Portage County, Wisconsin 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 Portage County, WI.

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, 48 Plans and 2024 Rates for Portage County, Wisconsin

Below, you’ll find a summary of the 48 plans for Portage County, Wisconsin 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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Security Health Plan

Local: 1-715-221-9258x19258 | Toll Free: 1-844-293-9624 | TTY: 1-800-947-3529

Toc - Plan #1 Security Health Plan
Gold

(EPO) SimplyOne $3,500 - 30%

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-293-9624

Annual Out of Pocket Expenses:

Individual Family
$3,500 $7,000 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$413.93
$469.80
$528.99
$739.26
$1,123.37
$730.58
$786.45
$845.64
$1,055.91
$1,047.23
$1,103.10
$1,162.29
$1,372.56
$1,363.88
$1,419.75
$1,478.94
$1,689.21
$316.65
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$827.86
$939.60
$1,057.98
$1,478.52
$2,246.74
$1,144.51
$1,256.25
$1,374.63
$1,795.17
$1,461.16
$1,572.90
$1,691.28
$2,111.82
$1,777.81
$1,889.55
$2,007.93
$2,428.47
$316.65
Toc - Plan #2 Security Health Plan
Silver

(EPO) SimplyOne $4,100 HDHP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-293-9624

Annual Out of Pocket Expenses:

Individual Family
$4,100 $8,200 Annual Deductible
$7,050 $14,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$453.27
$514.45
$579.26
$809.52
$1,230.14
$800.01
$861.19
$926.00
$1,156.26
$1,146.75
$1,207.93
$1,272.74
$1,503.00
$1,493.49
$1,554.67
$1,619.48
$1,849.74
$346.74
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$906.54
$1,028.90
$1,158.52
$1,619.04
$2,460.28
$1,253.28
$1,375.64
$1,505.26
$1,965.78
$1,600.02
$1,722.38
$1,852.00
$2,312.52
$1,946.76
$2,069.12
$2,198.74
$2,659.26
$346.74
Toc - Plan #3 Security Health Plan
Expanded Bronze

(EPO) SimplyOne $6,200 HDHP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-293-9624

Annual Out of Pocket Expenses:

Individual Family
$6,200 $12,400 Annual Deductible
$7,550 $15,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$329.60
$374.09
$421.22
$588.65
$894.51
$581.74
$626.23
$673.36
$840.79
$833.88
$878.37
$925.50
$1,092.93
$1,086.02
$1,130.51
$1,177.64
$1,345.07
$252.14
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$659.20
$748.18
$842.44
$1,177.30
$1,789.02
$911.34
$1,000.32
$1,094.58
$1,429.44
$1,163.48
$1,252.46
$1,346.72
$1,681.58
$1,415.62
$1,504.60
$1,598.86
$1,933.72
$252.14
Toc - Plan #4 Security Health Plan
Bronze

(EPO) SimplyOne $9,100

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-293-9624

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$288.28
$327.19
$368.41
$514.86
$782.38
$508.81
$547.72
$588.94
$735.39
$729.34
$768.25
$809.47
$955.92
$949.87
$988.78
$1,030.00
$1,176.45
$220.53
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$576.56
$654.38
$736.82
$1,029.72
$1,564.76
$797.09
$874.91
$957.35
$1,250.25
$1,017.62
$1,095.44
$1,177.88
$1,470.78
$1,238.15
$1,315.97
$1,398.41
$1,691.31
$220.53
Toc - Plan #5 Security Health Plan
Catastrophic

(EPO) SimplyOne Protection

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-293-9624

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$192.51
$218.48
$246.01
$343.80
$522.44
$339.77
$365.74
$393.27
$491.06
$487.03
$513.00
$540.53
$638.32
$634.29
$660.26
$687.79
$785.58
$147.26
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$385.02
$436.96
$492.02
$687.60
$1,044.88
$532.28
$584.22
$639.28
$834.86
$679.54
$731.48
$786.54
$982.12
$826.80
$878.74
$933.80
$1,129.38
$147.26
Toc - Plan #6 Security Health Plan
Gold

(EPO) SimplyOne $1,500 - 25%

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-293-9624

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$452.36
$513.42
$578.10
$807.89
$1,227.67
$798.41
$859.47
$924.15
$1,153.94
$1,144.46
$1,205.52
$1,270.20
$1,499.99
$1,490.51
$1,551.57
$1,616.25
$1,846.04
$346.05
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$904.72
$1,026.84
$1,156.20
$1,615.78
$2,455.34
$1,250.77
$1,372.89
$1,502.25
$1,961.83
$1,596.82
$1,718.94
$1,848.30
$2,307.88
$1,942.87
$2,064.99
$2,194.35
$2,653.93
$346.05
Toc - Plan #7 Security Health Plan
Silver

(EPO) SimplyOne $5,900 - 40%

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-293-9624

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$389.48
$442.04
$497.74
$695.59
$1,057.01
$687.42
$739.98
$795.68
$993.53
$985.36
$1,037.92
$1,093.62
$1,291.47
$1,283.30
$1,335.86
$1,391.56
$1,589.41
$297.94
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$778.96
$884.08
$995.48
$1,391.18
$2,114.02
$1,076.90
$1,182.02
$1,293.42
$1,689.12
$1,374.84
$1,479.96
$1,591.36
$1,987.06
$1,672.78
$1,777.90
$1,889.30
$2,285.00
$297.94
Toc - Plan #8 Security Health Plan
Expanded Bronze

(EPO) SimplyOne $7,500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-293-9624

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$289.15
$328.17
$369.52
$516.40
$784.73
$510.34
$549.36
$590.71
$737.59
$731.53
$770.55
$811.90
$958.78
$952.72
$991.74
$1,033.09
$1,179.97
$221.19
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$578.30
$656.34
$739.04
$1,032.80
$1,569.46
$799.49
$877.53
$960.23
$1,253.99
$1,020.68
$1,098.72
$1,181.42
$1,475.18
$1,241.87
$1,319.91
$1,402.61
$1,696.37
$221.19
Toc - Plan #9 Security Health Plan
Gold

(HMO) Premier $1,500 - 25%

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-293-9624

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$522.85
$593.42
$668.19
$933.79
$1,418.98
$922.82
$993.39
$1,068.16
$1,333.76
$1,322.79
$1,393.36
$1,468.13
$1,733.73
$1,722.76
$1,793.33
$1,868.10
$2,133.70
$399.97
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,045.70
$1,186.84
$1,336.38
$1,867.58
$2,837.96
$1,445.67
$1,586.81
$1,736.35
$2,267.55
$1,845.64
$1,986.78
$2,136.32
$2,667.52
$2,245.61
$2,386.75
$2,536.29
$3,067.49
$399.97
Toc - Plan #10 Security Health Plan
Gold

(HMO) Premier $3,500 - 30%

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-293-9624

Annual Out of Pocket Expenses:

Individual Family
$3,500 $7,000 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$478.43
$543.00
$611.42
$854.45
$1,298.43
$844.42
$908.99
$977.41
$1,220.44
$1,210.41
$1,274.98
$1,343.40
$1,586.43
$1,576.40
$1,640.97
$1,709.39
$1,952.42
$365.99
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$956.86
$1,086.00
$1,222.84
$1,708.90
$2,596.86
$1,322.85
$1,451.99
$1,588.83
$2,074.89
$1,688.84
$1,817.98
$1,954.82
$2,440.88
$2,054.83
$2,183.97
$2,320.81
$2,806.87
$365.99
Toc - Plan #11 Security Health Plan
Silver

(HMO) Premier $5,900 - 40%

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-293-9624

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$450.17
$510.93
$575.30
$803.98
$1,221.72
$794.54
$855.30
$919.67
$1,148.35
$1,138.91
$1,199.67
$1,264.04
$1,492.72
$1,483.28
$1,544.04
$1,608.41
$1,837.09
$344.37
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$900.34
$1,021.86
$1,150.60
$1,607.96
$2,443.44
$1,244.71
$1,366.23
$1,494.97
$1,952.33
$1,589.08
$1,710.60
$1,839.34
$2,296.70
$1,933.45
$2,054.97
$2,183.71
$2,641.07
$344.37
Toc - Plan #12 Security Health Plan
Silver

(HMO) Premier $4,100 HDHP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-293-9624

Annual Out of Pocket Expenses:

Individual Family
$4,100 $8,200 Annual Deductible
$7,050 $14,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$523.90
$594.61
$669.53
$935.66
$1,421.83
$924.67
$995.38
$1,070.30
$1,336.43
$1,325.44
$1,396.15
$1,471.07
$1,737.20
$1,726.21
$1,796.92
$1,871.84
$2,137.97
$400.77
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,047.80
$1,189.22
$1,339.06
$1,871.32
$2,843.66
$1,448.57
$1,589.99
$1,739.83
$2,272.09
$1,849.34
$1,990.76
$2,140.60
$2,672.86
$2,250.11
$2,391.53
$2,541.37
$3,073.63
$400.77
Toc - Plan #13 Security Health Plan
Expanded Bronze

(HMO) Premier $6,200 HDHP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-293-9624

Annual Out of Pocket Expenses:

Individual Family
$6,200 $12,400 Annual Deductible
$7,550 $15,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$380.96
$432.38
$486.86
$680.38
$1,033.90
$672.39
$723.81
$778.29
$971.81
$963.82
$1,015.24
$1,069.72
$1,263.24
$1,255.25
$1,306.67
$1,361.15
$1,554.67
$291.43
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$761.92
$864.76
$973.72
$1,360.76
$2,067.80
$1,053.35
$1,156.19
$1,265.15
$1,652.19
$1,344.78
$1,447.62
$1,556.58
$1,943.62
$1,636.21
$1,739.05
$1,848.01
$2,235.05
$291.43
Toc - Plan #14 Security Health Plan
Expanded Bronze

(HMO) Premier $7,500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-293-9624

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$334.21
$379.31
$427.10
$596.88
$907.01
$589.87
$634.97
$682.76
$852.54
$845.53
$890.63
$938.42
$1,108.20
$1,101.19
$1,146.29
$1,194.08
$1,363.86
$255.66
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$668.42
$758.62
$854.20
$1,193.76
$1,814.02
$924.08
$1,014.28
$1,109.86
$1,449.42
$1,179.74
$1,269.94
$1,365.52
$1,705.08
$1,435.40
$1,525.60
$1,621.18
$1,960.74
$255.66
Toc - Plan #15 Security Health Plan
Bronze

(HMO) Premier $9,100

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-293-9624

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$333.21
$378.18
$425.82
$595.09
$904.29
$588.10
$633.07
$680.71
$849.98
$842.99
$887.96
$935.60
$1,104.87
$1,097.88
$1,142.85
$1,190.49
$1,359.76
$254.89
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$666.42
$756.36
$851.64
$1,190.18
$1,808.58
$921.31
$1,011.25
$1,106.53
$1,445.07
$1,176.20
$1,266.14
$1,361.42
$1,699.96
$1,431.09
$1,521.03
$1,616.31
$1,954.85
$254.89
Toc - Plan #16 Security Health Plan
Catastrophic

(HMO) Premier Protection

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-293-9624

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$222.50
$252.53
$284.35
$397.37
$603.85
$392.71
$422.74
$454.56
$567.58
$562.92
$592.95
$624.77
$737.79
$733.13
$763.16
$794.98
$908.00
$170.21
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$445.00
$505.06
$568.70
$794.74
$1,207.70
$615.21
$675.27
$738.91
$964.95
$785.42
$845.48
$909.12
$1,135.16
$955.63
$1,015.69
$1,079.33
$1,305.37
$170.21

ADVERTISEMENT

Molina Healthcare

Local: 1-888-560-2043 | Toll Free: 1-888-560-2043

Toc - Plan #17 Molina Healthcare
Gold

(HMO) Gold 1

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-560-2043

Annual Out of Pocket Expenses:

Individual Family
$1,550 $3,100 Annual Deductible
$8,100 $16,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$563.08
$639.09
$719.62
$1,005.66
$1,528.20
$993.84
$1,069.85
$1,150.38
$1,436.42
$1,424.60
$1,500.61
$1,581.14
$1,867.18
$1,855.36
$1,931.37
$2,011.90
$2,297.94
$430.76
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,126.16
$1,278.18
$1,439.24
$2,011.32
$3,056.40
$1,556.92
$1,708.94
$1,870.00
$2,442.08
$1,987.68
$2,139.70
$2,300.76
$2,872.84
$2,418.44
$2,570.46
$2,731.52
$3,303.60
$430.76
Toc - Plan #18 Molina Healthcare
Silver

(HMO) Silver 1

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-560-2043

Annual Out of Pocket Expenses:

Individual Family
$5,000 $10,000 Annual Deductible
$7,850 $15,700 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$478.05
$542.58
$610.95
$853.79
$1,297.42
$843.76
$908.29
$976.66
$1,219.50
$1,209.47
$1,274.00
$1,342.37
$1,585.21
$1,575.18
$1,639.71
$1,708.08
$1,950.92
$365.71
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$956.10
$1,085.16
$1,221.90
$1,707.58
$2,594.84
$1,321.81
$1,450.87
$1,587.61
$2,073.29
$1,687.52
$1,816.58
$1,953.32
$2,439.00
$2,053.23
$2,182.29
$2,319.03
$2,804.71
$365.71
Toc - Plan #19 Molina Healthcare
Gold

(HMO) Gold 8

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-560-2043

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$581.23
$659.69
$742.81
$1,038.07
$1,577.45
$1,025.87
$1,104.33
$1,187.45
$1,482.71
$1,470.51
$1,548.97
$1,632.09
$1,927.35
$1,915.15
$1,993.61
$2,076.73
$2,371.99
$444.64
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,162.46
$1,319.38
$1,485.62
$2,076.14
$3,154.90
$1,607.10
$1,764.02
$1,930.26
$2,520.78
$2,051.74
$2,208.66
$2,374.90
$2,965.42
$2,496.38
$2,653.30
$2,819.54
$3,410.06
$444.64
Toc - Plan #20 Molina Healthcare
Silver

(HMO) Silver 8

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-560-2043

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$466.81
$529.83
$596.59
$833.73
$1,266.93
$823.92
$886.94
$953.70
$1,190.84
$1,181.03
$1,244.05
$1,310.81
$1,547.95
$1,538.14
$1,601.16
$1,667.92
$1,905.06
$357.11
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$933.62
$1,059.66
$1,193.18
$1,667.46
$2,533.86
$1,290.73
$1,416.77
$1,550.29
$2,024.57
$1,647.84
$1,773.88
$1,907.40
$2,381.68
$2,004.95
$2,130.99
$2,264.51
$2,738.79
$357.11
Toc - Plan #21 Molina Healthcare
Silver

(HMO) Silver 12 with First 4 Primary Care Visits Free

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-560-2043

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$470.64
$534.18
$601.48
$840.57
$1,277.32
$830.68
$894.22
$961.52
$1,200.61
$1,190.72
$1,254.26
$1,321.56
$1,560.65
$1,550.76
$1,614.30
$1,681.60
$1,920.69
$360.04
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$941.28
$1,068.36
$1,202.96
$1,681.14
$2,554.64
$1,301.32
$1,428.40
$1,563.00
$2,041.18
$1,661.36
$1,788.44
$1,923.04
$2,401.22
$2,021.40
$2,148.48
$2,283.08
$2,761.26
$360.04
Toc - Plan #22 Molina Healthcare
Gold

(HMO) Gold 1 with Adult Vision Services

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-560-2043

Annual Out of Pocket Expenses:

Individual Family
$1,550 $3,100 Annual Deductible
$8,100 $16,200 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$566.30
$642.75
$723.74
$1,011.42
$1,536.95
$999.52
$1,075.97
$1,156.96
$1,444.64
$1,432.74
$1,509.19
$1,590.18
$1,877.86
$1,865.96
$1,942.41
$2,023.40
$2,311.08
$433.22
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,132.60
$1,285.50
$1,447.48
$2,022.84
$3,073.90
$1,565.82
$1,718.72
$1,880.70
$2,456.06
$1,999.04
$2,151.94
$2,313.92
$2,889.28
$2,432.26
$2,585.16
$2,747.14
$3,322.50
$433.22
Toc - Plan #23 Molina Healthcare
Silver

(HMO) Silver 1 with Adult Vision Services

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-888-560-2043

Annual Out of Pocket Expenses:

Individual Family
$5,000 $10,000 Annual Deductible
$7,850 $15,700 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$480.97
$545.90
$614.67
$859.00
$1,305.34
$848.91
$913.84
$982.61
$1,226.94
$1,216.85
$1,281.78
$1,350.55
$1,594.88
$1,584.79
$1,649.72
$1,718.49
$1,962.82
$367.94
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$961.94
$1,091.80
$1,229.34
$1,718.00
$2,610.68
$1,329.88
$1,459.74
$1,597.28
$2,085.94
$1,697.82
$1,827.68
$1,965.22
$2,453.88
$2,065.76
$2,195.62
$2,333.16
$2,821.82
$367.94

ADVERTISEMENT

Anthem Blue Cross and Blue Shield

Local: 1-855-748-1813 | Toll Free: 1-855-748-1813

Toc - Plan #24 Anthem Blue Cross and Blue Shield
Expanded Bronze

(POS) Anthem Bronze Blue Preferred/Broad 0 ($0 Virtual PCP + $0 Select Drugs + Incentives)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1813

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$359.58
$408.12
$459.54
$642.21
$975.90
$634.66
$683.20
$734.62
$917.29
$909.74
$958.28
$1,009.70
$1,192.37
$1,184.82
$1,233.36
$1,284.78
$1,467.45
$275.08
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$719.16
$816.24
$919.08
$1,284.42
$1,951.80
$994.24
$1,091.32
$1,194.16
$1,559.50
$1,269.32
$1,366.40
$1,469.24
$1,834.58
$1,544.40
$1,641.48
$1,744.32
$2,109.66
$275.08
Toc - Plan #25 Anthem Blue Cross and Blue Shield
Silver

(POS) Anthem Silver Blue Preferred/Broad 4100 ($0 Virtual PCP + $0 Select Drugs + Incentives)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1813

Annual Out of Pocket Expenses:

Individual Family
$4,100 $8,200 Annual Deductible
$7,700 $15,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$425.62
$483.08
$543.94
$760.16
$1,155.13
$751.22
$808.68
$869.54
$1,085.76
$1,076.82
$1,134.28
$1,195.14
$1,411.36
$1,402.42
$1,459.88
$1,520.74
$1,736.96
$325.60
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$851.24
$966.16
$1,087.88
$1,520.32
$2,310.26
$1,176.84
$1,291.76
$1,413.48
$1,845.92
$1,502.44
$1,617.36
$1,739.08
$2,171.52
$1,828.04
$1,942.96
$2,064.68
$2,497.12
$325.60
Toc - Plan #26 Anthem Blue Cross and Blue Shield
Bronze

(POS) Anthem Bronze Blue Preferred/Broad 9450 ($0 Virtual PCP + $0 Select Drugs + Incentives)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1813

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$325.84
$369.83
$416.42
$581.95
$884.33
$575.11
$619.10
$665.69
$831.22
$824.38
$868.37
$914.96
$1,080.49
$1,073.65
$1,117.64
$1,164.23
$1,329.76
$249.27
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$651.68
$739.66
$832.84
$1,163.90
$1,768.66
$900.95
$988.93
$1,082.11
$1,413.17
$1,150.22
$1,238.20
$1,331.38
$1,662.44
$1,399.49
$1,487.47
$1,580.65
$1,911.71
$249.27
Toc - Plan #27 Anthem Blue Cross and Blue Shield
Expanded Bronze

(POS) Anthem Bronze Blue Preferred/Broad 0% for HSA

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1813

Annual Out of Pocket Expenses:

Individual Family
$7,900 $15,800 Annual Deductible
$7,900 $15,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$341.80
$387.94
$436.82
$610.45
$927.65
$603.28
$649.42
$698.30
$871.93
$864.76
$910.90
$959.78
$1,133.41
$1,126.24
$1,172.38
$1,221.26
$1,394.89
$261.48
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$683.60
$775.88
$873.64
$1,220.90
$1,855.30
$945.08
$1,037.36
$1,135.12
$1,482.38
$1,206.56
$1,298.84
$1,396.60
$1,743.86
$1,468.04
$1,560.32
$1,658.08
$2,005.34
$261.48
Toc - Plan #28 Anthem Blue Cross and Blue Shield
Expanded Bronze

(POS) Anthem Bronze Blue Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1813

Annual Out of Pocket Expenses:

Individual Family
$5,000 $10,000 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$343.11
$389.43
$438.49
$612.79
$931.20
$605.59
$651.91
$700.97
$875.27
$868.07
$914.39
$963.45
$1,137.75
$1,130.55
$1,176.87
$1,225.93
$1,400.23
$262.48
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$686.22
$778.86
$876.98
$1,225.58
$1,862.40
$948.70
$1,041.34
$1,139.46
$1,488.06
$1,211.18
$1,303.82
$1,401.94
$1,750.54
$1,473.66
$1,566.30
$1,664.42
$2,013.02
$262.48
Toc - Plan #29 Anthem Blue Cross and Blue Shield
Silver

(POS) Anthem Silver Blue Preferred/Broad 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1813

Annual Out of Pocket Expenses:

Individual Family
$5,300 $10,600 Annual Deductible
$9,250 $18,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$415.62
$471.73
$531.16
$742.30
$1,127.99
$733.57
$789.68
$849.11
$1,060.25
$1,051.52
$1,107.63
$1,167.06
$1,378.20
$1,369.47
$1,425.58
$1,485.01
$1,696.15
$317.95
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$831.24
$943.46
$1,062.32
$1,484.60
$2,255.98
$1,149.19
$1,261.41
$1,380.27
$1,802.55
$1,467.14
$1,579.36
$1,698.22
$2,120.50
$1,785.09
$1,897.31
$2,016.17
$2,438.45
$317.95
Toc - Plan #30 Anthem Blue Cross and Blue Shield
Gold

(POS) Anthem Gold Blue Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1813

Annual Out of Pocket Expenses:

Individual Family
$1,000 $2,000 Annual Deductible
$6,800 $13,600 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$455.13
$516.57
$581.66
$812.86
$1,235.22
$803.30
$864.74
$929.83
$1,161.03
$1,151.47
$1,212.91
$1,278.00
$1,509.20
$1,499.64
$1,561.08
$1,626.17
$1,857.37
$348.17
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$910.26
$1,033.14
$1,163.32
$1,625.72
$2,470.44
$1,258.43
$1,381.31
$1,511.49
$1,973.89
$1,606.60
$1,729.48
$1,859.66
$2,322.06
$1,954.77
$2,077.65
$2,207.83
$2,670.23
$348.17
Toc - Plan #31 Anthem Blue Cross and Blue Shield
Expanded Bronze

(POS) Anthem Bronze Blue Preferred/Broad 7500/50% Standard

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1813

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$342.10
$388.28
$437.20
$610.99
$928.46
$603.81
$649.99
$698.91
$872.70
$865.52
$911.70
$960.62
$1,134.41
$1,127.23
$1,173.41
$1,222.33
$1,396.12
$261.71
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$684.20
$776.56
$874.40
$1,221.98
$1,856.92
$945.91
$1,038.27
$1,136.11
$1,483.69
$1,207.62
$1,299.98
$1,397.82
$1,745.40
$1,469.33
$1,561.69
$1,659.53
$2,007.11
$261.71
Toc - Plan #32 Anthem Blue Cross and Blue Shield
Silver

(POS) Anthem Silver Blue Preferred/Broad 5900/40% Standard

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1813

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$415.29
$471.35
$530.74
$741.71
$1,127.10
$732.99
$789.05
$848.44
$1,059.41
$1,050.69
$1,106.75
$1,166.14
$1,377.11
$1,368.39
$1,424.45
$1,483.84
$1,694.81
$317.70
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$830.58
$942.70
$1,061.48
$1,483.42
$2,254.20
$1,148.28
$1,260.40
$1,379.18
$1,801.12
$1,465.98
$1,578.10
$1,696.88
$2,118.82
$1,783.68
$1,895.80
$2,014.58
$2,436.52
$317.70
Toc - Plan #33 Anthem Blue Cross and Blue Shield
Gold

(POS) Anthem Gold Blue Preferred/Broad 1500/25% Standard

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1813

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$463.68
$526.28
$592.58
$828.13
$1,258.43
$818.40
$881.00
$947.30
$1,182.85
$1,173.12
$1,235.72
$1,302.02
$1,537.57
$1,527.84
$1,590.44
$1,656.74
$1,892.29
$354.72
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$927.36
$1,052.56
$1,185.16
$1,656.26
$2,516.86
$1,282.08
$1,407.28
$1,539.88
$2,010.98
$1,636.80
$1,762.00
$1,894.60
$2,365.70
$1,991.52
$2,116.72
$2,249.32
$2,720.42
$354.72
Toc - Plan #34 Anthem Blue Cross and Blue Shield
Silver

(POS) Anthem Silver Blue Preferred/Broad 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives)

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1813

Annual Out of Pocket Expenses:

Individual Family
$4,000 $8,000 Annual Deductible
$9,450 $18,900 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$425.38
$482.81
$543.64
$759.73
$1,154.48
$750.80
$808.23
$869.06
$1,085.15
$1,076.22
$1,133.65
$1,194.48
$1,410.57
$1,401.64
$1,459.07
$1,519.90
$1,735.99
$325.42
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$850.76
$965.62
$1,087.28
$1,519.46
$2,308.96
$1,176.18
$1,291.04
$1,412.70
$1,844.88
$1,501.60
$1,616.46
$1,738.12
$2,170.30
$1,827.02
$1,941.88
$2,063.54
$2,495.72
$325.42

ADVERTISEMENT

Aspirus Health Plan

Local: 1-866-631-4611 | Toll Free: 1-866-631-4611 | TTY: 1-866-631-8597

Toc - Plan #35 Aspirus Health Plan
Silver

(HMO) HMO Silver 7500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-631-4611

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 Annual Deductible
$8,400 $16,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$438.48
$497.67
$560.37
$783.12
$1,190.02
$773.91
$833.10
$895.80
$1,118.55
$1,109.34
$1,168.53
$1,231.23
$1,453.98
$1,444.77
$1,503.96
$1,566.66
$1,789.41
$335.43
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$876.96
$995.34
$1,120.74
$1,566.24
$2,380.04
$1,212.39
$1,330.77
$1,456.17
$1,901.67
$1,547.82
$1,666.20
$1,791.60
$2,237.10
$1,883.25
$2,001.63
$2,127.03
$2,572.53
$335.43
Toc - Plan #36 Aspirus Health Plan
Expanded Bronze

(HMO) HMO HDHP Bronze 6250

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-631-4611

Annual Out of Pocket Expenses:

Individual Family
$6,250 $12,500 Annual Deductible
$7,250 $14,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$350.93
$398.31
$448.49
$626.77
$952.44
$619.39
$666.77
$716.95
$895.23
$887.85
$935.23
$985.41
$1,163.69
$1,156.31
$1,203.69
$1,253.87
$1,432.15
$268.46
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$701.86
$796.62
$896.98
$1,253.54
$1,904.88
$970.32
$1,065.08
$1,165.44
$1,522.00
$1,238.78
$1,333.54
$1,433.90
$1,790.46
$1,507.24
$1,602.00
$1,702.36
$2,058.92
$268.46
Toc - Plan #37 Aspirus Health Plan
Bronze

(HMO) HMO Bronze 9450

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-631-4611

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$322.72
$366.29
$412.44
$576.38
$875.87
$569.60
$613.17
$659.32
$823.26
$816.48
$860.05
$906.20
$1,070.14
$1,063.36
$1,106.93
$1,153.08
$1,317.02
$246.88
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$645.44
$732.58
$824.88
$1,152.76
$1,751.74
$892.32
$979.46
$1,071.76
$1,399.64
$1,139.20
$1,226.34
$1,318.64
$1,646.52
$1,386.08
$1,473.22
$1,565.52
$1,893.40
$246.88
Toc - Plan #38 Aspirus Health Plan
Gold

(HMO) HMO Gold 2400

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-631-4611

Annual Out of Pocket Expenses:

Individual Family
$2,400 $4,800 Annual Deductible
$6,500 $13,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$456.56
$518.20
$583.49
$815.42
$1,239.11
$805.83
$867.47
$932.76
$1,164.69
$1,155.10
$1,216.74
$1,282.03
$1,513.96
$1,504.37
$1,566.01
$1,631.30
$1,863.23
$349.27
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$913.12
$1,036.40
$1,166.98
$1,630.84
$2,478.22
$1,262.39
$1,385.67
$1,516.25
$1,980.11
$1,611.66
$1,734.94
$1,865.52
$2,329.38
$1,960.93
$2,084.21
$2,214.79
$2,678.65
$349.27
Toc - Plan #39 Aspirus Health Plan
Catastrophic

(HMO) HMO Catastrophic 9450 with 3 free PCP Visits

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-631-4611

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$233.62
$265.16
$298.57
$417.25
$634.05
$412.34
$443.88
$477.29
$595.97
$591.06
$622.60
$656.01
$774.69
$769.78
$801.32
$834.73
$953.41
$178.72
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$467.24
$530.32
$597.14
$834.50
$1,268.10
$645.96
$709.04
$775.86
$1,013.22
$824.68
$887.76
$954.58
$1,191.94
$1,003.40
$1,066.48
$1,133.30
$1,370.66
$178.72
Toc - Plan #40 Aspirus Health Plan
Expanded Bronze

(HMO) HMO HDHP Bronze 7200

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-631-4611

Annual Out of Pocket Expenses:

Individual Family
$7,200 $14,400 Annual Deductible
$7,200 $14,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$349.56
$396.75
$446.73
$624.31
$948.69
$616.97
$664.16
$714.14
$891.72
$884.38
$931.57
$981.55
$1,159.13
$1,151.79
$1,198.98
$1,248.96
$1,426.54
$267.41
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$699.12
$793.50
$893.46
$1,248.62
$1,897.38
$966.53
$1,060.91
$1,160.87
$1,516.03
$1,233.94
$1,328.32
$1,428.28
$1,783.44
$1,501.35
$1,595.73
$1,695.69
$2,050.85
$267.41
Toc - Plan #41 Aspirus Health Plan
Expanded Bronze

(HMO) HMO Bronze 7500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-631-4611

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$343.92
$390.35
$439.53
$614.24
$933.40
$607.02
$653.45
$702.63
$877.34
$870.12
$916.55
$965.73
$1,140.44
$1,133.22
$1,179.65
$1,228.83
$1,403.54
$263.10
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$687.84
$780.70
$879.06
$1,228.48
$1,866.80
$950.94
$1,043.80
$1,142.16
$1,491.58
$1,214.04
$1,306.90
$1,405.26
$1,754.68
$1,477.14
$1,570.00
$1,668.36
$2,017.78
$263.10
Toc - Plan #42 Aspirus Health Plan
Silver

(HMO) HMO Silver 5900

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-631-4611

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$437.33
$496.37
$558.91
$781.08
$1,186.93
$771.89
$830.93
$893.47
$1,115.64
$1,106.45
$1,165.49
$1,228.03
$1,450.20
$1,441.01
$1,500.05
$1,562.59
$1,784.76
$334.56
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$874.66
$992.74
$1,117.82
$1,562.16
$2,373.86
$1,209.22
$1,327.30
$1,452.38
$1,896.72
$1,543.78
$1,661.86
$1,786.94
$2,231.28
$1,878.34
$1,996.42
$2,121.50
$2,565.84
$334.56
Toc - Plan #43 Aspirus Health Plan
Silver

(HMO) HMO HDHP Silver 5400

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-631-4611

Annual Out of Pocket Expenses:

Individual Family
$5,400 $10,800 Annual Deductible
$5,400 $10,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$444.80
$504.84
$568.45
$794.41
$1,207.18
$785.07
$845.11
$908.72
$1,134.68
$1,125.34
$1,185.38
$1,248.99
$1,474.95
$1,465.61
$1,525.65
$1,589.26
$1,815.22
$340.27
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$889.60
$1,009.68
$1,136.90
$1,588.82
$2,414.36
$1,229.87
$1,349.95
$1,477.17
$1,929.09
$1,570.14
$1,690.22
$1,817.44
$2,269.36
$1,910.41
$2,030.49
$2,157.71
$2,609.63
$340.27
Toc - Plan #44 Aspirus Health Plan
Gold

(HMO) HMO Gold 1500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-631-4611

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$456.06
$517.63
$582.84
$814.52
$1,237.75
$804.95
$866.52
$931.73
$1,163.41
$1,153.84
$1,215.41
$1,280.62
$1,512.30
$1,502.73
$1,564.30
$1,629.51
$1,861.19
$348.89
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$912.12
$1,035.26
$1,165.68
$1,629.04
$2,475.50
$1,261.01
$1,384.15
$1,514.57
$1,977.93
$1,609.90
$1,733.04
$1,863.46
$2,326.82
$1,958.79
$2,081.93
$2,212.35
$2,675.71
$348.89
Toc - Plan #45 Aspirus Health Plan
Expanded Bronze

(HMO) HMO Bronze $0 Medical Deductible

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-631-4611

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$345.30
$391.91
$441.29
$616.70
$937.14
$609.45
$656.06
$705.44
$880.85
$873.60
$920.21
$969.59
$1,145.00
$1,137.75
$1,184.36
$1,233.74
$1,409.15
$264.15
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$690.60
$783.82
$882.58
$1,233.40
$1,874.28
$954.75
$1,047.97
$1,146.73
$1,497.55
$1,218.90
$1,312.12
$1,410.88
$1,761.70
$1,483.05
$1,576.27
$1,675.03
$2,025.85
$264.15
Toc - Plan #46 Aspirus Health Plan
Silver

(POS) POS Silver 5900

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-631-4611

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$500.77
$568.37
$639.99
$894.38
$1,359.09
$883.86
$951.46
$1,023.08
$1,277.47
$1,266.95
$1,334.55
$1,406.17
$1,660.56
$1,650.04
$1,717.64
$1,789.26
$2,043.65
$383.09
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$1,001.54
$1,136.74
$1,279.98
$1,788.76
$2,718.18
$1,384.63
$1,519.83
$1,663.07
$2,171.85
$1,767.72
$1,902.92
$2,046.16
$2,554.94
$2,150.81
$2,286.01
$2,429.25
$2,938.03
$383.09
Toc - Plan #47 Aspirus Health Plan
Expanded Bronze

(POS) POS HDHP Bronze 6250

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-631-4611

Annual Out of Pocket Expenses:

Individual Family
$6,250 $12,500 Annual Deductible
$7,250 $14,500 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$386.25
$438.39
$493.62
$689.83
$1,048.27
$681.73
$733.87
$789.10
$985.31
$977.21
$1,029.35
$1,084.58
$1,280.79
$1,272.69
$1,324.83
$1,380.06
$1,576.27
$295.48
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$772.50
$876.78
$987.24
$1,379.66
$2,096.54
$1,067.98
$1,172.26
$1,282.72
$1,675.14
$1,363.46
$1,467.74
$1,578.20
$1,970.62
$1,658.94
$1,763.22
$1,873.68
$2,266.10
$295.48
Toc - Plan #48 Aspirus Health Plan
Expanded Bronze

(POS) POS Bronze 7500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-631-4611

Annual Out of Pocket Expenses:

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

Monthly Premiums:

[show premiums]
Age Individual
Individual
1 Child
Individual
2 Children
Individual
3+ Children
Child
0-14
21
30
40
50
60
$393.39
$446.50
$502.76
$702.60
$1,067.67
$694.34
$747.45
$803.71
$1,003.55
$995.29
$1,048.40
$1,104.66
$1,304.50
$1,296.24
$1,349.35
$1,405.61
$1,605.45
$300.95
Age Couple
Couple
1 Child
Couple
2 Chidren
Couple
3+ Children
Child
0-14
21
30
40
50
60
$786.78
$893.00
$1,005.52
$1,405.20
$2,135.34
$1,087.73
$1,193.95
$1,306.47
$1,706.15
$1,388.68
$1,494.90
$1,607.42
$2,007.10
$1,689.63
$1,795.85
$1,908.37
$2,308.05
$300.95

‡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 Portage County here.

Portage County is in “Rating Area 10” of Wisconsin.

Currently, there are 48 plans offered in Rating Area 10.

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2024 Obamacare Plans for Portage County, WI

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