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Providers for Zip Code 37075

Obamacare 2016 Marketplace Rates For Sumner County, Tennessee

Saturday, July 23rd, 2016

Click for Hendersonville, Tennessee Forecast

The health insurance rates listed below are for calendar year 2016.

2016 Rates and Providers

(click here for 2014)

(click here for 2015)

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

Obamacare Providers, Plans and 2016 Rates for Sumner County

Sumner County is in “Rating Area 4” of Tennessee.

Currently, there are 4 providers offering 74 plans to Rating Area 4.

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 for:

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

Each scenario is covered for age

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

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

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

BlueCross BlueShield of Tennessee

Local: 1-888-743-0455 | Toll Free: 1-888-743-0455

Plan: (PPO) Silver S01S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$310.94
$352.92
$397.38
$555.34
$843.89
$621.88
$705.84
$794.76
$1110.68
$1687.78
$819.33
$903.29
$992.21
$1308.13
$1016.78
$1100.74
$1189.66
$1505.58
$1214.23
$1298.19
$1387.11
$1703.03
$508.39
$550.37
$594.83
$752.79
$705.84
$747.82
$792.28
$950.24
$903.29
$945.27
$989.73
$1147.69
$197.45

Plan: (PPO) Silver S02S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $6,250 : Family: $12,500

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$272.53
$309.32
$348.29
$486.74
$739.65
$545.06
$618.64
$696.58
$973.48
$1479.30
$718.12
$791.70
$869.64
$1146.54
$891.18
$964.76
$1042.70
$1319.60
$1064.24
$1137.82
$1215.76
$1492.66
$445.59
$482.38
$521.35
$659.80
$618.65
$655.44
$694.41
$832.86
$791.71
$828.50
$867.47
$1005.92
$173.06

Plan: (PPO) Silver S04S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

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

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$264.88
$300.64
$338.52
$473.08
$718.88
$529.76
$601.28
$677.04
$946.16
$1437.76
$697.96
$769.48
$845.24
$1114.36
$866.16
$937.68
$1013.44
$1282.56
$1034.36
$1105.88
$1181.64
$1450.76
$433.08
$468.84
$506.72
$641.28
$601.28
$637.04
$674.92
$809.48
$769.48
$805.24
$843.12
$977.68
$168.20

Plan: (PPO) Silver S08S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $2,000 : Family: $4,000
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
$299.36
$339.77
$382.58
$534.66
$812.46
$598.72
$679.54
$765.16
$1069.32
$1624.92
$788.81
$869.63
$955.25
$1259.41
$978.90
$1059.72
$1145.34
$1449.50
$1168.99
$1249.81
$1335.43
$1639.59
$489.45
$529.86
$572.67
$724.75
$679.54
$719.95
$762.76
$914.84
$869.63
$910.04
$952.85
$1104.93
$190.09

Plan: (PPO) Silver S09S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $2,500 : Family: $5,000
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
Silver 21
30
40
50
60
$275.74
$312.96
$352.40
$492.47
$748.36
$551.48
$625.92
$704.80
$984.94
$1496.72
$726.57
$801.01
$879.89
$1160.03
$901.66
$976.10
$1054.98
$1335.12
$1076.75
$1151.19
$1230.07
$1510.21
$450.83
$488.05
$527.49
$667.56
$625.92
$663.14
$702.58
$842.65
$801.01
$838.23
$877.67
$1017.74
$175.09

Plan: (PPO) Silver S11S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $5,500 : Family: $11,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$312.84
$355.07
$399.81
$558.73
$849.05
$625.68
$710.14
$799.62
$1117.46
$1698.10
$824.33
$908.79
$998.27
$1316.11
$1022.98
$1107.44
$1196.92
$1514.76
$1221.63
$1306.09
$1395.57
$1713.41
$511.49
$553.72
$598.46
$757.38
$710.14
$752.37
$797.11
$956.03
$908.79
$951.02
$995.76
$1154.68
$198.65

Plan: (PPO) Silver S12S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $4,000 : Family: $8,000
Out of Pocket Maximum per year: Individual: $5,500 : Family: $11,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$313.66
$356.00
$400.86
$560.20
$851.27
$627.32
$712.00
$801.72
$1120.40
$1702.54
$826.49
$911.17
$1000.89
$1319.57
$1025.66
$1110.34
$1200.06
$1518.74
$1224.83
$1309.51
$1399.23
$1717.91
$512.83
$555.17
$600.03
$759.37
$712.00
$754.34
$799.20
$958.54
$911.17
$953.51
$998.37
$1157.71
$199.17

Plan: (PPO) Silver S14S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$326.83
$370.95
$417.69
$583.72
$887.02
$653.66
$741.90
$835.38
$1167.44
$1774.04
$861.20
$949.44
$1042.92
$1374.98
$1068.74
$1156.98
$1250.46
$1582.52
$1276.28
$1364.52
$1458.00
$1790.06
$534.37
$578.49
$625.23
$791.26
$741.91
$786.03
$832.77
$998.80
$949.45
$993.57
$1040.31
$1206.34
$207.54

Plan: (PPO) Silver S16S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

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

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$291.37
$330.70
$372.37
$520.39
$790.78
$582.74
$661.40
$744.74
$1040.78
$1581.56
$767.76
$846.42
$929.76
$1225.80
$952.78
$1031.44
$1114.78
$1410.82
$1137.80
$1216.46
$1299.80
$1595.84
$476.39
$515.72
$557.39
$705.41
$661.41
$700.74
$742.41
$890.43
$846.43
$885.76
$927.43
$1075.45
$185.02

Plan: (PPO) Silver S01E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$264.30
$299.98
$337.78
$472.04
$717.31
$528.60
$599.96
$675.56
$944.08
$1434.62
$696.43
$767.79
$843.39
$1111.91
$864.26
$935.62
$1011.22
$1279.74
$1032.09
$1103.45
$1179.05
$1447.57
$432.13
$467.81
$505.61
$639.87
$599.96
$635.64
$673.44
$807.70
$767.79
$803.47
$841.27
$975.53
$167.83

Plan: (PPO) Silver S02E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $6,250 : Family: $12,500

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$231.65
$262.92
$296.05
$413.73
$628.70
$463.30
$525.84
$592.10
$827.46
$1257.40
$610.40
$672.94
$739.20
$974.56
$757.50
$820.04
$886.30
$1121.66
$904.60
$967.14
$1033.40
$1268.76
$378.75
$410.02
$443.15
$560.83
$525.85
$557.12
$590.25
$707.93
$672.95
$704.22
$737.35
$855.03
$147.10

Plan: (PPO) Silver S04E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

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

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$225.15
$255.55
$287.74
$402.12
$611.06
$450.30
$511.10
$575.48
$804.24
$1222.12
$593.27
$654.07
$718.45
$947.21
$736.24
$797.04
$861.42
$1090.18
$879.21
$940.01
$1004.39
$1233.15
$368.12
$398.52
$430.71
$545.09
$511.09
$541.49
$573.68
$688.06
$654.06
$684.46
$716.65
$831.03
$142.97

Plan: (PPO) Silver S08E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $2,000 : Family: $4,000
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
$254.46
$288.81
$325.20
$454.47
$690.60
$508.92
$577.62
$650.40
$908.94
$1381.20
$670.50
$739.20
$811.98
$1070.52
$832.08
$900.78
$973.56
$1232.10
$993.66
$1062.36
$1135.14
$1393.68
$416.04
$450.39
$486.78
$616.05
$577.62
$611.97
$648.36
$777.63
$739.20
$773.55
$809.94
$939.21
$161.58

Plan: (PPO) Silver S09E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $2,500 : Family: $5,000
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
Silver 21
30
40
50
60
$234.37
$266.01
$299.52
$418.58
$636.08
$468.74
$532.02
$599.04
$837.16
$1272.16
$617.56
$680.84
$747.86
$985.98
$766.38
$829.66
$896.68
$1134.80
$915.20
$978.48
$1045.50
$1283.62
$383.19
$414.83
$448.34
$567.40
$532.01
$563.65
$597.16
$716.22
$680.83
$712.47
$745.98
$865.04
$148.82

Plan: (PPO) Silver S11E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $5,500 : Family: $11,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$265.91
$301.81
$339.83
$474.92
$721.68
$531.82
$603.62
$679.66
$949.84
$1443.36
$700.67
$772.47
$848.51
$1118.69
$869.52
$941.32
$1017.36
$1287.54
$1038.37
$1110.17
$1186.21
$1456.39
$434.76
$470.66
$508.68
$643.77
$603.61
$639.51
$677.53
$812.62
$772.46
$808.36
$846.38
$981.47
$168.85

Plan: (PPO) Silver S12E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $4,000 : Family: $8,000
Out of Pocket Maximum per year: Individual: $5,500 : Family: $11,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$266.61
$302.60
$340.73
$476.17
$723.58
$533.22
$605.20
$681.46
$952.34
$1447.16
$702.52
$774.50
$850.76
$1121.64
$871.82
$943.80
$1020.06
$1290.94
$1041.12
$1113.10
$1189.36
$1460.24
$435.91
$471.90
$510.03
$645.47
$605.21
$641.20
$679.33
$814.77
$774.51
$810.50
$848.63
$984.07
$169.30

Plan: (PPO) Silver S14E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$277.81
$315.31
$355.04
$496.17
$753.98
$555.62
$630.62
$710.08
$992.34
$1507.96
$732.03
$807.03
$886.49
$1168.75
$908.44
$983.44
$1062.90
$1345.16
$1084.85
$1159.85
$1239.31
$1521.57
$454.22
$491.72
$531.45
$672.58
$630.63
$668.13
$707.86
$848.99
$807.04
$844.54
$884.27
$1025.40
$176.41

Plan: (PPO) Silver S16E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

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

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$247.66
$281.09
$316.51
$442.32
$672.15
$495.32
$562.18
$633.02
$884.64
$1344.30
$652.58
$719.44
$790.28
$1041.90
$809.84
$876.70
$947.54
$1199.16
$967.10
$1033.96
$1104.80
$1356.42
$404.92
$438.35
$473.77
$599.58
$562.18
$595.61
$631.03
$756.84
$719.44
$752.87
$788.29
$914.10
$157.26

Plan: (PPO) Silver S19E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $3,000 : Family: $6,000
Out of Pocket Maximum per year: Individual: $4,250 : Family: $8,500

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$235.12
$266.86
$300.48
$419.92
$638.12
$470.24
$533.72
$600.96
$839.84
$1276.24
$619.54
$683.02
$750.26
$989.14
$768.84
$832.32
$899.56
$1138.44
$918.14
$981.62
$1048.86
$1287.74
$384.42
$416.16
$449.78
$569.22
$533.72
$565.46
$599.08
$718.52
$683.02
$714.76
$748.38
$867.82
$149.30

Plan: (PPO) Silver S19S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $3,000 : Family: $6,000
Out of Pocket Maximum per year: Individual: $4,250 : Family: $8,500

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$276.61
$313.95
$353.51
$494.03
$750.72
$553.22
$627.90
$707.02
$988.06
$1501.44
$728.87
$803.55
$882.67
$1163.71
$904.52
$979.20
$1058.32
$1339.36
$1080.17
$1154.85
$1233.97
$1515.01
$452.26
$489.60
$529.16
$669.68
$627.91
$665.25
$704.81
$845.33
$803.56
$840.90
$880.46
$1020.98
$175.65

Plan: (PPO) Bronze B04P, Network P, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

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

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$264.88
$300.64
$338.52
$473.08
$718.88
$529.76
$601.28
$677.04
$946.16
$1437.76
$697.96
$769.48
$845.24
$1114.36
$866.16
$937.68
$1013.44
$1282.56
$1034.36
$1105.88
$1181.64
$1450.76
$433.08
$468.84
$506.72
$641.28
$601.28
$637.04
$674.92
$809.48
$769.48
$805.24
$843.12
$977.68
$168.20

Plan: (PPO) Silver S09P, Network P, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $2,500 : Family: $5,000
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
Silver 21
30
40
50
60
$308.55
$350.20
$394.33
$551.07
$837.40
$617.10
$700.40
$788.66
$1102.14
$1674.80
$813.03
$896.33
$984.59
$1298.07
$1008.96
$1092.26
$1180.52
$1494.00
$1204.89
$1288.19
$1376.45
$1689.93
$504.48
$546.13
$590.26
$747.00
$700.41
$742.06
$786.19
$942.93
$896.34
$937.99
$982.12
$1138.86
$195.93

Plan: (PPO) Silver S11P, Network P, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $5,500 : Family: $11,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$350.07
$397.33
$447.39
$625.23
$950.09
$700.14
$794.66
$894.78
$1250.46
$1900.18
$922.43
$1016.95
$1117.07
$1472.75
$1144.72
$1239.24
$1339.36
$1695.04
$1367.01
$1461.53
$1561.65
$1917.33
$572.36
$619.62
$669.68
$847.52
$794.65
$841.91
$891.97
$1069.81
$1016.94
$1064.20
$1114.26
$1292.10
$222.29

Plan: (PPO) Silver S12P, Network P, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $4,000 : Family: $8,000
Out of Pocket Maximum per year: Individual: $5,500 : Family: $11,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$350.98
$398.36
$448.55
$626.85
$952.56
$701.96
$796.72
$897.10
$1253.70
$1905.12
$924.83
$1019.59
$1119.97
$1476.57
$1147.70
$1242.46
$1342.84
$1699.44
$1370.57
$1465.33
$1565.71
$1922.31
$573.85
$621.23
$671.42
$849.72
$796.72
$844.10
$894.29
$1072.59
$1019.59
$1066.97
$1117.16
$1295.46
$222.87

Plan: (PPO) Gold G08P, Network P, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $2,100 : Family: $4,200
Out of Pocket Maximum per year: Individual: $2,100 : Family: $4,200

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
Gold 21
30
40
50
60
$456.99
$518.68
$584.03
$816.18
$1240.27
$913.98
$1037.36
$1168.06
$1632.36
$2480.54
$1204.17
$1327.55
$1458.25
$1922.55
$1494.36
$1617.74
$1748.44
$2212.74
$1784.55
$1907.93
$2038.63
$2502.93
$747.18
$808.87
$874.22
$1106.37
$1037.37
$1099.06
$1164.41
$1396.56
$1327.56
$1389.25
$1454.60
$1686.75
$290.19

Plan: (PPO) Gold G11P, Network P, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

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

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$500.83
$568.44
$640.06
$894.48
$1359.25
$1001.66
$1136.88
$1280.12
$1788.96
$2718.50
$1319.69
$1454.91
$1598.15
$2106.99
$1637.72
$1772.94
$1916.18
$2425.02
$1955.75
$2090.97
$2234.21
$2743.05
$818.86
$886.47
$958.09
$1212.51
$1136.89
$1204.50
$1276.12
$1530.54
$1454.92
$1522.53
$1594.15
$1848.57
$318.03

Plan: (PPO) Bronze B01S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $3,000 : Family: $6,000
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
Bronze 21
30
40
50
60
$242.81
$275.59
$310.31
$433.66
$658.99
$485.62
$551.18
$620.62
$867.32
$1317.98
$639.80
$705.36
$774.80
$1021.50
$793.98
$859.54
$928.98
$1175.68
$948.16
$1013.72
$1083.16
$1329.86
$396.99
$429.77
$464.49
$587.84
$551.17
$583.95
$618.67
$742.02
$705.35
$738.13
$772.85
$896.20
$154.18

Plan: (PPO) Bronze B02S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $4,000 : Family: $8,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$210.31
$238.70
$268.78
$375.61
$570.78
$420.62
$477.40
$537.56
$751.22
$1141.56
$554.17
$610.95
$671.11
$884.77
$687.72
$744.50
$804.66
$1018.32
$821.27
$878.05
$938.21
$1151.87
$343.86
$372.25
$402.33
$509.16
$477.41
$505.80
$535.88
$642.71
$610.96
$639.35
$669.43
$776.26
$133.55

Plan: (PPO) Bronze B04S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

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

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$236.71
$268.67
$302.52
$422.76
$642.43
$473.42
$537.34
$605.04
$845.52
$1284.86
$623.73
$687.65
$755.35
$995.83
$774.04
$837.96
$905.66
$1146.14
$924.35
$988.27
$1055.97
$1296.45
$387.02
$418.98
$452.83
$573.07
$537.33
$569.29
$603.14
$723.38
$687.64
$719.60
$753.45
$873.69
$150.31

Plan: (PPO) Bronze B01E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $3,000 : Family: $6,000
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
Bronze 21
30
40
50
60
$206.39
$234.25
$263.77
$368.61
$560.14
$412.78
$468.50
$527.54
$737.22
$1120.28
$543.84
$599.56
$658.60
$868.28
$674.90
$730.62
$789.66
$999.34
$805.96
$861.68
$920.72
$1130.40
$337.45
$365.31
$394.83
$499.67
$468.51
$496.37
$525.89
$630.73
$599.57
$627.43
$656.95
$761.79
$131.06

Plan: (PPO) Bronze B02E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $4,000 : Family: $8,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$178.76
$202.89
$228.46
$319.27
$485.15
$357.52
$405.78
$456.92
$638.54
$970.30
$471.03
$519.29
$570.43
$752.05
$584.54
$632.80
$683.94
$865.56
$698.05
$746.31
$797.45
$979.07
$292.27
$316.40
$341.97
$432.78
$405.78
$429.91
$455.48
$546.29
$519.29
$543.42
$568.99
$659.80
$113.51

Plan: (PPO) Bronze B04E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

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

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$201.21
$228.37
$257.15
$359.36
$546.08
$402.42
$456.74
$514.30
$718.72
$1092.16
$530.19
$584.51
$642.07
$846.49
$657.96
$712.28
$769.84
$974.26
$785.73
$840.05
$897.61
$1102.03
$328.98
$356.14
$384.92
$487.13
$456.75
$483.91
$512.69
$614.90
$584.52
$611.68
$640.46
$742.67
$127.77

Plan: (PPO) Bronze B07E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $5,200 : Family: $10,400
Out of Pocket Maximum per year: Individual: $6,400 : Family: $12,800

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
Bronze 21
30
40
50
60
$161.78
$183.62
$206.75
$288.94
$439.07
$323.56
$367.24
$413.50
$577.88
$878.14
$426.29
$469.97
$516.23
$680.61
$529.02
$572.70
$618.96
$783.34
$631.75
$675.43
$721.69
$886.07
$264.51
$286.35
$309.48
$391.67
$367.24
$389.08
$412.21
$494.40
$469.97
$491.81
$514.94
$597.13
$102.73

Plan: (PPO) Bronze B07S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $5,200 : Family: $10,400
Out of Pocket Maximum per year: Individual: $6,400 : Family: $12,800

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
Bronze 21
30
40
50
60
$190.33
$216.02
$243.24
$339.93
$516.56
$380.66
$432.04
$486.48
$679.86
$1033.12
$501.52
$552.90
$607.34
$800.72
$622.38
$673.76
$728.20
$921.58
$743.24
$794.62
$849.06
$1042.44
$311.19
$336.88
$364.10
$460.79
$432.05
$457.74
$484.96
$581.65
$552.91
$578.60
$605.82
$702.51
$120.86

Plan: (PPO) Gold G01S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $5,250 : Family: $10,500

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$413.45
$469.27
$528.39
$738.42
$1122.10
$826.90
$938.54
$1056.78
$1476.84
$2244.20
$1089.44
$1201.08
$1319.32
$1739.38
$1351.98
$1463.62
$1581.86
$2001.92
$1614.52
$1726.16
$1844.40
$2264.46
$675.99
$731.81
$790.93
$1000.96
$938.53
$994.35
$1053.47
$1263.50
$1201.07
$1256.89
$1316.01
$1526.04
$262.54

Plan: (PPO) Gold G06S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $1,500 : Family: $3,000
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
$457.41
$519.16
$584.57
$816.93
$1241.41
$914.82
$1038.32
$1169.14
$1633.86
$2482.82
$1205.28
$1328.78
$1459.60
$1924.32
$1495.74
$1619.24
$1750.06
$2214.78
$1786.20
$1909.70
$2040.52
$2505.24
$747.87
$809.62
$875.03
$1107.39
$1038.33
$1100.08
$1165.49
$1397.85
$1328.79
$1390.54
$1455.95
$1688.31
$290.46

Plan: (PPO) Gold G08S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $2,100 : Family: $4,200
Out of Pocket Maximum per year: Individual: $2,100 : Family: $4,200

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
Gold 21
30
40
50
60
$408.39
$463.52
$521.92
$729.38
$1108.37
$816.78
$927.04
$1043.84
$1458.76
$2216.74
$1076.11
$1186.37
$1303.17
$1718.09
$1335.44
$1445.70
$1562.50
$1977.42
$1594.77
$1705.03
$1821.83
$2236.75
$667.72
$722.85
$781.25
$988.71
$927.05
$982.18
$1040.58
$1248.04
$1186.38
$1241.51
$1299.91
$1507.37
$259.33

Plan: (PPO) Gold G10S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

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

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$383.03
$434.74
$489.51
$684.09
$1039.54
$766.06
$869.48
$979.02
$1368.18
$2079.08
$1009.28
$1112.70
$1222.24
$1611.40
$1252.50
$1355.92
$1465.46
$1854.62
$1495.72
$1599.14
$1708.68
$2097.84
$626.25
$677.96
$732.73
$927.31
$869.47
$921.18
$975.95
$1170.53
$1112.69
$1164.40
$1219.17
$1413.75
$243.22

Plan: (PPO) Gold G11S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

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

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$447.57
$507.99
$571.99
$799.36
$1214.70
$895.14
$1015.98
$1143.98
$1598.72
$2429.40
$1179.35
$1300.19
$1428.19
$1882.93
$1463.56
$1584.40
$1712.40
$2167.14
$1747.77
$1868.61
$1996.61
$2451.35
$731.78
$792.20
$856.20
$1083.57
$1015.99
$1076.41
$1140.41
$1367.78
$1300.20
$1360.62
$1424.62
$1651.99
$284.21

Plan: (PPO) Gold G01E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $5,250 : Family: $10,500

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$351.43
$398.87
$449.13
$627.65
$953.78
$702.86
$797.74
$898.26
$1255.30
$1907.56
$926.02
$1020.90
$1121.42
$1478.46
$1149.18
$1244.06
$1344.58
$1701.62
$1372.34
$1467.22
$1567.74
$1924.78
$574.59
$622.03
$672.29
$850.81
$797.75
$845.19
$895.45
$1073.97
$1020.91
$1068.35
$1118.61
$1297.13
$223.16

Plan: (PPO) Gold G06E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $1,500 : Family: $3,000
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
$388.80
$441.29
$496.89
$694.40
$1055.20
$777.60
$882.58
$993.78
$1388.80
$2110.40
$1024.49
$1129.47
$1240.67
$1635.69
$1271.38
$1376.36
$1487.56
$1882.58
$1518.27
$1623.25
$1734.45
$2129.47
$635.69
$688.18
$743.78
$941.29
$882.58
$935.07
$990.67
$1188.18
$1129.47
$1181.96
$1237.56
$1435.07
$246.89

Plan: (PPO) Gold G08E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $2,100 : Family: $4,200
Out of Pocket Maximum per year: Individual: $2,100 : Family: $4,200

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
Gold 21
30
40
50
60
$347.13
$393.99
$443.63
$619.97
$942.11
$694.26
$787.98
$887.26
$1239.94
$1884.22
$914.69
$1008.41
$1107.69
$1460.37
$1135.12
$1228.84
$1328.12
$1680.80
$1355.55
$1449.27
$1548.55
$1901.23
$567.56
$614.42
$664.06
$840.40
$787.99
$834.85
$884.49
$1060.83
$1008.42
$1055.28
$1104.92
$1281.26
$220.43

Plan: (PPO) Gold G10E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

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

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$325.58
$369.53
$416.09
$581.49
$883.62
$651.16
$739.06
$832.18
$1162.98
$1767.24
$857.90
$945.80
$1038.92
$1369.72
$1064.64
$1152.54
$1245.66
$1576.46
$1271.38
$1359.28
$1452.40
$1783.20
$532.32
$576.27
$622.83
$788.23
$739.06
$783.01
$829.57
$994.97
$945.80
$989.75
$1036.31
$1201.71
$206.74

Plan: (PPO) Gold G11E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

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

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$380.44
$431.80
$486.20
$679.47
$1032.51
$760.88
$863.60
$972.40
$1358.94
$2065.02
$1002.46
$1105.18
$1213.98
$1600.52
$1244.04
$1346.76
$1455.56
$1842.10
$1485.62
$1588.34
$1697.14
$2083.68
$622.02
$673.38
$727.78
$921.05
$863.60
$914.96
$969.36
$1162.63
$1105.18
$1156.54
$1210.94
$1404.21
$241.58

Plan: (PPO) Platinum P01S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $1,800 : Family: $3,600

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
Platinum 21
30
40
50
60
$524.62
$595.44
$670.46
$936.97
$1423.82
$1049.24
$1190.88
$1340.92
$1873.94
$2847.64
$1382.37
$1524.01
$1674.05
$2207.07
$1715.50
$1857.14
$2007.18
$2540.20
$2048.63
$2190.27
$2340.31
$2873.33
$857.75
$928.57
$1003.59
$1270.10
$1190.88
$1261.70
$1336.72
$1603.23
$1524.01
$1594.83
$1669.85
$1936.36
$333.13

Plan: (PPO) Platinum P02S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $1,500 : Family: $3,000

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
Platinum 21
30
40
50
60
$552.85
$627.48
$706.54
$987.39
$1500.43
$1105.70
$1254.96
$1413.08
$1974.78
$3000.86
$1456.76
$1606.02
$1764.14
$2325.84
$1807.82
$1957.08
$2115.20
$2676.90
$2158.88
$2308.14
$2466.26
$3027.96
$903.91
$978.54
$1057.60
$1338.45
$1254.97
$1329.60
$1408.66
$1689.51
$1606.03
$1680.66
$1759.72
$2040.57
$351.06

Plan: (PPO) Platinum P03S, Network S

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Platinum 21
30
40
50
60
$573.70
$651.15
$733.19
$1024.63
$1557.02
$1147.40
$1302.30
$1466.38
$2049.26
$3114.04
$1511.70
$1666.60
$1830.68
$2413.56
$1876.00
$2030.90
$2194.98
$2777.86
$2240.30
$2395.20
$2559.28
$3142.16
$938.00
$1015.45
$1097.49
$1388.93
$1302.30
$1379.75
$1461.79
$1753.23
$1666.60
$1744.05
$1826.09
$2117.53
$364.30

Plan: (PPO) Platinum P01E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $1,800 : Family: $3,600

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
Platinum 21
30
40
50
60
$445.93
$506.13
$569.90
$796.43
$1210.25
$891.86
$1012.26
$1139.80
$1592.86
$2420.50
$1175.03
$1295.43
$1422.97
$1876.03
$1458.20
$1578.60
$1706.14
$2159.20
$1741.37
$1861.77
$1989.31
$2442.37
$729.10
$789.30
$853.07
$1079.60
$1012.27
$1072.47
$1136.24
$1362.77
$1295.44
$1355.64
$1419.41
$1645.94
$283.17

Plan: (PPO) Platinum P02E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $1,500 : Family: $3,000

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
Platinum 21
30
40
50
60
$469.93
$533.37
$600.57
$839.29
$1275.39
$939.86
$1066.74
$1201.14
$1678.58
$2550.78
$1238.27
$1365.15
$1499.55
$1976.99
$1536.68
$1663.56
$1797.96
$2275.40
$1835.09
$1961.97
$2096.37
$2573.81
$768.34
$831.78
$898.98
$1137.70
$1066.75
$1130.19
$1197.39
$1436.11
$1365.16
$1428.60
$1495.80
$1734.52
$298.41

Plan: (PPO) Platinum P03E, Network E

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-743-0455 - Provider Directory for This Plan: (BlueCross BlueShield of Tennessee)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Platinum 21
30
40
50
60
$487.65
$553.48
$623.22
$870.94
$1323.48
$975.30
$1106.96
$1246.44
$1741.88
$2646.96
$1284.96
$1416.62
$1556.10
$2051.54
$1594.62
$1726.28
$1865.76
$2361.20
$1904.28
$2035.94
$2175.42
$2670.86
$797.31
$863.14
$932.88
$1180.60
$1106.97
$1172.80
$1242.54
$1490.26
$1416.63
$1482.46
$1552.20
$1799.92
$309.66

UnitedHealthcare Insurance Company

Local: 1-877-632-4195 | Toll Free:

Plan: (POS) Gold Compass 1000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: - Provider Directory for This Plan: (UnitedHealthcare Insurance Company)

Deductible: Individual: $1,000 : Family: $2,000
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
Gold 21
30
40
50
60
$287.29
$326.06
$367.14
$513.08
$779.67
$574.58
$652.12
$734.28
$1026.16
$1559.34
$757.00
$834.54
$916.70
$1208.58
$939.42
$1016.96
$1099.12
$1391.00
$1121.84
$1199.38
$1281.54
$1573.42
$469.71
$508.48
$549.56
$695.50
$652.13
$690.90
$731.98
$877.92
$834.55
$873.32
$914.40
$1060.34
$182.42

Plan: (POS) Gold Compass HSA 1600

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: - Provider Directory for This Plan: (UnitedHealthcare Insurance Company)

Deductible: Individual: $1,600 : Family: $4,800
Out of Pocket Maximum per year: Individual: $3,500 : Family: $6,850

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
$265.83
$301.70
$339.72
$474.75
$721.43
$531.66
$603.40
$679.44
$949.50
$1442.86
$700.45
$772.19
$848.23
$1118.29
$869.24
$940.98
$1017.02
$1287.08
$1038.03
$1109.77
$1185.81
$1455.87
$434.62
$470.49
$508.51
$643.54
$603.41
$639.28
$677.30
$812.33
$772.20
$808.07
$846.09
$981.12
$168.79

Plan: (POS) Silver Compass 2000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: - Provider Directory for This Plan: (UnitedHealthcare Insurance Company)

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
$246.79
$280.10
$315.39
$440.75
$669.77
$493.58
$560.20
$630.78
$881.50
$1339.54
$650.29
$716.91
$787.49
$1038.21
$807.00
$873.62
$944.20
$1194.92
$963.71
$1030.33
$1100.91
$1351.63
$403.50
$436.81
$472.10
$597.46
$560.21
$593.52
$628.81
$754.17
$716.92
$750.23
$785.52
$910.88
$156.71

Plan: (POS) Silver Compass HSA 3600

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: - Provider Directory for This Plan: (UnitedHealthcare Insurance Company)

Deductible: Individual: $3,600 : Family: $7,200
Out of Pocket Maximum per year: Individual: $3,600 : Family: $7,200

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
$245.41
$278.53
$313.62
$438.28
$666.01
$490.82
$557.06
$627.24
$876.56
$1332.02
$646.65
$712.89
$783.07
$1032.39
$802.48
$868.72
$938.90
$1188.22
$958.31
$1024.55
$1094.73
$1344.05
$401.24
$434.36
$469.45
$594.11
$557.07
$590.19
$625.28
$749.94
$712.90
$746.02
$781.11
$905.77
$155.83

Plan: (POS) Silver Compass 5000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: - Provider Directory for This Plan: (UnitedHealthcare Insurance Company)

Deductible: Individual: $5,000 : Family: $10,000
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
$237.45
$269.49
$303.44
$424.06
$644.40
$474.90
$538.98
$606.88
$848.12
$1288.80
$625.67
$689.75
$757.65
$998.89
$776.44
$840.52
$908.42
$1149.66
$927.21
$991.29
$1059.19
$1300.43
$388.22
$420.26
$454.21
$574.83
$538.99
$571.03
$604.98
$725.60
$689.76
$721.80
$755.75
$876.37
$150.77

Plan: (POS) Bronze Compass HSA 5200

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: - Provider Directory for This Plan: (UnitedHealthcare Insurance Company)

Deductible: Individual: $5,200 : Family: $10,400
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$208.03
$236.10
$265.85
$371.52
$564.56
$416.06
$472.20
$531.70
$743.04
$1129.12
$548.15
$604.29
$663.79
$875.13
$680.24
$736.38
$795.88
$1007.22
$812.33
$868.47
$927.97
$1139.31
$340.12
$368.19
$397.94
$503.61
$472.21
$500.28
$530.03
$635.70
$604.30
$632.37
$662.12
$767.79
$132.09

Plan: (POS) Bronze Compass 6400

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: - Provider Directory for This Plan: (UnitedHealthcare Insurance Company)

Deductible: Individual: $6,400 : Family: $12,800
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$214.60
$243.56
$274.25
$383.26
$582.41
$429.20
$487.12
$548.50
$766.52
$1164.82
$565.47
$623.39
$684.77
$902.79
$701.74
$759.66
$821.04
$1039.06
$838.01
$895.93
$957.31
$1175.33
$350.87
$379.83
$410.52
$519.53
$487.14
$516.10
$546.79
$655.80
$623.41
$652.37
$683.06
$792.07
$136.27

Plan: (POS) Bronze Compass 4200

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: - Provider Directory for This Plan: (UnitedHealthcare Insurance Company)

Deductible: Individual: $4,200 : Family: $8,400
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
Bronze 21
30
40
50
60
$208.03
$236.10
$265.85
$371.52
$564.56
$416.06
$472.20
$531.70
$743.04
$1129.12
$548.15
$604.29
$663.79
$875.13
$680.24
$736.38
$795.88
$1007.22
$812.33
$868.47
$927.97
$1139.31
$340.12
$368.19
$397.94
$503.61
$472.21
$500.28
$530.03
$635.70
$604.30
$632.37
$662.12
$767.79
$132.09

Plan: (POS) Catastrophic Compass 6850

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: - Provider Directory for This Plan: (UnitedHealthcare Insurance Company)

Deductible: Individual: $6,850 : Family: $13,700
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
Catastrophic 21
30
40
50
60
$172.03
$195.24
$219.84
$307.23
$466.86
$344.06
$390.48
$439.68
$614.46
$933.72
$453.29
$499.71
$548.91
$723.69
$562.52
$608.94
$658.14
$832.92
$671.75
$718.17
$767.37
$942.15
$281.26
$304.47
$329.07
$416.46
$390.49
$413.70
$438.30
$525.69
$499.72
$522.93
$547.53
$634.92
$109.23

Humana Insurance Company

Local: 1-877-720-4854 | Toll Free: 1-877-720-4854

TTY: 1-800-325-2028

Plan: (PPO) Humana Basic 6850/Nashville PPOx

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Insurance Company)

Deductible: Individual: $6,850 : Family: $13,700
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
Catastrophic 21
30
40
50
60
$164.83
$187.08
$210.65
$294.39
$447.35
$329.66
$374.16
$421.30
$588.78
$894.70
$434.33
$478.83
$525.97
$693.45
$539.00
$583.50
$630.64
$798.12
$643.67
$688.17
$735.31
$902.79
$269.50
$291.75
$315.32
$399.06
$374.17
$396.42
$419.99
$503.73
$478.84
$501.09
$524.66
$608.40
$104.67

Plan: (PPO) Humana Bronze 6450/Nashville PPOx

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Insurance Company)

Deductible: Individual: $6,450 : Family: $12,900
Out of Pocket Maximum per year: Individual: $6,450 : Family: $12,900

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
$232.49
$263.88
$297.12
$415.23
$630.98
$464.98
$527.76
$594.24
$830.46
$1261.96
$612.61
$675.39
$741.87
$978.09
$760.24
$823.02
$889.50
$1125.72
$907.87
$970.65
$1037.13
$1273.35
$380.12
$411.51
$444.75
$562.86
$527.75
$559.14
$592.38
$710.49
$675.38
$706.77
$740.01
$858.12
$147.63

Plan: (PPO) Humana Silver 3800/Nashville PPOx

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Insurance Company)

Deductible: Individual: $3,800 : Family: $7,600
Out of Pocket Maximum per year: Individual: $6,300 : Family: $12,600

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
$274.17
$311.18
$350.39
$489.67
$744.10
$548.34
$622.36
$700.78
$979.34
$1488.20
$722.44
$796.46
$874.88
$1153.44
$896.54
$970.56
$1048.98
$1327.54
$1070.64
$1144.66
$1223.08
$1501.64
$448.27
$485.28
$524.49
$663.77
$622.37
$659.38
$698.59
$837.87
$796.47
$833.48
$872.69
$1011.97
$174.10

Plan: (PPO) Humana Gold 2250/Nashville PPOx

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Insurance Company)

Deductible: Individual: $2,250 : Family: $4,500
Out of Pocket Maximum per year: Individual: $3,500 : Family: $7,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$307.40
$348.90
$392.86
$549.02
$834.28
$614.80
$697.80
$785.72
$1098.04
$1668.56
$810.00
$893.00
$980.92
$1293.24
$1005.20
$1088.20
$1176.12
$1488.44
$1200.40
$1283.40
$1371.32
$1683.64
$502.60
$544.10
$588.06
$744.22
$697.80
$739.30
$783.26
$939.42
$893.00
$934.50
$978.46
$1134.62
$195.20

Cigna Health and Life Insurance Company

Local: 1-877-900-1237 | Toll Free: 1-877-900-1237

Plan: (EPO) Cigna Connect HSA Bronze 6000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-900-1237 - Provider Directory for This Plan: (Cigna Health and Life Insurance Company)

Deductible: Individual: $6,000 : Family: $12,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$173.62
$197.05
$221.88
$310.08
$471.19
$347.24
$394.10
$443.76
$620.16
$942.38
$457.49
$504.35
$554.01
$730.41
$567.74
$614.60
$664.26
$840.66
$677.99
$724.85
$774.51
$950.91
$283.87
$307.30
$332.13
$420.33
$394.12
$417.55
$442.38
$530.58
$504.37
$527.80
$552.63
$640.83
$110.25

Plan: (EPO) Cigna Connect Flex Bronze 6400

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-900-1237 - Provider Directory for This Plan: (Cigna Health and Life Insurance Company)

Deductible: Individual: $6,400 : Family: $12,800
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
Bronze 21
30
40
50
60
$180.00
$204.30
$230.04
$321.48
$488.52
$360.00
$408.60
$460.08
$642.96
$977.04
$474.30
$522.90
$574.38
$757.26
$588.60
$637.20
$688.68
$871.56
$702.90
$751.50
$802.98
$985.86
$294.30
$318.60
$344.34
$435.78
$408.60
$432.90
$458.64
$550.08
$522.90
$547.20
$572.94
$664.38
$114.30

Plan: (EPO) Cigna Connect HSA Silver 2700

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-900-1237 - Provider Directory for This Plan: (Cigna Health and Life Insurance Company)

Deductible: Individual: $2,700 : Family: $5,400
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$205.34
$233.06
$262.42
$366.73
$557.28
$410.68
$466.12
$524.84
$733.46
$1114.56
$541.07
$596.51
$655.23
$863.85
$671.46
$726.90
$785.62
$994.24
$801.85
$857.29
$916.01
$1124.63
$335.73
$363.45
$392.81
$497.12
$466.12
$493.84
$523.20
$627.51
$596.51
$624.23
$653.59
$757.90
$130.39

Plan: (EPO) Cigna Connect Flex Silver 2250

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-900-1237 - Provider Directory for This Plan: (Cigna Health and Life Insurance Company)

Deductible: Individual: $2,250 : Family: $4,500
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
$228.66
$259.53
$292.23
$408.39
$620.59
$457.32
$519.06
$584.46
$816.78
$1241.18
$602.52
$664.26
$729.66
$961.98
$747.72
$809.46
$874.86
$1107.18
$892.92
$954.66
$1020.06
$1252.38
$373.86
$404.73
$437.43
$553.59
$519.06
$549.93
$582.63
$698.79
$664.26
$695.13
$727.83
$843.99
$145.20

Plan: (EPO) Cigna Connect Flex Silver 4000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-900-1237 - Provider Directory for This Plan: (Cigna Health and Life Insurance Company)

Deductible: Individual: $4,000 : Family: $8,000
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
$219.62
$249.27
$280.68
$392.25
$596.06
$439.24
$498.54
$561.36
$784.50
$1192.12
$578.70
$638.00
$700.82
$923.96
$718.16
$777.46
$840.28
$1063.42
$857.62
$916.92
$979.74
$1202.88
$359.08
$388.73
$420.14
$531.71
$498.54
$528.19
$559.60
$671.17
$638.00
$667.65
$699.06
$810.63
$139.46

Plan: (EPO) Cigna Connect Flex Gold 1200

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-900-1237 - Provider Directory for This Plan: (Cigna Health and Life Insurance Company)

Deductible: Individual: $1,200 : Family: $2,400
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
$264.16
$299.82
$337.60
$471.79
$716.93
$528.32
$599.64
$675.20
$943.58
$1433.86
$696.06
$767.38
$842.94
$1111.32
$863.80
$935.12
$1010.68
$1279.06
$1031.54
$1102.86
$1178.42
$1446.80
$431.90
$467.56
$505.34
$639.53
$599.64
$635.30
$673.08
$807.27
$767.38
$803.04
$840.82
$975.01
$167.74

†Source: Our summary of lowest costs and numbers of providers is based on a government report released September 25, 2013. For more detailed information about specific plans and providers, see HealthCare.gov.

‡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 Sumner County here.