Salt Lake County, Utah 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 Salt Lake County, UT.
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, 87 Plans and 2024 Rates for Salt Lake County, Utah
Below, you’ll find a summary of the 87 plans for Salt Lake County, Utah 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
2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 |
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Molina HealthcareLocal: 1-801-858-0400 | Toll Free: 1-888-858-3973 |
Toc - Plan #1 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Gold 1 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$360.81 $501.53 $533.64 $767.45 $1,082.43 |
$646.94 $787.66 $819.77 $1,053.58 |
$933.07 $1,073.79 $1,105.90 $1,339.71 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$721.62 $1,003.06 $1,067.28 $1,534.90 $2,164.86 |
$1,007.75 $1,289.19 $1,353.41 $1,821.03 |
$1,293.88 $1,575.32 $1,639.54 $2,107.16 |
Toc - Plan #2 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Silver 1 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$375.38 $521.78 $555.19 $798.44 $1,126.14 |
$673.06 $819.46 $852.87 $1,096.12 |
$970.74 $1,117.14 $1,150.55 $1,393.80 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$750.76 $1,043.56 $1,110.38 $1,596.88 $2,252.28 |
$1,048.44 $1,341.24 $1,408.06 $1,894.56 |
$1,346.12 $1,638.92 $1,705.74 $2,192.24 |
Toc - Plan #3 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Gold 8 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$374.37 $520.37 $553.69 $796.27 $1,123.10 |
$671.24 $817.24 $850.56 $1,093.14 |
$968.11 $1,114.11 $1,147.43 $1,390.01 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$748.74 $1,040.74 $1,107.38 $1,592.54 $2,246.20 |
$1,045.61 $1,337.61 $1,404.25 $1,889.41 |
$1,342.48 $1,634.48 $1,701.12 $2,186.28 |
Toc - Plan #4 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Silver 8 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$384.83 $534.91 $569.16 $818.53 $1,154.49 |
$690.00 $840.08 $874.33 $1,123.70 |
$995.17 $1,145.25 $1,179.50 $1,428.87 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$769.66 $1,069.82 $1,138.32 $1,637.06 $2,308.98 |
$1,074.83 $1,374.99 $1,443.49 $1,942.23 |
$1,380.00 $1,680.16 $1,748.66 $2,247.40 |
Toc - Plan #5 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Silver 12 with First 4 Primary Care Visits Free |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$371.12 $515.85 $548.88 $789.37 $1,113.35 |
$665.42 $810.15 $843.18 $1,083.67 |
$959.72 $1,104.45 $1,137.48 $1,377.97 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$742.24 $1,031.70 $1,097.76 $1,578.74 $2,226.70 |
$1,036.54 $1,326.00 $1,392.06 $1,873.04 |
$1,330.84 $1,620.30 $1,686.36 $2,167.34 |
Toc - Plan #6 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Gold 1 with Adult Vision Services |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$363.97 $505.92 $538.31 $774.16 $1,091.91 |
$652.60 $794.55 $826.94 $1,062.79 |
$941.23 $1,083.18 $1,115.57 $1,351.42 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$727.94 $1,011.84 $1,076.62 $1,548.32 $2,183.82 |
$1,016.57 $1,300.47 $1,365.25 $1,836.95 |
$1,305.20 $1,589.10 $1,653.88 $2,125.58 |
Toc - Plan #7 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Silver 1 with Adult Vision Services |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$378.84 $526.59 $560.31 $805.80 $1,136.52 |
$679.26 $827.01 $860.73 $1,106.22 |
$979.68 $1,127.43 $1,161.15 $1,406.64 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$757.68 $1,053.18 $1,120.62 $1,611.60 $2,273.04 |
$1,058.10 $1,353.60 $1,421.04 $1,912.02 |
$1,358.52 $1,654.02 $1,721.46 $2,212.44 |
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Regence BlueCross BlueShield of UtahLocal: 1-888-231-8424 | Toll Free: 1-888-231-8424 |
Toc - Plan #8 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Silver
(EPO) Silver 4500 Deductible |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$358.71 $498.61 $530.54 $762.98 $1,076.13 |
$643.17 $783.07 $815.00 $1,047.44 |
$927.63 $1,067.53 $1,099.46 $1,331.90 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$717.42 $997.22 $1,061.08 $1,525.96 $2,152.26 |
$1,001.88 $1,281.68 $1,345.54 $1,810.42 |
$1,286.34 $1,566.14 $1,630.00 $2,094.88 |
Toc - Plan #9 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Silver
(EPO) Silver 6500 Deductible |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$348.28 $484.10 $515.10 $740.79 $1,044.83 |
$624.46 $760.28 $791.28 $1,016.97 |
$900.64 $1,036.46 $1,067.46 $1,293.15 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$696.56 $968.20 $1,030.20 $1,481.58 $2,089.66 |
$972.74 $1,244.38 $1,306.38 $1,757.76 |
$1,248.92 $1,520.56 $1,582.56 $2,033.94 |
Toc - Plan #10 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Gold
(EPO) Gold 2500 Deductible |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$370.61 $515.15 $548.13 $788.29 $1,111.83 |
$664.51 $809.05 $842.03 $1,082.19 |
$958.41 $1,102.95 $1,135.93 $1,376.09 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$741.22 $1,030.30 $1,096.26 $1,576.58 $2,223.66 |
$1,035.12 $1,324.20 $1,390.16 $1,870.48 |
$1,329.02 $1,618.10 $1,684.06 $2,164.38 |
Toc - Plan #11 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Silver
(EPO) SaveWell Silver 5000 Deductible |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$358.71 $498.61 $530.54 $762.98 $1,076.13 |
$643.17 $783.07 $815.00 $1,047.44 |
$927.63 $1,067.53 $1,099.46 $1,331.90 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$717.42 $997.22 $1,061.08 $1,525.96 $2,152.26 |
$1,001.88 $1,281.68 $1,345.54 $1,810.42 |
$1,286.34 $1,566.14 $1,630.00 $2,094.88 |
Toc - Plan #12 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Expanded Bronze
(EPO) SaveWell Bronze 7500 Deductible |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$255.32 $354.90 $377.62 $543.07 $765.96 |
$457.79 $557.37 $580.09 $745.54 |
$660.26 $759.84 $782.56 $948.01 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$510.64 $709.80 $755.24 $1,086.14 $1,531.92 |
$713.11 $912.27 $957.71 $1,288.61 |
$915.58 $1,114.74 $1,160.18 $1,491.08 |
Toc - Plan #13 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Expanded Bronze
(EPO) SaveWell Bronze 8500 Deductible |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$248.58 $345.53 $367.65 $528.73 $745.73 |
$445.70 $542.65 $564.77 $725.85 |
$642.82 $739.77 $761.89 $922.97 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$497.16 $691.06 $735.30 $1,057.46 $1,491.46 |
$694.28 $888.18 $932.42 $1,254.58 |
$891.40 $1,085.30 $1,129.54 $1,451.70 |
Toc - Plan #14 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze HSA 7000 Deductible |
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Benefits & Coverage
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$272.73 $379.09 $403.36 $580.08 $818.18 |
$489.00 $595.36 $619.63 $796.35 |
$705.27 $811.63 $835.90 $1,012.62 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$545.46 $758.18 $806.72 $1,160.16 $1,636.36 |
$761.73 $974.45 $1,022.99 $1,376.43 |
$978.00 $1,190.72 $1,239.26 $1,592.70 |
Toc - Plan #15 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Essential 8500 Deductible With 4 Copay No Deductible Office Visits |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$255.96 $355.79 $378.57 $544.43 $767.88 |
$458.94 $558.77 $581.55 $747.41 |
$661.92 $761.75 $784.53 $950.39 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$511.92 $711.58 $757.14 $1,088.86 $1,535.76 |
$714.90 $914.56 $960.12 $1,291.84 |
$917.88 $1,117.54 $1,163.10 $1,494.82 |
Toc - Plan #16 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Gold
(EPO) Regence Standard Gold 1500 Deductible |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$397.28 $552.22 $587.58 $845.02 $1,191.84 |
$712.32 $867.26 $902.62 $1,160.06 |
$1,027.36 $1,182.30 $1,217.66 $1,475.10 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$794.56 $1,104.44 $1,175.16 $1,690.04 $2,383.68 |
$1,109.60 $1,419.48 $1,490.20 $2,005.08 |
$1,424.64 $1,734.52 $1,805.24 $2,320.12 |
Toc - Plan #17 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Silver
(EPO) Regence Standard Silver 5900 Deductible |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$353.14 $490.87 $522.30 $751.13 $1,059.42 |
$633.18 $770.91 $802.34 $1,031.17 |
$913.22 $1,050.95 $1,082.38 $1,311.21 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$706.28 $981.74 $1,044.60 $1,502.26 $2,118.84 |
$986.32 $1,261.78 $1,324.64 $1,782.30 |
$1,266.36 $1,541.82 $1,604.68 $2,062.34 |
Toc - Plan #18 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Expanded Bronze
(EPO) Regence Standard Bronze 7500 Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$266.40 $370.29 $394.01 $566.62 $799.19 |
$477.65 $581.54 $605.26 $777.87 |
$688.90 $792.79 $816.51 $989.12 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$532.80 $740.58 $788.02 $1,133.24 $1,598.38 |
$744.05 $951.83 $999.27 $1,344.49 |
$955.30 $1,163.08 $1,210.52 $1,555.74 |
Toc - Plan #19 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Gold
(EPO) SaveWell Standard Gold 1500 Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$387.55 $538.70 $573.19 $824.32 $1,162.65 |
$694.88 $846.03 $880.52 $1,131.65 |
$1,002.21 $1,153.36 $1,187.85 $1,438.98 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$775.10 $1,077.40 $1,146.38 $1,648.64 $2,325.30 |
$1,082.43 $1,384.73 $1,453.71 $1,955.97 |
$1,389.76 $1,692.06 $1,761.04 $2,263.30 |
Toc - Plan #20 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Silver
(EPO) SaveWell Standard Silver 5900 Deductible |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$344.47 $478.81 $509.47 $732.69 $1,033.41 |
$617.63 $751.97 $782.63 $1,005.85 |
$890.79 $1,025.13 $1,055.79 $1,279.01 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$688.94 $957.62 $1,018.94 $1,465.38 $2,066.82 |
$962.10 $1,230.78 $1,292.10 $1,738.54 |
$1,235.26 $1,503.94 $1,565.26 $2,011.70 |
Toc - Plan #21 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Expanded Bronze
(EPO) SaveWell Standard Bronze 7500 Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$259.83 $361.16 $384.29 $552.65 $779.48 |
$465.88 $567.21 $590.34 $758.70 |
$671.93 $773.26 $796.39 $964.75 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$519.66 $722.32 $768.58 $1,105.30 $1,558.96 |
$725.71 $928.37 $974.63 $1,311.35 |
$931.76 $1,134.42 $1,180.68 $1,517.40 |
ADVERTISEMENT
BridgeSpan Health CompanyLocal: 1-855-857-9945 | Toll Free: 1-855-857-9945 | TTY: 1-800-735-2900 |
Toc - Plan #22 BridgeSpan Health Company | ||||||||||||||||||||
Gold
(HMO) BridgeSpan Standard Gold Plan |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-857-9945
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$402.59 $559.60 $595.43 $856.31 $1,207.77 |
$721.85 $878.86 $914.69 $1,175.57 |
$1,041.11 $1,198.12 $1,233.95 $1,494.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$805.18 $1,119.20 $1,190.86 $1,712.62 $2,415.54 |
$1,124.44 $1,438.46 $1,510.12 $2,031.88 |
$1,443.70 $1,757.72 $1,829.38 $2,351.14 |
Toc - Plan #23 BridgeSpan Health Company | ||||||||||||||||||||
Silver
(HMO) BridgeSpan Standard Silver Plan |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-857-9945
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$357.84 $497.40 $529.25 $761.13 $1,073.52 |
$641.61 $781.17 $813.02 $1,044.90 |
$925.38 $1,064.94 $1,096.79 $1,328.67 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$715.68 $994.80 $1,058.50 $1,522.26 $2,147.04 |
$999.45 $1,278.57 $1,342.27 $1,806.03 |
$1,283.22 $1,562.34 $1,626.04 $2,089.80 |
Toc - Plan #24 BridgeSpan Health Company | ||||||||||||||||||||
Expanded Bronze
(HMO) BridgeSpan Standard Bronze Plan |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-857-9945
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$270.37 $375.82 $399.88 $575.08 $811.11 |
$484.77 $590.22 $614.28 $789.48 |
$699.17 $804.62 $828.68 $1,003.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$540.74 $751.64 $799.76 $1,150.16 $1,622.22 |
$755.14 $966.04 $1,014.16 $1,364.56 |
$969.54 $1,180.44 $1,228.56 $1,578.96 |
ADVERTISEMENT
Aetna CVS HealthLocal: 1-844-365-7373 | Toll Free: 1-844-365-7373 |
Toc - Plan #25 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: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$227.20 $315.81 $336.03 $483.26 $681.60 |
$407.37 $495.98 $516.20 $663.43 |
$587.54 $676.15 $696.37 $843.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$454.40 $631.62 $672.06 $966.52 $1,363.20 |
$634.57 $811.79 $852.23 $1,146.69 |
$814.74 $991.96 $1,032.40 $1,326.86 |
Toc - Plan #26 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: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$255.24 $354.79 $377.50 $542.90 $765.72 |
$457.65 $557.20 $579.91 $745.31 |
$660.06 $759.61 $782.32 $947.72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$510.48 $709.58 $755.00 $1,085.80 $1,531.44 |
$712.89 $911.99 $957.41 $1,288.21 |
$915.30 $1,114.40 $1,159.82 $1,490.62 |
Toc - Plan #27 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: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$256.23 $356.16 $378.96 $544.99 $768.67 |
$459.42 $559.35 $582.15 $748.18 |
$662.61 $762.54 $785.34 $951.37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$512.46 $712.32 $757.92 $1,089.98 $1,537.34 |
$715.65 $915.51 $961.11 $1,293.17 |
$918.84 $1,118.70 $1,164.30 $1,496.36 |
Toc - Plan #28 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: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$340.97 $473.95 $504.30 $725.24 $1,022.91 |
$611.36 $744.34 $774.69 $995.63 |
$881.75 $1,014.73 $1,045.08 $1,266.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$681.94 $947.90 $1,008.60 $1,450.48 $2,045.82 |
$952.33 $1,218.29 $1,278.99 $1,720.87 |
$1,222.72 $1,488.68 $1,549.38 $1,991.26 |
Toc - Plan #29 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: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$369.73 $513.92 $546.83 $786.41 $1,109.18 |
$662.93 $807.12 $840.03 $1,079.61 |
$956.13 $1,100.32 $1,133.23 $1,372.81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$739.46 $1,027.84 $1,093.66 $1,572.82 $2,218.36 |
$1,032.66 $1,321.04 $1,386.86 $1,866.02 |
$1,325.86 $1,614.24 $1,680.06 $2,159.22 |
Toc - Plan #30 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: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$311.16 $432.52 $460.21 $661.84 $933.48 |
$557.91 $679.27 $706.96 $908.59 |
$804.66 $926.02 $953.71 $1,155.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$622.32 $865.04 $920.42 $1,323.68 $1,866.96 |
$869.07 $1,111.79 $1,167.17 $1,570.43 |
$1,115.82 $1,358.54 $1,413.92 $1,817.18 |
Toc - Plan #31 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: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$310.43 $431.49 $459.12 $660.27 $931.27 |
$556.60 $677.66 $705.29 $906.44 |
$802.77 $923.83 $951.46 $1,152.61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$620.86 $862.98 $918.24 $1,320.54 $1,862.54 |
$867.03 $1,109.15 $1,164.41 $1,566.71 |
$1,113.20 $1,355.32 $1,410.58 $1,812.88 |
Toc - Plan #32 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: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$310.17 $431.13 $458.73 $659.72 $930.49 |
$556.13 $677.09 $704.69 $905.68 |
$802.09 $923.05 $950.65 $1,151.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$620.34 $862.26 $917.46 $1,319.44 $1,860.98 |
$866.30 $1,108.22 $1,163.42 $1,565.40 |
$1,112.26 $1,354.18 $1,409.38 $1,811.36 |
Toc - Plan #33 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: 1-844-365-7373
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$340.09 $472.72 $502.99 $723.37 $1,020.26 |
$609.78 $742.41 $772.68 $993.06 |
$879.47 $1,012.10 $1,042.37 $1,262.75 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$680.18 $945.44 $1,005.98 $1,446.74 $2,040.52 |
$949.87 $1,215.13 $1,275.67 $1,716.43 |
$1,219.56 $1,484.82 $1,545.36 $1,986.12 |
ADVERTISEMENT
University of Utah Health PlansLocal: 1-801-213-4111x1 | Toll Free: 1-833-981-0214 | TTY: 1-800-346-4128 |
Toc - Plan #34 University of Utah Health Plans | ||||||||||||||||||||
Gold
(EPO) Healthy Premier Gold Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-981-0214
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$461.25 $641.14 $682.19 $981.08 $1,383.75 |
$827.02 $1,006.91 $1,047.96 $1,346.85 |
$1,192.79 $1,372.68 $1,413.73 $1,712.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$922.50 $1,282.28 $1,364.38 $1,962.16 $2,767.50 |
$1,288.27 $1,648.05 $1,730.15 $2,327.93 |
$1,654.04 $2,013.82 $2,095.92 $2,693.70 |
Toc - Plan #35 University of Utah Health Plans | ||||||||||||||||||||
Silver
(EPO) Healthy Premier Silver Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-981-0214
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$420.39 $584.34 $621.76 $894.17 $1,261.17 |
$753.76 $917.71 $955.13 $1,227.54 |
$1,087.13 $1,251.08 $1,288.50 $1,560.91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$840.78 $1,168.68 $1,243.52 $1,788.34 $2,522.34 |
$1,174.15 $1,502.05 $1,576.89 $2,121.71 |
$1,507.52 $1,835.42 $1,910.26 $2,455.08 |
Toc - Plan #36 University of Utah Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Healthy Premier Bronze HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-981-0214
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$281.76 $391.65 $416.72 $599.30 $845.28 |
$505.20 $615.09 $640.16 $822.74 |
$728.64 $838.53 $863.60 $1,046.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$563.52 $783.30 $833.44 $1,198.60 $1,690.56 |
$786.96 $1,006.74 $1,056.88 $1,422.04 |
$1,010.40 $1,230.18 $1,280.32 $1,645.48 |
Toc - Plan #37 University of Utah Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Healthy Premier Expanded Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-981-0214
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$305.41 $424.52 $451.70 $649.61 $916.23 |
$547.60 $666.71 $693.89 $891.80 |
$789.79 $908.90 $936.08 $1,133.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$610.82 $849.04 $903.40 $1,299.22 $1,832.46 |
$853.01 $1,091.23 $1,145.59 $1,541.41 |
$1,095.20 $1,333.42 $1,387.78 $1,783.60 |
Toc - Plan #38 University of Utah Health Plans | ||||||||||||||||||||
Gold
(EPO) Healthy Premier Gold Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-981-0214
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$445.70 $619.52 $659.19 $948.00 $1,337.10 |
$799.14 $972.96 $1,012.63 $1,301.44 |
$1,152.58 $1,326.40 $1,366.07 $1,654.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$891.40 $1,239.04 $1,318.38 $1,896.00 $2,674.20 |
$1,244.84 $1,592.48 $1,671.82 $2,249.44 |
$1,598.28 $1,945.92 $2,025.26 $2,602.88 |
Toc - Plan #39 University of Utah Health Plans | ||||||||||||||||||||
Silver
(EPO) Healthy Premier Silver Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-981-0214
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$418.27 $581.40 $618.62 $889.66 $1,254.81 |
$749.96 $913.09 $950.31 $1,221.35 |
$1,081.65 $1,244.78 $1,282.00 $1,553.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$836.54 $1,162.80 $1,237.24 $1,779.32 $2,509.62 |
$1,168.23 $1,494.49 $1,568.93 $2,111.01 |
$1,499.92 $1,826.18 $1,900.62 $2,442.70 |
Toc - Plan #40 University of Utah Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Healthy Premier Expanded Bronze Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-981-0214
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$310.60 $431.73 $459.38 $660.65 $931.80 |
$556.91 $678.04 $705.69 $906.96 |
$803.22 $924.35 $952.00 $1,153.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$621.20 $863.46 $918.76 $1,321.30 $1,863.60 |
$867.51 $1,109.77 $1,165.07 $1,567.61 |
$1,113.82 $1,356.08 $1,411.38 $1,813.92 |
Toc - Plan #41 University of Utah Health Plans | ||||||||||||||||||||
Gold
(EPO) U Health Plus Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-981-0214
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$370.20 $514.58 $547.53 $787.42 $1,110.60 |
$663.77 $808.15 $841.10 $1,080.99 |
$957.34 $1,101.72 $1,134.67 $1,374.56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$740.40 $1,029.16 $1,095.06 $1,574.84 $2,221.20 |
$1,033.97 $1,322.73 $1,388.63 $1,868.41 |
$1,327.54 $1,616.30 $1,682.20 $2,161.98 |
Toc - Plan #42 University of Utah Health Plans | ||||||||||||||||||||
Silver
(EPO) U Health Plus Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-981-0214
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$358.80 $498.73 $530.67 $763.17 $1,076.40 |
$643.33 $783.26 $815.20 $1,047.70 |
$927.86 $1,067.79 $1,099.73 $1,332.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$717.60 $997.46 $1,061.34 $1,526.34 $2,152.80 |
$1,002.13 $1,281.99 $1,345.87 $1,810.87 |
$1,286.66 $1,566.52 $1,630.40 $2,095.40 |
Toc - Plan #43 University of Utah Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) U Health Plus Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-981-0214
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$250.05 $347.57 $369.82 $531.86 $750.15 |
$448.34 $545.86 $568.11 $730.15 |
$646.63 $744.15 $766.40 $928.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$500.10 $695.14 $739.64 $1,063.72 $1,500.30 |
$698.39 $893.43 $937.93 $1,262.01 |
$896.68 $1,091.72 $1,136.22 $1,460.30 |
Toc - Plan #44 University of Utah Health Plans | ||||||||||||||||||||
Gold
(EPO) U Health Plus Gold Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-981-0214
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$361.40 $502.35 $534.51 $768.70 $1,084.20 |
$647.99 $788.94 $821.10 $1,055.29 |
$934.58 $1,075.53 $1,107.69 $1,341.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$722.80 $1,004.70 $1,069.02 $1,537.40 $2,168.40 |
$1,009.39 $1,291.29 $1,355.61 $1,823.99 |
$1,295.98 $1,577.88 $1,642.20 $2,110.58 |
Toc - Plan #45 University of Utah Health Plans | ||||||||||||||||||||
Silver
(EPO) U Health Plus Silver Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-981-0214
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$356.91 $496.10 $527.87 $759.15 $1,070.73 |
$639.94 $779.13 $810.90 $1,042.18 |
$922.97 $1,062.16 $1,093.93 $1,325.21 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$713.82 $992.20 $1,055.74 $1,518.30 $2,141.46 |
$996.85 $1,275.23 $1,338.77 $1,801.33 |
$1,279.88 $1,558.26 $1,621.80 $2,084.36 |
Toc - Plan #46 University of Utah Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) U Health Plus Expanded Bronze Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-981-0214
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$251.87 $350.10 $372.52 $535.73 $755.61 |
$451.60 $549.83 $572.25 $735.46 |
$651.33 $749.56 $771.98 $935.19 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$503.74 $700.20 $745.04 $1,071.46 $1,511.22 |
$703.47 $899.93 $944.77 $1,271.19 |
$903.20 $1,099.66 $1,144.50 $1,470.92 |
Toc - Plan #47 University of Utah Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Healthy Premier Bronze w.3 Copays |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-981-0214
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$311.56 $433.07 $460.80 $662.69 $934.68 |
$558.63 $680.14 $707.87 $909.76 |
$805.70 $927.21 $954.94 $1,156.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$623.12 $866.14 $921.60 $1,325.38 $1,869.36 |
$870.19 $1,113.21 $1,168.67 $1,572.45 |
$1,117.26 $1,360.28 $1,415.74 $1,819.52 |
Toc - Plan #48 University of Utah Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Healthy Premier Expanded Bronze Standard Choice |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-833-981-0214
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$310.60 $431.73 $459.38 $660.65 $931.80 |
$556.91 $678.04 $705.69 $906.96 |
$803.22 $924.35 $952.00 $1,153.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$621.20 $863.46 $918.76 $1,321.30 $1,863.60 |
$867.51 $1,109.77 $1,165.07 $1,567.61 |
$1,113.82 $1,356.08 $1,411.38 $1,813.92 |
ADVERTISEMENT
Select HealthLocal: 1-801-442-5038 | Toll Free: 1-800-538-5038 |
Toc - Plan #49 Select Health | ||||||||||||||||||||
Gold
(HMO) Med Gold 1500 Medical Deductible - no deductible for office visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$446.06 $620.03 $659.73 $948.78 $1,338.18 |
$799.79 $973.76 $1,013.46 $1,302.51 |
$1,153.52 $1,327.49 $1,367.19 $1,656.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$892.12 $1,240.06 $1,319.46 $1,897.56 $2,676.36 |
$1,245.85 $1,593.79 $1,673.19 $2,251.29 |
$1,599.58 $1,947.52 $2,026.92 $2,605.02 |
Toc - Plan #50 Select Health | ||||||||||||||||||||
Expanded Bronze
(HMO) Med Expanded Bronze 8050 Deductible - HSA Qualified |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$323.89 $450.20 $479.03 $688.91 $971.66 |
$580.73 $707.04 $735.87 $945.75 |
$837.57 $963.88 $992.71 $1,202.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$647.78 $900.40 $958.06 $1,377.82 $1,943.32 |
$904.62 $1,157.24 $1,214.90 $1,634.66 |
$1,161.46 $1,414.08 $1,471.74 $1,891.50 |
Toc - Plan #51 Select Health | ||||||||||||||||||||
Gold
(HMO) Value Gold 1500 Medical Deductible - no deductible for office visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$390.00 $542.11 $576.82 $829.54 $1,170.00 |
$699.27 $851.38 $886.09 $1,138.81 |
$1,008.54 $1,160.65 $1,195.36 $1,448.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$780.00 $1,084.22 $1,153.64 $1,659.08 $2,340.00 |
$1,089.27 $1,393.49 $1,462.91 $1,968.35 |
$1,398.54 $1,702.76 $1,772.18 $2,277.62 |
Toc - Plan #52 Select Health | ||||||||||||||||||||
Silver
(HMO) Value Silver 3000 Medical Deductible - no deductible for office visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$333.45 $463.50 $493.17 $709.25 $1,000.35 |
$597.88 $727.93 $757.60 $973.68 |
$862.31 $992.36 $1,022.03 $1,238.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$666.90 $927.00 $986.34 $1,418.50 $2,000.70 |
$931.33 $1,191.43 $1,250.77 $1,682.93 |
$1,195.76 $1,455.86 $1,515.20 $1,947.36 |
Toc - Plan #53 Select Health | ||||||||||||||||||||
Expanded Bronze
(HMO) Value Expanded Bronze 6900 Medical Deductible - no deductible for office visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$257.63 $358.10 $381.03 $547.98 $772.89 |
$461.93 $562.40 $585.33 $752.28 |
$666.23 $766.70 $789.63 $956.58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$515.26 $716.20 $762.06 $1,095.96 $1,545.78 |
$719.56 $920.50 $966.36 $1,300.26 |
$923.86 $1,124.80 $1,170.66 $1,504.56 |
Toc - Plan #54 Select Health | ||||||||||||||||||||
Gold
(HMO) Signature Gold 1500 Medical Deductible - no deductible for office visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$379.92 $528.09 $561.90 $808.09 $1,139.76 |
$681.20 $829.37 $863.18 $1,109.37 |
$982.48 $1,130.65 $1,164.46 $1,410.65 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$759.84 $1,056.18 $1,123.80 $1,616.18 $2,279.52 |
$1,061.12 $1,357.46 $1,425.08 $1,917.46 |
$1,362.40 $1,658.74 $1,726.36 $2,218.74 |
Toc - Plan #55 Select Health | ||||||||||||||||||||
Silver
(HMO) Value Benchmark Silver 5900 Medical Deductible - no deductible for office visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$318.37 $442.53 $470.87 $677.17 $955.11 |
$570.84 $695.00 $723.34 $929.64 |
$823.31 $947.47 $975.81 $1,182.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$636.74 $885.06 $941.74 $1,354.34 $1,910.22 |
$889.21 $1,137.53 $1,194.21 $1,606.81 |
$1,141.68 $1,390.00 $1,446.68 $1,859.28 |
Toc - Plan #56 Select Health | ||||||||||||||||||||
Silver
(HMO) Med Benchmark Silver 5900 Medical Deductible - no deductible for office visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$364.13 $506.14 $538.55 $774.51 $1,092.39 |
$652.89 $794.90 $827.31 $1,063.27 |
$941.65 $1,083.66 $1,116.07 $1,352.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$728.26 $1,012.28 $1,077.10 $1,549.02 $2,184.78 |
$1,017.02 $1,301.04 $1,365.86 $1,837.78 |
$1,305.78 $1,589.80 $1,654.62 $2,126.54 |
Toc - Plan #57 Select Health | ||||||||||||||||||||
Expanded Bronze
(HMO) Value Benchmark Expanded Bronze Copay Plan |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$266.42 $370.32 $394.04 $566.68 $799.26 |
$477.69 $581.59 $605.31 $777.95 |
$688.96 $792.86 $816.58 $989.22 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$532.84 $740.64 $788.08 $1,133.36 $1,598.52 |
$744.11 $951.91 $999.35 $1,344.63 |
$955.38 $1,163.18 $1,210.62 $1,555.90 |
Toc - Plan #58 Select Health | ||||||||||||||||||||
Expanded Bronze
(HMO) Med Benchmark Expanded Bronze Copay Plan |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$304.72 $423.56 $450.68 $648.13 $914.15 |
$546.36 $665.20 $692.32 $889.77 |
$788.00 $906.84 $933.96 $1,131.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$609.44 $847.12 $901.36 $1,296.26 $1,828.30 |
$851.08 $1,088.76 $1,143.00 $1,537.90 |
$1,092.72 $1,330.40 $1,384.64 $1,779.54 |
Toc - Plan #59 Select Health | ||||||||||||||||||||
Silver
(HMO) Signature Benchmark Silver 5900 Medical Deductible - no deductible for office visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$310.14 $431.09 $458.69 $659.66 $930.41 |
$556.08 $677.03 $704.63 $905.60 |
$802.02 $922.97 $950.57 $1,151.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$620.28 $862.18 $917.38 $1,319.32 $1,860.82 |
$866.22 $1,108.12 $1,163.32 $1,565.26 |
$1,112.16 $1,354.06 $1,409.26 $1,811.20 |
Toc - Plan #60 Select Health | ||||||||||||||||||||
Gold
(HMO) Med Benchmark Gold Standardized Plan |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$493.02 $685.30 $729.17 $1,048.65 $1,479.05 |
$883.98 $1,076.26 $1,120.13 $1,439.61 |
$1,274.94 $1,467.22 $1,511.09 $1,830.57 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$986.04 $1,370.60 $1,458.34 $2,097.30 $2,958.10 |
$1,377.00 $1,761.56 $1,849.30 $2,488.26 |
$1,767.96 $2,152.52 $2,240.26 $2,879.22 |
Toc - Plan #61 Select Health | ||||||||||||||||||||
Silver
(HMO) Med Benchmark Silver Standardized Plan |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$417.34 $580.10 $617.24 $887.68 $1,252.01 |
$748.29 $911.05 $948.19 $1,218.63 |
$1,079.24 $1,242.00 $1,279.14 $1,549.58 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$834.68 $1,160.20 $1,234.48 $1,775.36 $2,504.02 |
$1,165.63 $1,491.15 $1,565.43 $2,106.31 |
$1,496.58 $1,822.10 $1,896.38 $2,437.26 |
Toc - Plan #62 Select Health | ||||||||||||||||||||
Expanded Bronze
(HMO) Med Benchmark Expanded Bronze Standardized Plan |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$332.50 $462.18 $491.77 $707.24 $997.50 |
$596.18 $725.86 $755.45 $970.92 |
$859.86 $989.54 $1,019.13 $1,234.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$665.00 $924.36 $983.54 $1,414.48 $1,995.00 |
$928.68 $1,188.04 $1,247.22 $1,678.16 |
$1,192.36 $1,451.72 $1,510.90 $1,941.84 |
Toc - Plan #63 Select Health | ||||||||||||||||||||
Gold
(HMO) Value Benchmark Gold Standardized Plan |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$431.06 $599.17 $637.53 $916.86 $1,293.17 |
$772.89 $941.00 $979.36 $1,258.69 |
$1,114.72 $1,282.83 $1,321.19 $1,600.52 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$862.12 $1,198.34 $1,275.06 $1,833.72 $2,586.34 |
$1,203.95 $1,540.17 $1,616.89 $2,175.55 |
$1,545.78 $1,882.00 $1,958.72 $2,517.38 |
Toc - Plan #64 Select Health | ||||||||||||||||||||
Silver
(HMO) Value Benchmark Silver Standardized Plan |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$364.89 $507.19 $539.67 $776.11 $1,094.66 |
$654.25 $796.55 $829.03 $1,065.47 |
$943.61 $1,085.91 $1,118.39 $1,354.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$729.78 $1,014.38 $1,079.34 $1,552.22 $2,189.32 |
$1,019.14 $1,303.74 $1,368.70 $1,841.58 |
$1,308.50 $1,593.10 $1,658.06 $2,130.94 |
Toc - Plan #65 Select Health | ||||||||||||||||||||
Gold
(HMO) Signature Benchmark Gold Standardized Plan |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$419.91 $583.68 $621.05 $893.15 $1,259.73 |
$752.90 $916.67 $954.04 $1,226.14 |
$1,085.89 $1,249.66 $1,287.03 $1,559.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$839.82 $1,167.36 $1,242.10 $1,786.30 $2,519.46 |
$1,172.81 $1,500.35 $1,575.09 $2,119.29 |
$1,505.80 $1,833.34 $1,908.08 $2,452.28 |
Toc - Plan #66 Select Health | ||||||||||||||||||||
Silver
(HMO) Signature Benchmark Silver Standardized Plan |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$355.45 $494.08 $525.72 $756.05 $1,066.35 |
$637.32 $775.95 $807.59 $1,037.92 |
$919.19 $1,057.82 $1,089.46 $1,319.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$710.90 $988.16 $1,051.44 $1,512.10 $2,132.70 |
$992.77 $1,270.03 $1,333.31 $1,793.97 |
$1,274.64 $1,551.90 $1,615.18 $2,075.84 |
Toc - Plan #67 Select Health | ||||||||||||||||||||
Gold
(HMO) Signature Benchmark Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$388.09 $539.44 $573.98 $825.46 $1,164.26 |
$695.84 $847.19 $881.73 $1,133.21 |
$1,003.59 $1,154.94 $1,189.48 $1,440.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$776.18 $1,078.88 $1,147.96 $1,650.92 $2,328.52 |
$1,083.93 $1,386.63 $1,455.71 $1,958.67 |
$1,391.68 $1,694.38 $1,763.46 $2,266.42 |
Toc - Plan #68 Select Health | ||||||||||||||||||||
Platinum
(HMO) Value Benchmark Platinum |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$480.06 $667.29 $710.01 $1,021.09 $1,440.18 |
$860.75 $1,047.98 $1,090.70 $1,401.78 |
$1,241.44 $1,428.67 $1,471.39 $1,782.47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$960.12 $1,334.58 $1,420.02 $2,042.18 $2,880.36 |
$1,340.81 $1,715.27 $1,800.71 $2,422.87 |
$1,721.50 $2,095.96 $2,181.40 $2,803.56 |
Toc - Plan #69 Select Health | ||||||||||||||||||||
Platinum
(HMO) Med Benchmark Platinum |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$549.07 $763.20 $812.07 $1,167.87 $1,647.20 |
$984.48 $1,198.61 $1,247.48 $1,603.28 |
$1,419.89 $1,634.02 $1,682.89 $2,038.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,098.14 $1,526.40 $1,624.14 $2,335.74 $3,294.40 |
$1,533.55 $1,961.81 $2,059.55 $2,771.15 |
$1,968.96 $2,397.22 $2,494.96 $3,206.56 |
Toc - Plan #70 Select Health | ||||||||||||||||||||
Platinum
(HMO) Signature Benchmark Platinum |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$467.65 $650.03 $691.66 $994.69 $1,402.95 |
$838.50 $1,020.88 $1,062.51 $1,365.54 |
$1,209.35 $1,391.73 $1,433.36 $1,736.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$935.30 $1,300.06 $1,383.32 $1,989.38 $2,805.90 |
$1,306.15 $1,670.91 $1,754.17 $2,360.23 |
$1,677.00 $2,041.76 $2,125.02 $2,731.08 |
Toc - Plan #71 Select Health | ||||||||||||||||||||
Platinum
(HMO) Med Benchmark Platinum Standardized Plan |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$597.01 $829.84 $882.98 $1,269.84 $1,791.03 |
$1,070.44 $1,303.27 $1,356.41 $1,743.27 |
$1,543.87 $1,776.70 $1,829.84 $2,216.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,194.02 $1,659.68 $1,765.96 $2,539.68 $3,582.06 |
$1,667.45 $2,133.11 $2,239.39 $3,013.11 |
$2,140.88 $2,606.54 $2,712.82 $3,486.54 |
Toc - Plan #72 Select Health | ||||||||||||||||||||
Platinum
(HMO) Value Benchmark Platinum Standardized Plan |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$521.98 $725.55 $772.01 $1,110.25 $1,565.93 |
$935.91 $1,139.48 $1,185.94 $1,524.18 |
$1,349.84 $1,553.41 $1,599.87 $1,938.11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,043.96 $1,451.10 $1,544.02 $2,220.50 $3,131.86 |
$1,457.89 $1,865.03 $1,957.95 $2,634.43 |
$1,871.82 $2,278.96 $2,371.88 $3,048.36 |
Toc - Plan #73 Select Health | ||||||||||||||||||||
Platinum
(HMO) Signature Benchmark Platinum Standardized Plan |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$508.48 $706.79 $752.05 $1,081.54 $1,525.44 |
$911.71 $1,110.02 $1,155.28 $1,484.77 |
$1,314.94 $1,513.25 $1,558.51 $1,888.00 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,016.96 $1,413.58 $1,504.10 $2,163.08 $3,050.88 |
$1,420.19 $1,816.81 $1,907.33 $2,566.31 |
$1,823.42 $2,220.04 $2,310.56 $2,969.54 |
ADVERTISEMENT
Cigna HealthcareLocal: 1-877-900-1237 | Toll Free: 1-877-900-1237 | TTY: 1-800-676-3777 |
Toc - Plan #74 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Connect Bronze 4500 Indiv Med Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$282.03 $392.02 $417.12 $599.88 $846.09 |
$505.68 $615.67 $640.77 $823.53 |
$729.33 $839.32 $864.42 $1,047.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$564.06 $784.04 $834.24 $1,199.76 $1,692.18 |
$787.71 $1,007.69 $1,057.89 $1,423.41 |
$1,011.36 $1,231.34 $1,281.54 $1,647.06 |
Toc - Plan #75 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Connect Bronze 5500 Indiv Med Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$284.99 $396.13 $421.50 $606.17 $854.96 |
$510.98 $622.12 $647.49 $832.16 |
$736.97 $848.11 $873.48 $1,058.15 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$569.98 $792.26 $843.00 $1,212.34 $1,709.92 |
$795.97 $1,018.25 $1,068.99 $1,438.33 |
$1,021.96 $1,244.24 $1,294.98 $1,664.32 |
Toc - Plan #76 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Connect Silver 800 Indiv Med Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$355.41 $494.02 $525.65 $755.95 $1,066.22 |
$637.25 $775.86 $807.49 $1,037.79 |
$919.09 $1,057.70 $1,089.33 $1,319.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$710.82 $988.04 $1,051.30 $1,511.90 $2,132.44 |
$992.66 $1,269.88 $1,333.14 $1,793.74 |
$1,274.50 $1,551.72 $1,614.98 $2,075.58 |
Toc - Plan #77 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Connect Silver 5000 Indiv Med Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$357.66 $497.14 $528.97 $760.74 $1,072.97 |
$641.28 $780.76 $812.59 $1,044.36 |
$924.90 $1,064.38 $1,096.21 $1,327.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$715.32 $994.28 $1,057.94 $1,521.48 $2,145.94 |
$998.94 $1,277.90 $1,341.56 $1,805.10 |
$1,282.56 $1,561.52 $1,625.18 $2,088.72 |
Toc - Plan #78 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Connect Bronze 6500 Indiv Med Deductible Enhanced Diabetes Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$284.63 $395.64 $420.97 $605.42 $853.89 |
$510.35 $621.36 $646.69 $831.14 |
$736.07 $847.08 $872.41 $1,056.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$569.26 $791.28 $841.94 $1,210.84 $1,707.78 |
$794.98 $1,017.00 $1,067.66 $1,436.56 |
$1,020.70 $1,242.72 $1,293.38 $1,662.28 |
Toc - Plan #79 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Connect Silver CMS Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$355.89 $494.69 $526.36 $756.98 $1,067.67 |
$638.11 $776.91 $808.58 $1,039.20 |
$920.33 $1,059.13 $1,090.80 $1,321.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$711.78 $989.38 $1,052.72 $1,513.96 $2,135.34 |
$994.00 $1,271.60 $1,334.94 $1,796.18 |
$1,276.22 $1,553.82 $1,617.16 $2,078.40 |
Toc - Plan #80 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Connect Bronze 0 Indiv Med Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$315.30 $438.27 $466.33 $670.64 $945.90 |
$565.33 $688.30 $716.36 $920.67 |
$815.36 $938.33 $966.39 $1,170.70 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$630.60 $876.54 $932.66 $1,341.28 $1,891.80 |
$880.63 $1,126.57 $1,182.69 $1,591.31 |
$1,130.66 $1,376.60 $1,432.72 $1,841.34 |
Toc - Plan #81 Cigna Healthcare | ||||||||||||||||||||
Gold
(EPO) Connect Gold CMS Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$433.81 $603.00 $641.61 $922.72 $1,301.43 |
$777.82 $947.01 $985.62 $1,266.73 |
$1,121.83 $1,291.02 $1,329.63 $1,610.74 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$867.62 $1,206.00 $1,283.22 $1,845.44 $2,602.86 |
$1,211.63 $1,550.01 $1,627.23 $2,189.45 |
$1,555.64 $1,894.02 $1,971.24 $2,533.46 |
Toc - Plan #82 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Connect Bronze CMS Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$284.19 $395.03 $420.32 $604.48 $852.57 |
$509.56 $620.40 $645.69 $829.85 |
$734.93 $845.77 $871.06 $1,055.22 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$568.38 $790.06 $840.64 $1,208.96 $1,705.14 |
$793.75 $1,015.43 $1,066.01 $1,434.33 |
$1,019.12 $1,240.80 $1,291.38 $1,659.70 |
ADVERTISEMENT
Imperial Health Plan of the Southwest, Inc.Local: 1-626-838-5100x8 | Toll Free: 1-800-595-0619 | TTY: 1-800-595-0619 |
Toc - Plan #83 Imperial Health Plan of the Southwest, Inc. | ||||||||||||||||||||
Expanded Bronze
(HMO) Imperial Standard Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-595-0619
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$262.39 $364.72 $388.07 $558.10 $787.16 |
$470.47 $572.80 $596.15 $766.18 |
$678.55 $780.88 $804.23 $974.26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$524.78 $729.44 $776.14 $1,116.20 $1,574.32 |
$732.86 $937.52 $984.22 $1,324.28 |
$940.94 $1,145.60 $1,192.30 $1,532.36 |
Toc - Plan #84 Imperial Health Plan of the Southwest, Inc. | ||||||||||||||||||||
Silver
(HMO) Imperial Standard Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-595-0619
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$349.32 $485.56 $516.65 $743.01 $1,047.96 |
$626.33 $762.57 $793.66 $1,020.02 |
$903.34 $1,039.58 $1,070.67 $1,297.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$698.64 $971.12 $1,033.30 $1,486.02 $2,095.92 |
$975.65 $1,248.13 $1,310.31 $1,763.03 |
$1,252.66 $1,525.14 $1,587.32 $2,040.04 |
Toc - Plan #85 Imperial Health Plan of the Southwest, Inc. | ||||||||||||||||||||
Gold
(HMO) Imperial Standard Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-595-0619
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$406.42 $564.93 $601.10 $864.46 $1,219.25 |
$728.71 $887.22 $923.39 $1,186.75 |
$1,051.00 $1,209.51 $1,245.68 $1,509.04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$812.84 $1,129.86 $1,202.20 $1,728.92 $2,438.50 |
$1,135.13 $1,452.15 $1,524.49 $2,051.21 |
$1,457.42 $1,774.44 $1,846.78 $2,373.50 |
Toc - Plan #86 Imperial Health Plan of the Southwest, Inc. | ||||||||||||||||||||
Silver
(HMO) Imperial Preferred Silver |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-595-0619
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$353.78 $491.76 $523.24 $752.50 $1,061.33 |
$634.33 $772.31 $803.79 $1,033.05 |
$914.88 $1,052.86 $1,084.34 $1,313.60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$707.56 $983.52 $1,046.48 $1,505.00 $2,122.66 |
$988.11 $1,264.07 $1,327.03 $1,785.55 |
$1,268.66 $1,544.62 $1,607.58 $2,066.10 |
Toc - Plan #87 Imperial Health Plan of the Southwest, Inc. | ||||||||||||||||||||
Gold
(HMO) Imperial Preferred Gold |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-595-0619
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$419.88 $583.64 $621.01 $893.09 $1,259.63 |
$752.85 $916.61 $953.98 $1,226.06 |
$1,085.82 $1,249.58 $1,286.95 $1,559.03 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$839.76 $1,167.28 $1,242.02 $1,786.18 $2,519.26 |
$1,172.73 $1,500.25 $1,574.99 $2,119.15 |
$1,505.70 $1,833.22 $1,907.96 $2,452.12 |
‡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 Salt Lake County here.
Salt Lake County is in “Rating Area 3” of Utah.
Currently, there are 87 plans offered in Rating Area 3.