Obamacare 2024 Rates for Adams County, Wisconsin
ADVERTISEMENT
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 Friendship, WI.
The health insurance rates listed below are for calendar year 2024.
For information on subsidies to make your coverage affordable, you must take one of the following actions:
- Contact a licensed health insurance agent
- Complete an application at Healthcare.gov
- Contact the provider directly
Obamacare Providers, 84 Plans and 2024 Rates for Adams County, Wisconsin
Below, you’ll find a summary of the 84 plans for Adams County, Wisconsin and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options.
Obamacare Rates and Providers for Other Years
2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 |
ADVERTISEMENT
QuartzLocal: 1-608-644-3430 | Toll Free: 1-800-362-3310 | TTY: 1-800-877-8973 |
Toc - Plan #1 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I402 MAINTENANCE VALUE TIER RX W/DENTAL |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$461.23 $523.50 $589.45 $823.76 $1,251.78 |
$814.07 $876.34 $942.29 $1,176.60 |
$1,166.91 $1,229.18 $1,295.13 $1,529.44 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$922.46 $1,047.00 $1,178.90 $1,647.52 $2,503.56 |
$1,275.30 $1,399.84 $1,531.74 $2,000.36 |
$1,628.14 $1,752.68 $1,884.58 $2,353.20 |
Toc - Plan #2 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I410 STANDARD W/DENTAL |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$464.83 $527.57 $594.04 $830.17 $1,261.52 |
$820.42 $883.16 $949.63 $1,185.76 |
$1,176.01 $1,238.75 $1,305.22 $1,541.35 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$929.66 $1,055.14 $1,188.08 $1,660.34 $2,523.04 |
$1,285.25 $1,410.73 $1,543.67 $2,015.93 |
$1,640.84 $1,766.32 $1,899.26 $2,371.52 |
Toc - Plan #3 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I308 VALUE TIER RX W/DENTAL |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$491.36 $557.68 $627.95 $877.55 $1,333.53 |
$867.24 $933.56 $1,003.83 $1,253.43 |
$1,243.12 $1,309.44 $1,379.71 $1,629.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$982.72 $1,115.36 $1,255.90 $1,755.10 $2,667.06 |
$1,358.60 $1,491.24 $1,631.78 $2,130.98 |
$1,734.48 $1,867.12 $2,007.66 $2,506.86 |
Toc - Plan #4 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I204 VALUE TIER RX W/DENTAL |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$365.59 $414.94 $467.21 $652.93 $992.19 |
$645.26 $694.61 $746.88 $932.60 |
$924.93 $974.28 $1,026.55 $1,212.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$731.18 $829.88 $934.42 $1,305.86 $1,984.38 |
$1,010.85 $1,109.55 $1,214.09 $1,585.53 |
$1,290.52 $1,389.22 $1,493.76 $1,865.20 |
Toc - Plan #5 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I205 VALUE TIER RX W/DENTAL |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$355.81 $403.84 $454.72 $635.47 $965.65 |
$628.00 $676.03 $726.91 $907.66 |
$900.19 $948.22 $999.10 $1,179.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$711.62 $807.68 $909.44 $1,270.94 $1,931.30 |
$983.81 $1,079.87 $1,181.63 $1,543.13 |
$1,256.00 $1,352.06 $1,453.82 $1,815.32 |
Toc - Plan #6 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I320 VALUE TIER RX W/DENTAL |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$503.05 $570.95 $642.89 $898.43 $1,365.26 |
$887.88 $955.78 $1,027.72 $1,283.26 |
$1,272.71 $1,340.61 $1,412.55 $1,668.09 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,006.10 $1,141.90 $1,285.78 $1,796.86 $2,730.52 |
$1,390.93 $1,526.73 $1,670.61 $2,181.69 |
$1,775.76 $1,911.56 $2,055.44 $2,566.52 |
Toc - Plan #7 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I420 VALUE TIER RX |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$422.62 $479.67 $540.11 $754.80 $1,146.99 |
$745.92 $802.97 $863.41 $1,078.10 |
$1,069.22 $1,126.27 $1,186.71 $1,401.40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$845.24 $959.34 $1,080.22 $1,509.60 $2,293.98 |
$1,168.54 $1,282.64 $1,403.52 $1,832.90 |
$1,491.84 $1,605.94 $1,726.82 $2,156.20 |
Toc - Plan #8 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I402 MAINTENANCE VALUE TIER RX |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$439.25 $498.54 $561.35 $784.49 $1,192.11 |
$775.27 $834.56 $897.37 $1,120.51 |
$1,111.29 $1,170.58 $1,233.39 $1,456.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$878.50 $997.08 $1,122.70 $1,568.98 $2,384.22 |
$1,214.52 $1,333.10 $1,458.72 $1,905.00 |
$1,550.54 $1,669.12 $1,794.74 $2,241.02 |
Toc - Plan #9 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I410 STANDARD |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$442.67 $502.42 $565.72 $790.60 $1,201.39 |
$781.31 $841.06 $904.36 $1,129.24 |
$1,119.95 $1,179.70 $1,243.00 $1,467.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$885.34 $1,004.84 $1,131.44 $1,581.20 $2,402.78 |
$1,223.98 $1,343.48 $1,470.08 $1,919.84 |
$1,562.62 $1,682.12 $1,808.72 $2,258.48 |
Toc - Plan #10 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I308 VALUE TIER RX |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$467.93 $531.10 $598.01 $835.72 $1,269.96 |
$825.90 $889.07 $955.98 $1,193.69 |
$1,183.87 $1,247.04 $1,313.95 $1,551.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$935.86 $1,062.20 $1,196.02 $1,671.44 $2,539.92 |
$1,293.83 $1,420.17 $1,553.99 $2,029.41 |
$1,651.80 $1,778.14 $1,911.96 $2,387.38 |
Toc - Plan #11 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I309 STANDARD |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$455.45 $516.93 $582.06 $813.43 $1,236.09 |
$803.87 $865.35 $930.48 $1,161.85 |
$1,152.29 $1,213.77 $1,278.90 $1,510.27 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$910.90 $1,033.86 $1,164.12 $1,626.86 $2,472.18 |
$1,259.32 $1,382.28 $1,512.54 $1,975.28 |
$1,607.74 $1,730.70 $1,860.96 $2,323.70 |
Toc - Plan #12 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I204 VALUE TIER RX |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$348.16 $395.16 $444.94 $621.81 $944.90 |
$614.50 $661.50 $711.28 $888.15 |
$880.84 $927.84 $977.62 $1,154.49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$696.32 $790.32 $889.88 $1,243.62 $1,889.80 |
$962.66 $1,056.66 $1,156.22 $1,509.96 |
$1,229.00 $1,323.00 $1,422.56 $1,776.30 |
Toc - Plan #13 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I205 VALUE TIER RX |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$338.85 $384.59 $433.04 $605.18 $919.62 |
$598.07 $643.81 $692.26 $864.40 |
$857.29 $903.03 $951.48 $1,123.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$677.70 $769.18 $866.08 $1,210.36 $1,839.24 |
$936.92 $1,028.40 $1,125.30 $1,469.58 |
$1,196.14 $1,287.62 $1,384.52 $1,728.80 |
Toc - Plan #14 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I206 STANDARD |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$323.40 $367.05 $413.30 $577.59 $877.70 |
$570.80 $614.45 $660.70 $824.99 |
$818.20 $861.85 $908.10 $1,072.39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$646.80 $734.10 $826.60 $1,155.18 $1,755.40 |
$894.20 $981.50 $1,074.00 $1,402.58 |
$1,141.60 $1,228.90 $1,321.40 $1,649.98 |
Toc - Plan #15 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I320 VALUE TIER RX |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$479.07 $543.74 $612.24 $855.61 $1,300.18 |
$845.55 $910.22 $978.72 $1,222.09 |
$1,212.03 $1,276.70 $1,345.20 $1,588.57 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$958.14 $1,087.48 $1,224.48 $1,711.22 $2,600.36 |
$1,324.62 $1,453.96 $1,590.96 $2,077.70 |
$1,691.10 $1,820.44 $1,957.44 $2,444.18 |
Toc - Plan #16 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I401 VALUE TIER RX |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
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 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
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 |
Toc - Plan #17 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I303 VALUE TIER RX |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$445.16 $505.25 $568.90 $795.04 $1,208.14 |
$785.70 $845.79 $909.44 $1,135.58 |
$1,126.24 $1,186.33 $1,249.98 $1,476.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$890.32 $1,010.50 $1,137.80 $1,590.08 $2,416.28 |
$1,230.86 $1,351.04 $1,478.34 $1,930.62 |
$1,571.40 $1,691.58 $1,818.88 $2,271.16 |
Toc - Plan #18 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I201 VALUE TIER RX |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$304.75 $345.88 $389.46 $544.27 $827.07 |
$537.88 $579.01 $622.59 $777.40 |
$771.01 $812.14 $855.72 $1,010.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$609.50 $691.76 $778.92 $1,088.54 $1,654.14 |
$842.63 $924.89 $1,012.05 $1,321.67 |
$1,075.76 $1,158.02 $1,245.18 $1,554.80 |
Toc - Plan #19 Quartz | ||||||||||||||||||||
Expanded Bronze
(HMO) QUARTZ ONE BRONZE I203 HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$331.22 $375.93 $423.29 $591.55 $898.92 |
$584.60 $629.31 $676.67 $844.93 |
$837.98 $882.69 $930.05 $1,098.31 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$662.44 $751.86 $846.58 $1,183.10 $1,797.84 |
$915.82 $1,005.24 $1,099.96 $1,436.48 |
$1,169.20 $1,258.62 $1,353.34 $1,689.86 |
Toc - Plan #20 Quartz | ||||||||||||||||||||
Catastrophic
(HMO) QUARTZ ONE CATASTROPHIC I101 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$240.48 $272.94 $307.33 $429.49 $652.65 |
$424.44 $456.90 $491.29 $613.45 |
$608.40 $640.86 $675.25 $797.41 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$480.96 $545.88 $614.66 $858.98 $1,305.30 |
$664.92 $729.84 $798.62 $1,042.94 |
$848.88 $913.80 $982.58 $1,226.90 |
Toc - Plan #21 Quartz | ||||||||||||||||||||
Silver
(HMO) QUARTZ ONE SILVER I304 HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$472.14 $535.87 $603.39 $843.23 $1,281.37 |
$833.32 $897.05 $964.57 $1,204.41 |
$1,194.50 $1,258.23 $1,325.75 $1,565.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$944.28 $1,071.74 $1,206.78 $1,686.46 $2,562.74 |
$1,305.46 $1,432.92 $1,567.96 $2,047.64 |
$1,666.64 $1,794.10 $1,929.14 $2,408.82 |
Toc - Plan #22 Quartz | ||||||||||||||||||||
Gold
(HMO) QUARTZ ONE GOLD I403 HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-362-3310
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$433.16 $491.63 $553.57 $773.62 $1,175.58 |
$764.52 $822.99 $884.93 $1,104.98 |
$1,095.88 $1,154.35 $1,216.29 $1,436.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$866.32 $983.26 $1,107.14 $1,547.24 $2,351.16 |
$1,197.68 $1,314.62 $1,438.50 $1,878.60 |
$1,529.04 $1,645.98 $1,769.86 $2,209.96 |
ADVERTISEMENT
Security Health PlanLocal: 1-715-221-9258x19258 | Toll Free: 1-844-293-9624 | TTY: 1-800-947-3529 |
Toc - Plan #23 Security Health Plan | ||||||||||||||||||||
Gold
(HMO) Premier $1,500 - 25% |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$528.41 $599.73 $675.30 $943.72 $1,434.08 |
$932.64 $1,003.96 $1,079.53 $1,347.95 |
$1,336.87 $1,408.19 $1,483.76 $1,752.18 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,056.82 $1,199.46 $1,350.60 $1,887.44 $2,868.16 |
$1,461.05 $1,603.69 $1,754.83 $2,291.67 |
$1,865.28 $2,007.92 $2,159.06 $2,695.90 |
Toc - Plan #24 Security Health Plan | ||||||||||||||||||||
Gold
(HMO) Premier $3,500 - 30% |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$483.52 $548.78 $617.92 $863.54 $1,312.24 |
$853.40 $918.66 $987.80 $1,233.42 |
$1,223.28 $1,288.54 $1,357.68 $1,603.30 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$967.04 $1,097.56 $1,235.84 $1,727.08 $2,624.48 |
$1,336.92 $1,467.44 $1,605.72 $2,096.96 |
$1,706.80 $1,837.32 $1,975.60 $2,466.84 |
Toc - Plan #25 Security Health Plan | ||||||||||||||||||||
Silver
(HMO) Premier $5,900 - 40% |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$454.95 $516.36 $581.42 $812.53 $1,234.72 |
$802.98 $864.39 $929.45 $1,160.56 |
$1,151.01 $1,212.42 $1,277.48 $1,508.59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$909.90 $1,032.72 $1,162.84 $1,625.06 $2,469.44 |
$1,257.93 $1,380.75 $1,510.87 $1,973.09 |
$1,605.96 $1,728.78 $1,858.90 $2,321.12 |
Toc - Plan #26 Security Health Plan | ||||||||||||||||||||
Silver
(HMO) Premier $4,100 HDHP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$529.47 $600.94 $676.65 $945.61 $1,436.95 |
$934.51 $1,005.98 $1,081.69 $1,350.65 |
$1,339.55 $1,411.02 $1,486.73 $1,755.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,058.94 $1,201.88 $1,353.30 $1,891.22 $2,873.90 |
$1,463.98 $1,606.92 $1,758.34 $2,296.26 |
$1,869.02 $2,011.96 $2,163.38 $2,701.30 |
Toc - Plan #27 Security Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Premier $6,200 HDHP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$385.01 $436.98 $492.04 $687.62 $1,044.90 |
$679.54 $731.51 $786.57 $982.15 |
$974.07 $1,026.04 $1,081.10 $1,276.68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$770.02 $873.96 $984.08 $1,375.24 $2,089.80 |
$1,064.55 $1,168.49 $1,278.61 $1,669.77 |
$1,359.08 $1,463.02 $1,573.14 $1,964.30 |
Toc - Plan #28 Security Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Premier $7,500 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$337.76 $383.35 $431.65 $603.23 $916.66 |
$596.14 $641.73 $690.03 $861.61 |
$854.52 $900.11 $948.41 $1,119.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$675.52 $766.70 $863.30 $1,206.46 $1,833.32 |
$933.90 $1,025.08 $1,121.68 $1,464.84 |
$1,192.28 $1,283.46 $1,380.06 $1,723.22 |
Toc - Plan #29 Security Health Plan | ||||||||||||||||||||
Bronze
(HMO) Premier $9,100 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$336.75 $382.20 $430.35 $601.42 $913.91 |
$594.36 $639.81 $687.96 $859.03 |
$851.97 $897.42 $945.57 $1,116.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$673.50 $764.40 $860.70 $1,202.84 $1,827.82 |
$931.11 $1,022.01 $1,118.31 $1,460.45 |
$1,188.72 $1,279.62 $1,375.92 $1,718.06 |
Toc - Plan #30 Security Health Plan | ||||||||||||||||||||
Catastrophic
(HMO) Premier Protection |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$224.87 $255.22 $287.37 $401.60 $610.27 |
$396.89 $427.24 $459.39 $573.62 |
$568.91 $599.26 $631.41 $745.64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$449.74 $510.44 $574.74 $803.20 $1,220.54 |
$621.76 $682.46 $746.76 $975.22 |
$793.78 $854.48 $918.78 $1,147.24 |
ADVERTISEMENT
Dean Health PlanLocal: 1-800-279-1302 | Toll Free: 1-800-279-1302 | TTY: 1-800-279-1302 |
Toc - Plan #31 Dean Health Plan | ||||||||||||||||||||
Catastrophic
(HMO) Dean Catastrophic Safety Net |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$196.50 $223.03 $251.13 $350.96 $533.31 |
$346.83 $373.36 $401.46 $501.29 |
$497.16 $523.69 $551.79 $651.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$393.00 $446.06 $502.26 $701.92 $1,066.62 |
$543.33 $596.39 $652.59 $852.25 |
$693.66 $746.72 $802.92 $1,002.58 |
Toc - Plan #32 Dean Health Plan | ||||||||||||||||||||
Silver
(HMO) Dean Silver Copay Plus 4800X (Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$410.33 $465.73 $524.40 $732.85 $1,113.64 |
$724.23 $779.63 $838.30 $1,046.75 |
$1,038.13 $1,093.53 $1,152.20 $1,360.65 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$820.66 $931.46 $1,048.80 $1,465.70 $2,227.28 |
$1,134.56 $1,245.36 $1,362.70 $1,779.60 |
$1,448.46 $1,559.26 $1,676.60 $2,093.50 |
Toc - Plan #33 Dean Health Plan | ||||||||||||||||||||
Silver
(HMO) Dean Silver HSA-E HDHP 3550X |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$411.63 $467.19 $526.06 $735.16 $1,117.15 |
$726.52 $782.08 $840.95 $1,050.05 |
$1,041.41 $1,096.97 $1,155.84 $1,364.94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$823.26 $934.38 $1,052.12 $1,470.32 $2,234.30 |
$1,138.15 $1,249.27 $1,367.01 $1,785.21 |
$1,453.04 $1,564.16 $1,681.90 $2,100.10 |
Toc - Plan #34 Dean Health Plan | ||||||||||||||||||||
Gold
(HMO) Dean Gold Copay Plus 1500X (Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$433.97 $492.56 $554.62 $775.07 $1,177.80 |
$765.96 $824.55 $886.61 $1,107.06 |
$1,097.95 $1,156.54 $1,218.60 $1,439.05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$867.94 $985.12 $1,109.24 $1,550.14 $2,355.60 |
$1,199.93 $1,317.11 $1,441.23 $1,882.13 |
$1,531.92 $1,649.10 $1,773.22 $2,214.12 |
Toc - Plan #35 Dean Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Dean Bronze HSA-E HDHP 7450X |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$286.50 $325.18 $366.15 $511.69 $777.57 |
$505.67 $544.35 $585.32 $730.86 |
$724.84 $763.52 $804.49 $950.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$573.00 $650.36 $732.30 $1,023.38 $1,555.14 |
$792.17 $869.53 $951.47 $1,242.55 |
$1,011.34 $1,088.70 $1,170.64 $1,461.72 |
Toc - Plan #36 Dean Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Dean Bronze Copay Plus 9400X (Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$271.86 $308.56 $347.44 $485.54 $737.83 |
$479.83 $516.53 $555.41 $693.51 |
$687.80 $724.50 $763.38 $901.48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$543.72 $617.12 $694.88 $971.08 $1,475.66 |
$751.69 $825.09 $902.85 $1,179.05 |
$959.66 $1,033.06 $1,110.82 $1,387.02 |
Toc - Plan #37 Dean Health Plan | ||||||||||||||||||||
Gold
(HMO) Dean Gold HSA HDHP 2000X |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$387.25 $439.53 $494.91 $691.63 $1,051.00 |
$683.50 $735.78 $791.16 $987.88 |
$979.75 $1,032.03 $1,087.41 $1,284.13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$774.50 $879.06 $989.82 $1,383.26 $2,102.00 |
$1,070.75 $1,175.31 $1,286.07 $1,679.51 |
$1,367.00 $1,471.56 $1,582.32 $1,975.76 |
Toc - Plan #38 Dean Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Dean Bronze Copay PCP 8000X (Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$266.17 $302.11 $340.17 $475.38 $722.39 |
$469.79 $505.73 $543.79 $679.00 |
$673.41 $709.35 $747.41 $882.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$532.34 $604.22 $680.34 $950.76 $1,444.78 |
$735.96 $807.84 $883.96 $1,154.38 |
$939.58 $1,011.46 $1,087.58 $1,358.00 |
Toc - Plan #39 Dean Health Plan | ||||||||||||||||||||
Silver
(HMO) Dean Silver Copay PCP 4500X (Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$389.67 $442.27 $497.99 $695.94 $1,057.55 |
$687.76 $740.36 $796.08 $994.03 |
$985.85 $1,038.45 $1,094.17 $1,292.12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$779.34 $884.54 $995.98 $1,391.88 $2,115.10 |
$1,077.43 $1,182.63 $1,294.07 $1,689.97 |
$1,375.52 $1,480.72 $1,592.16 $1,988.06 |
Toc - Plan #40 Dean Health Plan | ||||||||||||||||||||
Gold
(HMO) Dean Gold Copay PCP 3000X (Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$391.35 $444.18 $500.14 $698.95 $1,062.12 |
$690.73 $743.56 $799.52 $998.33 |
$990.11 $1,042.94 $1,098.90 $1,297.71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$782.70 $888.36 $1,000.28 $1,397.90 $2,124.24 |
$1,082.08 $1,187.74 $1,299.66 $1,697.28 |
$1,381.46 $1,487.12 $1,599.04 $1,996.66 |
Toc - Plan #41 Dean Health Plan | ||||||||||||||||||||
Gold
(HMO) Dean Gold Standard 1500X (Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
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 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
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 |
Toc - Plan #42 Dean Health Plan | ||||||||||||||||||||
Silver
(HMO) Dean Silver Standard 5900X (Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$392.90 $445.94 $502.12 $701.71 $1,066.32 |
$693.47 $746.51 $802.69 $1,002.28 |
$994.04 $1,047.08 $1,103.26 $1,302.85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$785.80 $891.88 $1,004.24 $1,403.42 $2,132.64 |
$1,086.37 $1,192.45 $1,304.81 $1,703.99 |
$1,386.94 $1,493.02 $1,605.38 $2,004.56 |
Toc - Plan #43 Dean Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) Dean Bronze Standard 7500X (Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$275.82 $313.06 $352.50 $492.62 $748.58 |
$486.82 $524.06 $563.50 $703.62 |
$697.82 $735.06 $774.50 $914.62 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$551.64 $626.12 $705.00 $985.24 $1,497.16 |
$762.64 $837.12 $916.00 $1,196.24 |
$973.64 $1,048.12 $1,127.00 $1,407.24 |
Toc - Plan #44 Dean Health Plan | ||||||||||||||||||||
Bronze
(HMO) Dean Bronze Standard 9100X (Free Virtual Visits) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-279-1302
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$244.73 $277.77 $312.77 $437.09 $664.21 |
$431.95 $464.99 $499.99 $624.31 |
$619.17 $652.21 $687.21 $811.53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$489.46 $555.54 $625.54 $874.18 $1,328.42 |
$676.68 $742.76 $812.76 $1,061.40 |
$863.90 $929.98 $999.98 $1,248.62 |
ADVERTISEMENT
Anthem Blue Cross and Blue ShieldLocal: 1-855-748-1813 | Toll Free: 1-855-748-1813 |
Toc - Plan #45 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(POS) Anthem Bronze Blue Preferred/Broad 0 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$347.00 $393.85 $443.47 $619.74 $941.76 |
$612.46 $659.31 $708.93 $885.20 |
$877.92 $924.77 $974.39 $1,150.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$694.00 $787.70 $886.94 $1,239.48 $1,883.52 |
$959.46 $1,053.16 $1,152.40 $1,504.94 |
$1,224.92 $1,318.62 $1,417.86 $1,770.40 |
Toc - Plan #46 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(POS) Anthem Silver Blue Preferred/Broad 4100 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$410.73 $466.18 $524.91 $733.56 $1,114.72 |
$724.94 $780.39 $839.12 $1,047.77 |
$1,039.15 $1,094.60 $1,153.33 $1,361.98 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$821.46 $932.36 $1,049.82 $1,467.12 $2,229.44 |
$1,135.67 $1,246.57 $1,364.03 $1,781.33 |
$1,449.88 $1,560.78 $1,678.24 $2,095.54 |
Toc - Plan #47 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Bronze
(POS) Anthem Bronze Blue Preferred/Broad 9450 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$314.44 $356.89 $401.85 $561.59 $853.39 |
$554.99 $597.44 $642.40 $802.14 |
$795.54 $837.99 $882.95 $1,042.69 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$628.88 $713.78 $803.70 $1,123.18 $1,706.78 |
$869.43 $954.33 $1,044.25 $1,363.73 |
$1,109.98 $1,194.88 $1,284.80 $1,604.28 |
Toc - Plan #48 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(POS) Anthem Bronze Blue Preferred/Broad 0% for HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$329.85 $374.38 $421.55 $589.11 $895.21 |
$582.19 $626.72 $673.89 $841.45 |
$834.53 $879.06 $926.23 $1,093.79 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$659.70 $748.76 $843.10 $1,178.22 $1,790.42 |
$912.04 $1,001.10 $1,095.44 $1,430.56 |
$1,164.38 $1,253.44 $1,347.78 $1,682.90 |
Toc - Plan #49 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(POS) Anthem Bronze Blue Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$331.11 $375.81 $423.16 $591.36 $898.63 |
$584.41 $629.11 $676.46 $844.66 |
$837.71 $882.41 $929.76 $1,097.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$662.22 $751.62 $846.32 $1,182.72 $1,797.26 |
$915.52 $1,004.92 $1,099.62 $1,436.02 |
$1,168.82 $1,258.22 $1,352.92 $1,689.32 |
Toc - Plan #50 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(POS) Anthem Silver Blue Preferred/Broad 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$401.09 $455.24 $512.59 $716.35 $1,088.56 |
$707.92 $762.07 $819.42 $1,023.18 |
$1,014.75 $1,068.90 $1,126.25 $1,330.01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$802.18 $910.48 $1,025.18 $1,432.70 $2,177.12 |
$1,109.01 $1,217.31 $1,332.01 $1,739.53 |
$1,415.84 $1,524.14 $1,638.84 $2,046.36 |
Toc - Plan #51 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Gold
(POS) Anthem Gold Blue Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$439.21 $498.50 $561.31 $784.43 $1,192.02 |
$775.21 $834.50 $897.31 $1,120.43 |
$1,111.21 $1,170.50 $1,233.31 $1,456.43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$878.42 $997.00 $1,122.62 $1,568.86 $2,384.04 |
$1,214.42 $1,333.00 $1,458.62 $1,904.86 |
$1,550.42 $1,669.00 $1,794.62 $2,240.86 |
Toc - Plan #52 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Expanded Bronze
(POS) Anthem Bronze Blue Preferred/Broad 7500/50% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$330.14 $374.71 $421.92 $589.63 $896.00 |
$582.70 $627.27 $674.48 $842.19 |
$835.26 $879.83 $927.04 $1,094.75 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$660.28 $749.42 $843.84 $1,179.26 $1,792.00 |
$912.84 $1,001.98 $1,096.40 $1,431.82 |
$1,165.40 $1,254.54 $1,348.96 $1,684.38 |
Toc - Plan #53 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(POS) Anthem Silver Blue Preferred/Broad 5900/40% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$400.76 $454.86 $512.17 $715.76 $1,087.66 |
$707.34 $761.44 $818.75 $1,022.34 |
$1,013.92 $1,068.02 $1,125.33 $1,328.92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$801.52 $909.72 $1,024.34 $1,431.52 $2,175.32 |
$1,108.10 $1,216.30 $1,330.92 $1,738.10 |
$1,414.68 $1,522.88 $1,637.50 $2,044.68 |
Toc - Plan #54 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Gold
(POS) Anthem Gold Blue Preferred/Broad 1500/25% Standard |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$447.47 $507.88 $571.87 $799.18 $1,214.43 |
$789.78 $850.19 $914.18 $1,141.49 |
$1,132.09 $1,192.50 $1,256.49 $1,483.80 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$894.94 $1,015.76 $1,143.74 $1,598.36 $2,428.86 |
$1,237.25 $1,358.07 $1,486.05 $1,940.67 |
$1,579.56 $1,700.38 $1,828.36 $2,282.98 |
Toc - Plan #55 Anthem Blue Cross and Blue Shield | ||||||||||||||||||||
Silver
(POS) Anthem Silver Blue Preferred/Broad 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-748-1813
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$410.51 $465.93 $524.63 $733.17 $1,114.12 |
$724.55 $779.97 $838.67 $1,047.21 |
$1,038.59 $1,094.01 $1,152.71 $1,361.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$821.02 $931.86 $1,049.26 $1,466.34 $2,228.24 |
$1,135.06 $1,245.90 $1,363.30 $1,780.38 |
$1,449.10 $1,559.94 $1,677.34 $2,094.42 |
ADVERTISEMENT
Aspirus Health PlanLocal: 1-866-631-4611 | Toll Free: 1-866-631-4611 | TTY: 1-866-631-8597 |
Toc - Plan #56 Aspirus Health Plan | ||||||||||||||||||||
Silver
(HMO) HMO Silver 7500 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-631-4611
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$406.97 $461.91 $520.10 $726.84 $1,104.51 |
$718.30 $773.24 $831.43 $1,038.17 |
$1,029.63 $1,084.57 $1,142.76 $1,349.50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$813.94 $923.82 $1,040.20 $1,453.68 $2,209.02 |
$1,125.27 $1,235.15 $1,351.53 $1,765.01 |
$1,436.60 $1,546.48 $1,662.86 $2,076.34 |
Toc - Plan #57 Aspirus Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) HMO HDHP Bronze 6250 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-631-4611
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$325.72 $369.69 $416.27 $581.73 $884.00 |
$574.89 $618.86 $665.44 $830.90 |
$824.06 $868.03 $914.61 $1,080.07 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$651.44 $739.38 $832.54 $1,163.46 $1,768.00 |
$900.61 $988.55 $1,081.71 $1,412.63 |
$1,149.78 $1,237.72 $1,330.88 $1,661.80 |
Toc - Plan #58 Aspirus Health Plan | ||||||||||||||||||||
Bronze
(HMO) HMO Bronze 9450 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-631-4611
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$299.53 $339.97 $382.80 $534.97 $812.93 |
$528.67 $569.11 $611.94 $764.11 |
$757.81 $798.25 $841.08 $993.25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$599.06 $679.94 $765.60 $1,069.94 $1,625.86 |
$828.20 $909.08 $994.74 $1,299.08 |
$1,057.34 $1,138.22 $1,223.88 $1,528.22 |
Toc - Plan #59 Aspirus Health Plan | ||||||||||||||||||||
Gold
(HMO) HMO Gold 2400 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-631-4611
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$423.76 $480.96 $541.56 $756.83 $1,150.07 |
$747.93 $805.13 $865.73 $1,081.00 |
$1,072.10 $1,129.30 $1,189.90 $1,405.17 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$847.52 $961.92 $1,083.12 $1,513.66 $2,300.14 |
$1,171.69 $1,286.09 $1,407.29 $1,837.83 |
$1,495.86 $1,610.26 $1,731.46 $2,162.00 |
Toc - Plan #60 Aspirus Health Plan | ||||||||||||||||||||
Catastrophic
(HMO) HMO Catastrophic 9450 with 3 free PCP Visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-631-4611
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$216.84 $246.11 $277.12 $387.27 $588.49 |
$382.72 $411.99 $443.00 $553.15 |
$548.60 $577.87 $608.88 $719.03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$433.68 $492.22 $554.24 $774.54 $1,176.98 |
$599.56 $658.10 $720.12 $940.42 |
$765.44 $823.98 $886.00 $1,106.30 |
Toc - Plan #61 Aspirus Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) HMO HDHP Bronze 7200 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-631-4611
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$324.44 $368.24 $414.63 $579.45 $880.52 |
$572.63 $616.43 $662.82 $827.64 |
$820.82 $864.62 $911.01 $1,075.83 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$648.88 $736.48 $829.26 $1,158.90 $1,761.04 |
$897.07 $984.67 $1,077.45 $1,407.09 |
$1,145.26 $1,232.86 $1,325.64 $1,655.28 |
Toc - Plan #62 Aspirus Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) HMO Bronze 7500 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-631-4611
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$319.21 $362.30 $407.95 $570.10 $866.33 |
$563.40 $606.49 $652.14 $814.29 |
$807.59 $850.68 $896.33 $1,058.48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$638.42 $724.60 $815.90 $1,140.20 $1,732.66 |
$882.61 $968.79 $1,060.09 $1,384.39 |
$1,126.80 $1,212.98 $1,304.28 $1,628.58 |
Toc - Plan #63 Aspirus Health Plan | ||||||||||||||||||||
Silver
(HMO) HMO Silver 5900 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-631-4611
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$405.91 $460.71 $518.75 $724.95 $1,101.64 |
$716.43 $771.23 $829.27 $1,035.47 |
$1,026.95 $1,081.75 $1,139.79 $1,345.99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$811.82 $921.42 $1,037.50 $1,449.90 $2,203.28 |
$1,122.34 $1,231.94 $1,348.02 $1,760.42 |
$1,432.86 $1,542.46 $1,658.54 $2,070.94 |
Toc - Plan #64 Aspirus Health Plan | ||||||||||||||||||||
Silver
(HMO) HMO HDHP Silver 5400 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-631-4611
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$412.83 $468.57 $527.60 $737.32 $1,120.43 |
$728.65 $784.39 $843.42 $1,053.14 |
$1,044.47 $1,100.21 $1,159.24 $1,368.96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$825.66 $937.14 $1,055.20 $1,474.64 $2,240.86 |
$1,141.48 $1,252.96 $1,371.02 $1,790.46 |
$1,457.30 $1,568.78 $1,686.84 $2,106.28 |
Toc - Plan #65 Aspirus Health Plan | ||||||||||||||||||||
Gold
(HMO) HMO Gold 1500 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-631-4611
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$423.29 $480.43 $540.96 $755.99 $1,148.80 |
$747.11 $804.25 $864.78 $1,079.81 |
$1,070.93 $1,128.07 $1,188.60 $1,403.63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$846.58 $960.86 $1,081.92 $1,511.98 $2,297.60 |
$1,170.40 $1,284.68 $1,405.74 $1,835.80 |
$1,494.22 $1,608.50 $1,729.56 $2,159.62 |
Toc - Plan #66 Aspirus Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) HMO Bronze $0 Medical Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-631-4611
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$320.49 $363.75 $409.58 $572.39 $869.80 |
$565.66 $608.92 $654.75 $817.56 |
$810.83 $854.09 $899.92 $1,062.73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$640.98 $727.50 $819.16 $1,144.78 $1,739.60 |
$886.15 $972.67 $1,064.33 $1,389.95 |
$1,131.32 $1,217.84 $1,309.50 $1,635.12 |
Toc - Plan #67 Aspirus Health Plan | ||||||||||||||||||||
Silver
(POS) POS Silver 5900 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-631-4611
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$464.79 $527.53 $594.00 $830.11 $1,261.43 |
$820.35 $883.09 $949.56 $1,185.67 |
$1,175.91 $1,238.65 $1,305.12 $1,541.23 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$929.58 $1,055.06 $1,188.00 $1,660.22 $2,522.86 |
$1,285.14 $1,410.62 $1,543.56 $2,015.78 |
$1,640.70 $1,766.18 $1,899.12 $2,371.34 |
Toc - Plan #68 Aspirus Health Plan | ||||||||||||||||||||
Expanded Bronze
(POS) POS HDHP Bronze 6250 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-631-4611
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$358.49 $406.89 $458.15 $640.26 $972.94 |
$632.74 $681.14 $732.40 $914.51 |
$906.99 $955.39 $1,006.65 $1,188.76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$716.98 $813.78 $916.30 $1,280.52 $1,945.88 |
$991.23 $1,088.03 $1,190.55 $1,554.77 |
$1,265.48 $1,362.28 $1,464.80 $1,829.02 |
Toc - Plan #69 Aspirus Health Plan | ||||||||||||||||||||
Expanded Bronze
(POS) POS Bronze 7500 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-866-631-4611
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$365.12 $414.42 $466.63 $652.11 $990.95 |
$644.44 $693.74 $745.95 $931.43 |
$923.76 $973.06 $1,025.27 $1,210.75 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$730.24 $828.84 $933.26 $1,304.22 $1,981.90 |
$1,009.56 $1,108.16 $1,212.58 $1,583.54 |
$1,288.88 $1,387.48 $1,491.90 $1,862.86 |
ADVERTISEMENT
Group Health Cooperative-SCWLocal: 1-608-828-4831 | Toll Free: 1-855-344-2729 | TTY: 1-608-828-4815 |
Toc - Plan #70 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Gold 2800 Ded/2800 MOOP HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$416.97 $473.26 $532.88 $744.70 $1,131.64 |
$735.95 $792.24 $851.86 $1,063.68 |
$1,054.93 $1,111.22 $1,170.84 $1,382.66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$833.94 $946.52 $1,065.76 $1,489.40 $2,263.28 |
$1,152.92 $1,265.50 $1,384.74 $1,808.38 |
$1,471.90 $1,584.48 $1,703.72 $2,127.36 |
Toc - Plan #71 Group Health Cooperative-SCW | ||||||||||||||||||||
Silver
(HMO) Silver 5700 Ded/5700 MOOP HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$414.43 $470.37 $529.63 $740.16 $1,124.74 |
$731.47 $787.41 $846.67 $1,057.20 |
$1,048.51 $1,104.45 $1,163.71 $1,374.24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$828.86 $940.74 $1,059.26 $1,480.32 $2,249.48 |
$1,145.90 $1,257.78 $1,376.30 $1,797.36 |
$1,462.94 $1,574.82 $1,693.34 $2,114.40 |
Toc - Plan #72 Group Health Cooperative-SCW | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 4000 Ded/9450 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$341.80 $387.95 $436.82 $610.46 $927.64 |
$603.28 $649.43 $698.30 $871.94 |
$864.76 $910.91 $959.78 $1,133.42 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$683.60 $775.90 $873.64 $1,220.92 $1,855.28 |
$945.08 $1,037.38 $1,135.12 $1,482.40 |
$1,206.56 $1,298.86 $1,396.60 $1,743.88 |
Toc - Plan #73 Group Health Cooperative-SCW | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 7900 Ded/7900 MOOP HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$334.00 $379.09 $426.85 $596.52 $906.46 |
$589.51 $634.60 $682.36 $852.03 |
$845.02 $890.11 $937.87 $1,107.54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$668.00 $758.18 $853.70 $1,193.04 $1,812.92 |
$923.51 $1,013.69 $1,109.21 $1,448.55 |
$1,179.02 $1,269.20 $1,364.72 $1,704.06 |
Toc - Plan #74 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Gold 2500 Ded/6500 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$423.51 $480.68 $541.24 $756.38 $1,149.39 |
$747.49 $804.66 $865.22 $1,080.36 |
$1,071.47 $1,128.64 $1,189.20 $1,404.34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$847.02 $961.36 $1,082.48 $1,512.76 $2,298.78 |
$1,171.00 $1,285.34 $1,406.46 $1,836.74 |
$1,494.98 $1,609.32 $1,730.44 $2,160.72 |
Toc - Plan #75 Group Health Cooperative-SCW | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 7000 Ded/8500 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$355.63 $403.64 $454.50 $635.16 $965.18 |
$627.69 $675.70 $726.56 $907.22 |
$899.75 $947.76 $998.62 $1,179.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$711.26 $807.28 $909.00 $1,270.32 $1,930.36 |
$983.32 $1,079.34 $1,181.06 $1,542.38 |
$1,255.38 $1,351.40 $1,453.12 $1,814.44 |
Toc - Plan #76 Group Health Cooperative-SCW | ||||||||||||||||||||
Silver
(HMO) Silver 4900 Ded/7900 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$493.15 $559.72 $630.24 $880.76 $1,338.40 |
$870.41 $936.98 $1,007.50 $1,258.02 |
$1,247.67 $1,314.24 $1,384.76 $1,635.28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$986.30 $1,119.44 $1,260.48 $1,761.52 $2,676.80 |
$1,363.56 $1,496.70 $1,637.74 $2,138.78 |
$1,740.82 $1,873.96 $2,015.00 $2,516.04 |
Toc - Plan #77 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Gold 1000 Ded/6000 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$430.59 $488.72 $550.30 $769.04 $1,168.62 |
$760.00 $818.13 $879.71 $1,098.45 |
$1,089.41 $1,147.54 $1,209.12 $1,427.86 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$861.18 $977.44 $1,100.60 $1,538.08 $2,337.24 |
$1,190.59 $1,306.85 $1,430.01 $1,867.49 |
$1,520.00 $1,636.26 $1,759.42 $2,196.90 |
Toc - Plan #78 Group Health Cooperative-SCW | ||||||||||||||||||||
Catastrophic
(HMO) Catastrophic 9450 Ded/9450 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$274.13 $311.14 $350.34 $489.60 $743.99 |
$483.84 $520.85 $560.05 $699.31 |
$693.55 $730.56 $769.76 $909.02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$548.26 $622.28 $700.68 $979.20 $1,487.98 |
$757.97 $831.99 $910.39 $1,188.91 |
$967.68 $1,041.70 $1,120.10 $1,398.62 |
Toc - Plan #79 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Gold 2500 Ded/5000 MOOP Primary Care Preferred with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$440.83 $500.34 $563.38 $787.32 $1,196.40 |
$778.07 $837.58 $900.62 $1,124.56 |
$1,115.31 $1,174.82 $1,237.86 $1,461.80 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$881.66 $1,000.68 $1,126.76 $1,574.64 $2,392.80 |
$1,218.90 $1,337.92 $1,464.00 $1,911.88 |
$1,556.14 $1,675.16 $1,801.24 $2,249.12 |
Toc - Plan #80 Group Health Cooperative-SCW | ||||||||||||||||||||
Silver
(HMO) Silver 9400 Ded/9400 MOOP Primary Care Preferred with Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$509.77 $578.59 $651.48 $910.44 $1,383.51 |
$899.74 $968.56 $1,041.45 $1,300.41 |
$1,289.71 $1,358.53 $1,431.42 $1,690.38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1,019.54 $1,157.18 $1,302.96 $1,820.88 $2,767.02 |
$1,409.51 $1,547.15 $1,692.93 $2,210.85 |
$1,799.48 $1,937.12 $2,082.90 $2,600.82 |
Toc - Plan #81 Group Health Cooperative-SCW | ||||||||||||||||||||
Gold
(HMO) Gold 1500 Ded/8700 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$417.93 $474.35 $534.12 $746.43 $1,134.26 |
$737.65 $794.07 $853.84 $1,066.15 |
$1,057.37 $1,113.79 $1,173.56 $1,385.87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$835.86 $948.70 $1,068.24 $1,492.86 $2,268.52 |
$1,155.58 $1,268.42 $1,387.96 $1,812.58 |
$1,475.30 $1,588.14 $1,707.68 $2,132.30 |
Toc - Plan #82 Group Health Cooperative-SCW | ||||||||||||||||||||
Silver
(HMO) Silver 5900 Ded/9100 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$473.79 $537.75 $605.50 $846.18 $1,285.85 |
$836.24 $900.20 $967.95 $1,208.63 |
$1,198.69 $1,262.65 $1,330.40 $1,571.08 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$947.58 $1,075.50 $1,211.00 $1,692.36 $2,571.70 |
$1,310.03 $1,437.95 $1,573.45 $2,054.81 |
$1,672.48 $1,800.40 $1,935.90 $2,417.26 |
Toc - Plan #83 Group Health Cooperative-SCW | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze 7500 Ded/9400 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$351.90 $399.40 $449.72 $628.48 $955.04 |
$621.10 $668.60 $718.92 $897.68 |
$890.30 $937.80 $988.12 $1,166.88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$703.80 $798.80 $899.44 $1,256.96 $1,910.08 |
$973.00 $1,068.00 $1,168.64 $1,526.16 |
$1,242.20 $1,337.20 $1,437.84 $1,795.36 |
Toc - Plan #84 Group Health Cooperative-SCW | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze No Medical Ded/9450 MOOP |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-344-2729
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$382.37 $433.99 $488.67 $682.91 $1,037.75 |
$674.89 $726.51 $781.19 $975.43 |
$967.41 $1,019.03 $1,073.71 $1,267.95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$764.74 $867.98 $977.34 $1,365.82 $2,075.50 |
$1,057.26 $1,160.50 $1,269.86 $1,658.34 |
$1,349.78 $1,453.02 $1,562.38 $1,950.86 |
‡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 Adams County here.
Adams County is in “Rating Area 15” of Wisconsin.
Currently, there are 84 plans offered in Rating Area 15.