South Carolina Obamacare

2017 Obamacare Rates for Williamsburg County

South Carolina 2017 Obamacare Rates for Williamsburg County

 
Kingstree, SC

Providers for Zip Code 29556

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Obamacare Providers, Plans and 2017 Rates for Williamsburg County

The health insurance rates listed below are for calendar year 2017.

2017 Rates and Providers

(click here for 2014)

(click here for 2015)

(click here for 2016)

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

Currently, there are 26 plans offered in Williamsburg County.

Below, you’ll find a summary of plans and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options. For detailed information on available subsidies to make your coverage affordable, you must complete an application at HealthCare.gov or contact the provider directly.

 

The table below shows premiums for the following scenarios:

  • Individual
  • Couple
  • Couple with 1 2 or 3 children
  • Individual with 1 2 or 3 children
  • A child alone

Each scenario is covered for age

  • Age 21, 30, 40, 50
  • Age 60 (Individual and Couple only)

 

Note: If you are over 65, you qualify for Medicare. Click here to see listings of 2017 Medicare Advantage plans for Williamsburg County

 

For each plan, there are links that go to the insurance provider's website in a new window. You can find links to:

  • a summary of plan benefits and costs,
  • a plan brochure, and
  • a "Provider Directory" -- where you can find out which doctors and hospitals in the Kingstree, SC area accept this insurance coverage as within the plan's "network".

‡Source: HealthCare.gov has released sample rates for all counties in those states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Williamsburg County here.

Blue Cross and Blue Shield of South Carolina

Local: 1-855-404-6752 | Toll Free: 1-855-404-6752

TTY: 1-800-735-8583

Plan: (EPO) BlueEssentials HD Bronze 4

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $5,600 : Family: $11,200
Out of Pocket Maximum per year: Individual: $6,550 : Family: $13,100

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $294.72
$334.50
$376.65
$526.36
$799.86		 $589.44
$669.00
$753.30
$1052.72
$1599.72		 $776.59
$856.15
$940.45
$1239.87		 $963.74
$1043.30
$1127.60
$1427.02		 $1150.89
$1230.45
$1314.75
$1614.17		 $481.87
$521.65
$563.80
$713.51		 $669.02
$708.80
$750.95
$900.66		 $856.17
$895.95
$938.10
$1087.81		 $187.15

Plan: (EPO) BlueEssentials Gold 1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $1,200 : Family: $2,400
Out of Pocket Maximum per year: Individual: $4,500 : Family: $9,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $414.39
$470.33
$529.59
$740.09
$1124.64		 $828.78
$940.66
$1059.18
$1480.18
$2249.28		 $1091.92
$1203.80
$1322.32
$1743.32		 $1355.06
$1466.94
$1585.46
$2006.46		 $1618.20
$1730.08
$1848.60
$2269.60		 $677.53
$733.47
$792.73
$1003.23		 $940.67
$996.61
$1055.87
$1266.37		 $1203.81
$1259.75
$1319.01
$1529.51		 $263.14

Plan: (EPO) BlueEssentials Silver 1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $260 : Family: $520
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $353.51
$401.24
$451.79
$631.37
$959.43		 $707.02
$802.48
$903.58
$1262.74
$1918.86		 $931.50
$1026.96
$1128.06
$1487.22		 $1155.98
$1251.44
$1352.54
$1711.70		 $1380.46
$1475.92
$1577.02
$1936.18		 $577.99
$625.72
$676.27
$855.85		 $802.47
$850.20
$900.75
$1080.33		 $1026.95
$1074.68
$1125.23
$1304.81		 $224.48

Plan: (EPO) BlueEssentials Silver 2

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $2,000 : Family: $4,000
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $336.97
$382.46
$430.65
$601.83
$914.54		 $673.94
$764.92
$861.30
$1203.66
$1829.08		 $887.92
$978.90
$1075.28
$1417.64		 $1101.90
$1192.88
$1289.26
$1631.62		 $1315.88
$1406.86
$1503.24
$1845.60		 $550.95
$596.44
$644.63
$815.81		 $764.93
$810.42
$858.61
$1029.79		 $978.91
$1024.40
$1072.59
$1243.77		 $213.98

Plan: (EPO) BlueEssentials Silver 3

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $342.69
$388.95
$437.95
$612.04
$930.05		 $685.38
$777.90
$875.90
$1224.08
$1860.10		 $902.99
$995.51
$1093.51
$1441.69		 $1120.60
$1213.12
$1311.12
$1659.30		 $1338.21
$1430.73
$1528.73
$1876.91		 $560.30
$606.56
$655.56
$829.65		 $777.91
$824.17
$873.17
$1047.26		 $995.52
$1041.78
$1090.78
$1264.87		 $217.61

Plan: (EPO) BlueEssentials Bronze 1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $6,350 : Family: $12,700
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $292.35
$331.81
$373.62
$522.13
$793.43		 $584.70
$663.62
$747.24
$1044.26
$1586.86		 $770.34
$849.26
$932.88
$1229.90		 $955.98
$1034.90
$1118.52
$1415.54		 $1141.62
$1220.54
$1304.16
$1601.18		 $477.99
$517.45
$559.26
$707.77		 $663.63
$703.09
$744.90
$893.41		 $849.27
$888.73
$930.54
$1079.05		 $185.64

Plan: (EPO) BlueEssentials HD Bronze 2

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $6,300 : Family: $12,600
Out of Pocket Maximum per year: Individual: $6,550 : Family: $13,100

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $293.81
$333.48
$375.49
$524.75
$797.41		 $587.62
$666.96
$750.98
$1049.50
$1594.82		 $774.19
$853.53
$937.55
$1236.07		 $960.76
$1040.10
$1124.12
$1422.64		 $1147.33
$1226.67
$1310.69
$1609.21		 $480.38
$520.05
$562.06
$711.32		 $666.95
$706.62
$748.63
$897.89		 $853.52
$893.19
$935.20
$1084.46		 $186.57

Plan: (EPO) BlueEssentials Gold 2

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $800 : Family: $1,600
Out of Pocket Maximum per year: Individual: $5,000 : Family: $10,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $413.20
$468.98
$528.07
$737.98
$1121.43		 $826.40
$937.96
$1056.14
$1475.96
$2242.86		 $1088.78
$1200.34
$1318.52
$1738.34		 $1351.16
$1462.72
$1580.90
$2000.72		 $1613.54
$1725.10
$1843.28
$2263.10		 $675.58
$731.36
$790.45
$1000.36		 $937.96
$993.74
$1052.83
$1262.74		 $1200.34
$1256.12
$1315.21
$1525.12		 $262.38

Plan: (EPO) BlueEssentials HD Gold 3

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $2,200 : Family: $4,400
Out of Pocket Maximum per year: Individual: $2,200 : Family: $4,400

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $417.31
$473.65
$533.33
$745.32
$1132.59		 $834.62
$947.30
$1066.66
$1490.64
$2265.18		 $1099.61
$1212.29
$1331.65
$1755.63		 $1364.60
$1477.28
$1596.64
$2020.62		 $1629.59
$1742.27
$1861.63
$2285.61		 $682.30
$738.64
$798.32
$1010.31		 $947.29
$1003.63
$1063.31
$1275.30		 $1212.28
$1268.62
$1328.30
$1540.29		 $264.99

Plan: (EPO) BlueEssentials Silver 4

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $342.53
$388.77
$437.75
$611.76
$929.63		 $685.06
$777.54
$875.50
$1223.52
$1859.26		 $902.57
$995.05
$1093.01
$1441.03		 $1120.08
$1212.56
$1310.52
$1658.54		 $1337.59
$1430.07
$1528.03
$1876.05		 $560.04
$606.28
$655.26
$829.27		 $777.55
$823.79
$872.77
$1046.78		 $995.06
$1041.30
$1090.28
$1264.29		 $217.51

Plan: (EPO) BlueEssentials HD Silver 5

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $2,600 : Family: $5,200
Out of Pocket Maximum per year: Individual: $5,000 : Family: $10,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $344.68
$391.21
$440.50
$615.60
$935.46		 $689.36
$782.42
$881.00
$1231.20
$1870.92		 $908.23
$1001.29
$1099.87
$1450.07		 $1127.10
$1220.16
$1318.74
$1668.94		 $1345.97
$1439.03
$1537.61
$1887.81		 $563.55
$610.08
$659.37
$834.47		 $782.42
$828.95
$878.24
$1053.34		 $1001.29
$1047.82
$1097.11
$1272.21		 $218.87

Plan: (EPO) BlueEssentials HD Silver 6

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $3,800 : Family: $7,600
Out of Pocket Maximum per year: Individual: $3,800 : Family: $7,600

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $347.50
$394.42
$444.11
$620.64
$943.12		 $695.00
$788.84
$888.22
$1241.28
$1886.24		 $915.66
$1009.50
$1108.88
$1461.94		 $1136.32
$1230.16
$1329.54
$1682.60		 $1356.98
$1450.82
$1550.20
$1903.26		 $568.16
$615.08
$664.77
$841.30		 $788.82
$835.74
$885.43
$1061.96		 $1009.48
$1056.40
$1106.09
$1282.62		 $220.66

Plan: (EPO) BlueEssentials HD Bronze 3

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $5,200 : Family: $10,400
Out of Pocket Maximum per year: Individual: $6,550 : Family: $13,100

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $296.53
$336.56
$378.97
$529.60
$804.79		 $593.06
$673.12
$757.94
$1059.20
$1609.58		 $781.36
$861.42
$946.24
$1247.50		 $969.66
$1049.72
$1134.54
$1435.80		 $1157.96
$1238.02
$1322.84
$1624.10		 $484.83
$524.86
$567.27
$717.90		 $673.13
$713.16
$755.57
$906.20		 $861.43
$901.46
$943.87
$1094.50		 $188.30

Plan: (EPO) BlueEssentials HD Bronze 5

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

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

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $293.79
$333.46
$375.47
$524.72
$797.36		 $587.58
$666.92
$750.94
$1049.44
$1594.72		 $774.14
$853.48
$937.50
$1236.00		 $960.70
$1040.04
$1124.06
$1422.56		 $1147.26
$1226.60
$1310.62
$1609.12		 $480.35
$520.02
$562.03
$711.28		 $666.91
$706.58
$748.59
$897.84		 $853.47
$893.14
$935.15
$1084.40		 $186.56

Plan: (EPO) BlueEssentials Silver 7

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $6,400 : Family: $12,800
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $318.27
$361.23
$406.74
$568.42
$863.78		 $636.54
$722.46
$813.48
$1136.84
$1727.56		 $838.64
$924.56
$1015.58
$1338.94		 $1040.74
$1126.66
$1217.68
$1541.04		 $1242.84
$1328.76
$1419.78
$1743.14		 $520.37
$563.33
$608.84
$770.52		 $722.47
$765.43
$810.94
$972.62		 $924.57
$967.53
$1013.04
$1174.72		 $202.10

Plan: (EPO) BlueEssentials Silver 8

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $5,250 : Family: $10,500
Out of Pocket Maximum per year: Individual: $6,700 : Family: $13,400

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $331.91
$376.72
$424.19
$592.80
$900.81		 $663.82
$753.44
$848.38
$1185.60
$1801.62		 $874.59
$964.21
$1059.15
$1396.37		 $1085.36
$1174.98
$1269.92
$1607.14		 $1296.13
$1385.75
$1480.69
$1817.91		 $542.68
$587.49
$634.96
$803.57		 $753.45
$798.26
$845.73
$1014.34		 $964.22
$1009.03
$1056.50
$1225.11		 $210.77

Plan: (EPO) BlueEssentials Silver 9

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $327.39
$371.59
$418.41
$584.72
$888.54		 $654.78
$743.18
$836.82
$1169.44
$1777.08		 $862.67
$951.07
$1044.71
$1377.33		 $1070.56
$1158.96
$1252.60
$1585.22		 $1278.45
$1366.85
$1460.49
$1793.11		 $535.28
$579.48
$626.30
$792.61		 $743.17
$787.37
$834.19
$1000.50		 $951.06
$995.26
$1042.08
$1208.39		 $207.89

Plan: (EPO) BlueEssentials Silver 10

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $7,150 : Family: $14,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $322.96
$366.55
$412.74
$576.80
$876.50		 $645.92
$733.10
$825.48
$1153.60
$1753.00		 $851.00
$938.18
$1030.56
$1358.68		 $1056.08
$1143.26
$1235.64
$1563.76		 $1261.16
$1348.34
$1440.72
$1768.84		 $528.04
$571.63
$617.82
$781.88		 $733.12
$776.71
$822.90
$986.96		 $938.20
$981.79
$1027.98
$1192.04		 $205.08

Plan: (EPO) BlueEssentials Silver 11

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $326.73
$370.84
$417.56
$583.54
$886.75		 $653.46
$741.68
$835.12
$1167.08
$1773.50		 $860.93
$949.15
$1042.59
$1374.55		 $1068.40
$1156.62
$1250.06
$1582.02		 $1275.87
$1364.09
$1457.53
$1789.49		 $534.20
$578.31
$625.03
$791.01		 $741.67
$785.78
$832.50
$998.48		 $949.14
$993.25
$1039.97
$1205.95		 $207.47

Plan: (EPO) BlueEssentials Silver 12

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $4,800 : Family: $9,600
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $328.00
$372.28
$419.19
$585.81
$890.20		 $656.00
$744.56
$838.38
$1171.62
$1780.40		 $864.28
$952.84
$1046.66
$1379.90		 $1072.56
$1161.12
$1254.94
$1588.18		 $1280.84
$1369.40
$1463.22
$1796.46		 $536.28
$580.56
$627.47
$794.09		 $744.56
$788.84
$835.75
$1002.37		 $952.84
$997.12
$1044.03
$1210.65		 $208.28

Plan: (EPO) BlueEssentials Gold 4

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $2,200 : Family: $4,400
Out of Pocket Maximum per year: Individual: $5,000 : Family: $10,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $402.12
$456.41
$513.91
$718.19
$1091.36		 $804.24
$912.82
$1027.82
$1436.38
$2182.72		 $1059.59
$1168.17
$1283.17
$1691.73		 $1314.94
$1423.52
$1538.52
$1947.08		 $1570.29
$1678.87
$1793.87
$2202.43		 $657.47
$711.76
$769.26
$973.54		 $912.82
$967.11
$1024.61
$1228.89		 $1168.17
$1222.46
$1279.96
$1484.24		 $255.35

Plan: (EPO) BlueEssentials HD Silver 13

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $4,400 : Family: $8,800
Out of Pocket Maximum per year: Individual: $4,400 : Family: $8,800

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $335.83
$381.16
$429.19
$599.79
$911.43		 $671.66
$762.32
$858.38
$1199.58
$1822.86		 $884.91
$975.57
$1071.63
$1412.83		 $1098.16
$1188.82
$1284.88
$1626.08		 $1311.41
$1402.07
$1498.13
$1839.33		 $549.08
$594.41
$642.44
$813.04		 $762.33
$807.66
$855.69
$1026.29		 $975.58
$1020.91
$1068.94
$1239.54		 $213.25

Plan: (EPO) BlueEssentials Silver 14

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $317.65
$360.53
$405.95
$567.32
$862.10		 $635.30
$721.06
$811.90
$1134.64
$1724.20		 $837.01
$922.77
$1013.61
$1336.35		 $1038.72
$1124.48
$1215.32
$1538.06		 $1240.43
$1326.19
$1417.03
$1739.77		 $519.36
$562.24
$607.66
$769.03		 $721.07
$763.95
$809.37
$970.74		 $922.78
$965.66
$1011.08
$1172.45		 $201.71

Plan: (EPO) BlueEssentials Catastrophic 1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $7,150 : Family: $14,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Catastrophic 21
30
40
50
60		 $238.72
$270.95
$305.09
$426.36
$647.89		 $477.44
$541.90
$610.18
$852.72
$1295.78		 $629.03
$693.49
$761.77
$1004.31		 $780.62
$845.08
$913.36
$1155.90		 $932.21
$996.67
$1064.95
$1307.49		 $390.31
$422.54
$456.68
$577.95		 $541.90
$574.13
$608.27
$729.54		 $693.49
$725.72
$759.86
$881.13		 $151.59

Plan: (EPO) Blue Cross Blue Shield Gold 1, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $4,000 : Family: $8,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $420.12
$476.84
$536.92
$750.34
$1140.22		 $840.24
$953.68
$1073.84
$1500.68
$2280.44		 $1107.02
$1220.46
$1340.62
$1767.46		 $1373.80
$1487.24
$1607.40
$2034.24		 $1640.58
$1754.02
$1874.18
$2301.02		 $686.90
$743.62
$803.70
$1017.12		 $953.68
$1010.40
$1070.48
$1283.90		 $1220.46
$1277.18
$1337.26
$1550.68		 $266.78

Plan: (EPO) Blue Cross Blue Shield Silver 1, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-404-6752 - Provider Directory for This Plan: (Blue Cross and Blue Shield of South Carolina)

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $344.38
$390.87
$440.11
$615.06
$934.64		 $688.76
$781.74
$880.22
$1230.12
$1869.28		 $907.44
$1000.42
$1098.90
$1448.80		 $1126.12
$1219.10
$1317.58
$1667.48		 $1344.80
$1437.78
$1536.26
$1886.16		 $563.06
$609.55
$658.79
$833.74		 $781.74
$828.23
$877.47
$1052.42		 $1000.42
$1046.91
$1096.15
$1271.10		 $218.68