859.12
$1,847.35
$1,923.04
$2,003.21
$2,288.02
$428.90

Silver

Plan: (EPO) BlueSelect Silver 1456

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $5,950 : Family: $11,900
Out of Pocket Maximum per year: 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
0-14
Silver 21
30
40
50
60
$371.49
$421.64
$474.76
$663.48
$1,008.22
$742.98
$843.28
$949.52
$1,326.96
$2,016.44
$1,027.17
$1,127.47
$1,233.71
$1,611.15
$1,311.36
$1,411.66
$1,517.90
$1,895.34
$1,595.55
$1,695.85
$1,802.09
$2,179.53
$655.68
$705.83
$758.95
$947.67
$939.87
$990.02
$1,043.14
$1,231.86
$1,224.06
$1,274.21
$1,327.33
$1,516.05
$284.19

Bronze

Plan: (EPO) BlueSelect Bronze 1452

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $7,350 : Family: $14,700
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Bronze 21
30
40
50
60
$234.12
$265.73
$299.21
$418.14
$635.40
$468.24
$531.46
$598.42
$836.28
$1,270.80
$647.34
$710.56
$777.52
$1,015.38
$826.44
$889.66
$956.62
$1,194.48
$1,005.54
$1,068.76
$1,135.72
$1,373.58
$413.22
$444.83
$478.31
$597.24
$592.32
$623.93
$657.41
$776.34
$771.42
$803.03
$836.51
$955.44
$179.10

Silver

Plan: (EPO) BlueSelect Silver 1464

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $5,450 : Family: $10,900
Out of Pocket Maximum per year: 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
0-14
Silver 21
30
40
50
60
$385.67
$437.74
$492.89
$688.81
$1,046.71
$771.34
$875.48
$985.78
$1,377.62
$2,093.42
$1,066.38
$1,170.52
$1,280.82
$1,672.66
$1,361.42
$1,465.56
$1,575.86
$1,967.70
$1,656.46
$1,760.60
$1,870.90
$2,262.74
$680.71
$732.78
$787.93
$983.85
$975.75
$1,027.82
$1,082.97
$1,278.89
$1,270.79
$1,322.86
$1,378.01
$1,573.93
$295.04

Platinum

Plan: (EPO) BlueSelect Platinum 1451

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $800 : Family: $1,600
Out of Pocket Maximum per year: 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
0-14
Platinum 21
30
40
50
60
$467.53
$530.65
$597.50
$835.01
$1,268.88
$935.06
$1,061.30
$1,195.00
$1,670.02
$2,537.76
$1,292.72
$1,418.96
$1,552.66
$2,027.68
$1,650.38
$1,776.62
$1,910.32
$2,385.34
$2,008.04
$2,134.28
$2,267.98
$2,743.00
$825.19
$888.31
$955.16
$1,192.67
$1,182.85
$1,245.97
$1,312.82
$1,550.33
$1,540.51
$1,603.63
$1,670.48
$1,907.99
$357.66

Expanded Bronze

Plan: (EPO) BlueSelect Bronze 1449

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $6,400 : Family: $12,800
Out of Pocket Maximum per year: Individual: $6,900 : Family: $13,800

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
0-14
Expanded Bronze 21
30
40
50
60
$254.12
$288.43
$324.77
$453.86
$689.68
$508.24
$576.86
$649.54
$907.72
$1,379.36
$702.64
$771.26
$843.94
$1,102.12
$897.04
$965.66
$1,038.34
$1,296.52
$1,091.44
$1,160.06
$1,232.74
$1,490.92
$448.52
$482.83
$519.17
$648.26
$642.92
$677.23
$713.57
$842.66
$837.32
$871.63
$907.97
$1,037.06
$194.40

Platinum

Plan: (EPO) BlueSelect Platinum 1457

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

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
0-14
Platinum 21
30
40
50
60
$482.15
$547.24
$616.19
$861.12
$1,308.56
$964.30
$1,094.48
$1,232.38
$1,722.24
$2,617.12
$1,333.14
$1,463.32
$1,601.22
$2,091.08
$1,701.98
$1,832.16
$1,970.06
$2,459.92
$2,070.82
$2,201.00
$2,338.90
$2,828.76
$850.99
$916.08
$985.03
$1,229.96
$1,219.83
$1,284.92
$1,353.87
$1,598.80
$1,588.67
$1,653.76
$1,722.71
$1,967.64
$368.84

Silver

Plan: (EPO) BlueSelect Silver 1443

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $6,050 : Family: $12,100
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Silver 21
30
40
50
60
$341.49
$387.59
$436.42
$609.90
$926.80
$682.98
$775.18
$872.84
$1,219.80
$1,853.60
$944.22
$1,036.42
$1,134.08
$1,481.04
$1,205.46
$1,297.66
$1,395.32
$1,742.28
$1,466.70
$1,558.90
$1,656.56
$2,003.52
$602.73
$648.83
$697.66
$871.14
$863.97
$910.07
$958.90
$1,132.38
$1,125.21
$1,171.31
$1,220.14
$1,393.62
$261.24

Gold

Plan: (EPO) BlueSelect Gold 1535

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $0 : Family: $0
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
0-14
Gold 21
30
40
50
60
$398.83
$452.67
$509.70
$712.31
$1,082.42
$797.66
$905.34
$1,019.40
$1,424.62
$2,164.84
$1,102.76
$1,210.44
$1,324.50
$1,729.72
$1,407.86
$1,515.54
$1,629.60
$2,034.82
$1,712.96
$1,820.64
$1,934.70
$2,339.92
$703.93
$757.77
$814.80
$1,017.41
$1,009.03
$1,062.87
$1,119.90
$1,322.51
$1,314.13
$1,367.97
$1,425.00
$1,627.61
$305.10

Bronze

Plan: (EPO) BlueSelect Bronze (HSA) 1735

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

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
0-14
Bronze 21
30
40
50
60
$243.36
$276.21
$311.01
$434.64
$660.48
$486.72
$552.42
$622.02
$869.28
$1,320.96
$672.89
$738.59
$808.19
$1,055.45
$859.06
$924.76
$994.36
$1,241.62
$1,045.23
$1,110.93
$1,180.53
$1,427.79
$429.53
$462.38
$497.18
$620.81
$615.70
$648.55
$683.35
$806.98
$801.87
$834.72
$869.52
$993.15
$186.17

Silver

Plan: (EPO) BlueSelect Silver 1736S

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Silver 21
30
40
50
60
$378.46
$429.55
$483.67
$675.93
$1,027.14
$756.92
$859.10
$967.34
$1,351.86
$2,054.28
$1,046.44
$1,148.62
$1,256.86
$1,641.38
$1,335.96
$1,438.14
$1,546.38
$1,930.90
$1,625.48
$1,727.66
$1,835.90
$2,220.42
$667.98
$719.07
$773.19
$965.45
$957.50
$1,008.59
$1,062.71
$1,254.97
$1,247.02
$1,298.11
$1,352.23
$1,544.49
$289.52

Expanded Bronze

Plan: (EPO) BlueSelect Bronze 1737S

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Expanded Bronze 21
30
40
50
60
$247.09
$280.45
$315.78
$441.30
$670.60
$494.18
$560.90
$631.56
$882.60
$1,341.20
$683.20
$749.92
$820.58
$1,071.62
$872.22
$938.94
$1,009.60
$1,260.64
$1,061.24
$1,127.96
$1,198.62
$1,449.66
$436.11
$469.47
$504.80
$630.32
$625.13
$658.49
$693.82
$819.34
$814.15
$847.51
$882.84
$1,008.36
$189.02

Gold

Plan: (EPO) BlueSelect Gold 1835

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Customer Service Phone: 1-800-352-2583

Deductible: Individual: $2,000 : Family: $4,000
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
0-14
Gold 21
30
40
50
60
$374.87
$425.48
$479.08
$669.52
$1,017.40
$749.74
$850.96
$958.16
$1,339.04
$2,034.80
$1,036.52
$1,137.74
$1,244.94
$1,625.82
$1,323.30
$1,424.52
$1,531.72
$1,912.60
$1,610.08
$1,711.30
$1,818.50
$2,199.38
$661.65
$712.26
$765.86
$956.30
$948.43
$999.04
$1,052.64
$1,243.08
$1,235.21
$1,285.82
$1,339.42
$1,529.86
$286.78

Health First Commercial Plans, Inc.

Local: 1-855-443-4735 | Toll Free: 1-855-443-4735

TTY: 1-800-955-8771

Expanded Bronze

Plan: (HMO) Health First GYM ACCESS Bronze HMO 70 1656

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $6,550 : Family: $13,100
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Expanded Bronze 21
30
40
50
60
$297.38
$337.52
$380.05
$531.11
$807.08
$594.76
$675.04
$760.10
$1,062.22
$1,614.16
$822.25
$902.53
$987.59
$1,289.71
$1,049.74
$1,130.02
$1,215.08
$1,517.20
$1,277.23
$1,357.51
$1,442.57
$1,744.69
$524.87
$565.01
$607.54
$758.60
$752.36
$792.50
$835.03
$986.09
$979.85
$1,019.99
$1,062.52
$1,213.58
$227.49

Bronze

Plan: (HMO) Health First GYM ACCESS Bronze HMO 100 HSA 1658

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $6,350 : Family: $12,700
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
0-14
Bronze 21
30
40
50
60
$280.76
$318.67
$358.81
$501.44
$761.99
$561.52
$637.34
$717.62
$1,002.88
$1,523.98
$776.30
$852.12
$932.40
$1,217.66
$991.08
$1,066.90
$1,147.18
$1,432.44
$1,205.86
$1,281.68
$1,361.96
$1,647.22
$495.54
$533.45
$573.59
$716.22
$710.32
$748.23
$788.37
$931.00
$925.10
$963.01
$1,003.15
$1,145.78
$214.78

Bronze

Plan: (HMO) Health First GYM ACCESS Bronze HMO 70 HSA 1662

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $5,150 : Family: $10,300
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Bronze 21
30
40
50
60
$281.62
$319.64
$359.91
$502.97
$764.31
$563.24
$639.28
$719.82
$1,005.94
$1,528.62
$778.68
$854.72
$935.26
$1,221.38
$994.12
$1,070.16
$1,150.70
$1,436.82
$1,209.56
$1,285.60
$1,366.14
$1,652.26
$497.06
$535.08
$575.35
$718.41
$712.50
$750.52
$790.79
$933.85
$927.94
$965.96
$1,006.23
$1,149.29
$215.44

Silver

Plan: (HMO) Health First GYM ACCESS Silver HMO 100 1664

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Silver 21
30
40
50
60
$413.12
$468.89
$527.96
$737.83
$1,121.20
$826.24
$937.78
$1,055.92
$1,475.66
$2,242.40
$1,142.27
$1,253.81
$1,371.95
$1,791.69
$1,458.30
$1,569.84
$1,687.98
$2,107.72
$1,774.33
$1,885.87
$2,004.01
$2,423.75
$729.15
$784.92
$843.99
$1,053.86
$1,045.18
$1,100.95
$1,160.02
$1,369.89
$1,361.21
$1,416.98
$1,476.05
$1,685.92
$316.03

Silver

Plan: (HMO) Health First GYM ACCESS Silver HMO 100 1672

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $4,000 : Family: $8,000
Out of Pocket Maximum per year: Individual: $4,750 : Family: $9,500

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
0-14
Silver 21
30
40
50
60
$424.47
$481.78
$542.48
$758.11
$1,152.02
$848.94
$963.56
$1,084.96
$1,516.22
$2,304.04
$1,173.66
$1,288.28
$1,409.68
$1,840.94
$1,498.38
$1,613.00
$1,734.40
$2,165.66
$1,823.10
$1,937.72
$2,059.12
$2,490.38
$749.19
$806.50
$867.20
$1,082.83
$1,073.91
$1,131.22
$1,191.92
$1,407.55
$1,398.63
$1,455.94
$1,516.64
$1,732.27
$324.72

Bronze

Plan: (HMO) Health First GYM ACCESS Bronze HMO 50 1796

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $6,900 : Family: $13,800
Out of Pocket Maximum per year: 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
0-14
Bronze 21
30
40
50
60
$282.61
$320.76
$361.18
$504.74
$767.01
$565.22
$641.52
$722.36
$1,009.48
$1,534.02
$781.42
$857.72
$938.56
$1,225.68
$997.62
$1,073.92
$1,154.76
$1,441.88
$1,213.82
$1,290.12
$1,370.96
$1,658.08
$498.81
$536.96
$577.38
$720.94
$715.01
$753.16
$793.58
$937.14
$931.21
$969.36
$1,009.78
$1,153.34
$216.20

Silver

Plan: (HMO) Health First GYM ACCESS Silver HMO 90 1680

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $4,250 : Family: $8,500
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Silver 21
30
40
50
60
$441.61
$501.22
$564.37
$788.71
$1,198.52
$883.22
$1,002.44
$1,128.74
$1,577.42
$2,397.04
$1,221.05
$1,340.27
$1,466.57
$1,915.25
$1,558.88
$1,678.10
$1,804.40
$2,253.08
$1,896.71
$2,015.93
$2,142.23
$2,590.91
$779.44
$839.05
$902.20
$1,126.54
$1,117.27
$1,176.88
$1,240.03
$1,464.37
$1,455.10
$1,514.71
$1,577.86
$1,802.20
$337.83

Silver

Plan: (HMO) Health First GYM ACCESS Silver HMO 80 1688

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $3,100 : Family: $6,200
Out of Pocket Maximum per year: Individual: $6,050 : Family: $12,100

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
0-14
Silver 21
30
40
50
60
$415.30
$471.36
$530.75
$741.72
$1,127.12
$830.60
$942.72
$1,061.50
$1,483.44
$2,254.24
$1,148.30
$1,260.42
$1,379.20
$1,801.14
$1,466.00
$1,578.12
$1,696.90
$2,118.84
$1,783.70
$1,895.82
$2,014.60
$2,436.54
$733.00
$789.06
$848.45
$1,059.42
$1,050.70
$1,106.76
$1,166.15
$1,377.12
$1,368.40
$1,424.46
$1,483.85
$1,694.82
$317.70

Silver

Plan: (HMO) Health First GYM ACCESS Silver HMO 70 1704

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

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
0-14
Silver 21
30
40
50
60
$420.90
$477.73
$537.92
$751.73
$1,142.33
$841.80
$955.46
$1,075.84
$1,503.46
$2,284.66
$1,163.79
$1,277.45
$1,397.83
$1,825.45
$1,485.78
$1,599.44
$1,719.82
$2,147.44
$1,807.77
$1,921.43
$2,041.81
$2,469.43
$742.89
$799.72
$859.91
$1,073.72
$1,064.88
$1,121.71
$1,181.90
$1,395.71
$1,386.87
$1,443.70
$1,503.89
$1,717.70
$321.99

Silver

Plan: (HMO) Health First GYM ACCESS Silver HMO 70 1720

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $2,000 : Family: $4,000
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
0-14
Silver 21
30
40
50
60
$422.25
$479.25
$539.64
$754.14
$1,145.99
$844.50
$958.50
$1,079.28
$1,508.28
$2,291.98
$1,167.52
$1,281.52
$1,402.30
$1,831.30
$1,490.54
$1,604.54
$1,725.32
$2,154.32
$1,813.56
$1,927.56
$2,048.34
$2,477.34
$745.27
$802.27
$862.66
$1,077.16
$1,068.29
$1,125.29
$1,185.68
$1,400.18
$1,391.31
$1,448.31
$1,508.70
$1,723.20
$323.02

Silver

Plan: (HMO) Health First GYM ACCESS Silver HMO 80 HSA 1728

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Silver 21
30
40
50
60
$413.07
$468.83
$527.90
$737.74
$1,121.06
$826.14
$937.66
$1,055.80
$1,475.48
$2,242.12
$1,142.14
$1,253.66
$1,371.80
$1,791.48
$1,458.14
$1,569.66
$1,687.80
$2,107.48
$1,774.14
$1,885.66
$2,003.80
$2,423.48
$729.07
$784.83
$843.90
$1,053.74
$1,045.07
$1,100.83
$1,159.90
$1,369.74
$1,361.07
$1,416.83
$1,475.90
$1,685.74
$316.00

Gold

Plan: (HMO) Health First GYM ACCESS Gold HMO 100 1736

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $2,800 : Family: $5,600

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
0-14
Gold 21
30
40
50
60
$404.30
$458.88
$516.69
$722.07
$1,097.26
$808.60
$917.76
$1,033.38
$1,444.14
$2,194.52
$1,117.89
$1,227.05
$1,342.67
$1,753.43
$1,427.18
$1,536.34
$1,651.96
$2,062.72
$1,736.47
$1,845.63
$1,961.25
$2,372.01
$713.59
$768.17
$825.98
$1,031.36
$1,022.88
$1,077.46
$1,135.27
$1,340.65
$1,332.17
$1,386.75
$1,444.56
$1,649.94
$309.29

Gold

Plan: (HMO) Health First GYM ACCESS Gold HMO 80 1740

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $2,000 : Family: $4,000
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
0-14
Gold 21
30
40
50
60
$398.91
$452.76
$509.80
$712.45
$1,082.63
$797.82
$905.52
$1,019.60
$1,424.90
$2,165.26
$1,102.98
$1,210.68
$1,324.76
$1,730.06
$1,408.14
$1,515.84
$1,629.92
$2,035.22
$1,713.30
$1,821.00
$1,935.08
$2,340.38
$704.07
$757.92
$814.96
$1,017.61
$1,009.23
$1,063.08
$1,120.12
$1,322.77
$1,314.39
$1,368.24
$1,425.28
$1,627.93
$305.16

Gold

Plan: (HMO) Health First GYM ACCESS Gold HMO 70 1742

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

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
0-14
Gold 21
30
40
50
60
$412.24
$467.89
$526.84
$736.26
$1,118.82
$824.48
$935.78
$1,053.68
$1,472.52
$2,237.64
$1,139.84
$1,251.14
$1,369.04
$1,787.88
$1,455.20
$1,566.50
$1,684.40
$2,103.24
$1,770.56
$1,881.86
$1,999.76
$2,418.60
$727.60
$783.25
$842.20
$1,051.62
$1,042.96
$1,098.61
$1,157.56
$1,366.98
$1,358.32
$1,413.97
$1,472.92
$1,682.34
$315.36

Gold

Plan: (HMO) Health First GYM ACCESS Gold HMO 90 HSA 1744

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $1,500 : Family: $3,000
Out of Pocket Maximum per year: 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
0-14
Gold 21
30
40
50
60
$396.97
$450.57
$507.33
$709.00
$1,077.39
$793.94
$901.14
$1,014.66
$1,418.00
$2,154.78
$1,097.63
$1,204.83
$1,318.35
$1,721.69
$1,401.32
$1,508.52
$1,622.04
$2,025.38
$1,705.01
$1,812.21
$1,925.73
$2,329.07
$700.66
$754.26
$811.02
$1,012.69
$1,004.35
$1,057.95
$1,114.71
$1,316.38
$1,308.04
$1,361.64
$1,418.40
$1,620.07
$303.69

Catastrophic

Plan: (HMO) Health First GYM ACCESS Catastrophic HMO 1746

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $7,350 : Family: $14,700
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Catastrophic 21
30
40
50
60
$153.50
$174.22
$196.17
$274.15
$416.60
$307.00
$348.44
$392.34
$548.30
$833.20
$424.43
$465.87
$509.77
$665.73
$541.86
$583.30
$627.20
$783.16
$659.29
$700.73
$744.63
$900.59
$270.93
$291.65
$313.60
$391.58
$388.36
$409.08
$431.03
$509.01
$505.79
$526.51
$548.46
$626.44
$117.43

Bronze

Plan: (POS) Health First GYM ACCESS Bronze POS 100 HSA 1659

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $6,350 : Family: $12,700
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
0-14
Bronze 21
30
40
50
60
$298.90
$339.25
$382.00
$533.84
$811.22
$597.80
$678.50
$764.00
$1,067.68
$1,622.44
$826.46
$907.16
$992.66
$1,296.34
$1,055.12
$1,135.82
$1,221.32
$1,525.00
$1,283.78
$1,364.48
$1,449.98
$1,753.66
$527.56
$567.91
$610.66
$762.50
$756.22
$796.57
$839.32
$991.16
$984.88
$1,025.23
$1,067.98
$1,219.82
$228.66

Silver

Plan: (POS) Health First GYM ACCESS Silver POS 80 1692

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $3,100 : Family: $6,200
Out of Pocket Maximum per year: Individual: $6,050 : Family: $12,100

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
0-14
Silver 21
30
40
50
60
$444.01
$503.95
$567.45
$793.01
$1,205.05
$888.02
$1,007.90
$1,134.90
$1,586.02
$2,410.10
$1,227.69
$1,347.57
$1,474.57
$1,925.69
$1,567.36
$1,687.24
$1,814.24
$2,265.36
$1,907.03
$2,026.91
$2,153.91
$2,605.03
$783.68
$843.62
$907.12
$1,132.68
$1,123.35
$1,183.29
$1,246.79
$1,472.35
$1,463.02
$1,522.96
$1,586.46
$1,812.02
$339.67

Silver

Plan: (POS) Health First GYM ACCESS Silver POS 70 1708

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

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
0-14
Silver 21
30
40
50
60
$447.55
$507.97
$571.97
$799.33
$1,214.66
$895.10
$1,015.94
$1,143.94
$1,598.66
$2,429.32
$1,237.48
$1,358.32
$1,486.32
$1,941.04
$1,579.86
$1,700.70
$1,828.70
$2,283.42
$1,922.24
$2,043.08
$2,171.08
$2,625.80
$789.93
$850.35
$914.35
$1,141.71
$1,132.31
$1,192.73
$1,256.73
$1,484.09
$1,474.69
$1,535.11
$1,599.11
$1,826.47
$342.38

Gold

Plan: (POS) Health First GYM ACCESS Gold POS 100 1737

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $2,800 : Family: $5,600

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
0-14
Gold 21
30
40
50
60
$433.81
$492.38
$554.41
$774.79
$1,177.37
$867.62
$984.76
$1,108.82
$1,549.58
$2,354.74
$1,199.49
$1,316.63
$1,440.69
$1,881.45
$1,531.36
$1,648.50
$1,772.56
$2,213.32
$1,863.23
$1,980.37
$2,104.43
$2,545.19
$765.68
$824.25
$886.28
$1,106.66
$1,097.55
$1,156.12
$1,218.15
$1,438.53
$1,429.42
$1,487.99
$1,550.02
$1,770.40
$331.87

Catastrophic

Plan: (POS) Health First GYM ACCESS Catastrophic POS 1747

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $7,350 : Family: $14,700
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Catastrophic 21
30
40
50
60
$163.15
$185.18
$208.51
$291.39
$442.80
$326.30
$370.36
$417.02
$582.78
$885.60
$451.11
$495.17
$541.83
$707.59
$575.92
$619.98
$666.64
$832.40
$700.73
$744.79
$791.45
$957.21
$287.96
$309.99
$333.32
$416.20
$412.77
$434.80
$458.13
$541.01
$537.58
$559.61
$582.94
$665.82
$124.81

Expanded Bronze

Plan: (HMO) Health First Bronze HMO 60 1750

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Expanded Bronze 21
30
40
50
60
$280.74
$318.63
$358.78
$501.39
$761.92
$561.48
$637.26
$717.56
$1,002.78
$1,523.84
$776.24
$852.02
$932.32
$1,217.54
$991.00
$1,066.78
$1,147.08
$1,432.30
$1,205.76
$1,281.54
$1,361.84
$1,647.06
$495.50
$533.39
$573.54
$716.15
$710.26
$748.15
$788.30
$930.91
$925.02
$962.91
$1,003.06
$1,145.67
$214.76

Silver

Plan: (HMO) Health First Silver HMO 80 1754

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Silver 21
30
40
50
60
$415.60
$471.70
$531.14
$742.26
$1,127.94
$831.20
$943.40
$1,062.28
$1,484.52
$2,255.88
$1,149.13
$1,261.33
$1,380.21
$1,802.45
$1,467.06
$1,579.26
$1,698.14
$2,120.38
$1,784.99
$1,897.19
$2,016.07
$2,438.31
$733.53
$789.63
$849.07
$1,060.19
$1,051.46
$1,107.56
$1,167.00
$1,378.12
$1,369.39
$1,425.49
$1,484.93
$1,696.05
$317.93

Gold

Plan: (HMO) Health First Gold HMO 80 1770

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $1,400 : Family: $2,800
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
0-14
Gold 21
30
40
50
60
$390.82
$443.58
$499.46
$698.00
$1,060.68
$781.64
$887.16
$998.92
$1,396.00
$2,121.36
$1,080.61
$1,186.13
$1,297.89
$1,694.97
$1,379.58
$1,485.10
$1,596.86
$1,993.94
$1,678.55
$1,784.07
$1,895.83
$2,292.91
$689.79
$742.55
$798.43
$996.97
$988.76
$1,041.52
$1,097.40
$1,295.94
$1,287.73
$1,340.49
$1,396.37
$1,594.91
$298.97

Bronze

Plan: (HMO) Health First Bronze HMO 100 1774

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $7,350 : Family: $14,700
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Bronze 21
30
40
50
60
$266.00
$301.91
$339.94
$475.07
$721.92
$532.00
$603.82
$679.88
$950.14
$1,443.84
$735.49
$807.31
$883.37
$1,153.63
$938.98
$1,010.80
$1,086.86
$1,357.12
$1,142.47
$1,214.29
$1,290.35
$1,560.61
$469.49
$505.40
$543.43
$678.56
$672.98
$708.89
$746.92
$882.05
$876.47
$912.38
$950.41
$1,085.54
$203.49

Silver

Plan: (HMO) Health First Silver HMO 80 1778

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $2,900 : Family: $5,800
Out of Pocket Maximum per year: 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
0-14
Silver 21
30
40
50
60
$400.72
$454.82
$512.12
$715.69
$1,087.56
$801.44
$909.64
$1,024.24
$1,431.38
$2,175.12
$1,107.99
$1,216.19
$1,330.79
$1,737.93
$1,414.54
$1,522.74
$1,637.34
$2,044.48
$1,721.09
$1,829.29
$1,943.89
$2,351.03
$707.27
$761.37
$818.67
$1,022.24
$1,013.82
$1,067.92
$1,125.22
$1,328.79
$1,320.37
$1,374.47
$1,431.77
$1,635.34
$306.55

Expanded Bronze

Plan: (HMO) Health First Bronze HMO 100 HSA 1794

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

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
0-14
Expanded Bronze 21
30
40
50
60
$281.17
$319.13
$359.33
$502.17
$763.09
$562.34
$638.26
$718.66
$1,004.34
$1,526.18
$777.43
$853.35
$933.75
$1,219.43
$992.52
$1,068.44
$1,148.84
$1,434.52
$1,207.61
$1,283.53
$1,363.93
$1,649.61
$496.26
$534.22
$574.42
$717.26
$711.35
$749.31
$789.51
$932.35
$926.44
$964.40
$1,004.60
$1,147.44
$215.09

Silver

Plan: (HMO) Health First Silver HMO 90 1798

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $5,250 : Family: $10,500
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Silver 21
30
40
50
60
$426.34
$483.90
$544.86
$761.44
$1,157.09
$852.68
$967.80
$1,089.72
$1,522.88
$2,314.18
$1,178.83
$1,293.95
$1,415.87
$1,849.03
$1,504.98
$1,620.10
$1,742.02
$2,175.18
$1,831.13
$1,946.25
$2,068.17
$2,501.33
$752.49
$810.05
$871.01
$1,087.59
$1,078.64
$1,136.20
$1,197.16
$1,413.74
$1,404.79
$1,462.35
$1,523.31
$1,739.89
$326.15

Silver

Plan: (HMO) Health First Silver HMO 65 1806

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $1,550 : Family: $3,100
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Silver 21
30
40
50
60
$402.65
$457.01
$514.59
$719.14
$1,092.80
$805.30
$914.02
$1,029.18
$1,438.28
$2,185.60
$1,113.33
$1,222.05
$1,337.21
$1,746.31
$1,421.36
$1,530.08
$1,645.24
$2,054.34
$1,729.39
$1,838.11
$1,953.27
$2,362.37
$710.68
$765.04
$822.62
$1,027.17
$1,018.71
$1,073.07
$1,130.65
$1,335.20
$1,326.74
$1,381.10
$1,438.68
$1,643.23
$308.03

Expanded Bronze

Plan: (POS) Health First Bronze POS 60 1751

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Expanded Bronze 21
30
40
50
60
$298.21
$338.47
$381.11
$532.60
$809.34
$596.42
$676.94
$762.22
$1,065.20
$1,618.68
$824.55
$905.07
$990.35
$1,293.33
$1,052.68
$1,133.20
$1,218.48
$1,521.46
$1,280.81
$1,361.33
$1,446.61
$1,749.59
$526.34
$566.60
$609.24
$760.73
$754.47
$794.73
$837.37
$988.86
$982.60
$1,022.86
$1,065.50
$1,216.99
$228.13

Silver

Plan: (POS) Health First Silver POS 80 1758

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Silver 21
30
40
50
60
$440.63
$500.12
$563.13
$786.97
$1,195.88
$881.26
$1,000.24
$1,126.26
$1,573.94
$2,391.76
$1,218.34
$1,337.32
$1,463.34
$1,911.02
$1,555.42
$1,674.40
$1,800.42
$2,248.10
$1,892.50
$2,011.48
$2,137.50
$2,585.18
$777.71
$837.20
$900.21
$1,124.05
$1,114.79
$1,174.28
$1,237.29
$1,461.13
$1,451.87
$1,511.36
$1,574.37
$1,798.21
$337.08

Gold

Plan: (POS) Health First Gold POS 80 1771

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $1,400 : Family: $2,800
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
0-14
Gold 21
30
40
50
60
$417.58
$473.95
$533.66
$745.79
$1,133.30
$835.16
$947.90
$1,067.32
$1,491.58
$2,266.60
$1,154.61
$1,267.35
$1,386.77
$1,811.03
$1,474.06
$1,586.80
$1,706.22
$2,130.48
$1,793.51
$1,906.25
$2,025.67
$2,449.93
$737.03
$793.40
$853.11
$1,065.24
$1,056.48
$1,112.85
$1,172.56
$1,384.69
$1,375.93
$1,432.30
$1,492.01
$1,704.14
$319.45

Bronze

Plan: (POS) Health First Bronze POS 100 1775

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $7,350 : Family: $14,700
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
0-14
Bronze 21
30
40
50
60
$282.98
$321.18
$361.65
$505.40
$768.00
$565.96
$642.36
$723.30
$1,010.80
$1,536.00
$782.44
$858.84
$939.78
$1,227.28
$998.92
$1,075.32
$1,156.26
$1,443.76
$1,215.40
$1,291.80
$1,372.74
$1,660.24
$499.46
$537.66
$578.13
$721.88
$715.94
$754.14
$794.61
$938.36
$932.42
$970.62
$1,011.09
$1,154.84
$216.48

Silver

Plan: (POS) Health First Silver POS 80 1782

Summary of Benefits and Coverage - Plan Brochure
Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Customer Service Phone: 1-855-443-4735

Deductible: Individual: $2,900 : Family: $5,800
Out of Pocket Maximum per year: 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
0-14
Silver 21
30
40
50
60
$428.14
$485.93
$547.16
$764.65
$1,161.96
$856.28
$971.86
$1,094.32
$1,529.30
$2,323.92
$1,183.80
$1,299.38
$1,421.84
$1,856.82
$1,511.32
$1,626.90
$1,749.36
$2,184.34
$1,838.84
$1,954.42
$2,076.88
$2,511.86
$755.66
$813.45
$874.68
$1,092.17
$1,083.18
$1,140.97
$1,202.20
$1,419.69
$1,410.70
$1,468.49
$1,529.72
$1,747.21
$327.52

‡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 Indian River County here.

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