McHenry County, Illinois 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 McHenry County, IL.

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, 49 Plans and 2024 Rates for McHenry County, Illinois

Below, you’ll find a summary of the 49 plans for McHenry County, Illinois 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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Blue Cross and Blue Shield of Illinois

Local: 1-800-538-8833 | Toll Free: 1-800-538-8833 | TTY: 1-800-526-0844
Toc - Plan #1 Blue Cross and Blue Shield of Illinois
Gold

(HMO) Blue Precision Gold HMO? 207

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$750 $1,500 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 		$434.48
$493.14
$555.27
$775.99
$1,179.19 		$766.86
$825.52
$887.65
$1,108.37 		$1,099.24
$1,157.90
$1,220.03
$1,440.75 		$1,431.62
$1,490.28
$1,552.41
$1,773.13 		$332.38
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$868.96
$986.28
$1,110.54
$1,551.98
$2,358.38 		$1,201.34
$1,318.66
$1,442.92
$1,884.36 		$1,533.72
$1,651.04
$1,775.30
$2,216.74 		$1,866.10
$1,983.42
$2,107.68
$2,549.12 		$332.38
Toc - Plan #2 Blue Cross and Blue Shield of Illinois
Silver

(HMO) Blue Precision Silver HMO? 206

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$4,400 $8,800 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 		$363.92
$413.05
$465.09
$649.96
$987.68 		$642.32
$691.45
$743.49
$928.36 		$920.72
$969.85
$1,021.89
$1,206.76 		$1,199.12
$1,248.25
$1,300.29
$1,485.16 		$278.40
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$727.84
$826.10
$930.18
$1,299.92
$1,975.36 		$1,006.24
$1,104.50
$1,208.58
$1,578.32 		$1,284.64
$1,382.90
$1,486.98
$1,856.72 		$1,563.04
$1,661.30
$1,765.38
$2,135.12 		$278.40
Toc - Plan #3 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(HMO) Blue Precision Bronze HMO? 205

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$7,400 $14,800 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 		$314.53
$356.99
$401.96
$561.74
$853.62 		$555.14
$597.60
$642.57
$802.35 		$795.75
$838.21
$883.18
$1,042.96 		$1,036.36
$1,078.82
$1,123.79
$1,283.57 		$240.61
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$629.06
$713.98
$803.92
$1,123.48
$1,707.24 		$869.67
$954.59
$1,044.53
$1,364.09 		$1,110.28
$1,195.20
$1,285.14
$1,604.70 		$1,350.89
$1,435.81
$1,525.75
$1,845.31 		$240.61
Toc - Plan #4 Blue Cross and Blue Shield of Illinois
Gold

(HMO) Blue Precision Gold HMO? 703 - Rx Copays

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$2,000 $4,000 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 		$444.81
$504.85
$568.46
$794.42
$1,207.20 		$785.09
$845.13
$908.74
$1,134.70 		$1,125.37
$1,185.41
$1,249.02
$1,474.98 		$1,465.65
$1,525.69
$1,589.30
$1,815.26 		$340.28
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$889.62
$1,009.70
$1,136.92
$1,588.84
$2,414.40 		$1,229.90
$1,349.98
$1,477.20
$1,929.12 		$1,570.18
$1,690.26
$1,817.48
$2,269.40 		$1,910.46
$2,030.54
$2,157.76
$2,609.68 		$340.28
Toc - Plan #5 Blue Cross and Blue Shield of Illinois
Silver

(HMO) Blue Precision Silver HMO 704? - Rx Copays

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 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 		$380.32
$431.66
$486.05
$679.25
$1,032.18 		$671.26
$722.60
$776.99
$970.19 		$962.20
$1,013.54
$1,067.93
$1,261.13 		$1,253.14
$1,304.48
$1,358.87
$1,552.07 		$290.94
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$760.64
$863.32
$972.10
$1,358.50
$2,064.36 		$1,051.58
$1,154.26
$1,263.04
$1,649.44 		$1,342.52
$1,445.20
$1,553.98
$1,940.38 		$1,633.46
$1,736.14
$1,844.92
$2,231.32 		$290.94
Toc - Plan #6 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(HMO) Blue Precision Bronze HMO? 701 - Rx Copays

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

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 		$308.83
$350.53
$394.69
$551.58
$838.18 		$545.09
$586.79
$630.95
$787.84 		$781.35
$823.05
$867.21
$1,024.10 		$1,017.61
$1,059.31
$1,103.47
$1,260.36 		$236.26
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$617.66
$701.06
$789.38
$1,103.16
$1,676.36 		$853.92
$937.32
$1,025.64
$1,339.42 		$1,090.18
$1,173.58
$1,261.90
$1,575.68 		$1,326.44
$1,409.84
$1,498.16
$1,811.94 		$236.26
Toc - Plan #7 Blue Cross and Blue Shield of Illinois
Gold

(HMO) Blue Precision Gold HMO? 707

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

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 		$438.22
$497.38
$560.05
$782.66
$1,189.33 		$773.46
$832.62
$895.29
$1,117.90 		$1,108.70
$1,167.86
$1,230.53
$1,453.14 		$1,443.94
$1,503.10
$1,565.77
$1,788.38 		$335.24
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$876.44
$994.76
$1,120.10
$1,565.32
$2,378.66 		$1,211.68
$1,330.00
$1,455.34
$1,900.56 		$1,546.92
$1,665.24
$1,790.58
$2,235.80 		$1,882.16
$2,000.48
$2,125.82
$2,571.04 		$335.24
Toc - Plan #8 Blue Cross and Blue Shield of Illinois
Silver

(HMO) Blue Precision Silver HMO? 706

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

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 		$390.26
$442.94
$498.75
$697.00
$1,059.15 		$688.81
$741.49
$797.30
$995.55 		$987.36
$1,040.04
$1,095.85
$1,294.10 		$1,285.91
$1,338.59
$1,394.40
$1,592.65 		$298.55
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$780.52
$885.88
$997.50
$1,394.00
$2,118.30 		$1,079.07
$1,184.43
$1,296.05
$1,692.55 		$1,377.62
$1,482.98
$1,594.60
$1,991.10 		$1,676.17
$1,781.53
$1,893.15
$2,289.65 		$298.55
Toc - Plan #9 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(HMO) Blue Precision Bronze HMO? 708

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

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 		$331.18
$375.88
$423.24
$591.48
$898.81 		$584.53
$629.23
$676.59
$844.83 		$837.88
$882.58
$929.94
$1,098.18 		$1,091.23
$1,135.93
$1,183.29
$1,351.53 		$253.35
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$662.36
$751.76
$846.48
$1,182.96
$1,797.62 		$915.71
$1,005.11
$1,099.83
$1,436.31 		$1,169.06
$1,258.46
$1,353.18
$1,689.66 		$1,422.41
$1,511.81
$1,606.53
$1,943.01 		$253.35
Toc - Plan #10 Blue Cross and Blue Shield of Illinois
Gold

(PPO) Blue Choice Preferred Gold PPO? 204 - Rx Copays

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$750 $1,500 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 		$566.28
$642.72
$723.70
$1,011.37
$1,536.87 		$999.48
$1,075.92
$1,156.90
$1,444.57 		$1,432.68
$1,509.12
$1,590.10
$1,877.77 		$1,865.88
$1,942.32
$2,023.30
$2,310.97 		$433.20
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,132.56
$1,285.44
$1,447.40
$2,022.74
$3,073.74 		$1,565.76
$1,718.64
$1,880.60
$2,455.94 		$1,998.96
$2,151.84
$2,313.80
$2,889.14 		$2,432.16
$2,585.04
$2,747.00
$3,322.34 		$433.20
Toc - Plan #11 Blue Cross and Blue Shield of Illinois
Silver

(PPO) Blue Choice Preferred Silver PPO? 203

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$2,250 $4,500 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 		$478.55
$543.15
$611.58
$854.69
$1,298.78 		$844.64
$909.24
$977.67
$1,220.78 		$1,210.73
$1,275.33
$1,343.76
$1,586.87 		$1,576.82
$1,641.42
$1,709.85
$1,952.96 		$366.09
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$957.10
$1,086.30
$1,223.16
$1,709.38
$2,597.56 		$1,323.19
$1,452.39
$1,589.25
$2,075.47 		$1,689.28
$1,818.48
$1,955.34
$2,441.56 		$2,055.37
$2,184.57
$2,321.43
$2,807.65 		$366.09
Toc - Plan #12 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(PPO) Blue Choice Preferred Bronze PPO? 202

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$4,500 $9,000 Annual Deductible
$7,500 $15,000 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 		$416.23
$472.42
$531.94
$743.38
$1,129.64 		$734.64
$790.83
$850.35
$1,061.79 		$1,053.05
$1,109.24
$1,168.76
$1,380.20 		$1,371.46
$1,427.65
$1,487.17
$1,698.61 		$318.41
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$832.46
$944.84
$1,063.88
$1,486.76
$2,259.28 		$1,150.87
$1,263.25
$1,382.29
$1,805.17 		$1,469.28
$1,581.66
$1,700.70
$2,123.58 		$1,787.69
$1,900.07
$2,019.11
$2,441.99 		$318.41
Toc - Plan #13 Blue Cross and Blue Shield of Illinois
Catastrophic

(PPO) Blue Choice Preferred Security PPO? 200

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

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 		$342.16
$388.35
$437.28
$611.09
$928.61 		$603.91
$650.10
$699.03
$872.84 		$865.66
$911.85
$960.78
$1,134.59 		$1,127.41
$1,173.60
$1,222.53
$1,396.34 		$261.75
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$684.32
$776.70
$874.56
$1,222.18
$1,857.22 		$946.07
$1,038.45
$1,136.31
$1,483.93 		$1,207.82
$1,300.20
$1,398.06
$1,745.68 		$1,469.57
$1,561.95
$1,659.81
$2,007.43 		$261.75
Toc - Plan #14 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(PPO) Blue Choice Preferred Bronze PPO? 201

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

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 		$374.03
$424.52
$478.01
$668.01
$1,015.11 		$660.16
$710.65
$764.14
$954.14 		$946.29
$996.78
$1,050.27
$1,240.27 		$1,232.42
$1,282.91
$1,336.40
$1,526.40 		$286.13
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$748.06
$849.04
$956.02
$1,336.02
$2,030.22 		$1,034.19
$1,135.17
$1,242.15
$1,622.15 		$1,320.32
$1,421.30
$1,528.28
$1,908.28 		$1,606.45
$1,707.43
$1,814.41
$2,194.41 		$286.13
Toc - Plan #15 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(PPO) Blue Choice Preferred Bronze PPO? 601 - Rx Copays

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$7,500 $15,000 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 		$365.93
$415.33
$467.66
$653.56
$993.14 		$645.87
$695.27
$747.60
$933.50 		$925.81
$975.21
$1,027.54
$1,213.44 		$1,205.75
$1,255.15
$1,307.48
$1,493.38 		$279.94
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$731.86
$830.66
$935.32
$1,307.12
$1,986.28 		$1,011.80
$1,110.60
$1,215.26
$1,587.06 		$1,291.74
$1,390.54
$1,495.20
$1,867.00 		$1,571.68
$1,670.48
$1,775.14
$2,146.94 		$279.94
Toc - Plan #16 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(PPO) Blue Choice Preferred Bronze PPO? 701 - Rx Copays

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$9,000 $18,000 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 		$343.89
$390.31
$439.49
$614.18
$933.31 		$606.96
$653.38
$702.56
$877.25 		$870.03
$916.45
$965.63
$1,140.32 		$1,133.10
$1,179.52
$1,228.70
$1,403.39 		$263.07
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$687.78
$780.62
$878.98
$1,228.36
$1,866.62 		$950.85
$1,043.69
$1,142.05
$1,491.43 		$1,213.92
$1,306.76
$1,405.12
$1,754.50 		$1,476.99
$1,569.83
$1,668.19
$2,017.57 		$263.07
Toc - Plan #17 Blue Cross and Blue Shield of Illinois
Gold

(PPO) Blue Choice Preferred Gold PPO? 707

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

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 		$556.19
$631.27
$710.81
$993.35
$1,509.49 		$981.67
$1,056.75
$1,136.29
$1,418.83 		$1,407.15
$1,482.23
$1,561.77
$1,844.31 		$1,832.63
$1,907.71
$1,987.25
$2,269.79 		$425.48
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,112.38
$1,262.54
$1,421.62
$1,986.70
$3,018.98 		$1,537.86
$1,688.02
$1,847.10
$2,412.18 		$1,963.34
$2,113.50
$2,272.58
$2,837.66 		$2,388.82
$2,538.98
$2,698.06
$3,263.14 		$425.48
Toc - Plan #18 Blue Cross and Blue Shield of Illinois
Silver

(PPO) Blue Choice Preferred Silver PPO? 706

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

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 		$485.16
$550.66
$620.04
$866.50
$1,316.73 		$856.31
$921.81
$991.19
$1,237.65 		$1,227.46
$1,292.96
$1,362.34
$1,608.80 		$1,598.61
$1,664.11
$1,733.49
$1,979.95 		$371.15
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$970.32
$1,101.32
$1,240.08
$1,733.00
$2,633.46 		$1,341.47
$1,472.47
$1,611.23
$2,104.15 		$1,712.62
$1,843.62
$1,982.38
$2,475.30 		$2,083.77
$2,214.77
$2,353.53
$2,846.45 		$371.15
Toc - Plan #19 Blue Cross and Blue Shield of Illinois
Expanded Bronze

(PPO) Blue Choice Preferred Bronze PPO? 708

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

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 		$416.41
$472.62
$532.17
$743.70
$1,130.13 		$734.96
$791.17
$850.72
$1,062.25 		$1,053.51
$1,109.72
$1,169.27
$1,380.80 		$1,372.06
$1,428.27
$1,487.82
$1,699.35 		$318.55
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$832.82
$945.24
$1,064.34
$1,487.40
$2,260.26 		$1,151.37
$1,263.79
$1,382.89
$1,805.95 		$1,469.92
$1,582.34
$1,701.44
$2,124.50 		$1,788.47
$1,900.89
$2,019.99
$2,443.05 		$318.55
Toc - Plan #20 Blue Cross and Blue Shield of Illinois
Silver

(PPO) Blue Choice Preferred Silver PPO? 801 - Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-800-538-8833

Annual Out of Pocket Expenses:

Individual Family
$6,200 $12,400 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 		$471.66
$535.33
$602.78
$842.38
$1,280.08 		$832.48
$896.15
$963.60
$1,203.20 		$1,193.30
$1,256.97
$1,324.42
$1,564.02 		$1,554.12
$1,617.79
$1,685.24
$1,924.84 		$360.82
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$943.32
$1,070.66
$1,205.56
$1,684.76
$2,560.16 		$1,304.14
$1,431.48
$1,566.38
$2,045.58 		$1,664.96
$1,792.30
$1,927.20
$2,406.40 		$2,025.78
$2,153.12
$2,288.02
$2,767.22 		$360.82

ADVERTISEMENT

Cigna Healthcare

Local: 1-877-900-1237 | Toll Free: 1-877-900-1237 | TTY: 1-800-676-3777
Toc - Plan #21 Cigna Healthcare
Expanded Bronze

(HMO) Plus with Northwestern Medicine Bronze 5000 Indiv Med Ded - Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

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 		$365.89
$415.29
$467.61
$653.48
$993.03 		$645.80
$695.20
$747.52
$933.39 		$925.71
$975.11
$1,027.43
$1,213.30 		$1,205.62
$1,255.02
$1,307.34
$1,493.21 		$279.91
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$731.78
$830.58
$935.22
$1,306.96
$1,986.06 		$1,011.69
$1,110.49
$1,215.13
$1,586.87 		$1,291.60
$1,390.40
$1,495.04
$1,866.78 		$1,571.51
$1,670.31
$1,774.95
$2,146.69 		$279.91
Toc - Plan #22 Cigna Healthcare
Silver

(HMO) Plus with Northwestern Medicine Silver 5000 Indiv Med Deductible

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

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 		$406.92
$461.86
$520.05
$726.77
$1,104.39 		$718.22
$773.16
$831.35
$1,038.07 		$1,029.52
$1,084.46
$1,142.65
$1,349.37 		$1,340.82
$1,395.76
$1,453.95
$1,660.67 		$311.30
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$813.84
$923.72
$1,040.10
$1,453.54
$2,208.78 		$1,125.14
$1,235.02
$1,351.40
$1,764.84 		$1,436.44
$1,546.32
$1,662.70
$2,076.14 		$1,747.74
$1,857.62
$1,974.00
$2,387.44 		$311.30
Toc - Plan #23 Cigna Healthcare
Silver

(HMO) Plus with Northwestern Medicine Silver 3000 Indiv Med Ded - Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$3,000 $6,000 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 		$408.37
$463.50
$521.90
$729.36
$1,108.33 		$720.78
$775.91
$834.31
$1,041.77 		$1,033.19
$1,088.32
$1,146.72
$1,354.18 		$1,345.60
$1,400.73
$1,459.13
$1,666.59 		$312.41
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$816.74
$927.00
$1,043.80
$1,458.72
$2,216.66 		$1,129.15
$1,239.41
$1,356.21
$1,771.13 		$1,441.56
$1,551.82
$1,668.62
$2,083.54 		$1,753.97
$1,864.23
$1,981.03
$2,395.95 		$312.41
Toc - Plan #24 Cigna Healthcare
Expanded Bronze

(HMO) Plus Bronze CMS Standard

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

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 		$357.20
$405.42
$456.50
$637.95
$969.43 		$630.46
$678.68
$729.76
$911.21 		$903.72
$951.94
$1,003.02
$1,184.47 		$1,176.98
$1,225.20
$1,276.28
$1,457.73 		$273.26
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$714.40
$810.84
$913.00
$1,275.90
$1,938.86 		$987.66
$1,084.10
$1,186.26
$1,549.16 		$1,260.92
$1,357.36
$1,459.52
$1,822.42 		$1,534.18
$1,630.62
$1,732.78
$2,095.68 		$273.26
Toc - Plan #25 Cigna Healthcare
Silver

(HMO) Plus Silver CMS Standard

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

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 		$402.58
$456.92
$514.49
$719.00
$1,092.59 		$710.55
$764.89
$822.46
$1,026.97 		$1,018.52
$1,072.86
$1,130.43
$1,334.94 		$1,326.49
$1,380.83
$1,438.40
$1,642.91 		$307.97
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$805.16
$913.84
$1,028.98
$1,438.00
$2,185.18 		$1,113.13
$1,221.81
$1,336.95
$1,745.97 		$1,421.10
$1,529.78
$1,644.92
$2,053.94 		$1,729.07
$1,837.75
$1,952.89
$2,361.91 		$307.97
Toc - Plan #26 Cigna Healthcare
Gold

(HMO) Plus Gold CMS Standard - Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

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 		$474.00
$537.99
$605.77
$846.56
$1,286.42 		$836.61
$900.60
$968.38
$1,209.17 		$1,199.22
$1,263.21
$1,330.99
$1,571.78 		$1,561.83
$1,625.82
$1,693.60
$1,934.39 		$362.61
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$948.00
$1,075.98
$1,211.54
$1,693.12
$2,572.84 		$1,310.61
$1,438.59
$1,574.15
$2,055.73 		$1,673.22
$1,801.20
$1,936.76
$2,418.34 		$2,035.83
$2,163.81
$2,299.37
$2,780.95 		$362.61

ADVERTISEMENT

MercyCare Health Plans

Local: 1-877-908-6027 | Toll Free: 

Toc - Plan #27 MercyCare Health Plans
Gold

(HMO) MercyCare HMO Gold Option B

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

Annual Out of Pocket Expenses:

Individual Family
$3,200 $6,400 Annual Deductible
$3,200 $6,400 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 		$437.73
$496.83
$559.42
$781.79
$1,188.00 		$772.60
$831.70
$894.29
$1,116.66 		$1,107.47
$1,166.57
$1,229.16
$1,451.53 		$1,442.34
$1,501.44
$1,564.03
$1,786.40 		$334.87
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$875.46
$993.66
$1,118.84
$1,563.58
$2,376.00 		$1,210.33
$1,328.53
$1,453.71
$1,898.45 		$1,545.20
$1,663.40
$1,788.58
$2,233.32 		$1,880.07
$1,998.27
$2,123.45
$2,568.19 		$334.87
Toc - Plan #28 MercyCare Health Plans
Silver

(HMO) MercyCare HMO Silver Option A

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 Annual Deductible
$8,800 $17,600 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 		$411.46
$467.01
$525.85
$734.87
$1,116.70 		$726.23
$781.78
$840.62
$1,049.64 		$1,041.00
$1,096.55
$1,155.39
$1,364.41 		$1,355.77
$1,411.32
$1,470.16
$1,679.18 		$314.77
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$822.92
$934.02
$1,051.70
$1,469.74
$2,233.40 		$1,137.69
$1,248.79
$1,366.47
$1,784.51 		$1,452.46
$1,563.56
$1,681.24
$2,099.28 		$1,767.23
$1,878.33
$1,996.01
$2,414.05 		$314.77
Toc - Plan #29 MercyCare Health Plans
Silver

(HMO) MercyCare HMO Silver Option B

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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 		$416.99
$473.28
$532.91
$744.74
$1,131.70 		$735.99
$792.28
$851.91
$1,063.74 		$1,054.99
$1,111.28
$1,170.91
$1,382.74 		$1,373.99
$1,430.28
$1,489.91
$1,701.74 		$319.00
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$833.98
$946.56
$1,065.82
$1,489.48
$2,263.40 		$1,152.98
$1,265.56
$1,384.82
$1,808.48 		$1,471.98
$1,584.56
$1,703.82
$2,127.48 		$1,790.98
$1,903.56
$2,022.82
$2,446.48 		$319.00
Toc - Plan #30 MercyCare Health Plans
Gold

(HMO) MercyCare HMO Gold Standard

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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 		$428.92
$486.83
$548.16
$766.05
$1,164.08 		$757.05
$814.96
$876.29
$1,094.18 		$1,085.18
$1,143.09
$1,204.42
$1,422.31 		$1,413.31
$1,471.22
$1,532.55
$1,750.44 		$328.13
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$857.84
$973.66
$1,096.32
$1,532.10
$2,328.16 		$1,185.97
$1,301.79
$1,424.45
$1,860.23 		$1,514.10
$1,629.92
$1,752.58
$2,188.36 		$1,842.23
$1,958.05
$2,080.71
$2,516.49 		$328.13
Toc - Plan #31 MercyCare Health Plans
Silver

(HMO) MercyCare HMO Silver Standard

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone:

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 		$412.83
$468.56
$527.60
$737.31
$1,120.41 		$728.65
$784.38
$843.42
$1,053.13 		$1,044.47
$1,100.20
$1,159.24
$1,368.95 		$1,360.29
$1,416.02
$1,475.06
$1,684.77 		$315.82
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$825.66
$937.12
$1,055.20
$1,474.62
$2,240.82 		$1,141.48
$1,252.94
$1,371.02
$1,790.44 		$1,457.30
$1,568.76
$1,686.84
$2,106.26 		$1,773.12
$1,884.58
$2,002.66
$2,422.08 		$315.82

ADVERTISEMENT

Aetna CVS Health

Local: 1-855-586-6962 | Toll Free: 1-855-586-6962 | TTY: 1-855-586-6962
Toc - Plan #32 Aetna CVS Health
Expanded Bronze

(PPO) Bronze 1 PPO: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care + Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-586-6962

Annual Out of Pocket Expenses:

Individual Family
$8,995 $17,990 Annual Deductible
$9,395 $18,790 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 		$385.84
$437.92
$493.10
$689.10
$1,047.15 		$681.01
$733.09
$788.27
$984.27 		$976.18
$1,028.26
$1,083.44
$1,279.44 		$1,271.35
$1,323.43
$1,378.61
$1,574.61 		$295.17
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$771.68
$875.84
$986.20
$1,378.20
$2,094.30 		$1,066.85
$1,171.01
$1,281.37
$1,673.37 		$1,362.02
$1,466.18
$1,576.54
$1,968.54 		$1,657.19
$1,761.35
$1,871.71
$2,263.71 		$295.17
Toc - Plan #33 Aetna CVS Health
Expanded Bronze

(PPO) Bronze 4 PPO: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-586-6962

Annual Out of Pocket Expenses:

Individual Family
$0 $0 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 		$420.02
$476.73
$536.79
$750.16
$1,139.94 		$741.34
$798.05
$858.11
$1,071.48 		$1,062.66
$1,119.37
$1,179.43
$1,392.80 		$1,383.98
$1,440.69
$1,500.75
$1,714.12 		$321.32
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$840.04
$953.46
$1,073.58
$1,500.32
$2,279.88 		$1,161.36
$1,274.78
$1,394.90
$1,821.64 		$1,482.68
$1,596.10
$1,716.22
$2,142.96 		$1,804.00
$1,917.42
$2,037.54
$2,464.28 		$321.32
Toc - Plan #34 Aetna CVS Health
Expanded Bronze

(PPO) Bronze S PPO: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-586-6962

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 		$380.37
$431.71
$486.11
$679.33
$1,032.30 		$671.35
$722.69
$777.09
$970.31 		$962.33
$1,013.67
$1,068.07
$1,261.29 		$1,253.31
$1,304.65
$1,359.05
$1,552.27 		$290.98
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$760.74
$863.42
$972.22
$1,358.66
$2,064.60 		$1,051.72
$1,154.40
$1,263.20
$1,649.64 		$1,342.70
$1,445.38
$1,554.18
$1,940.62 		$1,633.68
$1,736.36
$1,845.16
$2,231.60 		$290.98
Toc - Plan #35 Aetna CVS Health
Gold

(PPO) Gold 3 PPO: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care + Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-586-6962

Annual Out of Pocket Expenses:

Individual Family
$795 $1,590 Annual Deductible
$9,195 $18,390 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 		$585.41
$664.44
$748.15
$1,045.54
$1,588.80 		$1,033.25
$1,112.28
$1,195.99
$1,493.38 		$1,481.09
$1,560.12
$1,643.83
$1,941.22 		$1,928.93
$2,007.96
$2,091.67
$2,389.06 		$447.84
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,170.82
$1,328.88
$1,496.30
$2,091.08
$3,177.60 		$1,618.66
$1,776.72
$1,944.14
$2,538.92 		$2,066.50
$2,224.56
$2,391.98
$2,986.76 		$2,514.34
$2,672.40
$2,839.82
$3,434.60 		$447.84
Toc - Plan #36 Aetna CVS Health
Gold

(PPO) Gold S PPO: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-586-6962

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 		$580.70
$659.09
$742.13
$1,037.12
$1,576.01 		$1,024.94
$1,103.33
$1,186.37
$1,481.36 		$1,469.18
$1,547.57
$1,630.61
$1,925.60 		$1,913.42
$1,991.81
$2,074.85
$2,369.84 		$444.24
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,161.40
$1,318.18
$1,484.26
$2,074.24
$3,152.02 		$1,605.64
$1,762.42
$1,928.50
$2,518.48 		$2,049.88
$2,206.66
$2,372.74
$2,962.72 		$2,494.12
$2,650.90
$2,816.98
$3,406.96 		$444.24
Toc - Plan #37 Aetna CVS Health
Silver

(PPO) Silver 5 PPO: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care + Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-586-6962

Annual Out of Pocket Expenses:

Individual Family
$8,200 $16,400 Annual Deductible
$8,850 $17,700 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 		$502.94
$570.84
$642.76
$898.25
$1,364.98 		$887.69
$955.59
$1,027.51
$1,283.00 		$1,272.44
$1,340.34
$1,412.26
$1,667.75 		$1,657.19
$1,725.09
$1,797.01
$2,052.50 		$384.75
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,005.88
$1,141.68
$1,285.52
$1,796.50
$2,729.96 		$1,390.63
$1,526.43
$1,670.27
$2,181.25 		$1,775.38
$1,911.18
$2,055.02
$2,566.00 		$2,160.13
$2,295.93
$2,439.77
$2,950.75 		$384.75
Toc - Plan #38 Aetna CVS Health
Silver

(PPO) Silver 7 PPO: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care + Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-586-6962

Annual Out of Pocket Expenses:

Individual Family
$7,795 $15,590 Annual Deductible
$8,845 $17,690 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 		$503.92
$571.94
$644.00
$899.99
$1,367.62 		$889.42
$957.44
$1,029.50
$1,285.49 		$1,274.92
$1,342.94
$1,415.00
$1,670.99 		$1,660.42
$1,728.44
$1,800.50
$2,056.49 		$385.50
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,007.84
$1,143.88
$1,288.00
$1,799.98
$2,735.24 		$1,393.34
$1,529.38
$1,673.50
$2,185.48 		$1,778.84
$1,914.88
$2,059.00
$2,570.98 		$2,164.34
$2,300.38
$2,444.50
$2,956.48 		$385.50
Toc - Plan #39 Aetna CVS Health
Silver

(PPO) Silver S PPO: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-586-6962

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 		$491.17
$557.48
$627.72
$877.23
$1,333.03 		$866.92
$933.23
$1,003.47
$1,252.98 		$1,242.67
$1,308.98
$1,379.22
$1,628.73 		$1,618.42
$1,684.73
$1,754.97
$2,004.48 		$375.75
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$982.34
$1,114.96
$1,255.44
$1,754.46
$2,666.06 		$1,358.09
$1,490.71
$1,631.19
$2,130.21 		$1,733.84
$1,866.46
$2,006.94
$2,505.96 		$2,109.59
$2,242.21
$2,382.69
$2,881.71 		$375.75
Toc - Plan #40 Aetna CVS Health
Silver

(PPO) Silver 6 PPO: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care + Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-586-6962

Annual Out of Pocket Expenses:

Individual Family
$7,795 $15,590 Annual Deductible
$8,445 $16,890 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 		$503.32
$571.27
$643.24
$898.93
$1,366.00 		$888.36
$956.31
$1,028.28
$1,283.97 		$1,273.40
$1,341.35
$1,413.32
$1,669.01 		$1,658.44
$1,726.39
$1,798.36
$2,054.05 		$385.04
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$1,006.64
$1,142.54
$1,286.48
$1,797.86
$2,732.00 		$1,391.68
$1,527.58
$1,671.52
$2,182.90 		$1,776.72
$1,912.62
$2,056.56
$2,567.94 		$2,161.76
$2,297.66
$2,441.60
$2,952.98 		$385.04
Toc - Plan #41 Aetna CVS Health
Expanded Bronze

(HMO) Bronze 1: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

Annual Out of Pocket Expenses:

Individual Family
$8,995 $17,990 Annual Deductible
$9,395 $18,790 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 		$267.19
$303.25
$341.46
$477.19
$725.13 		$471.59
$507.65
$545.86
$681.59 		$675.99
$712.05
$750.26
$885.99 		$880.39
$916.45
$954.66
$1,090.39 		$204.40
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$534.38
$606.50
$682.92
$954.38
$1,450.26 		$738.78
$810.90
$887.32
$1,158.78 		$943.18
$1,015.30
$1,091.72
$1,363.18 		$1,147.58
$1,219.70
$1,296.12
$1,567.58 		$204.40
Toc - Plan #42 Aetna CVS Health
Expanded Bronze

(HMO) Bronze S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

Annual Out of Pocket Expenses:

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 		$263.92
$299.55
$337.29
$471.36
$716.27 		$465.82
$501.45
$539.19
$673.26 		$667.72
$703.35
$741.09
$875.16 		$869.62
$905.25
$942.99
$1,077.06 		$201.90
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$527.84
$599.10
$674.58
$942.72
$1,432.54 		$729.74
$801.00
$876.48
$1,144.62 		$931.64
$1,002.90
$1,078.38
$1,346.52 		$1,133.54
$1,204.80
$1,280.28
$1,548.42 		$201.90
Toc - Plan #43 Aetna CVS Health
Gold

(HMO) Gold S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

Annual Out of Pocket Expenses:

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 		$343.07
$389.38
$438.44
$612.71
$931.07 		$605.52
$651.83
$700.89
$875.16 		$867.97
$914.28
$963.34
$1,137.61 		$1,130.42
$1,176.73
$1,225.79
$1,400.06 		$262.45
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$686.14
$778.76
$876.88
$1,225.42
$1,862.14 		$948.59
$1,041.21
$1,139.33
$1,487.87 		$1,211.04
$1,303.66
$1,401.78
$1,750.32 		$1,473.49
$1,566.11
$1,664.23
$2,012.77 		$262.45
Toc - Plan #44 Aetna CVS Health
Silver

(HMO) Silver 5: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

Annual Out of Pocket Expenses:

Individual Family
$8,395 $16,790 Annual Deductible
$8,885 $17,770 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 		$315.85
$358.49
$403.65
$564.10
$857.21 		$557.48
$600.12
$645.28
$805.73 		$799.11
$841.75
$886.91
$1,047.36 		$1,040.74
$1,083.38
$1,128.54
$1,288.99 		$241.63
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$631.70
$716.98
$807.30
$1,128.20
$1,714.42 		$873.33
$958.61
$1,048.93
$1,369.83 		$1,114.96
$1,200.24
$1,290.56
$1,611.46 		$1,356.59
$1,441.87
$1,532.19
$1,853.09 		$241.63
Toc - Plan #45 Aetna CVS Health
Silver

(HMO) Silver S: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

Annual Out of Pocket Expenses:

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 		$315.45
$358.03
$403.14
$563.39
$856.12 		$556.77
$599.35
$644.46
$804.71 		$798.09
$840.67
$885.78
$1,046.03 		$1,039.41
$1,081.99
$1,127.10
$1,287.35 		$241.32
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$630.90
$716.06
$806.28
$1,126.78
$1,712.24 		$872.22
$957.38
$1,047.60
$1,368.10 		$1,113.54
$1,198.70
$1,288.92
$1,609.42 		$1,354.86
$1,440.02
$1,530.24
$1,850.74 		$241.32
Toc - Plan #46 Aetna CVS Health
Expanded Bronze

(HMO) Bronze 4: Aetna network of doctors & hospitals + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

Annual Out of Pocket Expenses:

Individual Family
$0 $0 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 		$291.01
$330.30
$371.91
$519.74
$789.80 		$513.63
$552.92
$594.53
$742.36 		$736.25
$775.54
$817.15
$964.98 		$958.87
$998.16
$1,039.77
$1,187.60 		$222.62
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$582.02
$660.60
$743.82
$1,039.48
$1,579.60 		$804.64
$883.22
$966.44
$1,262.10 		$1,027.26
$1,105.84
$1,189.06
$1,484.72 		$1,249.88
$1,328.46
$1,411.68
$1,707.34 		$222.62
Toc - Plan #47 Aetna CVS Health
Gold

(HMO) Gold 3: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

Annual Out of Pocket Expenses:

Individual Family
$795 $1,590 Annual Deductible
$9,195 $18,390 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 		$344.16
$390.62
$439.83
$614.66
$934.03 		$607.44
$653.90
$703.11
$877.94 		$870.72
$917.18
$966.39
$1,141.22 		$1,134.00
$1,180.46
$1,229.67
$1,404.50 		$263.28
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$688.32
$781.24
$879.66
$1,229.32
$1,868.06 		$951.60
$1,044.52
$1,142.94
$1,492.60 		$1,214.88
$1,307.80
$1,406.22
$1,755.88 		$1,478.16
$1,571.08
$1,669.50
$2,019.16 		$263.28
Toc - Plan #48 Aetna CVS Health
Silver

(HMO) Silver 6: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

Annual Out of Pocket Expenses:

Individual Family
$7,795 $15,590 Annual Deductible
$8,445 $16,890 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 		$323.15
$366.77
$412.98
$577.14
$877.01 		$570.36
$613.98
$660.19
$824.35 		$817.57
$861.19
$907.40
$1,071.56 		$1,064.78
$1,108.40
$1,154.61
$1,318.77 		$247.21
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$646.30
$733.54
$825.96
$1,154.28
$1,754.02 		$893.51
$980.75
$1,073.17
$1,401.49 		$1,140.72
$1,227.96
$1,320.38
$1,648.70 		$1,387.93
$1,475.17
$1,567.59
$1,895.91 		$247.21
Toc - Plan #49 Aetna CVS Health
Silver

(HMO) Silver 7: Aetna network of doctors + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Rx Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-844-365-7373

Annual Out of Pocket Expenses:

Individual Family
$7,795 $15,590 Annual Deductible
$8,845 $17,690 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 		$323.41
$367.08
$413.32
$577.61
$877.74 		$570.82
$614.49
$660.73
$825.02 		$818.23
$861.90
$908.14
$1,072.43 		$1,065.64
$1,109.31
$1,155.55
$1,319.84 		$247.41
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$646.82
$734.16
$826.64
$1,155.22
$1,755.48 		$894.23
$981.57
$1,074.05
$1,402.63 		$1,141.64
$1,228.98
$1,321.46
$1,650.04 		$1,389.05
$1,476.39
$1,568.87
$1,897.45 		$247.41

‡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 McHenry County here.

McHenry County is in “Rating Area 3” of Illinois.

Currently, there are 49 plans offered in Rating Area 3.

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2024 Obamacare Plans for McHenry County, IL

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