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Obamacare 2021 Rates and Health Insurance Providers for Washington County , Wisconsin

Obamacare > Rates > Wisconsin > Washington County

Obamacare Rates and Providers for Other Years

2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 |

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 Washington County, WI.

The health insurance rates listed below are for calendar year 2021.

Obamacare Providers, Plans and 2021 Rates for Washington County, Wisconsin

Below, you’ll find a summary of the 59 plans for Washington County, Wisconsin and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options.

  • Together with CCHP

    Local: 1-844-201-4672 | Toll Free: 1-844-201-4672 | TTY: 1-844-531-4856

  • Molina Healthcare

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

  • Anthem Blue Cross and Blue Shield

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

  • Network Health

    Local: 1-920-720-1400x1400 | Toll Free: 1-855-275-1400 | TTY: 1-800-947-3529

  • Arise Health Plan

    Local: 1-920-490-6900 | Toll Free: 1-800-332-6249 | TTY: 1-888-332-0144

  • Common Ground Healthcare Cooperative

    Local: 1-877-514-2442 | Toll Free: 1-877-514-2442 | TTY: 1-844-472-2442

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

    The table below shows premiums for the following profiles at various ages:

    • Individuals
    • Couples
    • Couples with 1, 2, or 3 children
    • Individuals with 1, 2, or 3 children
    • A child alone

    Each plan links to the insurance provider's website. You can find the following:

    • Summary of plan benefits and costs
    • Plan brochure
    • Provider Directory where you can find out which doctors and hospitals in the West Bend, WI area accept this insurance coverage as within the plan's network.

    2021 Obamacare Rates, Providers, and Plans for Washington County

    ADVERTISEMENT

    Together with CCHP

    Local: 1-844-201-4672 | Toll Free: 1-844-201-4672 | TTY: 1-844-531-4856
    Toc - Plan #1

    Expanded Bronze

    (EPO) Together Bronze

    Annual Out of Pocket Expenses
    Individual Family
    $7,000 $14,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$310,15
    $352,01
    $396,36
    $553,91
    $841,72     		$620,30
    $704,02
    $792,72
    $1 107,82
    $1 683,44     		$857,56
    $941,28
    $1 029,98
    $1 345,08     		$1 094,82
    $1 178,54
    $1 267,24
    $1 582,34     		$1 332,08
    $1 415,80
    $1 504,50
    $1 819,60     		$547,41
    $589,27
    $633,62
    $791,17     		$784,67
    $826,53
    $870,88
    $1 028,43     		$1 021,93
    $1 063,79
    $1 108,14
    $1 265,69     		$237,26
    Toc - Plan #2

    Silver

    (EPO) Together Standard Silver

    Annual Out of Pocket Expenses
    Individual Family
    $4,000 $8,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$425,44
    $482,86
    $543,70
    $759,82
    $1 154,62     		$850,88
    $965,72
    $1 087,40
    $1 519,64
    $2 309,24     		$1 176,33
    $1 291,17
    $1 412,85
    $1 845,09     		$1 501,78
    $1 616,62
    $1 738,30
    $2 170,54     		$1 827,23
    $1 942,07
    $2 063,75
    $2 495,99     		$750,89
    $808,31
    $869,15
    $1 085,27     		$1 076,34
    $1 133,76
    $1 194,60
    $1 410,72     		$1 401,79
    $1 459,21
    $1 520,05
    $1 736,17     		$325,45
    Toc - Plan #3

    Silver

    (EPO) Together Silver

    Annual Out of Pocket Expenses
    Individual Family
    $5,400 $10,800 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$376,52
    $427,33
    $481,18
    $672,44
    $1 021,84     		$753,04
    $854,66
    $962,36
    $1 344,88
    $2 043,68     		$1 041,07
    $1 142,69
    $1 250,39
    $1 632,91     		$1 329,10
    $1 430,72
    $1 538,42
    $1 920,94     		$1 617,13
    $1 718,75
    $1 826,45
    $2 208,97     		$664,55
    $715,36
    $769,21
    $960,47     		$952,58
    $1 003,39
    $1 057,24
    $1 248,50     		$1 240,61
    $1 291,42
    $1 345,27
    $1 536,53     		$288,03
    Toc - Plan #4

    Gold

    (EPO) Together Gold

    Annual Out of Pocket Expenses
    Individual Family
    $2,000 $4,000 Annual Deductible
    $6,500 $13,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$445,44
    $505,56
    $569,25
    $795,53
    $1 208,89     		$890,88
    $1 011,12
    $1 138,50
    $1 591,06
    $2 417,78     		$1 231,63
    $1 351,87
    $1 479,25
    $1 931,81     		$1 572,38
    $1 692,62
    $1 820,00
    $2 272,56     		$1 913,13
    $2 033,37
    $2 160,75
    $2 613,31     		$786,19
    $846,31
    $910,00
    $1 136,28     		$1 126,94
    $1 187,06
    $1 250,75
    $1 477,03     		$1 467,69
    $1 527,81
    $1 591,50
    $1 817,78     		$340,75
    Toc - Plan #5

    Expanded Bronze

    (EPO) Together Bronze HDHP

    Annual Out of Pocket Expenses
    Individual Family
    $7,000 $14,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$335,25
    $380,50
    $428,44
    $598,74
    $909,84     		$670,50
    $761,00
    $856,88
    $1 197,48
    $1 819,68     		$926,96
    $1 017,46
    $1 113,34
    $1 453,94     		$1 183,42
    $1 273,92
    $1 369,80
    $1 710,40     		$1 439,88
    $1 530,38
    $1 626,26
    $1 966,86     		$591,71
    $636,96
    $684,90
    $855,20     		$848,17
    $893,42
    $941,36
    $1 111,66     		$1 104,63
    $1 149,88
    $1 197,82
    $1 368,12     		$256,46
    Toc - Plan #6

    Silver

    (EPO) Together Silver Select

    Annual Out of Pocket Expenses
    Individual Family
    $3,250 $6,500 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$409,70
    $465,00
    $523,58
    $731,71
    $1 111,90     		$819,40
    $930,00
    $1 047,16
    $1 463,42
    $2 223,80     		$1 132,81
    $1 243,41
    $1 360,57
    $1 776,83     		$1 446,22
    $1 556,82
    $1 673,98
    $2 090,24     		$1 759,63
    $1 870,23
    $1 987,39
    $2 403,65     		$723,11
    $778,41
    $836,99
    $1 045,12     		$1 036,52
    $1 091,82
    $1 150,40
    $1 358,53     		$1 349,93
    $1 405,23
    $1 463,81
    $1 671,94     		$313,41
    Toc - Plan #7

    Catastrophic

    (EPO) Together Catastrophic

    Annual Out of Pocket Expenses
    Individual Family
    $8,550 $17,100 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$261,22
    $296,48
    $333,83
    $466,53
    $708,94     		$522,44
    $592,96
    $667,66
    $933,06
    $1 417,88     		$722,27
    $792,79
    $867,49
    $1 132,89     		$922,10
    $992,62
    $1 067,32
    $1 332,72     		$1 121,93
    $1 192,45
    $1 267,15
    $1 532,55     		$461,05
    $496,31
    $533,66
    $666,36     		$660,88
    $696,14
    $733,49
    $866,19     		$860,71
    $895,97
    $933,32
    $1 066,02     		$199,83
    ADVERTISEMENT

    Molina Healthcare

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

    Toc - Plan #8

    Gold

    (HMO) Confident Care Gold 1

    Annual Out of Pocket Expenses
    Individual Family
    $2,925 $5,850 Annual Deductible
    $6,500 $13,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$446,43
    $506,69
    $570,53
    $797,32
    $1 211,60     		$892,86
    $1 013,38
    $1 141,06
    $1 594,64
    $2 423,20     		$1 234,38
    $1 354,90
    $1 482,58
    $1 936,16     		$1 575,90
    $1 696,42
    $1 824,10
    $2 277,68     		$1 917,42
    $2 037,94
    $2 165,62
    $2 619,20     		$787,95
    $848,21
    $912,05
    $1 138,84     		$1 129,47
    $1 189,73
    $1 253,57
    $1 480,36     		$1 470,99
    $1 531,25
    $1 595,09
    $1 821,88     		$341,52
    Toc - Plan #9

    Silver

    (HMO) Constant Care Silver 1

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,500 $17,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$393,50
    $446,62
    $502,89
    $702,79
    $1 067,96     		$787,00
    $893,24
    $1 005,78
    $1 405,58
    $2 135,92     		$1 088,03
    $1 194,27
    $1 306,81
    $1 706,61     		$1 389,06
    $1 495,30
    $1 607,84
    $2 007,64     		$1 690,09
    $1 796,33
    $1 908,87
    $2 308,67     		$694,53
    $747,65
    $803,92
    $1 003,82     		$995,56
    $1 048,68
    $1 104,95
    $1 304,85     		$1 296,59
    $1 349,71
    $1 405,98
    $1 605,88     		$301,03
    Toc - Plan #10

    Bronze

    (HMO) Core Care Bronze 1

    Annual Out of Pocket Expenses
    Individual Family
    $6,100 $12,200 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$311,89
    $353,99
    $398,59
    $557,03
    $846,47     		$623,78
    $707,98
    $797,18
    $1 114,06
    $1 692,94     		$862,37
    $946,57
    $1 035,77
    $1 352,65     		$1 100,96
    $1 185,16
    $1 274,36
    $1 591,24     		$1 339,55
    $1 423,75
    $1 512,95
    $1 829,83     		$550,48
    $592,58
    $637,18
    $795,62     		$789,07
    $831,17
    $875,77
    $1 034,21     		$1 027,66
    $1 069,76
    $1 114,36
    $1 272,80     		$238,59
    Toc - Plan #11

    Silver

    (HMO) Constant Care Silver 4

    Annual Out of Pocket Expenses
    Individual Family
    $7,450 $14,900 Annual Deductible
    $7,450 $14,900 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$389,34
    $441,90
    $497,58
    $695,36
    $1 056,67     		$778,68
    $883,80
    $995,16
    $1 390,72
    $2 113,34     		$1 076,53
    $1 181,65
    $1 293,01
    $1 688,57     		$1 374,38
    $1 479,50
    $1 590,86
    $1 986,42     		$1 672,23
    $1 777,35
    $1 888,71
    $2 284,27     		$687,19
    $739,75
    $795,43
    $993,21     		$985,04
    $1 037,60
    $1 093,28
    $1 291,06     		$1 282,89
    $1 335,45
    $1 391,13
    $1 588,91     		$297,85
    Toc - Plan #12

    Expanded Bronze

    (HMO) Core Care Bronze 4

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$326,70
    $370,81
    $417,53
    $583,49
    $886,67     		$653,40
    $741,62
    $835,06
    $1 166,98
    $1 773,34     		$903,33
    $991,55
    $1 084,99
    $1 416,91     		$1 153,26
    $1 241,48
    $1 334,92
    $1 666,84     		$1 403,19
    $1 491,41
    $1 584,85
    $1 916,77     		$576,63
    $620,74
    $667,46
    $833,42     		$826,56
    $870,67
    $917,39
    $1 083,35     		$1 076,49
    $1 120,60
    $1 167,32
    $1 333,28     		$249,93
    Toc - Plan #13

    Expanded Bronze

    (HMO) Core Care Bronze 5

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$317,65
    $360,53
    $405,95
    $567,32
    $862,09     		$635,30
    $721,06
    $811,90
    $1 134,64
    $1 724,18     		$878,30
    $964,06
    $1 054,90
    $1 377,64     		$1 121,30
    $1 207,06
    $1 297,90
    $1 620,64     		$1 364,30
    $1 450,06
    $1 540,90
    $1 863,64     		$560,65
    $603,53
    $648,95
    $810,32     		$803,65
    $846,53
    $891,95
    $1 053,32     		$1 046,65
    $1 089,53
    $1 134,95
    $1 296,32     		$243,00
    Toc - Plan #14

    Gold

    (HMO) Confident Care Gold 1 + Vision

    Annual Out of Pocket Expenses
    Individual Family
    $2,925 $5,850 Annual Deductible
    $6,500 $13,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$449,96
    $510,70
    $575,05
    $803,62
    $1 221,19     		$899,92
    $1 021,40
    $1 150,10
    $1 607,24
    $2 442,38     		$1 244,14
    $1 365,62
    $1 494,32
    $1 951,46     		$1 588,36
    $1 709,84
    $1 838,54
    $2 295,68     		$1 932,58
    $2 054,06
    $2 182,76
    $2 639,90     		$794,18
    $854,92
    $919,27
    $1 147,84     		$1 138,40
    $1 199,14
    $1 263,49
    $1 492,06     		$1 482,62
    $1 543,36
    $1 607,71
    $1 836,28     		$344,22
    Toc - Plan #15

    Silver

    (HMO) Constant Care Silver 1 + Vision

    Annual Out of Pocket Expenses
    Individual Family
    $0 $0 Annual Deductible
    $8,500 $17,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$397,03
    $450,63
    $507,41
    $709,10
    $1 077,54     		$794,06
    $901,26
    $1 014,82
    $1 418,20
    $2 155,08     		$1 097,79
    $1 204,99
    $1 318,55
    $1 721,93     		$1 401,52
    $1 508,72
    $1 622,28
    $2 025,66     		$1 705,25
    $1 812,45
    $1 926,01
    $2 329,39     		$700,76
    $754,36
    $811,14
    $1 012,83     		$1 004,49
    $1 058,09
    $1 114,87
    $1 316,56     		$1 308,22
    $1 361,82
    $1 418,60
    $1 620,29     		$303,73
    Toc - Plan #16

    Bronze

    (HMO) Core Care Bronze 1 + Vision

    Annual Out of Pocket Expenses
    Individual Family
    $6,100 $12,200 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$315,42
    $358,00
    $403,11
    $563,34
    $856,05     		$630,84
    $716,00
    $806,22
    $1 126,68
    $1 712,10     		$872,14
    $957,30
    $1 047,52
    $1 367,98     		$1 113,44
    $1 198,60
    $1 288,82
    $1 609,28     		$1 354,74
    $1 439,90
    $1 530,12
    $1 850,58     		$556,72
    $599,30
    $644,41
    $804,64     		$798,02
    $840,60
    $885,71
    $1 045,94     		$1 039,32
    $1 081,90
    $1 127,01
    $1 287,24     		$241,30
    Toc - Plan #17

    Silver

    (HMO) Constant Care Silver 2

    Annual Out of Pocket Expenses
    Individual Family
    $5,200 $10,400 Annual Deductible
    $8,150 $16,300 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$393,08
    $446,14
    $502,35
    $702,03
    $1 066,81     		$786,16
    $892,28
    $1 004,70
    $1 404,06
    $2 133,62     		$1 086,86
    $1 192,98
    $1 305,40
    $1 704,76     		$1 387,56
    $1 493,68
    $1 606,10
    $2 005,46     		$1 688,26
    $1 794,38
    $1 906,80
    $2 306,16     		$693,78
    $746,84
    $803,05
    $1 002,73     		$994,48
    $1 047,54
    $1 103,75
    $1 303,43     		$1 295,18
    $1 348,24
    $1 404,45
    $1 604,13     		$300,70
    Toc - Plan #18

    Bronze

    (HMO) Core Care Bronze 2

    Annual Out of Pocket Expenses
    Individual Family
    $8,000 $16,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$309,13
    $350,87
    $395,07
    $552,11
    $838,99     		$618,26
    $701,74
    $790,14
    $1 104,22
    $1 677,98     		$854,75
    $938,23
    $1 026,63
    $1 340,71     		$1 091,24
    $1 174,72
    $1 263,12
    $1 577,20     		$1 327,73
    $1 411,21
    $1 499,61
    $1 813,69     		$545,62
    $587,36
    $631,56
    $788,60     		$782,11
    $823,85
    $868,05
    $1 025,09     		$1 018,60
    $1 060,34
    $1 104,54
    $1 261,58     		$236,49
    ADVERTISEMENT

    Anthem Blue Cross and Blue Shield

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

    Toc - Plan #19

    Bronze

    (HMO) Anthem Bronze Pathway X 0 for HSA

    Annual Out of Pocket Expenses
    Individual Family
    $7,000 $14,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$289,25
    $328,30
    $369,66
    $516,60
    $785,02     		$578,50
    $656,60
    $739,32
    $1 033,20
    $1 570,04     		$799,78
    $877,88
    $960,60
    $1 254,48     		$1 021,06
    $1 099,16
    $1 181,88
    $1 475,76     		$1 242,34
    $1 320,44
    $1 403,16
    $1 697,04     		$510,53
    $549,58
    $590,94
    $737,88     		$731,81
    $770,86
    $812,22
    $959,16     		$953,09
    $992,14
    $1 033,50
    $1 180,44     		$221,28
    Toc - Plan #20

    Bronze

    (HMO) Anthem Bronze Pathway X 5000

    Annual Out of Pocket Expenses
    Individual Family
    $5,000 $10,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$286,14
    $324,77
    $365,69
    $511,05
    $776,58     		$572,28
    $649,54
    $731,38
    $1 022,10
    $1 553,16     		$791,18
    $868,44
    $950,28
    $1 241,00     		$1 010,08
    $1 087,34
    $1 169,18
    $1 459,90     		$1 228,98
    $1 306,24
    $1 388,08
    $1 678,80     		$505,04
    $543,67
    $584,59
    $729,95     		$723,94
    $762,57
    $803,49
    $948,85     		$942,84
    $981,47
    $1 022,39
    $1 167,75     		$218,90
    Toc - Plan #21

    Bronze

    (HMO) Anthem Bronze Pathway X 6550

    Annual Out of Pocket Expenses
    Individual Family
    $6,550 $13,100 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$276,97
    $314,36
    $353,97
    $494,67
    $751,70     		$553,94
    $628,72
    $707,94
    $989,34
    $1 503,40     		$765,82
    $840,60
    $919,82
    $1 201,22     		$977,70
    $1 052,48
    $1 131,70
    $1 413,10     		$1 189,58
    $1 264,36
    $1 343,58
    $1 624,98     		$488,85
    $526,24
    $565,85
    $706,55     		$700,73
    $738,12
    $777,73
    $918,43     		$912,61
    $950,00
    $989,61
    $1 130,31     		$211,88
    Toc - Plan #22

    Bronze

    (HMO) Anthem Bronze Pathway X 8550

    Annual Out of Pocket Expenses
    Individual Family
    $8,550 $17,100 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$274,25
    $311,27
    $350,49
    $489,81
    $744,31     		$548,50
    $622,54
    $700,98
    $979,62
    $1 488,62     		$758,30
    $832,34
    $910,78
    $1 189,42     		$968,10
    $1 042,14
    $1 120,58
    $1 399,22     		$1 177,90
    $1 251,94
    $1 330,38
    $1 609,02     		$484,05
    $521,07
    $560,29
    $699,61     		$693,85
    $730,87
    $770,09
    $909,41     		$903,65
    $940,67
    $979,89
    $1 119,21     		$209,80
    Toc - Plan #23

    Silver

    (HMO) Anthem Silver Pathway X 4000

    Annual Out of Pocket Expenses
    Individual Family
    $4,000 $8,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$354,42
    $402,27
    $452,95
    $632,99
    $961,90     		$708,84
    $804,54
    $905,90
    $1 265,98
    $1 923,80     		$979,97
    $1 075,67
    $1 177,03
    $1 537,11     		$1 251,10
    $1 346,80
    $1 448,16
    $1 808,24     		$1 522,23
    $1 617,93
    $1 719,29
    $2 079,37     		$625,55
    $673,40
    $724,08
    $904,12     		$896,68
    $944,53
    $995,21
    $1 175,25     		$1 167,81
    $1 215,66
    $1 266,34
    $1 446,38     		$271,13
    Toc - Plan #24

    Silver

    (HMO) Anthem Silver Pathway X 4750

    Annual Out of Pocket Expenses
    Individual Family
    $4,750 $9,500 Annual Deductible
    $7,250 $14,500 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$355,33
    $403,30
    $454,11
    $634,62
    $964,37     		$710,66
    $806,60
    $908,22
    $1 269,24
    $1 928,74     		$982,49
    $1 078,43
    $1 180,05
    $1 541,07     		$1 254,32
    $1 350,26
    $1 451,88
    $1 812,90     		$1 526,15
    $1 622,09
    $1 723,71
    $2 084,73     		$627,16
    $675,13
    $725,94
    $906,45     		$898,99
    $946,96
    $997,77
    $1 178,28     		$1 170,82
    $1 218,79
    $1 269,60
    $1 450,11     		$271,83
    Toc - Plan #25

    Silver

    (HMO) Anthem Silver Pathway X 6550

    Annual Out of Pocket Expenses
    Individual Family
    $6,550 $13,100 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$338,65
    $384,37
    $432,79
    $604,83
    $919,10     		$677,30
    $768,74
    $865,58
    $1 209,66
    $1 838,20     		$936,37
    $1 027,81
    $1 124,65
    $1 468,73     		$1 195,44
    $1 286,88
    $1 383,72
    $1 727,80     		$1 454,51
    $1 545,95
    $1 642,79
    $1 986,87     		$597,72
    $643,44
    $691,86
    $863,90     		$856,79
    $902,51
    $950,93
    $1 122,97     		$1 115,86
    $1 161,58
    $1 210,00
    $1 382,04     		$259,07
    Toc - Plan #26

    Gold

    (HMO) Anthem Gold Pathway X 2700

    Annual Out of Pocket Expenses
    Individual Family
    $2,700 $5,400 Annual Deductible
    $5,350 $10,700 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$406,39
    $461,25
    $519,37
    $725,81
    $1 102,94     		$812,78
    $922,50
    $1 038,74
    $1 451,62
    $2 205,88     		$1 123,67
    $1 233,39
    $1 349,63
    $1 762,51     		$1 434,56
    $1 544,28
    $1 660,52
    $2 073,40     		$1 745,45
    $1 855,17
    $1 971,41
    $2 384,29     		$717,28
    $772,14
    $830,26
    $1 036,70     		$1 028,17
    $1 083,03
    $1 141,15
    $1 347,59     		$1 339,06
    $1 393,92
    $1 452,04
    $1 658,48     		$310,89
    ADVERTISEMENT

    Network Health

    Local: 1-920-720-1400x1400 | Toll Free: 1-855-275-1400 | TTY: 1-800-947-3529
    Toc - Plan #27

    Expanded Bronze

    (HMO) Prestige Bronze 20 HDHP + Dental + Vision

    Annual Out of Pocket Expenses
    Individual Family
    $6,500 $13,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$375,06
    $425,70
    $479,33
    $669,86
    $1 017,91     		$750,12
    $851,40
    $958,66
    $1 339,72
    $2 035,82     		$1 037,04
    $1 138,32
    $1 245,58
    $1 626,64     		$1 323,96
    $1 425,24
    $1 532,50
    $1 913,56     		$1 610,88
    $1 712,16
    $1 819,42
    $2 200,48     		$661,98
    $712,62
    $766,25
    $956,78     		$948,90
    $999,54
    $1 053,17
    $1 243,70     		$1 235,82
    $1 286,46
    $1 340,09
    $1 530,62     		$286,92
    Toc - Plan #28

    Silver

    (HMO) Prestige Silver 20 HDHP + Dental + Vision

    Annual Out of Pocket Expenses
    Individual Family
    $3,500 $7,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$578,90
    $657,05
    $739,83
    $1 033,91
    $1 571,13     		$1 157,80
    $1 314,10
    $1 479,66
    $2 067,82
    $3 142,26     		$1 600,66
    $1 756,96
    $1 922,52
    $2 510,68     		$2 043,52
    $2 199,82
    $2 365,38
    $2 953,54     		$2 486,38
    $2 642,68
    $2 808,24
    $3 396,40     		$1 021,76
    $1 099,91
    $1 182,69
    $1 476,77     		$1 464,62
    $1 542,77
    $1 625,55
    $1 919,63     		$1 907,48
    $1 985,63
    $2 068,41
    $2 362,49     		$442,86
    Toc - Plan #29

    Expanded Bronze

    (HMO) Prestige Bronze Essential + Dental + Vision + Fitness + 3 Free PCP Visits

    Annual Out of Pocket Expenses
    Individual Family
    $7,750 $15,500 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$360,93
    $409,65
    $461,27
    $644,62
    $979,55     		$721,86
    $819,30
    $922,54
    $1 289,24
    $1 959,10     		$997,97
    $1 095,41
    $1 198,65
    $1 565,35     		$1 274,08
    $1 371,52
    $1 474,76
    $1 841,46     		$1 550,19
    $1 647,63
    $1 750,87
    $2 117,57     		$637,04
    $685,76
    $737,38
    $920,73     		$913,15
    $961,87
    $1 013,49
    $1 196,84     		$1 189,26
    $1 237,98
    $1 289,60
    $1 472,95     		$276,11
    Toc - Plan #30

    Silver

    (HMO) Prestige Silver Essential + Dental + Vision + Fitness + 3 Free PCP Visits

    Annual Out of Pocket Expenses
    Individual Family
    $4,000 $8,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$552,42
    $627,00
    $706,00
    $986,62
    $1 499,27     		$1 104,84
    $1 254,00
    $1 412,00
    $1 973,24
    $2 998,54     		$1 527,45
    $1 676,61
    $1 834,61
    $2 395,85     		$1 950,06
    $2 099,22
    $2 257,22
    $2 818,46     		$2 372,67
    $2 521,83
    $2 679,83
    $3 241,07     		$975,03
    $1 049,61
    $1 128,61
    $1 409,23     		$1 397,64
    $1 472,22
    $1 551,22
    $1 831,84     		$1 820,25
    $1 894,83
    $1 973,83
    $2 254,45     		$422,61
    Toc - Plan #31

    Gold

    (HMO) Prestige Gold Essential + Dental + Vision + Fitness + 3 Free PCP Visits

    Annual Out of Pocket Expenses
    Individual Family
    $1,750 $3,500 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$547,53
    $621,45
    $699,75
    $977,89
    $1 485,99     		$1 095,06
    $1 242,90
    $1 399,50
    $1 955,78
    $2 971,98     		$1 513,92
    $1 661,76
    $1 818,36
    $2 374,64     		$1 932,78
    $2 080,62
    $2 237,22
    $2 793,50     		$2 351,64
    $2 499,48
    $2 656,08
    $3 212,36     		$966,39
    $1 040,31
    $1 118,61
    $1 396,75     		$1 385,25
    $1 459,17
    $1 537,47
    $1 815,61     		$1 804,11
    $1 878,03
    $1 956,33
    $2 234,47     		$418,86
    Toc - Plan #32

    Expanded Bronze

    (HMO) Prestige Bronze 0 + Dental + Vision

    Annual Out of Pocket Expenses
    Individual Family
    $8,550 $17,100 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$335,58
    $380,88
    $428,87
    $599,34
    $910,76     		$671,16
    $761,76
    $857,74
    $1 198,68
    $1 821,52     		$927,88
    $1 018,48
    $1 114,46
    $1 455,40     		$1 184,60
    $1 275,20
    $1 371,18
    $1 712,12     		$1 441,32
    $1 531,92
    $1 627,90
    $1 968,84     		$592,30
    $637,60
    $685,59
    $856,06     		$849,02
    $894,32
    $942,31
    $1 112,78     		$1 105,74
    $1 151,04
    $1 199,03
    $1 369,50     		$256,72
    Toc - Plan #33

    Gold

    (HMO) Prestige Gold 50 + Dental + Vision

    Annual Out of Pocket Expenses
    Individual Family
    $1,000 $2,000 Annual Deductible
    $4,300 $8,600 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$564,65
    $640,88
    $721,63
    $1 008,47
    $1 532,47     		$1 129,30
    $1 281,76
    $1 443,26
    $2 016,94
    $3 064,94     		$1 561,26
    $1 713,72
    $1 875,22
    $2 448,90     		$1 993,22
    $2 145,68
    $2 307,18
    $2 880,86     		$2 425,18
    $2 577,64
    $2 739,14
    $3 312,82     		$996,61
    $1 072,84
    $1 153,59
    $1 440,43     		$1 428,57
    $1 504,80
    $1 585,55
    $1 872,39     		$1 860,53
    $1 936,76
    $2 017,51
    $2 304,35     		$431,96
    Toc - Plan #34

    Gold

    (HMO) Prestige Gold 0 HDHP + Dental + Vision

    Annual Out of Pocket Expenses
    Individual Family
    $2,800 $5,600 Annual Deductible
    $5,000 $10,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$572,15
    $649,38
    $731,20
    $1 021,85
    $1 552,79     		$1 144,30
    $1 298,76
    $1 462,40
    $2 043,70
    $3 105,58     		$1 581,99
    $1 736,45
    $1 900,09
    $2 481,39     		$2 019,68
    $2 174,14
    $2 337,78
    $2 919,08     		$2 457,37
    $2 611,83
    $2 775,47
    $3 356,77     		$1 009,84
    $1 087,07
    $1 168,89
    $1 459,54     		$1 447,53
    $1 524,76
    $1 606,58
    $1 897,23     		$1 885,22
    $1 962,45
    $2 044,27
    $2 334,92     		$437,69
    ADVERTISEMENT

    Arise Health Plan

    Local: 1-920-490-6900 | Toll Free: 1-800-332-6249 | TTY: 1-888-332-0144
    Toc - Plan #35

    Bronze

    (HMO) WPS HMO Bronze $8,550 | Select Network

    Annual Out of Pocket Expenses
    Individual Family
    $8,550 $17,100 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$318,18
    $361,13
    $406,63
    $568,27
    $863,54     		$636,36
    $722,26
    $813,26
    $1 136,54
    $1 727,08     		$879,77
    $965,67
    $1 056,67
    $1 379,95     		$1 123,18
    $1 209,08
    $1 300,08
    $1 623,36     		$1 366,59
    $1 452,49
    $1 543,49
    $1 866,77     		$561,59
    $604,54
    $650,04
    $811,68     		$805,00
    $847,95
    $893,45
    $1 055,09     		$1 048,41
    $1 091,36
    $1 136,86
    $1 298,50     		$243,41
    Toc - Plan #36

    Expanded Bronze

    (HMO) WPS HMO Bronze $6,500 with 3 Free PCP Visits | Select Network

    Annual Out of Pocket Expenses
    Individual Family
    $6,500 $13,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$330,38
    $374,98
    $422,23
    $590,06
    $896,65     		$660,76
    $749,96
    $844,46
    $1 180,12
    $1 793,30     		$913,50
    $1 002,70
    $1 097,20
    $1 432,86     		$1 166,24
    $1 255,44
    $1 349,94
    $1 685,60     		$1 418,98
    $1 508,18
    $1 602,68
    $1 938,34     		$583,12
    $627,72
    $674,97
    $842,80     		$835,86
    $880,46
    $927,71
    $1 095,54     		$1 088,60
    $1 133,20
    $1 180,45
    $1 348,28     		$252,74
    Toc - Plan #37

    Expanded Bronze

    (HMO) WPS HMO Bronze $7,200 | Select Network

    Annual Out of Pocket Expenses
    Individual Family
    $7,200 $14,400 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$323,70
    $367,40
    $413,69
    $578,13
    $878,52     		$647,40
    $734,80
    $827,38
    $1 156,26
    $1 757,04     		$895,03
    $982,43
    $1 075,01
    $1 403,89     		$1 142,66
    $1 230,06
    $1 322,64
    $1 651,52     		$1 390,29
    $1 477,69
    $1 570,27
    $1 899,15     		$571,33
    $615,03
    $661,32
    $825,76     		$818,96
    $862,66
    $908,95
    $1 073,39     		$1 066,59
    $1 110,29
    $1 156,58
    $1 321,02     		$247,63
    Toc - Plan #38

    Silver

    (HMO) WPS HMO Silver $7,500 | Select Network

    Annual Out of Pocket Expenses
    Individual Family
    $7,500 $15,000 Annual Deductible
    $7,500 $15,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$427,74
    $485,48
    $546,65
    $763,94
    $1 160,89     		$855,48
    $970,96
    $1 093,30
    $1 527,88
    $2 321,78     		$1 182,70
    $1 298,18
    $1 420,52
    $1 855,10     		$1 509,92
    $1 625,40
    $1 747,74
    $2 182,32     		$1 837,14
    $1 952,62
    $2 074,96
    $2 509,54     		$754,96
    $812,70
    $873,87
    $1 091,16     		$1 082,18
    $1 139,92
    $1 201,09
    $1 418,38     		$1 409,40
    $1 467,14
    $1 528,31
    $1 745,60     		$327,22
    Toc - Plan #39

    Silver

    (HMO) WPS HMO Silver $4,500 | Select Network

    Annual Out of Pocket Expenses
    Individual Family
    $4,500 $9,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$428,76
    $486,64
    $547,96
    $765,77
    $1 163,65     		$857,52
    $973,28
    $1 095,92
    $1 531,54
    $2 327,30     		$1 185,52
    $1 301,28
    $1 423,92
    $1 859,54     		$1 513,52
    $1 629,28
    $1 751,92
    $2 187,54     		$1 841,52
    $1 957,28
    $2 079,92
    $2 515,54     		$756,76
    $814,64
    $875,96
    $1 093,77     		$1 084,76
    $1 142,64
    $1 203,96
    $1 421,77     		$1 412,76
    $1 470,64
    $1 531,96
    $1 749,77     		$328,00
    Toc - Plan #40

    Silver

    (HMO) WPS HMO Silver $5,000 with 3 Free PCP Visits | Select Network

    Annual Out of Pocket Expenses
    Individual Family
    $5,000 $10,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$446,00
    $506,21
    $569,99
    $796,56
    $1 210,44     		$892,00
    $1 012,42
    $1 139,98
    $1 593,12
    $2 420,88     		$1 233,19
    $1 353,61
    $1 481,17
    $1 934,31     		$1 574,38
    $1 694,80
    $1 822,36
    $2 275,50     		$1 915,57
    $2 035,99
    $2 163,55
    $2 616,69     		$787,19
    $847,40
    $911,18
    $1 137,75     		$1 128,38
    $1 188,59
    $1 252,37
    $1 478,94     		$1 469,57
    $1 529,78
    $1 593,56
    $1 820,13     		$341,19
    Toc - Plan #41

    Gold

    (HMO) WPS HMO Gold $2,500 | Select Network

    Annual Out of Pocket Expenses
    Individual Family
    $2,500 $5,000 Annual Deductible
    $5,000 $10,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$590,79
    $670,55
    $755,03
    $1 055,15
    $1 603,40     		$1 181,58
    $1 341,10
    $1 510,06
    $2 110,30
    $3 206,80     		$1 633,53
    $1 793,05
    $1 962,01
    $2 562,25     		$2 085,48
    $2 245,00
    $2 413,96
    $3 014,20     		$2 537,43
    $2 696,95
    $2 865,91
    $3 466,15     		$1 042,74
    $1 122,50
    $1 206,98
    $1 507,10     		$1 494,69
    $1 574,45
    $1 658,93
    $1 959,05     		$1 946,64
    $2 026,40
    $2 110,88
    $2 411,00     		$451,95
    Toc - Plan #42

    Catastrophic

    (HMO) WPS HMO Catastrophic $8,550 with 3 Free PCP Visits | Select Network

    Annual Out of Pocket Expenses
    Individual Family
    $8,550 $17,100 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$276,62
    $313,96
    $353,52
    $494,04
    $750,75     		$553,24
    $627,92
    $707,04
    $988,08
    $1 501,50     		$764,85
    $839,53
    $918,65
    $1 199,69     		$976,46
    $1 051,14
    $1 130,26
    $1 411,30     		$1 188,07
    $1 262,75
    $1 341,87
    $1 622,91     		$488,23
    $525,57
    $565,13
    $705,65     		$699,84
    $737,18
    $776,74
    $917,26     		$911,45
    $948,79
    $988,35
    $1 128,87     		$211,61
    Toc - Plan #43

    Expanded Bronze

    (HMO) WPS HMO HDHP Bronze $7,000 | Select Network

    Annual Out of Pocket Expenses
    Individual Family
    $7,000 $14,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$330,78
    $375,44
    $422,74
    $590,77
    $897,74     		$661,56
    $750,88
    $845,48
    $1 181,54
    $1 795,48     		$914,61
    $1 003,93
    $1 098,53
    $1 434,59     		$1 167,66
    $1 256,98
    $1 351,58
    $1 687,64     		$1 420,71
    $1 510,03
    $1 604,63
    $1 940,69     		$583,83
    $628,49
    $675,79
    $843,82     		$836,88
    $881,54
    $928,84
    $1 096,87     		$1 089,93
    $1 134,59
    $1 181,89
    $1 349,92     		$253,05
    Toc - Plan #44

    Expanded Bronze

    (HMO) WPS HMO HDHP Bronze $6,830 | Select Network

    Annual Out of Pocket Expenses
    Individual Family
    $6,830 $13,660 Annual Deductible
    $6,830 $13,660 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$337,53
    $383,10
    $431,36
    $602,83
    $916,06     		$675,06
    $766,20
    $862,72
    $1 205,66
    $1 832,12     		$933,27
    $1 024,41
    $1 120,93
    $1 463,87     		$1 191,48
    $1 282,62
    $1 379,14
    $1 722,08     		$1 449,69
    $1 540,83
    $1 637,35
    $1 980,29     		$595,74
    $641,31
    $689,57
    $861,04     		$853,95
    $899,52
    $947,78
    $1 119,25     		$1 112,16
    $1 157,73
    $1 205,99
    $1 377,46     		$258,21
    Toc - Plan #45

    Expanded Bronze

    (HMO) WPS HMO HDHP Bronze $6,000 | Select Network

    Annual Out of Pocket Expenses
    Individual Family
    $6,000 $12,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$331,47
    $376,22
    $423,62
    $592,01
    $899,61     		$662,94
    $752,44
    $847,24
    $1 184,02
    $1 799,22     		$916,51
    $1 006,01
    $1 100,81
    $1 437,59     		$1 170,08
    $1 259,58
    $1 354,38
    $1 691,16     		$1 423,65
    $1 513,15
    $1 607,95
    $1 944,73     		$585,04
    $629,79
    $677,19
    $845,58     		$838,61
    $883,36
    $930,76
    $1 099,15     		$1 092,18
    $1 136,93
    $1 184,33
    $1 352,72     		$253,57
    Toc - Plan #46

    Silver

    (HMO) WPS HMO HDHP Silver $2,800 | Select Network

    Annual Out of Pocket Expenses
    Individual Family
    $2,800 $5,600 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$439,59
    $498,93
    $561,80
    $785,11
    $1 193,05     		$879,18
    $997,86
    $1 123,60
    $1 570,22
    $2 386,10     		$1 215,47
    $1 334,15
    $1 459,89
    $1 906,51     		$1 551,76
    $1 670,44
    $1 796,18
    $2 242,80     		$1 888,05
    $2 006,73
    $2 132,47
    $2 579,09     		$775,88
    $835,22
    $898,09
    $1 121,40     		$1 112,17
    $1 171,51
    $1 234,38
    $1 457,69     		$1 448,46
    $1 507,80
    $1 570,67
    $1 793,98     		$336,29
    Toc - Plan #47

    Silver

    (HMO) WPS HMO HDHP Silver $4,500 | Select Network

    Annual Out of Pocket Expenses
    Individual Family
    $4,500 $9,000 Annual Deductible
    $4,500 $9,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$438,57
    $497,78
    $560,49
    $783,29
    $1 190,28     		$877,14
    $995,56
    $1 120,98
    $1 566,58
    $2 380,56     		$1 212,65
    $1 331,07
    $1 456,49
    $1 902,09     		$1 548,16
    $1 666,58
    $1 792,00
    $2 237,60     		$1 883,67
    $2 002,09
    $2 127,51
    $2 573,11     		$774,08
    $833,29
    $896,00
    $1 118,80     		$1 109,59
    $1 168,80
    $1 231,51
    $1 454,31     		$1 445,10
    $1 504,31
    $1 567,02
    $1 789,82     		$335,51
    Toc - Plan #48

    Silver

    (HMO) WPS HMO HDHP Silver $5,500 | Select Network

    Annual Out of Pocket Expenses
    Individual Family
    $5,500 $11,000 Annual Deductible
    $5,500 $11,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$416,43
    $472,65
    $532,20
    $743,74
    $1 130,19     		$832,86
    $945,30
    $1 064,40
    $1 487,48
    $2 260,38     		$1 151,43
    $1 263,87
    $1 382,97
    $1 806,05     		$1 470,00
    $1 582,44
    $1 701,54
    $2 124,62     		$1 788,57
    $1 901,01
    $2 020,11
    $2 443,19     		$735,00
    $791,22
    $850,77
    $1 062,31     		$1 053,57
    $1 109,79
    $1 169,34
    $1 380,88     		$1 372,14
    $1 428,36
    $1 487,91
    $1 699,45     		$318,57
    Toc - Plan #49

    Bronze

    (POS) WPS POS Bronze $8,550 | Select Network

    Annual Out of Pocket Expenses
    Individual Family
    $8,550 $17,100 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$340,33
    $386,27
    $434,94
    $607,83
    $923,66     		$680,66
    $772,54
    $869,88
    $1 215,66
    $1 847,32     		$941,01
    $1 032,89
    $1 130,23
    $1 476,01     		$1 201,36
    $1 293,24
    $1 390,58
    $1 736,36     		$1 461,71
    $1 553,59
    $1 650,93
    $1 996,71     		$600,68
    $646,62
    $695,29
    $868,18     		$861,03
    $906,97
    $955,64
    $1 128,53     		$1 121,38
    $1 167,32
    $1 215,99
    $1 388,88     		$260,35
    Toc - Plan #50

    Expanded Bronze

    (POS) WPS POS HDHP Bronze $6,000 | Select Network

    Annual Out of Pocket Expenses
    Individual Family
    $6,000 $12,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$354,49
    $402,35
    $453,04
    $633,12
    $962,09     		$708,98
    $804,70
    $906,08
    $1 266,24
    $1 924,18     		$980,16
    $1 075,88
    $1 177,26
    $1 537,42     		$1 251,34
    $1 347,06
    $1 448,44
    $1 808,60     		$1 522,52
    $1 618,24
    $1 719,62
    $2 079,78     		$625,67
    $673,53
    $724,22
    $904,30     		$896,85
    $944,71
    $995,40
    $1 175,48     		$1 168,03
    $1 215,89
    $1 266,58
    $1 446,66     		$271,18
    ADVERTISEMENT

    Common Ground Healthcare Cooperative

    Local: 1-877-514-2442 | Toll Free: 1-877-514-2442 | TTY: 1-844-472-2442
    Toc - Plan #51

    Gold

    (EPO) Envision - Gold 1800/80

    Annual Out of Pocket Expenses
    Individual Family
    $1,800 $3,600 Annual Deductible
    $6,500 $13,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$471,45
    $535,09
    $602,50
    $842,00
    $1 279,49     		$942,90
    $1 070,18
    $1 205,00
    $1 684,00
    $2 558,98     		$1 303,55
    $1 430,83
    $1 565,65
    $2 044,65     		$1 664,20
    $1 791,48
    $1 926,30
    $2 405,30     		$2 024,85
    $2 152,13
    $2 286,95
    $2 765,95     		$832,10
    $895,74
    $963,15
    $1 202,65     		$1 192,75
    $1 256,39
    $1 323,80
    $1 563,30     		$1 553,40
    $1 617,04
    $1 684,45
    $1 923,95     		$360,65
    Toc - Plan #52

    Gold

    (EPO) Envision - Gold 2000/80

    Annual Out of Pocket Expenses
    Individual Family
    $2,000 $4,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$443,26
    $503,08
    $566,47
    $791,64
    $1 202,97     		$886,52
    $1 006,16
    $1 132,94
    $1 583,28
    $2 405,94     		$1 225,60
    $1 345,24
    $1 472,02
    $1 922,36     		$1 564,68
    $1 684,32
    $1 811,10
    $2 261,44     		$1 903,76
    $2 023,40
    $2 150,18
    $2 600,52     		$782,34
    $842,16
    $905,55
    $1 130,72     		$1 121,42
    $1 181,24
    $1 244,63
    $1 469,80     		$1 460,50
    $1 520,32
    $1 583,71
    $1 808,88     		$339,08
    Toc - Plan #53

    Silver

    (EPO) Envision - Silver 4000/75

    Annual Out of Pocket Expenses
    Individual Family
    $4,000 $8,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$433,52
    $492,03
    $554,02
    $774,24
    $1 176,54     		$867,04
    $984,06
    $1 108,04
    $1 548,48
    $2 353,08     		$1 198,67
    $1 315,69
    $1 439,67
    $1 880,11     		$1 530,30
    $1 647,32
    $1 771,30
    $2 211,74     		$1 861,93
    $1 978,95
    $2 102,93
    $2 543,37     		$765,15
    $823,66
    $885,65
    $1 105,87     		$1 096,78
    $1 155,29
    $1 217,28
    $1 437,50     		$1 428,41
    $1 486,92
    $1 548,91
    $1 769,13     		$331,63
    Toc - Plan #54

    Silver

    (EPO) Envision - Silver 3000/75/Copay40

    Annual Out of Pocket Expenses
    Individual Family
    $3,000 $6,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$453,38
    $514,57
    $579,40
    $809,71
    $1 230,44     		$906,76
    $1 029,14
    $1 158,80
    $1 619,42
    $2 460,88     		$1 253,59
    $1 375,97
    $1 505,63
    $1 966,25     		$1 600,42
    $1 722,80
    $1 852,46
    $2 313,08     		$1 947,25
    $2 069,63
    $2 199,29
    $2 659,91     		$800,21
    $861,40
    $926,23
    $1 156,54     		$1 147,04
    $1 208,23
    $1 273,06
    $1 503,37     		$1 493,87
    $1 555,06
    $1 619,89
    $1 850,20     		$346,83
    Toc - Plan #55

    Catastrophic

    (EPO) Envision - Catastrophic 8550/100

    Annual Out of Pocket Expenses
    Individual Family
    $8,550 $17,100 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$214,55
    $243,50
    $274,18
    $383,16
    $582,26     		$429,10
    $487,00
    $548,36
    $766,32
    $1 164,52     		$593,22
    $651,12
    $712,48
    $930,44     		$757,34
    $815,24
    $876,60
    $1 094,56     		$921,46
    $979,36
    $1 040,72
    $1 258,68     		$378,67
    $407,62
    $438,30
    $547,28     		$542,79
    $571,74
    $602,42
    $711,40     		$706,91
    $735,86
    $766,54
    $875,52     		$164,12
    Toc - Plan #56

    Expanded Bronze

    (EPO) Envision - Bronze 8550/100

    Annual Out of Pocket Expenses
    Individual Family
    $8,550 $17,100 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$301,84
    $342,58
    $385,74
    $539,07
    $819,16     		$603,68
    $685,16
    $771,48
    $1 078,14
    $1 638,32     		$834,58
    $916,06
    $1 002,38
    $1 309,04     		$1 065,48
    $1 146,96
    $1 233,28
    $1 539,94     		$1 296,38
    $1 377,86
    $1 464,18
    $1 770,84     		$532,74
    $573,48
    $616,64
    $769,97     		$763,64
    $804,38
    $847,54
    $1 000,87     		$994,54
    $1 035,28
    $1 078,44
    $1 231,77     		$230,90
    Toc - Plan #57

    Expanded Bronze

    (EPO) Envision - Bronze 8150/ 100

    Annual Out of Pocket Expenses
    Individual Family
    $8,150 $16,300 Annual Deductible
    $8,150 $16,300 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$321,52
    $364,91
    $410,89
    $574,22
    $872,58     		$643,04
    $729,82
    $821,78
    $1 148,44
    $1 745,16     		$888,99
    $975,77
    $1 067,73
    $1 394,39     		$1 134,94
    $1 221,72
    $1 313,68
    $1 640,34     		$1 380,89
    $1 467,67
    $1 559,63
    $1 886,29     		$567,47
    $610,86
    $656,84
    $820,17     		$813,42
    $856,81
    $902,79
    $1 066,12     		$1 059,37
    $1 102,76
    $1 148,74
    $1 312,07     		$245,95
    Toc - Plan #58

    Expanded Bronze

    (EPO) Envision - HSA Bronze 7000/100

    Annual Out of Pocket Expenses
    Individual Family
    $7,000 $14,000 Annual Deductible
    $7,000 $14,000 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$318,92
    $361,96
    $407,56
    $569,57
    $865,51     		$637,84
    $723,92
    $815,12
    $1 139,14
    $1 731,02     		$881,80
    $967,88
    $1 059,08
    $1 383,10     		$1 125,76
    $1 211,84
    $1 303,04
    $1 627,06     		$1 369,72
    $1 455,80
    $1 547,00
    $1 871,02     		$562,88
    $605,92
    $651,52
    $813,53     		$806,84
    $849,88
    $895,48
    $1 057,49     		$1 050,80
    $1 093,84
    $1 139,44
    $1 301,45     		$243,96
    Toc - Plan #59

    Silver

    (EPO) Envision - Silver 7000/75

    Annual Out of Pocket Expenses
    Individual Family
    $7,000 $14,000 Annual Deductible
    $8,550 $17,100 Maximum Out of Pocket Per Year
    Monthly Premiums:
    Age Individual
    		 Couple
    		Couple
    1 Child
    		 Couple
    2 Chidren
    		 Couple
    3+ Children
    		 Individual
    1 Child
    		 Individual
    2 Children
    		 Individual
    3+ Children
    		 Child
    0-14
    21
    30
    40
    50
    60     		$360,44
    $409,09
    $460,63
    $643,73
    $978,21     		$720,88
    $818,18
    $921,26
    $1 287,46
    $1 956,42     		$996,61
    $1 093,91
    $1 196,99
    $1 563,19     		$1 272,34
    $1 369,64
    $1 472,72
    $1 838,92     		$1 548,07
    $1 645,37
    $1 748,45
    $2 114,65     		$636,17
    $684,82
    $736,36
    $919,46     		$911,90
    $960,55
    $1 012,09
    $1 195,19     		$1 187,63
    $1 236,28
    $1 287,82
    $1 470,92     		$275,73

    ‡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 Washington County here.

    Washington County is in “Rating Area 12” of Wisconsin.

    Currently, there are 59 plans offered in Rating Area 12.

    Obamacare Rates and Providers for Other Years

    2014 | 2015 | 2016| 2017 | 2018 | 2019 2020 2021

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