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Obamacare 2021 Rates and Health Insurance Providers for Saint Johns County , Florida

Obamacare > Rates > Florida > Saint Johns County

Obamacare Rates and Providers for Other Years

2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 |

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 Saint Johns County, FL.

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

Obamacare Providers, Plans and 2021 Rates for Saint Johns County, Florida

Below, you’ll find a summary of the 111 plans for Saint Johns County, Florida and rates for each of these providers. This chart is designed to give you a preview of your health insurance options.

  • Florida Blue (BlueCross BlueShield FL)

    Local: 1-800-352-2583 | Toll Free: 1-800-352-2583 | TTY: 1-800-955-8771

  • AvMed

    Local: 1-800-477-8768 | Toll Free: 
  • Ambetter from Sunshine Health

    Local: 1-877-687-1169 | Toll Free: 1-877-687-1169 | TTY: 1-800-955-8770

  • Florida Blue HMO (a BlueCross BlueShield FL company)

    Local: 1-800-352-2583 | Toll Free: 1-800-352-2583 | TTY: 1-800-955-8771

  • Florida Health Care Plans

    Local: 1-386-676-7110 | Toll Free: 1-800-232-0578 | TTY: 1-800-955-8771

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

    The table below shows premiums for the following profiles at various ages:

    • Individuals
    • Couples
    • Couples with 1, 2, or 3 children
    • Individuals with 1, 2, or 3 children
    • A child alone

    Each plan links to the insurance provider's website. You can find the following:

    • Summary of plan benefits and costs
    • Plan brochure
    • Provider Directory where you can find out which doctors and hospitals in the Ponte Vedra Beach, FL area accept this insurance coverage as within the plan's network.

    2021 Obamacare Rates, Providers, and Plans for Saint Johns County

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    Florida Blue (BlueCross BlueShield FL)

    Local: 1-800-352-2583 | Toll Free: 1-800-352-2583 | TTY: 1-800-955-8771

    Toc - Plan #1

    Silver

    (EPO) BlueOptions Silver 1423 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $5,950 $11,900 Annual Deductible
    $7,150 $14,300 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $574,86
    $652,47
    $734,67
    $1 026,70
    $1 560,17
    $1 149,72
    $1 304,94
    $1 469,34
    $2 053,40
    $3 120,34
    $1 589,49
    $1 744,71
    $1 909,11
    $2 493,17
    $2 029,26
    $2 184,48
    $2 348,88
    $2 932,94
    $2 469,03
    $2 624,25
    $2 788,65
    $3 372,71
    $1 014,63
    $1 092,24
    $1 174,44
    $1 466,47
    $1 454,40
    $1 532,01
    $1 614,21
    $1 906,24
    $1 894,17
    $1 971,78
    $2 053,98
    $2 346,01
    $439,77
    Toc - Plan #2

    Bronze

    (EPO) BlueOptions Bronze 1419 ($0 Virtual Visits / $100+ in Rewards)

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $355,42
    $403,40
    $454,23
    $634,78
    $964,61
    $710,84
    $806,80
    $908,46
    $1 269,56
    $1 929,22
    $982,74
    $1 078,70
    $1 180,36
    $1 541,46
    $1 254,64
    $1 350,60
    $1 452,26
    $1 813,36
    $1 526,54
    $1 622,50
    $1 724,16
    $2 085,26
    $627,32
    $675,30
    $726,13
    $906,68
    $899,22
    $947,20
    $998,03
    $1 178,58
    $1 171,12
    $1 219,10
    $1 269,93
    $1 450,48
    $271,90
    Toc - Plan #3

    Silver

    (EPO) BlueOptions Silver 1431 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $5,600 $11,200 Annual Deductible
    $7,800 $15,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $592,00
    $671,92
    $756,58
    $1 057,31
    $1 606,69
    $1 184,00
    $1 343,84
    $1 513,16
    $2 114,62
    $3 213,38
    $1 636,88
    $1 796,72
    $1 966,04
    $2 567,50
    $2 089,76
    $2 249,60
    $2 418,92
    $3 020,38
    $2 542,64
    $2 702,48
    $2 871,80
    $3 473,26
    $1 044,88
    $1 124,80
    $1 209,46
    $1 510,19
    $1 497,76
    $1 577,68
    $1 662,34
    $1 963,07
    $1 950,64
    $2 030,56
    $2 115,22
    $2 415,95
    $452,88
    Toc - Plan #4

    Platinum

    (EPO) BlueOptions Platinum 1418 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $1,250 $2,500 Annual Deductible
    $4,250 $8,500 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $692,92
    $786,46
    $885,55
    $1 237,56
    $1 880,58
    $1 385,84
    $1 572,92
    $1 771,10
    $2 475,12
    $3 761,16
    $1 915,92
    $2 103,00
    $2 301,18
    $3 005,20
    $2 446,00
    $2 633,08
    $2 831,26
    $3 535,28
    $2 976,08
    $3 163,16
    $3 361,34
    $4 065,36
    $1 223,00
    $1 316,54
    $1 415,63
    $1 767,64
    $1 753,08
    $1 846,62
    $1 945,71
    $2 297,72
    $2 283,16
    $2 376,70
    $2 475,79
    $2 827,80
    $530,08
    Toc - Plan #5

    Expanded Bronze

    (EPO) BlueOptions Bronze 1416 ($0 Virtual Visits / 3 PCP Visits for $20)

    Annual Out of Pocket Expenses
    Individual Family
    $8,500 $17,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $383,06
    $434,77
    $489,55
    $684,15
    $1 039,62
    $766,12
    $869,54
    $979,10
    $1 368,30
    $2 079,24
    $1 059,16
    $1 162,58
    $1 272,14
    $1 661,34
    $1 352,20
    $1 455,62
    $1 565,18
    $1 954,38
    $1 645,24
    $1 748,66
    $1 858,22
    $2 247,42
    $676,10
    $727,81
    $782,59
    $977,19
    $969,14
    $1 020,85
    $1 075,63
    $1 270,23
    $1 262,18
    $1 313,89
    $1 368,67
    $1 563,27
    $293,04
    Toc - Plan #6

    Platinum

    (EPO) BlueOptions Platinum 1424 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $2,000 $4,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $734,26
    $833,39
    $938,38
    $1 311,39
    $1 992,78
    $1 468,52
    $1 666,78
    $1 876,76
    $2 622,78
    $3 985,56
    $2 030,23
    $2 228,49
    $2 438,47
    $3 184,49
    $2 591,94
    $2 790,20
    $3 000,18
    $3 746,20
    $3 153,65
    $3 351,91
    $3 561,89
    $4 307,91
    $1 295,97
    $1 395,10
    $1 500,09
    $1 873,10
    $1 857,68
    $1 956,81
    $2 061,80
    $2 434,81
    $2 419,39
    $2 518,52
    $2 623,51
    $2 996,52
    $561,71
    Toc - Plan #7

    Silver

    (EPO) BlueOptions Silver 1410 ($0 Virtual Visits / $100+ in Rewards)

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $524,04
    $594,79
    $669,72
    $935,94
    $1 422,24
    $1 048,08
    $1 189,58
    $1 339,44
    $1 871,88
    $2 844,48
    $1 448,97
    $1 590,47
    $1 740,33
    $2 272,77
    $1 849,86
    $1 991,36
    $2 141,22
    $2 673,66
    $2 250,75
    $2 392,25
    $2 542,11
    $3 074,55
    $924,93
    $995,68
    $1 070,61
    $1 336,83
    $1 325,82
    $1 396,57
    $1 471,50
    $1 737,72
    $1 726,71
    $1 797,46
    $1 872,39
    $2 138,61
    $400,89
    Toc - Plan #8

    Gold

    (EPO) BlueOptions Gold 1505 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $5,000 $10,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $583,32
    $662,07
    $745,48
    $1 041,81
    $1 583,13
    $1 166,64
    $1 324,14
    $1 490,96
    $2 083,62
    $3 166,26
    $1 612,88
    $1 770,38
    $1 937,20
    $2 529,86
    $2 059,12
    $2 216,62
    $2 383,44
    $2 976,10
    $2 505,36
    $2 662,86
    $2 829,68
    $3 422,34
    $1 029,56
    $1 108,31
    $1 191,72
    $1 488,05
    $1 475,80
    $1 554,55
    $1 637,96
    $1 934,29
    $1 922,04
    $2 000,79
    $2 084,20
    $2 380,53
    $446,24
    Toc - Plan #9

    Expanded Bronze

    (EPO) BlueOptions Bronze (HSA) 1705 ($100+ in Rewards / $4 Condition Care Rx)

    Annual Out of Pocket Expenses
    Individual Family
    $6,850 $13,700 Annual Deductible
    $6,850 $13,700 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $371,19
    $421,30
    $474,38
    $662,95
    $1 007,41
    $742,38
    $842,60
    $948,76
    $1 325,90
    $2 014,82
    $1 026,34
    $1 126,56
    $1 232,72
    $1 609,86
    $1 310,30
    $1 410,52
    $1 516,68
    $1 893,82
    $1 594,26
    $1 694,48
    $1 800,64
    $2 177,78
    $655,15
    $705,26
    $758,34
    $946,91
    $939,11
    $989,22
    $1 042,30
    $1 230,87
    $1 223,07
    $1 273,18
    $1 326,26
    $1 514,83
    $283,96
    Toc - Plan #10

    Silver

    (EPO) BlueOptions Silver 1706S ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $3,600 $7,200 Annual Deductible
    $8,150 $16,300 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $585,92
    $665,02
    $748,81
    $1 046,45
    $1 590,19
    $1 171,84
    $1 330,04
    $1 497,62
    $2 092,90
    $3 180,38
    $1 620,07
    $1 778,27
    $1 945,85
    $2 541,13
    $2 068,30
    $2 226,50
    $2 394,08
    $2 989,36
    $2 516,53
    $2 674,73
    $2 842,31
    $3 437,59
    $1 034,15
    $1 113,25
    $1 197,04
    $1 494,68
    $1 482,38
    $1 561,48
    $1 645,27
    $1 942,91
    $1 930,61
    $2 009,71
    $2 093,50
    $2 391,14
    $448,23
    Toc - Plan #11

    Expanded Bronze

    (EPO) BlueOptions Bronze 1707S ($0 Virtual Visits / $40 PCP Visits)

    Annual Out of Pocket Expenses
    Individual Family
    $8,150 $16,300 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $382,04
    $433,62
    $488,25
    $682,32
    $1 036,86
    $764,08
    $867,24
    $976,50
    $1 364,64
    $2 073,72
    $1 056,34
    $1 159,50
    $1 268,76
    $1 656,90
    $1 348,60
    $1 451,76
    $1 561,02
    $1 949,16
    $1 640,86
    $1 744,02
    $1 853,28
    $2 241,42
    $674,30
    $725,88
    $780,51
    $974,58
    $966,56
    $1 018,14
    $1 072,77
    $1 266,84
    $1 258,82
    $1 310,40
    $1 365,03
    $1 559,10
    $292,26
    Toc - Plan #12

    Gold

    (EPO) BlueOptions Gold 1805 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $1,500 $3,000 Annual Deductible
    $5,500 $11,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $564,87
    $641,13
    $721,90
    $1 008,86
    $1 533,06
    $1 129,74
    $1 282,26
    $1 443,80
    $2 017,72
    $3 066,12
    $1 561,87
    $1 714,39
    $1 875,93
    $2 449,85
    $1 994,00
    $2 146,52
    $2 308,06
    $2 881,98
    $2 426,13
    $2 578,65
    $2 740,19
    $3 314,11
    $997,00
    $1 073,26
    $1 154,03
    $1 440,99
    $1 429,13
    $1 505,39
    $1 586,16
    $1 873,12
    $1 861,26
    $1 937,52
    $2 018,29
    $2 305,25
    $432,13
    Toc - Plan #13

    Expanded Bronze

    (EPO) BlueOptions Bronze 2119 ($0 Deductible / $50 PCP Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $408,71
    $463,89
    $522,33
    $729,96
    $1 109,24
    $817,42
    $927,78
    $1 044,66
    $1 459,92
    $2 218,48
    $1 130,08
    $1 240,44
    $1 357,32
    $1 772,58
    $1 442,74
    $1 553,10
    $1 669,98
    $2 085,24
    $1 755,40
    $1 865,76
    $1 982,64
    $2 397,90
    $721,37
    $776,55
    $834,99
    $1 042,62
    $1 034,03
    $1 089,21
    $1 147,65
    $1 355,28
    $1 346,69
    $1 401,87
    $1 460,31
    $1 667,94
    $312,66
    Toc - Plan #14

    Silver

    (EPO) BlueSelect Silver 1456 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $5,950 $11,900 Annual Deductible
    $7,150 $14,300 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $374,20
    $424,72
    $478,23
    $668,32
    $1 015,58
    $748,40
    $849,44
    $956,46
    $1 336,64
    $2 031,16
    $1 034,66
    $1 135,70
    $1 242,72
    $1 622,90
    $1 320,92
    $1 421,96
    $1 528,98
    $1 909,16
    $1 607,18
    $1 708,22
    $1 815,24
    $2 195,42
    $660,46
    $710,98
    $764,49
    $954,58
    $946,72
    $997,24
    $1 050,75
    $1 240,84
    $1 232,98
    $1 283,50
    $1 337,01
    $1 527,10
    $286,26
    Toc - Plan #15

    Bronze

    (EPO) BlueSelect Bronze 1452 ($0 Virtual Visits / $100+ in Rewards)

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $266,76
    $302,77
    $340,92
    $476,43
    $723,99
    $533,52
    $605,54
    $681,84
    $952,86
    $1 447,98
    $737,59
    $809,61
    $885,91
    $1 156,93
    $941,66
    $1 013,68
    $1 089,98
    $1 361,00
    $1 145,73
    $1 217,75
    $1 294,05
    $1 565,07
    $470,83
    $506,84
    $544,99
    $680,50
    $674,90
    $710,91
    $749,06
    $884,57
    $878,97
    $914,98
    $953,13
    $1 088,64
    $204,07
    Toc - Plan #16

    Silver

    (EPO) BlueSelect Silver 1464 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $5,600 $11,200 Annual Deductible
    $7,800 $15,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $387,84
    $440,20
    $495,66
    $692,68
    $1 052,60
    $775,68
    $880,40
    $991,32
    $1 385,36
    $2 105,20
    $1 072,38
    $1 177,10
    $1 288,02
    $1 682,06
    $1 369,08
    $1 473,80
    $1 584,72
    $1 978,76
    $1 665,78
    $1 770,50
    $1 881,42
    $2 275,46
    $684,54
    $736,90
    $792,36
    $989,38
    $981,24
    $1 033,60
    $1 089,06
    $1 286,08
    $1 277,94
    $1 330,30
    $1 385,76
    $1 582,78
    $296,70
    Toc - Plan #17

    Platinum

    (EPO) BlueSelect Platinum 1451 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $1,250 $2,500 Annual Deductible
    $4,250 $8,500 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $458,26
    $520,13
    $585,66
    $818,45
    $1 243,72
    $916,52
    $1 040,26
    $1 171,32
    $1 636,90
    $2 487,44
    $1 267,09
    $1 390,83
    $1 521,89
    $1 987,47
    $1 617,66
    $1 741,40
    $1 872,46
    $2 338,04
    $1 968,23
    $2 091,97
    $2 223,03
    $2 688,61
    $808,83
    $870,70
    $936,23
    $1 169,02
    $1 159,40
    $1 221,27
    $1 286,80
    $1 519,59
    $1 509,97
    $1 571,84
    $1 637,37
    $1 870,16
    $350,57
    Toc - Plan #18

    Expanded Bronze

    (EPO) BlueSelect Bronze 1449 ($0 Virtual Visits / 3 PCP Visits for $20)

    Annual Out of Pocket Expenses
    Individual Family
    $8,500 $17,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $285,38
    $323,91
    $364,72
    $509,69
    $774,52
    $570,76
    $647,82
    $729,44
    $1 019,38
    $1 549,04
    $789,08
    $866,14
    $947,76
    $1 237,70
    $1 007,40
    $1 084,46
    $1 166,08
    $1 456,02
    $1 225,72
    $1 302,78
    $1 384,40
    $1 674,34
    $503,70
    $542,23
    $583,04
    $728,01
    $722,02
    $760,55
    $801,36
    $946,33
    $940,34
    $978,87
    $1 019,68
    $1 164,65
    $218,32
    Toc - Plan #19

    Platinum

    (EPO) BlueSelect Platinum 1457 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $2,000 $4,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $491,95
    $558,36
    $628,71
    $878,62
    $1 335,15
    $983,90
    $1 116,72
    $1 257,42
    $1 757,24
    $2 670,30
    $1 360,24
    $1 493,06
    $1 633,76
    $2 133,58
    $1 736,58
    $1 869,40
    $2 010,10
    $2 509,92
    $2 112,92
    $2 245,74
    $2 386,44
    $2 886,26
    $868,29
    $934,70
    $1 005,05
    $1 254,96
    $1 244,63
    $1 311,04
    $1 381,39
    $1 631,30
    $1 620,97
    $1 687,38
    $1 757,73
    $2 007,64
    $376,34
    Toc - Plan #20

    Silver

    (EPO) BlueSelect Silver 1443 ($0 Labs / $0 Virtual Visits / $100+ in Rewards)

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $340,11
    $386,02
    $434,66
    $607,44
    $923,06
    $680,22
    $772,04
    $869,32
    $1 214,88
    $1 846,12
    $940,40
    $1 032,22
    $1 129,50
    $1 475,06
    $1 200,58
    $1 292,40
    $1 389,68
    $1 735,24
    $1 460,76
    $1 552,58
    $1 649,86
    $1 995,42
    $600,29
    $646,20
    $694,84
    $867,62
    $860,47
    $906,38
    $955,02
    $1 127,80
    $1 120,65
    $1 166,56
    $1 215,20
    $1 387,98
    $260,18
    Toc - Plan #21

    Gold

    (EPO) BlueSelect Gold 1535 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $5,000 $10,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $399,17
    $453,06
    $510,14
    $712,92
    $1 083,35
    $798,34
    $906,12
    $1 020,28
    $1 425,84
    $2 166,70
    $1 103,71
    $1 211,49
    $1 325,65
    $1 731,21
    $1 409,08
    $1 516,86
    $1 631,02
    $2 036,58
    $1 714,45
    $1 822,23
    $1 936,39
    $2 341,95
    $704,54
    $758,43
    $815,51
    $1 018,29
    $1 009,91
    $1 063,80
    $1 120,88
    $1 323,66
    $1 315,28
    $1 369,17
    $1 426,25
    $1 629,03
    $305,37
    Toc - Plan #22

    Expanded Bronze

    (EPO) BlueSelect Bronze (HSA) 1735 ($100+ in Rewards / $4 Condition Care Rx)

    Annual Out of Pocket Expenses
    Individual Family
    $6,850 $13,700 Annual Deductible
    $6,850 $13,700 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $278,15
    $315,70
    $355,48
    $496,78
    $754,90
    $556,30
    $631,40
    $710,96
    $993,56
    $1 509,80
    $769,08
    $844,18
    $923,74
    $1 206,34
    $981,86
    $1 056,96
    $1 136,52
    $1 419,12
    $1 194,64
    $1 269,74
    $1 349,30
    $1 631,90
    $490,93
    $528,48
    $568,26
    $709,56
    $703,71
    $741,26
    $781,04
    $922,34
    $916,49
    $954,04
    $993,82
    $1 135,12
    $212,78
    Toc - Plan #23

    Silver

    (EPO) BlueSelect Silver 1736S ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $3,600 $7,200 Annual Deductible
    $8,150 $16,300 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $379,21
    $430,40
    $484,63
    $677,27
    $1 029,18
    $758,42
    $860,80
    $969,26
    $1 354,54
    $2 058,36
    $1 048,52
    $1 150,90
    $1 259,36
    $1 644,64
    $1 338,62
    $1 441,00
    $1 549,46
    $1 934,74
    $1 628,72
    $1 731,10
    $1 839,56
    $2 224,84
    $669,31
    $720,50
    $774,73
    $967,37
    $959,41
    $1 010,60
    $1 064,83
    $1 257,47
    $1 249,51
    $1 300,70
    $1 354,93
    $1 547,57
    $290,10
    Toc - Plan #24

    Expanded Bronze

    (EPO) BlueSelect Bronze 1737S ($0 Virtual Visits / $40 PCP Visits)

    Annual Out of Pocket Expenses
    Individual Family
    $8,150 $16,300 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $284,94
    $323,41
    $364,15
    $508,90
    $773,33
    $569,88
    $646,82
    $728,30
    $1 017,80
    $1 546,66
    $787,86
    $864,80
    $946,28
    $1 235,78
    $1 005,84
    $1 082,78
    $1 164,26
    $1 453,76
    $1 223,82
    $1 300,76
    $1 382,24
    $1 671,74
    $502,92
    $541,39
    $582,13
    $726,88
    $720,90
    $759,37
    $800,11
    $944,86
    $938,88
    $977,35
    $1 018,09
    $1 162,84
    $217,98
    Toc - Plan #25

    Gold

    (EPO) BlueSelect Gold 1835 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $1,500 $3,000 Annual Deductible
    $5,500 $11,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $381,34
    $432,82
    $487,35
    $681,07
    $1 034,96
    $762,68
    $865,64
    $974,70
    $1 362,14
    $2 069,92
    $1 054,41
    $1 157,37
    $1 266,43
    $1 653,87
    $1 346,14
    $1 449,10
    $1 558,16
    $1 945,60
    $1 637,87
    $1 740,83
    $1 849,89
    $2 237,33
    $673,07
    $724,55
    $779,08
    $972,80
    $964,80
    $1 016,28
    $1 070,81
    $1 264,53
    $1 256,53
    $1 308,01
    $1 362,54
    $1 556,26
    $291,73
    Toc - Plan #26

    Expanded Bronze

    (EPO) BlueSelect Bronze 2139 ($0 Deductible / $50 PCP Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $304,51
    $345,62
    $389,16
    $543,85
    $826,44
    $609,02
    $691,24
    $778,32
    $1 087,70
    $1 652,88
    $841,97
    $924,19
    $1 011,27
    $1 320,65
    $1 074,92
    $1 157,14
    $1 244,22
    $1 553,60
    $1 307,87
    $1 390,09
    $1 477,17
    $1 786,55
    $537,46
    $578,57
    $622,11
    $776,80
    $770,41
    $811,52
    $855,06
    $1 009,75
    $1 003,36
    $1 044,47
    $1 088,01
    $1 242,70
    $232,95

    ADVERTISEMENT

    AvMed

    Local: 1-800-477-8768 | Toll Free: 

    Toc - Plan #27

    Gold

    (HMO) AvMed Entrust Gold 125

    Annual Out of Pocket Expenses
    Individual Family
    $2,000 $4,000 Annual Deductible
    $4,700 $9,400 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $433,58
    $492,11
    $554,11
    $774,37
    $1 176,72
    $867,16
    $984,22
    $1 108,22
    $1 548,74
    $2 353,44
    $1 198,85
    $1 315,91
    $1 439,91
    $1 880,43
    $1 530,54
    $1 647,60
    $1 771,60
    $2 212,12
    $1 862,23
    $1 979,29
    $2 103,29
    $2 543,81
    $765,27
    $823,80
    $885,80
    $1 106,06
    $1 096,96
    $1 155,49
    $1 217,49
    $1 437,75
    $1 428,65
    $1 487,18
    $1 549,18
    $1 769,44
    $331,69
    Toc - Plan #28

    Silver

    (HMO) AvMed Entrust Silver 300

    Annual Out of Pocket Expenses
    Individual Family
    $3,000 $6,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $421,48
    $478,38
    $538,65
    $752,76
    $1 143,89
    $842,96
    $956,76
    $1 077,30
    $1 505,52
    $2 287,78
    $1 165,39
    $1 279,19
    $1 399,73
    $1 827,95
    $1 487,82
    $1 601,62
    $1 722,16
    $2 150,38
    $1 810,25
    $1 924,05
    $2 044,59
    $2 472,81
    $743,91
    $800,81
    $861,08
    $1 075,19
    $1 066,34
    $1 123,24
    $1 183,51
    $1 397,62
    $1 388,77
    $1 445,67
    $1 505,94
    $1 720,05
    $322,43
    Toc - Plan #29

    Silver

    (HMO) AvMed Entrust Silver 350

    Annual Out of Pocket Expenses
    Individual Family
    $3,500 $7,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $403,38
    $457,83
    $515,52
    $720,43
    $1 094,77
    $806,76
    $915,66
    $1 031,04
    $1 440,86
    $2 189,54
    $1 115,34
    $1 224,24
    $1 339,62
    $1 749,44
    $1 423,92
    $1 532,82
    $1 648,20
    $2 058,02
    $1 732,50
    $1 841,40
    $1 956,78
    $2 366,60
    $711,96
    $766,41
    $824,10
    $1 029,01
    $1 020,54
    $1 074,99
    $1 132,68
    $1 337,59
    $1 329,12
    $1 383,57
    $1 441,26
    $1 646,17
    $308,58
    Toc - Plan #30

    Silver

    (HMO) AvMed Entrust Silver 500

    Annual Out of Pocket Expenses
    Individual Family
    $5,500 $11,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $402,36
    $456,68
    $514,22
    $718,62
    $1 092,02
    $804,72
    $913,36
    $1 028,44
    $1 437,24
    $2 184,04
    $1 112,53
    $1 221,17
    $1 336,25
    $1 745,05
    $1 420,34
    $1 528,98
    $1 644,06
    $2 052,86
    $1 728,15
    $1 836,79
    $1 951,87
    $2 360,67
    $710,17
    $764,49
    $822,03
    $1 026,43
    $1 017,98
    $1 072,30
    $1 129,84
    $1 334,24
    $1 325,79
    $1 380,11
    $1 437,65
    $1 642,05
    $307,81
    Toc - Plan #31

    Silver

    (HMO) AvMed Entrust Silver 550

    Annual Out of Pocket Expenses
    Individual Family
    $6,500 $13,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $399,43
    $453,35
    $510,47
    $713,37
    $1 084,04
    $798,86
    $906,70
    $1 020,94
    $1 426,74
    $2 168,08
    $1 104,42
    $1 212,26
    $1 326,50
    $1 732,30
    $1 409,98
    $1 517,82
    $1 632,06
    $2 037,86
    $1 715,54
    $1 823,38
    $1 937,62
    $2 343,42
    $704,99
    $758,91
    $816,03
    $1 018,93
    $1 010,55
    $1 064,47
    $1 121,59
    $1 324,49
    $1 316,11
    $1 370,03
    $1 427,15
    $1 630,05
    $305,56
    Toc - Plan #32

    Expanded Bronze

    (HMO) AvMed Entrust Bronze 600

    Annual Out of Pocket Expenses
    Individual Family
    $6,500 $13,000 Annual Deductible
    $7,900 $15,800 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $332,26
    $377,12
    $424,63
    $593,42
    $901,76
    $664,52
    $754,24
    $849,26
    $1 186,84
    $1 803,52
    $918,70
    $1 008,42
    $1 103,44
    $1 441,02
    $1 172,88
    $1 262,60
    $1 357,62
    $1 695,20
    $1 427,06
    $1 516,78
    $1 611,80
    $1 949,38
    $586,44
    $631,30
    $678,81
    $847,60
    $840,62
    $885,48
    $932,99
    $1 101,78
    $1 094,80
    $1 139,66
    $1 187,17
    $1 355,96
    $254,18
    Toc - Plan #33

    Expanded Bronze

    (HMO) AvMed Entrust Bronze 650

    Annual Out of Pocket Expenses
    Individual Family
    $8,200 $16,400 Annual Deductible
    $8,200 $16,400 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $305,56
    $346,81
    $390,51
    $545,73
    $829,29
    $611,12
    $693,62
    $781,02
    $1 091,46
    $1 658,58
    $844,87
    $927,37
    $1 014,77
    $1 325,21
    $1 078,62
    $1 161,12
    $1 248,52
    $1 558,96
    $1 312,37
    $1 394,87
    $1 482,27
    $1 792,71
    $539,31
    $580,56
    $624,26
    $779,48
    $773,06
    $814,31
    $858,01
    $1 013,23
    $1 006,81
    $1 048,06
    $1 091,76
    $1 246,98
    $233,75
    Toc - Plan #34

    Catastrophic

    (HMO) AvMed Catastrophic 100

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $268,59
    $304,85
    $343,26
    $479,71
    $728,96
    $537,18
    $609,70
    $686,52
    $959,42
    $1 457,92
    $742,65
    $815,17
    $891,99
    $1 164,89
    $948,12
    $1 020,64
    $1 097,46
    $1 370,36
    $1 153,59
    $1 226,11
    $1 302,93
    $1 575,83
    $474,06
    $510,32
    $548,73
    $685,18
    $679,53
    $715,79
    $754,20
    $890,65
    $885,00
    $921,26
    $959,67
    $1 096,12
    $205,47
    Toc - Plan #35

    Gold

    (HMO) AvMed Entrust Gold 125 Adult Dental + Vision

    Annual Out of Pocket Expenses
    Individual Family
    $2,000 $4,000 Annual Deductible
    $4,700 $9,400 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $437,42
    $496,47
    $559,02
    $781,23
    $1 187,15
    $874,84
    $992,94
    $1 118,04
    $1 562,46
    $2 374,30
    $1 209,46
    $1 327,56
    $1 452,66
    $1 897,08
    $1 544,08
    $1 662,18
    $1 787,28
    $2 231,70
    $1 878,70
    $1 996,80
    $2 121,90
    $2 566,32
    $772,04
    $831,09
    $893,64
    $1 115,85
    $1 106,66
    $1 165,71
    $1 228,26
    $1 450,47
    $1 441,28
    $1 500,33
    $1 562,88
    $1 785,09
    $334,62
    Toc - Plan #36

    Silver

    (HMO) AvMed Entrust Silver 300 Adult Dental + Vision

    Annual Out of Pocket Expenses
    Individual Family
    $3,000 $6,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $425,21
    $482,61
    $543,41
    $759,42
    $1 154,01
    $850,42
    $965,22
    $1 086,82
    $1 518,84
    $2 308,02
    $1 175,70
    $1 290,50
    $1 412,10
    $1 844,12
    $1 500,98
    $1 615,78
    $1 737,38
    $2 169,40
    $1 826,26
    $1 941,06
    $2 062,66
    $2 494,68
    $750,49
    $807,89
    $868,69
    $1 084,70
    $1 075,77
    $1 133,17
    $1 193,97
    $1 409,98
    $1 401,05
    $1 458,45
    $1 519,25
    $1 735,26
    $325,28
    Toc - Plan #37

    Silver

    (HMO) AvMed Entrust Silver 350 Adult Dental + Vision

    Annual Out of Pocket Expenses
    Individual Family
    $3,500 $7,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $406,96
    $461,90
    $520,09
    $726,83
    $1 104,49
    $813,92
    $923,80
    $1 040,18
    $1 453,66
    $2 208,98
    $1 125,24
    $1 235,12
    $1 351,50
    $1 764,98
    $1 436,56
    $1 546,44
    $1 662,82
    $2 076,30
    $1 747,88
    $1 857,76
    $1 974,14
    $2 387,62
    $718,28
    $773,22
    $831,41
    $1 038,15
    $1 029,60
    $1 084,54
    $1 142,73
    $1 349,47
    $1 340,92
    $1 395,86
    $1 454,05
    $1 660,79
    $311,32
    Toc - Plan #38

    Silver

    (HMO) AvMed Entrust Silver 500 Adult Dental + Vision

    Annual Out of Pocket Expenses
    Individual Family
    $5,500 $11,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $405,93
    $460,73
    $518,77
    $724,98
    $1 101,68
    $811,86
    $921,46
    $1 037,54
    $1 449,96
    $2 203,36
    $1 122,39
    $1 231,99
    $1 348,07
    $1 760,49
    $1 432,92
    $1 542,52
    $1 658,60
    $2 071,02
    $1 743,45
    $1 853,05
    $1 969,13
    $2 381,55
    $716,46
    $771,26
    $829,30
    $1 035,51
    $1 026,99
    $1 081,79
    $1 139,83
    $1 346,04
    $1 337,52
    $1 392,32
    $1 450,36
    $1 656,57
    $310,53

    ADVERTISEMENT

    Ambetter from Sunshine Health

    Local: 1-877-687-1169 | Toll Free: 1-877-687-1169 | TTY: 1-800-955-8770

    Toc - Plan #39

    Gold

    (EPO) Ambetter Secure Care 5 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $1,450 $2,900 Annual Deductible
    $6,300 $12,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $343,44
    $389,79
    $438,90
    $613,36
    $932,06
    $686,88
    $779,58
    $877,80
    $1 226,72
    $1 864,12
    $949,60
    $1 042,30
    $1 140,52
    $1 489,44
    $1 212,32
    $1 305,02
    $1 403,24
    $1 752,16
    $1 475,04
    $1 567,74
    $1 665,96
    $2 014,88
    $606,16
    $652,51
    $701,62
    $876,08
    $868,88
    $915,23
    $964,34
    $1 138,80
    $1 131,60
    $1 177,95
    $1 227,06
    $1 401,52
    $262,72
    Toc - Plan #40

    Bronze

    (EPO) Ambetter Essential Care 1 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $8,300 $16,600 Annual Deductible
    $8,300 $16,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $240,19
    $272,61
    $306,95
    $428,96
    $651,85
    $480,38
    $545,22
    $613,90
    $857,92
    $1 303,70
    $664,12
    $728,96
    $797,64
    $1 041,66
    $847,86
    $912,70
    $981,38
    $1 225,40
    $1 031,60
    $1 096,44
    $1 165,12
    $1 409,14
    $423,93
    $456,35
    $490,69
    $612,70
    $607,67
    $640,09
    $674,43
    $796,44
    $791,41
    $823,83
    $858,17
    $980,18
    $183,74
    Toc - Plan #41

    Expanded Bronze

    (EPO) Ambetter Essential Care 2 HSA (2021)

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $245,69
    $278,84
    $313,97
    $438,78
    $666,77
    $491,38
    $557,68
    $627,94
    $877,56
    $1 333,54
    $679,32
    $745,62
    $815,88
    $1 065,50
    $867,26
    $933,56
    $1 003,82
    $1 253,44
    $1 055,20
    $1 121,50
    $1 191,76
    $1 441,38
    $433,63
    $466,78
    $501,91
    $626,72
    $621,57
    $654,72
    $689,85
    $814,66
    $809,51
    $842,66
    $877,79
    $1 002,60
    $187,94
    Toc - Plan #42

    Expanded Bronze

    (EPO) Ambetter Essential Care 10 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $7,200 $14,400 Annual Deductible
    $8,400 $16,800 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $246,13
    $279,35
    $314,55
    $439,58
    $667,98
    $492,26
    $558,70
    $629,10
    $879,16
    $1 335,96
    $680,54
    $746,98
    $817,38
    $1 067,44
    $868,82
    $935,26
    $1 005,66
    $1 255,72
    $1 057,10
    $1 123,54
    $1 193,94
    $1 444,00
    $434,41
    $467,63
    $502,83
    $627,86
    $622,69
    $655,91
    $691,11
    $816,14
    $810,97
    $844,19
    $879,39
    $1 004,42
    $188,28
    Toc - Plan #43

    Silver

    (EPO) Ambetter Balanced Care 4 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $7,200 $14,400 Annual Deductible
    $7,200 $14,400 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $343,47
    $389,83
    $438,94
    $613,42
    $932,15
    $686,94
    $779,66
    $877,88
    $1 226,84
    $1 864,30
    $949,69
    $1 042,41
    $1 140,63
    $1 489,59
    $1 212,44
    $1 305,16
    $1 403,38
    $1 752,34
    $1 475,19
    $1 567,91
    $1 666,13
    $2 015,09
    $606,22
    $652,58
    $701,69
    $876,17
    $868,97
    $915,33
    $964,44
    $1 138,92
    $1 131,72
    $1 178,08
    $1 227,19
    $1 401,67
    $262,75
    Toc - Plan #44

    Silver

    (EPO) Ambetter Balanced Care 11 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $6,000 $12,000 Annual Deductible
    $8,500 $17,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $334,95
    $380,16
    $428,06
    $598,21
    $909,03
    $669,90
    $760,32
    $856,12
    $1 196,42
    $1 818,06
    $926,13
    $1 016,55
    $1 112,35
    $1 452,65
    $1 182,36
    $1 272,78
    $1 368,58
    $1 708,88
    $1 438,59
    $1 529,01
    $1 624,81
    $1 965,11
    $591,18
    $636,39
    $684,29
    $854,44
    $847,41
    $892,62
    $940,52
    $1 110,67
    $1 103,64
    $1 148,85
    $1 196,75
    $1 366,90
    $256,23
    Toc - Plan #45

    Silver

    (EPO) Ambetter Balanced Care 12 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $6,500 $13,000 Annual Deductible
    $8,400 $16,800 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $327,60
    $371,82
    $418,66
    $585,08
    $889,08
    $655,20
    $743,64
    $837,32
    $1 170,16
    $1 778,16
    $905,81
    $994,25
    $1 087,93
    $1 420,77
    $1 156,42
    $1 244,86
    $1 338,54
    $1 671,38
    $1 407,03
    $1 495,47
    $1 589,15
    $1 921,99
    $578,21
    $622,43
    $669,27
    $835,69
    $828,82
    $873,04
    $919,88
    $1 086,30
    $1 079,43
    $1 123,65
    $1 170,49
    $1 336,91
    $250,61
    Toc - Plan #46

    Silver

    (EPO) Ambetter Balanced Care 24 (2021)

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $339,62
    $385,46
    $434,03
    $606,55
    $921,71
    $679,24
    $770,92
    $868,06
    $1 213,10
    $1 843,42
    $939,04
    $1 030,72
    $1 127,86
    $1 472,90
    $1 198,84
    $1 290,52
    $1 387,66
    $1 732,70
    $1 458,64
    $1 550,32
    $1 647,46
    $1 992,50
    $599,42
    $645,26
    $693,83
    $866,35
    $859,22
    $905,06
    $953,63
    $1 126,15
    $1 119,02
    $1 164,86
    $1 213,43
    $1 385,95
    $259,80
    Toc - Plan #47

    Silver

    (EPO) Ambetter Balanced Care 29 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $5,450 $10,900 Annual Deductible
    $8,400 $16,800 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $324,65
    $368,46
    $414,89
    $579,80
    $881,07
    $649,30
    $736,92
    $829,78
    $1 159,60
    $1 762,14
    $897,65
    $985,27
    $1 078,13
    $1 407,95
    $1 146,00
    $1 233,62
    $1 326,48
    $1 656,30
    $1 394,35
    $1 481,97
    $1 574,83
    $1 904,65
    $573,00
    $616,81
    $663,24
    $828,15
    $821,35
    $865,16
    $911,59
    $1 076,50
    $1 069,70
    $1 113,51
    $1 159,94
    $1 324,85
    $248,35
    Toc - Plan #48

    Silver

    (EPO) Ambetter Balanced Care 25 HSA (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $4,800 $9,600 Annual Deductible
    $4,800 $9,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $338,73
    $384,45
    $432,88
    $604,95
    $919,29
    $677,46
    $768,90
    $865,76
    $1 209,90
    $1 838,58
    $936,58
    $1 028,02
    $1 124,88
    $1 469,02
    $1 195,70
    $1 287,14
    $1 384,00
    $1 728,14
    $1 454,82
    $1 546,26
    $1 643,12
    $1 987,26
    $597,85
    $643,57
    $692,00
    $864,07
    $856,97
    $902,69
    $951,12
    $1 123,19
    $1 116,09
    $1 161,81
    $1 210,24
    $1 382,31
    $259,12
    Toc - Plan #49

    Silver

    (EPO) Ambetter Balanced Care 26 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $5,450 $10,900 Annual Deductible
    $8,100 $16,200 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $345,36
    $391,97
    $441,36
    $616,79
    $937,28
    $690,72
    $783,94
    $882,72
    $1 233,58
    $1 874,56
    $954,91
    $1 048,13
    $1 146,91
    $1 497,77
    $1 219,10
    $1 312,32
    $1 411,10
    $1 761,96
    $1 483,29
    $1 576,51
    $1 675,29
    $2 026,15
    $609,55
    $656,16
    $705,55
    $880,98
    $873,74
    $920,35
    $969,74
    $1 145,17
    $1 137,93
    $1 184,54
    $1 233,93
    $1 409,36
    $264,19
    Toc - Plan #50

    Silver

    (EPO) Ambetter Balanced Care 27 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $2,750 $5,500 Annual Deductible
    $6,500 $13,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $360,71
    $409,40
    $460,98
    $644,21
    $978,94
    $721,42
    $818,80
    $921,96
    $1 288,42
    $1 957,88
    $997,36
    $1 094,74
    $1 197,90
    $1 564,36
    $1 273,30
    $1 370,68
    $1 473,84
    $1 840,30
    $1 549,24
    $1 646,62
    $1 749,78
    $2 116,24
    $636,65
    $685,34
    $736,92
    $920,15
    $912,59
    $961,28
    $1 012,86
    $1 196,09
    $1 188,53
    $1 237,22
    $1 288,80
    $1 472,03
    $275,94
    Toc - Plan #51

    Silver

    (EPO) Ambetter Balanced Care 28 (2021)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,200 $16,400 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $367,44
    $417,04
    $469,58
    $656,24
    $997,21
    $734,88
    $834,08
    $939,16
    $1 312,48
    $1 994,42
    $1 015,97
    $1 115,17
    $1 220,25
    $1 593,57
    $1 297,06
    $1 396,26
    $1 501,34
    $1 874,66
    $1 578,15
    $1 677,35
    $1 782,43
    $2 155,75
    $648,53
    $698,13
    $750,67
    $937,33
    $929,62
    $979,22
    $1 031,76
    $1 218,42
    $1 210,71
    $1 260,31
    $1 312,85
    $1 499,51
    $281,09
    Toc - Plan #52

    Silver

    (EPO) Ambetter Balanced Care 12 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $6,500 $13,000 Annual Deductible
    $8,400 $16,800 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $340,50
    $386,45
    $435,14
    $608,11
    $924,08
    $681,00
    $772,90
    $870,28
    $1 216,22
    $1 848,16
    $941,47
    $1 033,37
    $1 130,75
    $1 476,69
    $1 201,94
    $1 293,84
    $1 391,22
    $1 737,16
    $1 462,41
    $1 554,31
    $1 651,69
    $1 997,63
    $600,97
    $646,92
    $695,61
    $868,58
    $861,44
    $907,39
    $956,08
    $1 129,05
    $1 121,91
    $1 167,86
    $1 216,55
    $1 389,52
    $260,47
    Toc - Plan #53

    Expanded Bronze

    (EPO) Ambetter Essential Care 2 HSA (2021) + Vision + Adult Dental

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $255,36
    $289,82
    $326,33
    $456,05
    $693,01
    $510,72
    $579,64
    $652,66
    $912,10
    $1 386,02
    $706,06
    $774,98
    $848,00
    $1 107,44
    $901,40
    $970,32
    $1 043,34
    $1 302,78
    $1 096,74
    $1 165,66
    $1 238,68
    $1 498,12
    $450,70
    $485,16
    $521,67
    $651,39
    $646,04
    $680,50
    $717,01
    $846,73
    $841,38
    $875,84
    $912,35
    $1 042,07
    $195,34
    Toc - Plan #54

    Gold

    (EPO) Ambetter Secure Care 5 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $1,450 $2,900 Annual Deductible
    $6,300 $12,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $356,95
    $405,13
    $456,17
    $637,50
    $968,74
    $713,90
    $810,26
    $912,34
    $1 275,00
    $1 937,48
    $986,96
    $1 083,32
    $1 185,40
    $1 548,06
    $1 260,02
    $1 356,38
    $1 458,46
    $1 821,12
    $1 533,08
    $1 629,44
    $1 731,52
    $2 094,18
    $630,01
    $678,19
    $729,23
    $910,56
    $903,07
    $951,25
    $1 002,29
    $1 183,62
    $1 176,13
    $1 224,31
    $1 275,35
    $1 456,68
    $273,06
    Toc - Plan #55

    Bronze

    (EPO) Ambetter Essential Care 1 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $8,300 $16,600 Annual Deductible
    $8,300 $16,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $249,64
    $283,34
    $319,03
    $445,85
    $677,51
    $499,28
    $566,68
    $638,06
    $891,70
    $1 355,02
    $690,25
    $757,65
    $829,03
    $1 082,67
    $881,22
    $948,62
    $1 020,00
    $1 273,64
    $1 072,19
    $1 139,59
    $1 210,97
    $1 464,61
    $440,61
    $474,31
    $510,00
    $636,82
    $631,58
    $665,28
    $700,97
    $827,79
    $822,55
    $856,25
    $891,94
    $1 018,76
    $190,97
    Toc - Plan #56

    Expanded Bronze

    (EPO) Ambetter Essential Care 10 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $7,200 $14,400 Annual Deductible
    $8,400 $16,800 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $255,82
    $290,35
    $326,93
    $456,88
    $694,27
    $511,64
    $580,70
    $653,86
    $913,76
    $1 388,54
    $707,34
    $776,40
    $849,56
    $1 109,46
    $903,04
    $972,10
    $1 045,26
    $1 305,16
    $1 098,74
    $1 167,80
    $1 240,96
    $1 500,86
    $451,52
    $486,05
    $522,63
    $652,58
    $647,22
    $681,75
    $718,33
    $848,28
    $842,92
    $877,45
    $914,03
    $1 043,98
    $195,70
    Toc - Plan #57

    Silver

    (EPO) Ambetter Balanced Care 4 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $7,200 $14,400 Annual Deductible
    $7,200 $14,400 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $356,99
    $405,17
    $456,22
    $637,56
    $968,84
    $713,98
    $810,34
    $912,44
    $1 275,12
    $1 937,68
    $987,07
    $1 083,43
    $1 185,53
    $1 548,21
    $1 260,16
    $1 356,52
    $1 458,62
    $1 821,30
    $1 533,25
    $1 629,61
    $1 731,71
    $2 094,39
    $630,08
    $678,26
    $729,31
    $910,65
    $903,17
    $951,35
    $1 002,40
    $1 183,74
    $1 176,26
    $1 224,44
    $1 275,49
    $1 456,83
    $273,09
    Toc - Plan #58

    Silver

    (EPO) Ambetter Balanced Care 11 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $6,000 $12,000 Annual Deductible
    $8,500 $17,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $348,14
    $395,12
    $444,90
    $621,75
    $944,81
    $696,28
    $790,24
    $889,80
    $1 243,50
    $1 889,62
    $962,60
    $1 056,56
    $1 156,12
    $1 509,82
    $1 228,92
    $1 322,88
    $1 422,44
    $1 776,14
    $1 495,24
    $1 589,20
    $1 688,76
    $2 042,46
    $614,46
    $661,44
    $711,22
    $888,07
    $880,78
    $927,76
    $977,54
    $1 154,39
    $1 147,10
    $1 194,08
    $1 243,86
    $1 420,71
    $266,32
    Toc - Plan #59

    Silver

    (EPO) Ambetter Balanced Care 24 (2021) + Vision + Adult Dental

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $352,99
    $400,63
    $451,11
    $630,42
    $957,99
    $705,98
    $801,26
    $902,22
    $1 260,84
    $1 915,98
    $976,01
    $1 071,29
    $1 172,25
    $1 530,87
    $1 246,04
    $1 341,32
    $1 442,28
    $1 800,90
    $1 516,07
    $1 611,35
    $1 712,31
    $2 070,93
    $623,02
    $670,66
    $721,14
    $900,45
    $893,05
    $940,69
    $991,17
    $1 170,48
    $1 163,08
    $1 210,72
    $1 261,20
    $1 440,51
    $270,03
    Toc - Plan #60

    Silver

    (EPO) Ambetter Balanced Care 25 HSA (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $4,800 $9,600 Annual Deductible
    $4,800 $9,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $352,06
    $399,58
    $449,92
    $628,76
    $955,47
    $704,12
    $799,16
    $899,84
    $1 257,52
    $1 910,94
    $973,44
    $1 068,48
    $1 169,16
    $1 526,84
    $1 242,76
    $1 337,80
    $1 438,48
    $1 796,16
    $1 512,08
    $1 607,12
    $1 707,80
    $2 065,48
    $621,38
    $668,90
    $719,24
    $898,08
    $890,70
    $938,22
    $988,56
    $1 167,40
    $1 160,02
    $1 207,54
    $1 257,88
    $1 436,72
    $269,32
    Toc - Plan #61

    Silver

    (EPO) Ambetter Balanced Care 26 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $5,450 $10,900 Annual Deductible
    $8,100 $16,200 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $358,95
    $407,40
    $458,73
    $641,07
    $974,17
    $717,90
    $814,80
    $917,46
    $1 282,14
    $1 948,34
    $992,49
    $1 089,39
    $1 192,05
    $1 556,73
    $1 267,08
    $1 363,98
    $1 466,64
    $1 831,32
    $1 541,67
    $1 638,57
    $1 741,23
    $2 105,91
    $633,54
    $681,99
    $733,32
    $915,66
    $908,13
    $956,58
    $1 007,91
    $1 190,25
    $1 182,72
    $1 231,17
    $1 282,50
    $1 464,84
    $274,59
    Toc - Plan #62

    Silver

    (EPO) Ambetter Balanced Care 27 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $2,750 $5,500 Annual Deductible
    $6,500 $13,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $374,91
    $425,51
    $479,12
    $669,57
    $1 017,48
    $749,82
    $851,02
    $958,24
    $1 339,14
    $2 034,96
    $1 036,62
    $1 137,82
    $1 245,04
    $1 625,94
    $1 323,42
    $1 424,62
    $1 531,84
    $1 912,74
    $1 610,22
    $1 711,42
    $1 818,64
    $2 199,54
    $661,71
    $712,31
    $765,92
    $956,37
    $948,51
    $999,11
    $1 052,72
    $1 243,17
    $1 235,31
    $1 285,91
    $1 339,52
    $1 529,97
    $286,80
    Toc - Plan #63

    Silver

    (EPO) Ambetter Balanced Care 28 (2021) + Vision + Adult Dental

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,200 $16,400 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $381,91
    $433,45
    $488,06
    $682,07
    $1 036,46
    $763,82
    $866,90
    $976,12
    $1 364,14
    $2 072,92
    $1 055,97
    $1 159,05
    $1 268,27
    $1 656,29
    $1 348,12
    $1 451,20
    $1 560,42
    $1 948,44
    $1 640,27
    $1 743,35
    $1 852,57
    $2 240,59
    $674,06
    $725,60
    $780,21
    $974,22
    $966,21
    $1 017,75
    $1 072,36
    $1 266,37
    $1 258,36
    $1 309,90
    $1 364,51
    $1 558,52
    $292,15

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    Toc - Plan #64

    Silver

    (HMO) BlueCare Silver 1490 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $5,950 $11,900 Annual Deductible
    $7,150 $14,300 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $594,69
    $674,97
    $760,01
    $1 062,12
    $1 613,99
    $1 189,38
    $1 349,94
    $1 520,02
    $2 124,24
    $3 227,98
    $1 644,32
    $1 804,88
    $1 974,96
    $2 579,18
    $2 099,26
    $2 259,82
    $2 429,90
    $3 034,12
    $2 554,20
    $2 714,76
    $2 884,84
    $3 489,06
    $1 049,63
    $1 129,91
    $1 214,95
    $1 517,06
    $1 504,57
    $1 584,85
    $1 669,89
    $1 972,00
    $1 959,51
    $2 039,79
    $2 124,83
    $2 426,94
    $454,94
    Toc - Plan #65

    Bronze

    (HMO) BlueCare Bronze 1486 ($0 Virtual Visits / $100+ in Rewards)

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $377,08
    $427,99
    $481,91
    $673,46
    $1 023,40
    $754,16
    $855,98
    $963,82
    $1 346,92
    $2 046,80
    $1 042,63
    $1 144,45
    $1 252,29
    $1 635,39
    $1 331,10
    $1 432,92
    $1 540,76
    $1 923,86
    $1 619,57
    $1 721,39
    $1 829,23
    $2 212,33
    $665,55
    $716,46
    $770,38
    $961,93
    $954,02
    $1 004,93
    $1 058,85
    $1 250,40
    $1 242,49
    $1 293,40
    $1 347,32
    $1 538,87
    $288,47
    Toc - Plan #66

    Silver

    (HMO) BlueCare Silver 1498 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $5,600 $11,200 Annual Deductible
    $7,800 $15,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $599,62
    $680,57
    $766,31
    $1 070,92
    $1 627,37
    $1 199,24
    $1 361,14
    $1 532,62
    $2 141,84
    $3 254,74
    $1 657,95
    $1 819,85
    $1 991,33
    $2 600,55
    $2 116,66
    $2 278,56
    $2 450,04
    $3 059,26
    $2 575,37
    $2 737,27
    $2 908,75
    $3 517,97
    $1 058,33
    $1 139,28
    $1 225,02
    $1 529,63
    $1 517,04
    $1 597,99
    $1 683,73
    $1 988,34
    $1 975,75
    $2 056,70
    $2 142,44
    $2 447,05
    $458,71
    Toc - Plan #67

    Platinum

    (HMO) BlueCare Platinum 1485 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $1,250 $2,500 Annual Deductible
    $4,250 $8,500 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $647,71
    $735,15
    $827,77
    $1 156,81
    $1 757,88
    $1 295,42
    $1 470,30
    $1 655,54
    $2 313,62
    $3 515,76
    $1 790,92
    $1 965,80
    $2 151,04
    $2 809,12
    $2 286,42
    $2 461,30
    $2 646,54
    $3 304,62
    $2 781,92
    $2 956,80
    $3 142,04
    $3 800,12
    $1 143,21
    $1 230,65
    $1 323,27
    $1 652,31
    $1 638,71
    $1 726,15
    $1 818,77
    $2 147,81
    $2 134,21
    $2 221,65
    $2 314,27
    $2 643,31
    $495,50
    Toc - Plan #68

    Expanded Bronze

    (HMO) BlueCare Bronze 1483 ($0 Virtual Visits / 3 PCP Visits for $20)

    Annual Out of Pocket Expenses
    Individual Family
    $8,500 $17,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $418,72
    $475,25
    $535,12
    $747,83
    $1 136,41
    $837,44
    $950,50
    $1 070,24
    $1 495,66
    $2 272,82
    $1 157,76
    $1 270,82
    $1 390,56
    $1 815,98
    $1 478,08
    $1 591,14
    $1 710,88
    $2 136,30
    $1 798,40
    $1 911,46
    $2 031,20
    $2 456,62
    $739,04
    $795,57
    $855,44
    $1 068,15
    $1 059,36
    $1 115,89
    $1 175,76
    $1 388,47
    $1 379,68
    $1 436,21
    $1 496,08
    $1 708,79
    $320,32
    Toc - Plan #69

    Platinum

    (HMO) BlueCare Platinum 1491 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $2,000 $4,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $699,12
    $793,50
    $893,48
    $1 248,63
    $1 897,41
    $1 398,24
    $1 587,00
    $1 786,96
    $2 497,26
    $3 794,82
    $1 933,07
    $2 121,83
    $2 321,79
    $3 032,09
    $2 467,90
    $2 656,66
    $2 856,62
    $3 566,92
    $3 002,73
    $3 191,49
    $3 391,45
    $4 101,75
    $1 233,95
    $1 328,33
    $1 428,31
    $1 783,46
    $1 768,78
    $1 863,16
    $1 963,14
    $2 318,29
    $2 303,61
    $2 397,99
    $2 497,97
    $2 853,12
    $534,83
    Toc - Plan #70

    Silver

    (HMO) BlueCare Silver 1477 ($0 Virtual Visits / $100+ in Rewards)

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $508,46
    $577,10
    $649,81
    $908,11
    $1 379,96
    $1 016,92
    $1 154,20
    $1 299,62
    $1 816,22
    $2 759,92
    $1 405,89
    $1 543,17
    $1 688,59
    $2 205,19
    $1 794,86
    $1 932,14
    $2 077,56
    $2 594,16
    $2 183,83
    $2 321,11
    $2 466,53
    $2 983,13
    $897,43
    $966,07
    $1 038,78
    $1 297,08
    $1 286,40
    $1 355,04
    $1 427,75
    $1 686,05
    $1 675,37
    $1 744,01
    $1 816,72
    $2 075,02
    $388,97
    Toc - Plan #71

    Gold

    (HMO) BlueCare Gold 1565 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $5,000 $10,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $597,96
    $678,68
    $764,19
    $1 067,96
    $1 622,86
    $1 195,92
    $1 357,36
    $1 528,38
    $2 135,92
    $3 245,72
    $1 653,36
    $1 814,80
    $1 985,82
    $2 593,36
    $2 110,80
    $2 272,24
    $2 443,26
    $3 050,80
    $2 568,24
    $2 729,68
    $2 900,70
    $3 508,24
    $1 055,40
    $1 136,12
    $1 221,63
    $1 525,40
    $1 512,84
    $1 593,56
    $1 679,07
    $1 982,84
    $1 970,28
    $2 051,00
    $2 136,51
    $2 440,28
    $457,44
    Toc - Plan #72

    Expanded Bronze

    (HMO) BlueCare Bronze (HSA) 1765 ($100+ in Rewards / $4 Condition Care Rx)

    Annual Out of Pocket Expenses
    Individual Family
    $6,850 $13,700 Annual Deductible
    $6,850 $13,700 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $398,39
    $452,17
    $509,14
    $711,52
    $1 081,23
    $796,78
    $904,34
    $1 018,28
    $1 423,04
    $2 162,46
    $1 101,55
    $1 209,11
    $1 323,05
    $1 727,81
    $1 406,32
    $1 513,88
    $1 627,82
    $2 032,58
    $1 711,09
    $1 818,65
    $1 932,59
    $2 337,35
    $703,16
    $756,94
    $813,91
    $1 016,29
    $1 007,93
    $1 061,71
    $1 118,68
    $1 321,06
    $1 312,70
    $1 366,48
    $1 423,45
    $1 625,83
    $304,77
    Toc - Plan #73

    Silver

    (HMO) BlueCare Silver 1766S ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $3,600 $7,200 Annual Deductible
    $8,150 $16,300 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $590,03
    $669,68
    $754,06
    $1 053,79
    $1 601,34
    $1 180,06
    $1 339,36
    $1 508,12
    $2 107,58
    $3 202,68
    $1 631,43
    $1 790,73
    $1 959,49
    $2 558,95
    $2 082,80
    $2 242,10
    $2 410,86
    $3 010,32
    $2 534,17
    $2 693,47
    $2 862,23
    $3 461,69
    $1 041,40
    $1 121,05
    $1 205,43
    $1 505,16
    $1 492,77
    $1 572,42
    $1 656,80
    $1 956,53
    $1 944,14
    $2 023,79
    $2 108,17
    $2 407,90
    $451,37
    Toc - Plan #74

    Expanded Bronze

    (HMO) BlueCare Bronze 1767S ($0 Virtual Visits / $40 PCP Visits)

    Annual Out of Pocket Expenses
    Individual Family
    $8,150 $16,300 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $416,55
    $472,78
    $532,35
    $743,96
    $1 130,52
    $833,10
    $945,56
    $1 064,70
    $1 487,92
    $2 261,04
    $1 151,76
    $1 264,22
    $1 383,36
    $1 806,58
    $1 470,42
    $1 582,88
    $1 702,02
    $2 125,24
    $1 789,08
    $1 901,54
    $2 020,68
    $2 443,90
    $735,21
    $791,44
    $851,01
    $1 062,62
    $1 053,87
    $1 110,10
    $1 169,67
    $1 381,28
    $1 372,53
    $1 428,76
    $1 488,33
    $1 699,94
    $318,66
    Toc - Plan #75

    Gold

    (HMO) BlueCare Gold 1865 ($0 Virtual Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $1,500 $3,000 Annual Deductible
    $5,500 $11,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $573,37
    $650,77
    $732,77
    $1 024,04
    $1 556,13
    $1 146,74
    $1 301,54
    $1 465,54
    $2 048,08
    $3 112,26
    $1 585,37
    $1 740,17
    $1 904,17
    $2 486,71
    $2 024,00
    $2 178,80
    $2 342,80
    $2 925,34
    $2 462,63
    $2 617,43
    $2 781,43
    $3 363,97
    $1 012,00
    $1 089,40
    $1 171,40
    $1 462,67
    $1 450,63
    $1 528,03
    $1 610,03
    $1 901,30
    $1 889,26
    $1 966,66
    $2 048,66
    $2 339,93
    $438,63
    Toc - Plan #76

    Expanded Bronze

    (HMO) BlueCare Bronze 2179 ($0 Deductible / $50 PCP Visits / $100+ in Rewards)

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $456,81
    $518,48
    $583,80
    $815,86
    $1 239,78
    $913,62
    $1 036,96
    $1 167,60
    $1 631,72
    $2 479,56
    $1 263,08
    $1 386,42
    $1 517,06
    $1 981,18
    $1 612,54
    $1 735,88
    $1 866,52
    $2 330,64
    $1 962,00
    $2 085,34
    $2 215,98
    $2 680,10
    $806,27
    $867,94
    $933,26
    $1 165,32
    $1 155,73
    $1 217,40
    $1 282,72
    $1 514,78
    $1 505,19
    $1 566,86
    $1 632,18
    $1 864,24
    $349,46

    ADVERTISEMENT

    Florida Health Care Plans

    Local: 1-386-676-7110 | Toll Free: 1-800-232-0578 | TTY: 1-800-955-8771

    Toc - Plan #77

    Catastrophic

    (HMO) Gym Access IND Essential Plus Catastrophic HMO 36

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $195,73
    $222,15
    $250,14
    $349,57
    $531,20
    $391,46
    $444,30
    $500,28
    $699,14
    $1 062,40
    $541,19
    $594,03
    $650,01
    $848,87
    $690,92
    $743,76
    $799,74
    $998,60
    $840,65
    $893,49
    $949,47
    $1 148,33
    $345,46
    $371,88
    $399,87
    $499,30
    $495,19
    $521,61
    $549,60
    $649,03
    $644,92
    $671,34
    $699,33
    $798,76
    $149,73
    Toc - Plan #78

    Catastrophic

    (POS) Gym Access IND Essential Plus Catastrophic POS 37

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $211,39
    $239,92
    $270,15
    $377,53
    $573,69
    $422,78
    $479,84
    $540,30
    $755,06
    $1 147,38
    $584,49
    $641,55
    $702,01
    $916,77
    $746,20
    $803,26
    $863,72
    $1 078,48
    $907,91
    $964,97
    $1 025,43
    $1 240,19
    $373,10
    $401,63
    $431,86
    $539,24
    $534,81
    $563,34
    $593,57
    $700,95
    $696,52
    $725,05
    $755,28
    $862,66
    $161,71
    Toc - Plan #79

    Silver

    (HMO) Gym Access IND Essential Plus Silver HMO 53

    Annual Out of Pocket Expenses
    Individual Family
    $2,900 $5,800 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $366,20
    $415,64
    $468,00
    $654,03
    $993,86
    $732,40
    $831,28
    $936,00
    $1 308,06
    $1 987,72
    $1 012,55
    $1 111,43
    $1 216,15
    $1 588,21
    $1 292,70
    $1 391,58
    $1 496,30
    $1 868,36
    $1 572,85
    $1 671,73
    $1 776,45
    $2 148,51
    $646,35
    $695,79
    $748,15
    $934,18
    $926,50
    $975,94
    $1 028,30
    $1 214,33
    $1 206,65
    $1 256,09
    $1 308,45
    $1 494,48
    $280,15
    Toc - Plan #80

    Gold

    (HMO) Gym Access IND Essential Plus Gold HMO 63

    Annual Out of Pocket Expenses
    Individual Family
    $2,000 $4,000 Annual Deductible
    $5,000 $10,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $364,16
    $413,32
    $465,39
    $650,38
    $988,32
    $728,32
    $826,64
    $930,78
    $1 300,76
    $1 976,64
    $1 006,90
    $1 105,22
    $1 209,36
    $1 579,34
    $1 285,48
    $1 383,80
    $1 487,94
    $1 857,92
    $1 564,06
    $1 662,38
    $1 766,52
    $2 136,50
    $642,74
    $691,90
    $743,97
    $928,96
    $921,32
    $970,48
    $1 022,55
    $1 207,54
    $1 199,90
    $1 249,06
    $1 301,13
    $1 486,12
    $278,58
    Toc - Plan #81

    Platinum

    (HMO) Gym Access IND Essential Plus Platinum HMO 65

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $2,000 $4,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $497,28
    $564,41
    $635,52
    $888,13
    $1 349,60
    $994,56
    $1 128,82
    $1 271,04
    $1 776,26
    $2 699,20
    $1 374,98
    $1 509,24
    $1 651,46
    $2 156,68
    $1 755,40
    $1 889,66
    $2 031,88
    $2 537,10
    $2 135,82
    $2 270,08
    $2 412,30
    $2 917,52
    $877,70
    $944,83
    $1 015,94
    $1 268,55
    $1 258,12
    $1 325,25
    $1 396,36
    $1 648,97
    $1 638,54
    $1 705,67
    $1 776,78
    $2 029,39
    $380,42
    Toc - Plan #82

    Silver

    (POS) Gym Access IND Essential Plus Silver POS 54

    Annual Out of Pocket Expenses
    Individual Family
    $2,900 $5,800 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $378,30
    $429,37
    $483,47
    $675,64
    $1 026,71
    $756,60
    $858,74
    $966,94
    $1 351,28
    $2 053,42
    $1 046,00
    $1 148,14
    $1 256,34
    $1 640,68
    $1 335,40
    $1 437,54
    $1 545,74
    $1 930,08
    $1 624,80
    $1 726,94
    $1 835,14
    $2 219,48
    $667,70
    $718,77
    $772,87
    $965,04
    $957,10
    $1 008,17
    $1 062,27
    $1 254,44
    $1 246,50
    $1 297,57
    $1 351,67
    $1 543,84
    $289,40
    Toc - Plan #83

    Platinum

    (HMO) Gym Access IND Platinum HMO 4000

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $4,000 $8,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $486,66
    $552,36
    $621,95
    $869,17
    $1 320,79
    $973,32
    $1 104,72
    $1 243,90
    $1 738,34
    $2 641,58
    $1 345,62
    $1 477,02
    $1 616,20
    $2 110,64
    $1 717,92
    $1 849,32
    $1 988,50
    $2 482,94
    $2 090,22
    $2 221,62
    $2 360,80
    $2 855,24
    $858,96
    $924,66
    $994,25
    $1 241,47
    $1 231,26
    $1 296,96
    $1 366,55
    $1 613,77
    $1 603,56
    $1 669,26
    $1 738,85
    $1 986,07
    $372,30
    Toc - Plan #84

    Platinum

    (POS) Gym Access IND Platinum POS 4000

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $4,000 $8,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $525,59
    $596,55
    $671,71
    $938,71
    $1 426,45
    $1 051,18
    $1 193,10
    $1 343,42
    $1 877,42
    $2 852,90
    $1 453,26
    $1 595,18
    $1 745,50
    $2 279,50
    $1 855,34
    $1 997,26
    $2 147,58
    $2 681,58
    $2 257,42
    $2 399,34
    $2 549,66
    $3 083,66
    $927,67
    $998,63
    $1 073,79
    $1 340,79
    $1 329,75
    $1 400,71
    $1 475,87
    $1 742,87
    $1 731,83
    $1 802,79
    $1 877,95
    $2 144,95
    $402,08
    Toc - Plan #85

    Gold

    (HMO) Gym Access IND Gold HMO 55001

    Annual Out of Pocket Expenses
    Individual Family
    $2,800 $5,600 Annual Deductible
    $6,300 $12,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $363,23
    $412,27
    $464,21
    $648,73
    $985,81
    $726,46
    $824,54
    $928,42
    $1 297,46
    $1 971,62
    $1 004,34
    $1 102,42
    $1 206,30
    $1 575,34
    $1 282,22
    $1 380,30
    $1 484,18
    $1 853,22
    $1 560,10
    $1 658,18
    $1 762,06
    $2 131,10
    $641,11
    $690,15
    $742,09
    $926,61
    $918,99
    $968,03
    $1 019,97
    $1 204,49
    $1 196,87
    $1 245,91
    $1 297,85
    $1 482,37
    $277,88
    Toc - Plan #86

    Gold

    (POS) Gym Access IND Gold POS 55001

    Annual Out of Pocket Expenses
    Individual Family
    $2,800 $5,600 Annual Deductible
    $6,300 $12,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $392,29
    $445,25
    $501,35
    $700,63
    $1 064,67
    $784,58
    $890,50
    $1 002,70
    $1 401,26
    $2 129,34
    $1 084,69
    $1 190,61
    $1 302,81
    $1 701,37
    $1 384,80
    $1 490,72
    $1 602,92
    $2 001,48
    $1 684,91
    $1 790,83
    $1 903,03
    $2 301,59
    $692,40
    $745,36
    $801,46
    $1 000,74
    $992,51
    $1 045,47
    $1 101,57
    $1 300,85
    $1 292,62
    $1 345,58
    $1 401,68
    $1 600,96
    $300,11
    Toc - Plan #87

    Gold

    (HMO) Gym Access IND Gold HMO 4500

    Annual Out of Pocket Expenses
    Individual Family
    $2,550 $5,100 Annual Deductible
    $4,500 $9,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $364,58
    $413,80
    $465,93
    $651,14
    $989,46
    $729,16
    $827,60
    $931,86
    $1 302,28
    $1 978,92
    $1 008,07
    $1 106,51
    $1 210,77
    $1 581,19
    $1 286,98
    $1 385,42
    $1 489,68
    $1 860,10
    $1 565,89
    $1 664,33
    $1 768,59
    $2 139,01
    $643,49
    $692,71
    $744,84
    $930,05
    $922,40
    $971,62
    $1 023,75
    $1 208,96
    $1 201,31
    $1 250,53
    $1 302,66
    $1 487,87
    $278,91
    Toc - Plan #88

    Expanded Bronze

    (HMO) Gym Access IND Bronze HMO HSA 5065

    Annual Out of Pocket Expenses
    Individual Family
    $6,300 $12,600 Annual Deductible
    $6,900 $13,800 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $267,25
    $303,33
    $341,54
    $477,30
    $725,31
    $534,50
    $606,66
    $683,08
    $954,60
    $1 450,62
    $738,95
    $811,11
    $887,53
    $1 159,05
    $943,40
    $1 015,56
    $1 091,98
    $1 363,50
    $1 147,85
    $1 220,01
    $1 296,43
    $1 567,95
    $471,70
    $507,78
    $545,99
    $681,75
    $676,15
    $712,23
    $750,44
    $886,20
    $880,60
    $916,68
    $954,89
    $1 090,65
    $204,45
    Toc - Plan #89

    Expanded Bronze

    (HMO) Gym Access IND Bronze HMO HSA 6060

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $267,80
    $303,95
    $342,25
    $478,28
    $726,80
    $535,60
    $607,90
    $684,50
    $956,56
    $1 453,60
    $740,47
    $812,77
    $889,37
    $1 161,43
    $945,34
    $1 017,64
    $1 094,24
    $1 366,30
    $1 150,21
    $1 222,51
    $1 299,11
    $1 571,17
    $472,67
    $508,82
    $547,12
    $683,15
    $677,54
    $713,69
    $751,99
    $888,02
    $882,41
    $918,56
    $956,86
    $1 092,89
    $204,87
    Toc - Plan #90

    Expanded Bronze

    (HMO) Gym Access IND Bronze HMO BC 3841

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $284,93
    $323,39
    $364,13
    $508,87
    $773,28
    $569,86
    $646,78
    $728,26
    $1 017,74
    $1 546,56
    $787,83
    $864,75
    $946,23
    $1 235,71
    $1 005,80
    $1 082,72
    $1 164,20
    $1 453,68
    $1 223,77
    $1 300,69
    $1 382,17
    $1 671,65
    $502,90
    $541,36
    $582,10
    $726,84
    $720,87
    $759,33
    $800,07
    $944,81
    $938,84
    $977,30
    $1 018,04
    $1 162,78
    $217,97
    Toc - Plan #91

    Expanded Bronze

    (POS) Gym Access IND Bronze POS BC 3841

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $307,72
    $349,26
    $393,26
    $549,58
    $835,14
    $615,44
    $698,52
    $786,52
    $1 099,16
    $1 670,28
    $850,85
    $933,93
    $1 021,93
    $1 334,57
    $1 086,26
    $1 169,34
    $1 257,34
    $1 569,98
    $1 321,67
    $1 404,75
    $1 492,75
    $1 805,39
    $543,13
    $584,67
    $628,67
    $784,99
    $778,54
    $820,08
    $864,08
    $1 020,40
    $1 013,95
    $1 055,49
    $1 099,49
    $1 255,81
    $235,41
    Toc - Plan #92

    Silver

    (HMO) Gym Access IND Silver HMO BC 0941

    Annual Out of Pocket Expenses
    Individual Family
    $5,600 $11,200 Annual Deductible
    $7,150 $14,300 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $353,51
    $401,23
    $451,78
    $631,36
    $959,42
    $707,02
    $802,46
    $903,56
    $1 262,72
    $1 918,84
    $977,46
    $1 072,90
    $1 174,00
    $1 533,16
    $1 247,90
    $1 343,34
    $1 444,44
    $1 803,60
    $1 518,34
    $1 613,78
    $1 714,88
    $2 074,04
    $623,95
    $671,67
    $722,22
    $901,80
    $894,39
    $942,11
    $992,66
    $1 172,24
    $1 164,83
    $1 212,55
    $1 263,10
    $1 442,68
    $270,44
    Toc - Plan #93

    Silver

    (POS) Gym Access IND Silver POS BC 0941

    Annual Out of Pocket Expenses
    Individual Family
    $5,600 $11,200 Annual Deductible
    $7,150 $14,300 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $381,79
    $433,33
    $487,93
    $681,87
    $1 036,17
    $763,58
    $866,66
    $975,86
    $1 363,74
    $2 072,34
    $1 055,65
    $1 158,73
    $1 267,93
    $1 655,81
    $1 347,72
    $1 450,80
    $1 560,00
    $1 947,88
    $1 639,79
    $1 742,87
    $1 852,07
    $2 239,95
    $673,86
    $725,40
    $780,00
    $973,94
    $965,93
    $1 017,47
    $1 072,07
    $1 266,01
    $1 258,00
    $1 309,54
    $1 364,14
    $1 558,08
    $292,07
    Toc - Plan #94

    Silver

    (HMO) Gym Access IND Silver HMO BC 7741

    Annual Out of Pocket Expenses
    Individual Family
    $6,000 $12,000 Annual Deductible
    $8,500 $17,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $336,19
    $381,57
    $429,64
    $600,42
    $912,40
    $672,38
    $763,14
    $859,28
    $1 200,84
    $1 824,80
    $929,56
    $1 020,32
    $1 116,46
    $1 458,02
    $1 186,74
    $1 277,50
    $1 373,64
    $1 715,20
    $1 443,92
    $1 534,68
    $1 630,82
    $1 972,38
    $593,37
    $638,75
    $686,82
    $857,60
    $850,55
    $895,93
    $944,00
    $1 114,78
    $1 107,73
    $1 153,11
    $1 201,18
    $1 371,96
    $257,18
    Toc - Plan #95

    Silver

    (POS) Gym Access IND Silver POS BC 7741

    Annual Out of Pocket Expenses
    Individual Family
    $6,000 $12,000 Annual Deductible
    $8,500 $17,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $363,08
    $412,10
    $464,02
    $648,46
    $985,39
    $726,16
    $824,20
    $928,04
    $1 296,92
    $1 970,78
    $1 003,92
    $1 101,96
    $1 205,80
    $1 574,68
    $1 281,68
    $1 379,72
    $1 483,56
    $1 852,44
    $1 559,44
    $1 657,48
    $1 761,32
    $2 130,20
    $640,84
    $689,86
    $741,78
    $926,22
    $918,60
    $967,62
    $1 019,54
    $1 203,98
    $1 196,36
    $1 245,38
    $1 297,30
    $1 481,74
    $277,76
    Toc - Plan #96

    Gold

    (HMO) Gym Access IND Gold HMO BC 5651

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $5,800 $11,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $383,84
    $435,66
    $490,55
    $685,54
    $1 041,75
    $767,68
    $871,32
    $981,10
    $1 371,08
    $2 083,50
    $1 061,32
    $1 164,96
    $1 274,74
    $1 664,72
    $1 354,96
    $1 458,60
    $1 568,38
    $1 958,36
    $1 648,60
    $1 752,24
    $1 862,02
    $2 252,00
    $677,48
    $729,30
    $784,19
    $979,18
    $971,12
    $1 022,94
    $1 077,83
    $1 272,82
    $1 264,76
    $1 316,58
    $1 371,47
    $1 566,46
    $293,64
    Toc - Plan #97

    Gold

    (POS) Gym Access IND Gold POS BC 5651

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $5,800 $11,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $414,55
    $470,52
    $529,80
    $740,39
    $1 125,09
    $829,10
    $941,04
    $1 059,60
    $1 480,78
    $2 250,18
    $1 146,23
    $1 258,17
    $1 376,73
    $1 797,91
    $1 463,36
    $1 575,30
    $1 693,86
    $2 115,04
    $1 780,49
    $1 892,43
    $2 010,99
    $2 432,17
    $731,68
    $787,65
    $846,93
    $1 057,52
    $1 048,81
    $1 104,78
    $1 164,06
    $1 374,65
    $1 365,94
    $1 421,91
    $1 481,19
    $1 691,78
    $317,13
    Toc - Plan #98

    Platinum

    (HMO) Gym Access IND Platinum HMO BC 5841

    Annual Out of Pocket Expenses
    Individual Family
    $800 $1,600 Annual Deductible
    $2,500 $5,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $477,34
    $541,78
    $610,04
    $852,52
    $1 295,49
    $954,68
    $1 083,56
    $1 220,08
    $1 705,04
    $2 590,98
    $1 319,85
    $1 448,73
    $1 585,25
    $2 070,21
    $1 685,02
    $1 813,90
    $1 950,42
    $2 435,38
    $2 050,19
    $2 179,07
    $2 315,59
    $2 800,55
    $842,51
    $906,95
    $975,21
    $1 217,69
    $1 207,68
    $1 272,12
    $1 340,38
    $1 582,86
    $1 572,85
    $1 637,29
    $1 705,55
    $1 948,03
    $365,17
    Toc - Plan #99

    Platinum

    (POS) Gym Access IND Platinum POS BC 5841

    Annual Out of Pocket Expenses
    Individual Family
    $800 $1,600 Annual Deductible
    $2,500 $5,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $515,53
    $585,12
    $658,84
    $920,73
    $1 399,13
    $1 031,06
    $1 170,24
    $1 317,68
    $1 841,46
    $2 798,26
    $1 425,44
    $1 564,62
    $1 712,06
    $2 235,84
    $1 819,82
    $1 959,00
    $2 106,44
    $2 630,22
    $2 214,20
    $2 353,38
    $2 500,82
    $3 024,60
    $909,91
    $979,50
    $1 053,22
    $1 315,11
    $1 304,29
    $1 373,88
    $1 447,60
    $1 709,49
    $1 698,67
    $1 768,26
    $1 841,98
    $2 103,87
    $394,38
    Toc - Plan #100

    Platinum

    (HMO) Gym Access IND Platinum HMO BC 1941

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $2,000 $4,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $497,10
    $564,21
    $635,30
    $887,82
    $1 349,13
    $994,20
    $1 128,42
    $1 270,60
    $1 775,64
    $2 698,26
    $1 374,49
    $1 508,71
    $1 650,89
    $2 155,93
    $1 754,78
    $1 889,00
    $2 031,18
    $2 536,22
    $2 135,07
    $2 269,29
    $2 411,47
    $2 916,51
    $877,39
    $944,50
    $1 015,59
    $1 268,11
    $1 257,68
    $1 324,79
    $1 395,88
    $1 648,40
    $1 637,97
    $1 705,08
    $1 776,17
    $2 028,69
    $380,29
    Toc - Plan #101

    Platinum

    (POS) Gym Access IND Platinum POS BC 1941

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $2,000 $4,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $536,87
    $609,35
    $686,12
    $958,85
    $1 457,06
    $1 073,74
    $1 218,70
    $1 372,24
    $1 917,70
    $2 914,12
    $1 484,45
    $1 629,41
    $1 782,95
    $2 328,41
    $1 895,16
    $2 040,12
    $2 193,66
    $2 739,12
    $2 305,87
    $2 450,83
    $2 604,37
    $3 149,83
    $947,58
    $1 020,06
    $1 096,83
    $1 369,56
    $1 358,29
    $1 430,77
    $1 507,54
    $1 780,27
    $1 769,00
    $1 841,48
    $1 918,25
    $2 190,98
    $410,71
    Toc - Plan #102

    Platinum

    (HMO) Gym Access IND Platinum HMO 91

    Annual Out of Pocket Expenses
    Individual Family
    $250 $500 Annual Deductible
    $2,500 $5,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $495,23
    $562,09
    $632,90
    $884,48
    $1 344,05
    $990,46
    $1 124,18
    $1 265,80
    $1 768,96
    $2 688,10
    $1 369,31
    $1 503,03
    $1 644,65
    $2 147,81
    $1 748,16
    $1 881,88
    $2 023,50
    $2 526,66
    $2 127,01
    $2 260,73
    $2 402,35
    $2 905,51
    $874,08
    $940,94
    $1 011,75
    $1 263,33
    $1 252,93
    $1 319,79
    $1 390,60
    $1 642,18
    $1 631,78
    $1 698,64
    $1 769,45
    $2 021,03
    $378,85
    Toc - Plan #103

    Platinum

    (HMO) Gym Access IND Platinum HMO 92

    Annual Out of Pocket Expenses
    Individual Family
    $500 $1,000 Annual Deductible
    $3,000 $6,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $494,08
    $560,78
    $631,43
    $882,42
    $1 340,92
    $988,16
    $1 121,56
    $1 262,86
    $1 764,84
    $2 681,84
    $1 366,13
    $1 499,53
    $1 640,83
    $2 142,81
    $1 744,10
    $1 877,50
    $2 018,80
    $2 520,78
    $2 122,07
    $2 255,47
    $2 396,77
    $2 898,75
    $872,05
    $938,75
    $1 009,40
    $1 260,39
    $1 250,02
    $1 316,72
    $1 387,37
    $1 638,36
    $1 627,99
    $1 694,69
    $1 765,34
    $2 016,33
    $377,97
    Toc - Plan #104

    Expanded Bronze

    (HMO) Gym Access IND Bronze Standardized HMO

    Annual Out of Pocket Expenses
    Individual Family
    $7,150 $14,300 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $268,88
    $305,18
    $343,63
    $480,22
    $729,73
    $537,76
    $610,36
    $687,26
    $960,44
    $1 459,46
    $743,45
    $816,05
    $892,95
    $1 166,13
    $949,14
    $1 021,74
    $1 098,64
    $1 371,82
    $1 154,83
    $1 227,43
    $1 304,33
    $1 577,51
    $474,57
    $510,87
    $549,32
    $685,91
    $680,26
    $716,56
    $755,01
    $891,60
    $885,95
    $922,25
    $960,70
    $1 097,29
    $205,69
    Toc - Plan #105

    Silver

    (HMO) Gym Access IND Silver Standardized HMO 1

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $369,36
    $419,22
    $472,04
    $659,67
    $1 002,43
    $738,72
    $838,44
    $944,08
    $1 319,34
    $2 004,86
    $1 021,28
    $1 121,00
    $1 226,64
    $1 601,90
    $1 303,84
    $1 403,56
    $1 509,20
    $1 884,46
    $1 586,40
    $1 686,12
    $1 791,76
    $2 167,02
    $651,92
    $701,78
    $754,60
    $942,23
    $934,48
    $984,34
    $1 037,16
    $1 224,79
    $1 217,04
    $1 266,90
    $1 319,72
    $1 507,35
    $282,56
    Toc - Plan #106

    Expanded Bronze

    (HMO) Gym Access IND Bronze HMO 1340

    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:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $248,32
    $281,84
    $317,35
    $443,50
    $673,94
    $496,64
    $563,68
    $634,70
    $887,00
    $1 347,88
    $686,61
    $753,65
    $824,67
    $1 076,97
    $876,58
    $943,62
    $1 014,64
    $1 266,94
    $1 066,55
    $1 133,59
    $1 204,61
    $1 456,91
    $438,29
    $471,81
    $507,32
    $633,47
    $628,26
    $661,78
    $697,29
    $823,44
    $818,23
    $851,75
    $887,26
    $1 013,41
    $189,97
    Toc - Plan #107

    Expanded Bronze

    (HMO) Gym Access IND Bronze HMO 1041

    Annual Out of Pocket Expenses
    Individual Family
    $7,200 $14,400 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $278,00
    $315,53
    $355,28
    $496,50
    $754,48
    $556,00
    $631,06
    $710,56
    $993,00
    $1 508,96
    $768,67
    $843,73
    $923,23
    $1 205,67
    $981,34
    $1 056,40
    $1 135,90
    $1 418,34
    $1 194,01
    $1 269,07
    $1 348,57
    $1 631,01
    $490,67
    $528,20
    $567,95
    $709,17
    $703,34
    $740,87
    $780,62
    $921,84
    $916,01
    $953,54
    $993,29
    $1 134,51
    $212,67
    Toc - Plan #108

    Expanded Bronze

    (POS) Gym Access IND Bronze POS 1042

    Annual Out of Pocket Expenses
    Individual Family
    $7,550 $15,100 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $300,24
    $340,77
    $383,70
    $536,22
    $814,83
    $600,48
    $681,54
    $767,40
    $1 072,44
    $1 629,66
    $830,16
    $911,22
    $997,08
    $1 302,12
    $1 059,84
    $1 140,90
    $1 226,76
    $1 531,80
    $1 289,52
    $1 370,58
    $1 456,44
    $1 761,48
    $529,92
    $570,45
    $613,38
    $765,90
    $759,60
    $800,13
    $843,06
    $995,58
    $989,28
    $1 029,81
    $1 072,74
    $1 225,26
    $229,68
    Toc - Plan #109

    Gold

    (HMO) Gym Access IND Gold HMO H.S.A 9010

    Annual Out of Pocket Expenses
    Individual Family
    $1,700 $3,400 Annual Deductible
    $4,000 $8,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $352,74
    $400,35
    $450,80
    $629,98
    $957,32
    $705,48
    $800,70
    $901,60
    $1 259,96
    $1 914,64
    $975,32
    $1 070,54
    $1 171,44
    $1 529,80
    $1 245,16
    $1 340,38
    $1 441,28
    $1 799,64
    $1 515,00
    $1 610,22
    $1 711,12
    $2 069,48
    $622,58
    $670,19
    $720,64
    $899,82
    $892,42
    $940,03
    $990,48
    $1 169,66
    $1 162,26
    $1 209,87
    $1 260,32
    $1 439,50
    $269,84
    Toc - Plan #110

    Expanded Bronze

    (HMO) Gym Access IND Bronze HMO OA 1211

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $304,94
    $346,10
    $389,71
    $544,61
    $827,59
    $609,88
    $692,20
    $779,42
    $1 089,22
    $1 655,18
    $843,16
    $925,48
    $1 012,70
    $1 322,50
    $1 076,44
    $1 158,76
    $1 245,98
    $1 555,78
    $1 309,72
    $1 392,04
    $1 479,26
    $1 789,06
    $538,22
    $579,38
    $622,99
    $777,89
    $771,50
    $812,66
    $856,27
    $1 011,17
    $1 004,78
    $1 045,94
    $1 089,55
    $1 244,45
    $233,28
    Toc - Plan #111

    Silver

    (HMO) Gym Access IND Silver HMO OA 1009

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    Couple
    Couple
    1 Child
    Couple
    2 Chidren
    Couple
    3+ Children
    Individual
    1 Child
    Individual
    2 Children
    Individual
    3+ Children
    Child
    0-14
    21
    30
    40
    50
    60
    $366,38
    $415,84
    $468,23
    $654,34
    $994,34
    $732,76
    $831,68
    $936,46
    $1 308,68
    $1 988,68
    $1 013,04
    $1 111,96
    $1 216,74
    $1 588,96
    $1 293,32
    $1 392,24
    $1 497,02
    $1 869,24
    $1 573,60
    $1 672,52
    $1 777,30
    $2 149,52
    $646,66
    $696,12
    $748,51
    $934,62
    $926,94
    $976,40
    $1 028,79
    $1 214,90
    $1 207,22
    $1 256,68
    $1 309,07
    $1 495,18
    $280,28

    ‡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 Saint Johns County here.

    Saint Johns County is in “Rating Area 15” of Florida.

    Currently, there are 111 plans offered in Rating Area 15.

    Obamacare Rates and Providers for Other Years

    2014 | 2015 | 2016| 2017 | 2018 | 2019 2020 2021

    You may also be interested in:

    Ways to Save Money on Obamacare in Florida

    There are three primary ways to reduce the cost of health plans under the Affordable Care Act in Florida.

    • You may be able to lower the cost of monthly premiums when you sign up for a private health insurance plan. Your subsidies will come in the form of a federal tax credit. This article is updated to cover the new tax credits available under the American Rescue Plan Act of 2021.
    • You may be able to reduce your out-of-pocket costs -- including copayments, deductibles, and coinsurance -- with cost-sharing subsidies paid for by insurers.
    • You may qualify for free or low-cost coverage through Medicaid in Florida, or your children may be able to obtain coverage through the Children’s Health Insurance Program (CHIP).

    Each of these forms of assistance depends on your income and family size.

    Many people who apply for coverage at the Florida exchange will be eligible for some form of financial assistance. Read on to learn more about each option.

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    Get Help Finding a Health Insurance Plan in Florida

    Get Help From Florida's Health Insurance Exchange

    The following links and telephone numbers take you to the official help resources for Healthcare.gov, the health insurance marketplace for Florida.

    Help by phone: 800-318-2596 (TTY: 855-889-4325)

    In-person help: Go to Find Local Help, where you can enter your city and state or zip code to find an application assister, insurance agent, or health insurance broker in your area.

    Get Help From a Licensed Insurance Broker

    To directly connect with a Florida insurance broker who can help you evaluate insurance plans and choose a plan that's appropriate for your situation, call 800-943-6832. (We receive advertising income from the licensed brokers who offer their services through this telephone number.)

    More Information

    For more detailed information, see How Do I Sign Up for Obamacare in Florida?

     

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