Edgecombe County, North Carolina Obamacare 2024 Rates

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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 Edgecombe County, NC.

The health insurance rates listed below are for calendar year 2024.

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

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

Obamacare Providers, 39 Plans and 2024 Rates for Edgecombe County, North Carolina

Below, you’ll find a summary of the 39 plans for Edgecombe County, North Carolina and rates for each of these providers. This chart is designed to give you a preview of your health insurance options.


Obamacare Rates and Providers for Other Years

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Blue Cross and Blue Shield of NC

Local: 1-800-324-4973 | Toll Free: 1-800-324-4973

Toc - Plan #1 Blue Cross and Blue Shield of NC
Silver

(PPO) Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$2,750 $5,500 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$481.43
$546.42
$615.27
$859.83
$1,306.60
$849.72
$914.71
$983.56
$1,228.12
$1,218.01
$1,283.00
$1,351.85
$1,596.41
$1,586.30
$1,651.29
$1,720.14
$1,964.70
$368.29
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$962.86
$1,092.84
$1,230.54
$1,719.66
$2,613.20
$1,331.15
$1,461.13
$1,598.83
$2,087.95
$1,699.44
$1,829.42
$1,967.12
$2,456.24
$2,067.73
$2,197.71
$2,335.41
$2,824.53
$368.29
Toc - Plan #2 Blue Cross and Blue Shield of NC
Silver

(PPO) Blue Advantage Silver Secure | $15 PCP | $15 Tier 1 Rx | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$1,600 $3,200 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$501.61
$569.33
$641.06
$895.88
$1,361.37
$885.34
$953.06
$1,024.79
$1,279.61
$1,269.07
$1,336.79
$1,408.52
$1,663.34
$1,652.80
$1,720.52
$1,792.25
$2,047.07
$383.73
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,003.22
$1,138.66
$1,282.12
$1,791.76
$2,722.74
$1,386.95
$1,522.39
$1,665.85
$2,175.49
$1,770.68
$1,906.12
$2,049.58
$2,559.22
$2,154.41
$2,289.85
$2,433.31
$2,942.95
$383.73
Toc - Plan #3 Blue Cross and Blue Shield of NC
Expanded Bronze

(PPO) Blue Advantage Bronze | 3 Free PCP | $20 Tier 1 Rx | Integrated | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$7,000 $14,000 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$364.56
$413.78
$465.91
$651.10
$989.42
$643.45
$692.67
$744.80
$929.99
$922.34
$971.56
$1,023.69
$1,208.88
$1,201.23
$1,250.45
$1,302.58
$1,487.77
$278.89
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$729.12
$827.56
$931.82
$1,302.20
$1,978.84
$1,008.01
$1,106.45
$1,210.71
$1,581.09
$1,286.90
$1,385.34
$1,489.60
$1,859.98
$1,565.79
$1,664.23
$1,768.49
$2,138.87
$278.89
Toc - Plan #4 Blue Cross and Blue Shield of NC
Gold

(PPO) Blue Advantage Gold | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$1,800 $3,600 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$499.28
$566.68
$638.08
$891.71
$1,355.05
$881.23
$948.63
$1,020.03
$1,273.66
$1,263.18
$1,330.58
$1,401.98
$1,655.61
$1,645.13
$1,712.53
$1,783.93
$2,037.56
$381.95
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$998.56
$1,133.36
$1,276.16
$1,783.42
$2,710.10
$1,380.51
$1,515.31
$1,658.11
$2,165.37
$1,762.46
$1,897.26
$2,040.06
$2,547.32
$2,144.41
$2,279.21
$2,422.01
$2,929.27
$381.95
Toc - Plan #5 Blue Cross and Blue Shield of NC
Expanded Bronze

(PPO) Blue Advantage Bronze | HSA Eligible | Integrated | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$8,050 $16,100 Annual Deductible
$8,050 $16,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$365.70
$415.07
$467.36
$653.14
$992.51
$645.46
$694.83
$747.12
$932.90
$925.22
$974.59
$1,026.88
$1,212.66
$1,204.98
$1,254.35
$1,306.64
$1,492.42
$279.76
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$731.40
$830.14
$934.72
$1,306.28
$1,985.02
$1,011.16
$1,109.90
$1,214.48
$1,586.04
$1,290.92
$1,389.66
$1,494.24
$1,865.80
$1,570.68
$1,669.42
$1,774.00
$2,145.56
$279.76
Toc - Plan #6 Blue Cross and Blue Shield of NC
Catastrophic

(PPO) Blue Advantage Catastrophic | 3 PCP $35 | Integrated | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$9,450 $18,900 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$288.86
$327.86
$369.16
$515.90
$783.97
$509.84
$548.84
$590.14
$736.88
$730.82
$769.82
$811.12
$957.86
$951.80
$990.80
$1,032.10
$1,178.84
$220.98
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$577.72
$655.72
$738.32
$1,031.80
$1,567.94
$798.70
$876.70
$959.30
$1,252.78
$1,019.68
$1,097.68
$1,180.28
$1,473.76
$1,240.66
$1,318.66
$1,401.26
$1,694.74
$220.98
Toc - Plan #7 Blue Cross and Blue Shield of NC
Silver

(PPO) Blue Advantage Silver Choice | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$3,500 $7,000 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$505.03
$573.21
$645.43
$901.98
$1,370.65
$891.38
$959.56
$1,031.78
$1,288.33
$1,277.73
$1,345.91
$1,418.13
$1,674.68
$1,664.08
$1,732.26
$1,804.48
$2,061.03
$386.35
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,010.06
$1,146.42
$1,290.86
$1,803.96
$2,741.30
$1,396.41
$1,532.77
$1,677.21
$2,190.31
$1,782.76
$1,919.12
$2,063.56
$2,576.66
$2,169.11
$2,305.47
$2,449.91
$2,963.01
$386.35
Toc - Plan #8 Blue Cross and Blue Shield of NC
Expanded Bronze

(PPO) Blue Advantage Bronze | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$5,500 $11,000 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$386.21
$438.35
$493.58
$689.77
$1,048.17
$681.66
$733.80
$789.03
$985.22
$977.11
$1,029.25
$1,084.48
$1,280.67
$1,272.56
$1,324.70
$1,379.93
$1,576.12
$295.45
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$772.42
$876.70
$987.16
$1,379.54
$2,096.34
$1,067.87
$1,172.15
$1,282.61
$1,674.99
$1,363.32
$1,467.60
$1,578.06
$1,970.44
$1,658.77
$1,763.05
$1,873.51
$2,265.89
$295.45
Toc - Plan #9 Blue Cross and Blue Shield of NC
Gold

(PPO) Blue Advantage Gold Standard | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$499.34
$566.75
$638.16
$891.82
$1,355.21
$881.34
$948.75
$1,020.16
$1,273.82
$1,263.34
$1,330.75
$1,402.16
$1,655.82
$1,645.34
$1,712.75
$1,784.16
$2,037.82
$382.00
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$998.68
$1,133.50
$1,276.32
$1,783.64
$2,710.42
$1,380.68
$1,515.50
$1,658.32
$2,165.64
$1,762.68
$1,897.50
$2,040.32
$2,547.64
$2,144.68
$2,279.50
$2,422.32
$2,929.64
$382.00
Toc - Plan #10 Blue Cross and Blue Shield of NC
Silver

(PPO) Blue Advantage Silver Standard | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$488.59
$554.55
$624.42
$872.62
$1,326.03
$862.36
$928.32
$998.19
$1,246.39
$1,236.13
$1,302.09
$1,371.96
$1,620.16
$1,609.90
$1,675.86
$1,745.73
$1,993.93
$373.77
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$977.18
$1,109.10
$1,248.84
$1,745.24
$2,652.06
$1,350.95
$1,482.87
$1,622.61
$2,119.01
$1,724.72
$1,856.64
$1,996.38
$2,492.78
$2,098.49
$2,230.41
$2,370.15
$2,866.55
$373.77
Toc - Plan #11 Blue Cross and Blue Shield of NC
Expanded Bronze

(PPO) Blue Advantage Bronze Standard | Nationwide Doctors

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-324-4973

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,400 $18,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$374.00
$424.49
$477.97
$667.96
$1,015.04
$660.11
$710.60
$764.08
$954.07
$946.22
$996.71
$1,050.19
$1,240.18
$1,232.33
$1,282.82
$1,336.30
$1,526.29
$286.11
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$748.00
$848.98
$955.94
$1,335.92
$2,030.08
$1,034.11
$1,135.09
$1,242.05
$1,622.03
$1,320.22
$1,421.20
$1,528.16
$1,908.14
$1,606.33
$1,707.31
$1,814.27
$2,194.25
$286.11

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WellCare of North Carolina

Local: 1-833-925-2861 | Toll Free: 1-833-925-2861 | TTY: 1-833-925-2861

Toc - Plan #12 WellCare of North Carolina
Expanded Bronze

(PPO) WellCare Secure Health Bronze

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-925-2861

Annual Out of Pocket Expenses:

Individual Family
$7,100 $14,200 Annual Deductible
$9,250 $18,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$641.80
$728.43
$820.20
$1,146.23
$1,741.81
$1,132.77
$1,219.40
$1,311.17
$1,637.20
$1,623.74
$1,710.37
$1,802.14
$2,128.17
$2,114.71
$2,201.34
$2,293.11
$2,619.14
$490.97
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,283.60
$1,456.86
$1,640.40
$2,292.46
$3,483.62
$1,774.57
$1,947.83
$2,131.37
$2,783.43
$2,265.54
$2,438.80
$2,622.34
$3,274.40
$2,756.51
$2,929.77
$3,113.31
$3,765.37
$490.97
Toc - Plan #13 WellCare of North Carolina
Silver

(PPO) WellCare Secure Health Silver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-925-2861

Annual Out of Pocket Expenses:

Individual Family
$8,100 $16,200 Annual Deductible
$8,100 $16,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$833.68
$946.22
$1,065.43
$1,488.94
$2,262.58
$1,471.44
$1,583.98
$1,703.19
$2,126.70
$2,109.20
$2,221.74
$2,340.95
$2,764.46
$2,746.96
$2,859.50
$2,978.71
$3,402.22
$637.76
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,667.36
$1,892.44
$2,130.86
$2,977.88
$4,525.16
$2,305.12
$2,530.20
$2,768.62
$3,615.64
$2,942.88
$3,167.96
$3,406.38
$4,253.40
$3,580.64
$3,805.72
$4,044.14
$4,891.16
$637.76
Toc - Plan #14 WellCare of North Carolina
Gold

(PPO) WellCare Secure Health Gold

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-925-2861

Annual Out of Pocket Expenses:

Individual Family
$1,850 $3,700 Annual Deductible
$6,900 $13,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$871.03
$988.61
$1,113.16
$1,555.64
$2,363.95
$1,537.36
$1,654.94
$1,779.49
$2,221.97
$2,203.69
$2,321.27
$2,445.82
$2,888.30
$2,870.02
$2,987.60
$3,112.15
$3,554.63
$666.33
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,742.06
$1,977.22
$2,226.32
$3,111.28
$4,727.90
$2,408.39
$2,643.55
$2,892.65
$3,777.61
$3,074.72
$3,309.88
$3,558.98
$4,443.94
$3,741.05
$3,976.21
$4,225.31
$5,110.27
$666.33
Toc - Plan #15 WellCare of North Carolina
Expanded Bronze

(PPO) Standard Expanded Bronze WellCare

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-925-2861

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,400 $18,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$636.66
$722.60
$813.64
$1,137.06
$1,727.87
$1,123.70
$1,209.64
$1,300.68
$1,624.10
$1,610.74
$1,696.68
$1,787.72
$2,111.14
$2,097.78
$2,183.72
$2,274.76
$2,598.18
$487.04
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,273.32
$1,445.20
$1,627.28
$2,274.12
$3,455.74
$1,760.36
$1,932.24
$2,114.32
$2,761.16
$2,247.40
$2,419.28
$2,601.36
$3,248.20
$2,734.44
$2,906.32
$3,088.40
$3,735.24
$487.04
Toc - Plan #16 WellCare of North Carolina
Silver

(PPO) Standard Silver WellCare

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-925-2861

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$815.50
$925.58
$1,042.19
$1,456.46
$2,213.23
$1,439.35
$1,549.43
$1,666.04
$2,080.31
$2,063.20
$2,173.28
$2,289.89
$2,704.16
$2,687.05
$2,797.13
$2,913.74
$3,328.01
$623.85
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,631.00
$1,851.16
$2,084.38
$2,912.92
$4,426.46
$2,254.85
$2,475.01
$2,708.23
$3,536.77
$2,878.70
$3,098.86
$3,332.08
$4,160.62
$3,502.55
$3,722.71
$3,955.93
$4,784.47
$623.85
Toc - Plan #17 WellCare of North Carolina
Gold

(PPO) Standard Gold WellCare

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-833-925-2861

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$846.16
$960.38
$1,081.38
$1,511.22
$2,296.44
$1,493.46
$1,607.68
$1,728.68
$2,158.52
$2,140.76
$2,254.98
$2,375.98
$2,805.82
$2,788.06
$2,902.28
$3,023.28
$3,453.12
$647.30
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,692.32
$1,920.76
$2,162.76
$3,022.44
$4,592.88
$2,339.62
$2,568.06
$2,810.06
$3,669.74
$2,986.92
$3,215.36
$3,457.36
$4,317.04
$3,634.22
$3,862.66
$4,104.66
$4,964.34
$647.30

ADVERTISEMENT

Aetna CVS Health

Local: 1-877-336-3915 | Toll Free: 1-877-336-3915

Toc - Plan #18 Aetna CVS Health
Expanded Bronze

(HMO) Bronze 2 HSA: Aetna network of doctors & hospitals + MinuteClinic + Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-336-3915

Annual Out of Pocket Expenses:

Individual Family
$6,200 $12,400 Annual Deductible
$7,500 $15,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$316.95
$359.74
$405.07
$566.08
$860.21
$559.42
$602.21
$647.54
$808.55
$801.89
$844.68
$890.01
$1,051.02
$1,044.36
$1,087.15
$1,132.48
$1,293.49
$242.47
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$633.90
$719.48
$810.14
$1,132.16
$1,720.42
$876.37
$961.95
$1,052.61
$1,374.63
$1,118.84
$1,204.42
$1,295.08
$1,617.10
$1,361.31
$1,446.89
$1,537.55
$1,859.57
$242.47
Toc - Plan #19 Aetna CVS Health
Silver

(HMO) Silver 7: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-336-3915

Annual Out of Pocket Expenses:

Individual Family
$7,795 $15,590 Annual Deductible
$8,845 $17,690 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$434.94
$493.65
$555.85
$776.79
$1,180.41
$767.67
$826.38
$888.58
$1,109.52
$1,100.40
$1,159.11
$1,221.31
$1,442.25
$1,433.13
$1,491.84
$1,554.04
$1,774.98
$332.73
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$869.88
$987.30
$1,111.70
$1,553.58
$2,360.82
$1,202.61
$1,320.03
$1,444.43
$1,886.31
$1,535.34
$1,652.76
$1,777.16
$2,219.04
$1,868.07
$1,985.49
$2,109.89
$2,551.77
$332.73
Toc - Plan #20 Aetna CVS Health
Silver

(HMO) Silver 2: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-336-3915

Annual Out of Pocket Expenses:

Individual Family
$5,000 $10,000 Annual Deductible
$8,000 $16,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$440.96
$500.48
$563.54
$787.54
$1,196.75
$778.29
$837.81
$900.87
$1,124.87
$1,115.62
$1,175.14
$1,238.20
$1,462.20
$1,452.95
$1,512.47
$1,575.53
$1,799.53
$337.33
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$881.92
$1,000.96
$1,127.08
$1,575.08
$2,393.50
$1,219.25
$1,338.29
$1,464.41
$1,912.41
$1,556.58
$1,675.62
$1,801.74
$2,249.74
$1,893.91
$2,012.95
$2,139.07
$2,587.07
$337.33
Toc - Plan #21 Aetna CVS Health
Expanded Bronze

(HMO) Bronze S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-336-3915

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,400 $18,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$322.61
$366.16
$412.29
$576.17
$875.55
$569.41
$612.96
$659.09
$822.97
$816.21
$859.76
$905.89
$1,069.77
$1,063.01
$1,106.56
$1,152.69
$1,316.57
$246.80
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$645.22
$732.32
$824.58
$1,152.34
$1,751.10
$892.02
$979.12
$1,071.38
$1,399.14
$1,138.82
$1,225.92
$1,318.18
$1,645.94
$1,385.62
$1,472.72
$1,564.98
$1,892.74
$246.80
Toc - Plan #22 Aetna CVS Health
Gold

(HMO) Gold S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-336-3915

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$435.64
$494.45
$556.75
$778.05
$1,182.33
$768.91
$827.72
$890.02
$1,111.32
$1,102.18
$1,160.99
$1,223.29
$1,444.59
$1,435.45
$1,494.26
$1,556.56
$1,777.86
$333.27
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$871.28
$988.90
$1,113.50
$1,556.10
$2,364.66
$1,204.55
$1,322.17
$1,446.77
$1,889.37
$1,537.82
$1,655.44
$1,780.04
$2,222.64
$1,871.09
$1,988.71
$2,113.31
$2,555.91
$333.27
Toc - Plan #23 Aetna CVS Health
Silver

(HMO) Silver S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-336-3915

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$425.71
$483.18
$544.05
$760.31
$1,155.37
$751.38
$808.85
$869.72
$1,085.98
$1,077.05
$1,134.52
$1,195.39
$1,411.65
$1,402.72
$1,460.19
$1,521.06
$1,737.32
$325.67
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$851.42
$966.36
$1,088.10
$1,520.62
$2,310.74
$1,177.09
$1,292.03
$1,413.77
$1,846.29
$1,502.76
$1,617.70
$1,739.44
$2,171.96
$1,828.43
$1,943.37
$2,065.11
$2,497.63
$325.67
Toc - Plan #24 Aetna CVS Health
Expanded Bronze

(HMO) Bronze 4: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-336-3915

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$9,400 $18,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$357.40
$405.65
$456.76
$638.32
$969.98
$630.81
$679.06
$730.17
$911.73
$904.22
$952.47
$1,003.58
$1,185.14
$1,177.63
$1,225.88
$1,276.99
$1,458.55
$273.41
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$714.80
$811.30
$913.52
$1,276.64
$1,939.96
$988.21
$1,084.71
$1,186.93
$1,550.05
$1,261.62
$1,358.12
$1,460.34
$1,823.46
$1,535.03
$1,631.53
$1,733.75
$2,096.87
$273.41
Toc - Plan #25 Aetna CVS Health
Gold

(HMO) Gold 3: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-336-3915

Annual Out of Pocket Expenses:

Individual Family
$795 $1,590 Annual Deductible
$9,195 $18,390 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$436.36
$495.27
$557.67
$779.34
$1,184.28
$770.18
$829.09
$891.49
$1,113.16
$1,104.00
$1,162.91
$1,225.31
$1,446.98
$1,437.82
$1,496.73
$1,559.13
$1,780.80
$333.82
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$872.72
$990.54
$1,115.34
$1,558.68
$2,368.56
$1,206.54
$1,324.36
$1,449.16
$1,892.50
$1,540.36
$1,658.18
$1,782.98
$2,226.32
$1,874.18
$1,992.00
$2,116.80
$2,560.14
$333.82
Toc - Plan #26 Aetna CVS Health
Gold

(HMO) Gold 4: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-336-3915

Annual Out of Pocket Expenses:

Individual Family
$3,500 $7,000 Annual Deductible
$9,000 $18,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$440.29
$499.73
$562.69
$786.36
$1,194.94
$777.11
$836.55
$899.51
$1,123.18
$1,113.93
$1,173.37
$1,236.33
$1,460.00
$1,450.75
$1,510.19
$1,573.15
$1,796.82
$336.82
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$880.58
$999.46
$1,125.38
$1,572.72
$2,389.88
$1,217.40
$1,336.28
$1,462.20
$1,909.54
$1,554.22
$1,673.10
$1,799.02
$2,246.36
$1,891.04
$2,009.92
$2,135.84
$2,583.18
$336.82
Toc - Plan #27 Aetna CVS Health
Silver

(HMO) Silver 5: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-336-3915

Annual Out of Pocket Expenses:

Individual Family
$8,395 $16,790 Annual Deductible
$8,885 $17,770 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$425.88
$483.37
$544.27
$760.61
$1,155.82
$751.68
$809.17
$870.07
$1,086.41
$1,077.48
$1,134.97
$1,195.87
$1,412.21
$1,403.28
$1,460.77
$1,521.67
$1,738.01
$325.80
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$851.76
$966.74
$1,088.54
$1,521.22
$2,311.64
$1,177.56
$1,292.54
$1,414.34
$1,847.02
$1,503.36
$1,618.34
$1,740.14
$2,172.82
$1,829.16
$1,944.14
$2,065.94
$2,498.62
$325.80
Toc - Plan #28 Aetna CVS Health
Silver

(HMO) Silver 6: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-336-3915

Annual Out of Pocket Expenses:

Individual Family
$7,795 $15,590 Annual Deductible
$8,445 $16,890 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$434.98
$493.70
$555.90
$776.87
$1,180.52
$767.74
$826.46
$888.66
$1,109.63
$1,100.50
$1,159.22
$1,221.42
$1,442.39
$1,433.26
$1,491.98
$1,554.18
$1,775.15
$332.76
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$869.96
$987.40
$1,111.80
$1,553.74
$2,361.04
$1,202.72
$1,320.16
$1,444.56
$1,886.50
$1,535.48
$1,652.92
$1,777.32
$2,219.26
$1,868.24
$1,985.68
$2,110.08
$2,552.02
$332.76

ADVERTISEMENT

Cigna Healthcare

Local: 1-877-900-1237 | Toll Free: 1-877-900-1237 | TTY: 1-800-676-3777

Toc - Plan #29 Cigna Healthcare
Bronze

(HMO) Connect Bronze 9450 Indiv Med Deductible

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$9,450 $18,900 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$501.37
$569.06
$640.75
$895.45
$1,360.72
$884.92
$952.61
$1,024.30
$1,279.00
$1,268.47
$1,336.16
$1,407.85
$1,662.55
$1,652.02
$1,719.71
$1,791.40
$2,046.10
$383.55
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,002.74
$1,138.12
$1,281.50
$1,790.90
$2,721.44
$1,386.29
$1,521.67
$1,665.05
$2,174.45
$1,769.84
$1,905.22
$2,048.60
$2,558.00
$2,153.39
$2,288.77
$2,432.15
$2,941.55
$383.55
Toc - Plan #30 Cigna Healthcare
Expanded Bronze

(HMO) Connect Bronze 6500 Indiv Med Deductible

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$530.08
$601.64
$677.45
$946.73
$1,438.64
$935.59
$1,007.15
$1,082.96
$1,352.24
$1,341.10
$1,412.66
$1,488.47
$1,757.75
$1,746.61
$1,818.17
$1,893.98
$2,163.26
$405.51
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,060.16
$1,203.28
$1,354.90
$1,893.46
$2,877.28
$1,465.67
$1,608.79
$1,760.41
$2,298.97
$1,871.18
$2,014.30
$2,165.92
$2,704.48
$2,276.69
$2,419.81
$2,571.43
$3,109.99
$405.51
Toc - Plan #31 Cigna Healthcare
Expanded Bronze

(HMO) Connect Bronze 5500 Indiv Med Deductible

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$5,500 $11,000 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$525.66
$596.62
$671.79
$938.83
$1,426.64
$927.79
$998.75
$1,073.92
$1,340.96
$1,329.92
$1,400.88
$1,476.05
$1,743.09
$1,732.05
$1,803.01
$1,878.18
$2,145.22
$402.13
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,051.32
$1,193.24
$1,343.58
$1,877.66
$2,853.28
$1,453.45
$1,595.37
$1,745.71
$2,279.79
$1,855.58
$1,997.50
$2,147.84
$2,681.92
$2,257.71
$2,399.63
$2,549.97
$3,084.05
$402.13
Toc - Plan #32 Cigna Healthcare
Silver

(HMO) Connect Silver 4500 Indiv Med Deductible

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$4,500 $9,000 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$612.92
$695.66
$783.31
$1,094.67
$1,663.46
$1,081.80
$1,164.54
$1,252.19
$1,563.55
$1,550.68
$1,633.42
$1,721.07
$2,032.43
$2,019.56
$2,102.30
$2,189.95
$2,501.31
$468.88
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,225.84
$1,391.32
$1,566.62
$2,189.34
$3,326.92
$1,694.72
$1,860.20
$2,035.50
$2,658.22
$2,163.60
$2,329.08
$2,504.38
$3,127.10
$2,632.48
$2,797.96
$2,973.26
$3,595.98
$468.88
Toc - Plan #33 Cigna Healthcare
Silver

(HMO) Connect Silver 3500 Indiv Med Deductible

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$3,500 $7,000 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$612.78
$695.50
$783.13
$1,094.42
$1,663.08
$1,081.56
$1,164.28
$1,251.91
$1,563.20
$1,550.34
$1,633.06
$1,720.69
$2,031.98
$2,019.12
$2,101.84
$2,189.47
$2,500.76
$468.78
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,225.56
$1,391.00
$1,566.26
$2,188.84
$3,326.16
$1,694.34
$1,859.78
$2,035.04
$2,657.62
$2,163.12
$2,328.56
$2,503.82
$3,126.40
$2,631.90
$2,797.34
$2,972.60
$3,595.18
$468.78
Toc - Plan #34 Cigna Healthcare
Silver

(HMO) Connect Silver 1500 Indiv Med Deductible

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$620.08
$703.79
$792.46
$1,107.46
$1,682.90
$1,094.44
$1,178.15
$1,266.82
$1,581.82
$1,568.80
$1,652.51
$1,741.18
$2,056.18
$2,043.16
$2,126.87
$2,215.54
$2,530.54
$474.36
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,240.16
$1,407.58
$1,584.92
$2,214.92
$3,365.80
$1,714.52
$1,881.94
$2,059.28
$2,689.28
$2,188.88
$2,356.30
$2,533.64
$3,163.64
$2,663.24
$2,830.66
$3,008.00
$3,638.00
$474.36
Toc - Plan #35 Cigna Healthcare
Silver

(HMO) Connect Silver 2500 Indiv Med Deductible Enhanced Diabetes Care

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$2,500 $5,000 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$618.32
$701.80
$790.22
$1,104.33
$1,678.13
$1,091.34
$1,174.82
$1,263.24
$1,577.35
$1,564.36
$1,647.84
$1,736.26
$2,050.37
$2,037.38
$2,120.86
$2,209.28
$2,523.39
$473.02
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,236.64
$1,403.60
$1,580.44
$2,208.66
$3,356.26
$1,709.66
$1,876.62
$2,053.46
$2,681.68
$2,182.68
$2,349.64
$2,526.48
$3,154.70
$2,655.70
$2,822.66
$2,999.50
$3,627.72
$473.02
Toc - Plan #36 Cigna Healthcare
Expanded Bronze

(HMO) Connect Bronze CMS Standard

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$9,400 $18,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$522.57
$593.12
$667.85
$933.31
$1,418.26
$922.34
$992.89
$1,067.62
$1,333.08
$1,322.11
$1,392.66
$1,467.39
$1,732.85
$1,721.88
$1,792.43
$1,867.16
$2,132.62
$399.77
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,045.14
$1,186.24
$1,335.70
$1,866.62
$2,836.52
$1,444.91
$1,586.01
$1,735.47
$2,266.39
$1,844.68
$1,985.78
$2,135.24
$2,666.16
$2,244.45
$2,385.55
$2,535.01
$3,065.93
$399.77
Toc - Plan #37 Cigna Healthcare
Expanded Bronze

(HMO) Connect Bronze 0 Indiv Med Deductible

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$557.74
$633.04
$712.79
$996.13
$1,513.71
$984.41
$1,059.71
$1,139.46
$1,422.80
$1,411.08
$1,486.38
$1,566.13
$1,849.47
$1,837.75
$1,913.05
$1,992.80
$2,276.14
$426.67
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,115.48
$1,266.08
$1,425.58
$1,992.26
$3,027.42
$1,542.15
$1,692.75
$1,852.25
$2,418.93
$1,968.82
$2,119.42
$2,278.92
$2,845.60
$2,395.49
$2,546.09
$2,705.59
$3,272.27
$426.67
Toc - Plan #38 Cigna Healthcare
Silver

(HMO) Connect Silver CMS Standard

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$9,100 $18,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$612.22
$694.87
$782.41
$1,093.42
$1,661.56
$1,080.57
$1,163.22
$1,250.76
$1,561.77
$1,548.92
$1,631.57
$1,719.11
$2,030.12
$2,017.27
$2,099.92
$2,187.46
$2,498.47
$468.35
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,224.44
$1,389.74
$1,564.82
$2,186.84
$3,323.12
$1,692.79
$1,858.09
$2,033.17
$2,655.19
$2,161.14
$2,326.44
$2,501.52
$3,123.54
$2,629.49
$2,794.79
$2,969.87
$3,591.89
$468.35
Toc - Plan #39 Cigna Healthcare
Gold

(HMO) Connect Gold CMS Standard

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$8,700 $17,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$831.24
$943.46
$1,062.33
$1,484.60
$2,255.99
$1,467.14
$1,579.36
$1,698.23
$2,120.50
$2,103.04
$2,215.26
$2,334.13
$2,756.40
$2,738.94
$2,851.16
$2,970.03
$3,392.30
$635.90
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,662.48
$1,886.92
$2,124.66
$2,969.20
$4,511.98
$2,298.38
$2,522.82
$2,760.56
$3,605.10
$2,934.28
$3,158.72
$3,396.46
$4,241.00
$3,570.18
$3,794.62
$4,032.36
$4,876.90
$635.90

‡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 Edgecombe County here.

Edgecombe County is in “Rating Area 14” of North Carolina.

Currently, there are 39 plans offered in Rating Area 14.

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2024 Obamacare Plans for Edgecombe County, NC

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