Obamacare 2016 Rates and Health Insurance Providers for Volusia County,Deltona,FL

The health insurance rates listed below are for calendar year 2016.

2016 Rates and Providers

(click here for 2014)

(click here for 2015)

This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for Deltona, FL.

Obamacare Providers, Plans and 2016 Rates for Volusia County

Volusia County is in “Rating Area 64” of Florida.

Currently, there are 5 providers offering 147 plans to Rating Area 64. †

Below, you’ll find a summary of plans and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options. For detailed information on available subsidies to make your coverage affordable, you must complete an application at HealthCare.gov or contact the provider directly.

The table below shows premiums for the following scenarios for:

Individual
Couple
Couple with 1 2 or 3 children
Individual with 1 2 or 3 children
A child alone

Each scenario is covered for age

Age 21, 30, 40, 50
Age 60 (Individual and Couple only)

For each plan, there are links that go to the insurance provider's website in a new window. You can find links to:

a summary of plan benefits and costs,
a plan brochure, and
a "Provider Directory" -- where you can find out which doctors and hospitals in the Deltona, FL area accept this insurance coverage as within the plan's "network".

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Blue Cross and Blue Shield of Florida Local: 1-855-805-8175 \| Toll Free: 1-855-805-8175
Plan: (EPO) BlueOptions Everyday Health 1423 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida) Deductible: Individual: $5,500 : Family: $11,000 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$310.41 $352.32 $396.70 $554.39 $842.45	$620.82 $704.64 $793.40 $1108.78 $1684.90	$817.93 $901.75 $990.51 $1305.89	$1015.04 $1098.86 $1187.62 $1503.00	$1212.15 $1295.97 $1384.73 $1700.11	$507.52 $549.43 $593.81 $751.50	$704.63 $746.54 $790.92 $948.61	$901.74 $943.65 $988.03 $1145.72	$197.11
Plan: (EPO) BlueOptions Essential 1419 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida) Deductible: Individual: $6,850 : Family: $13,700 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$263.14 $298.66 $336.29 $469.97 $714.16	$526.28 $597.32 $672.58 $939.94 $1428.32	$693.37 $764.41 $839.67 $1107.03	$860.46 $931.50 $1006.76 $1274.12	$1027.55 $1098.59 $1173.85 $1441.21	$430.23 $465.75 $503.38 $637.06	$597.32 $632.84 $670.47 $804.15	$764.41 $799.93 $837.56 $971.24	$167.09
Plan: (EPO) BlueOptions Everyday Health 1431 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida) Deductible: Individual: $5,000 : Family: $10,000 Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$341.38 $387.47 $436.28 $609.70 $926.51	$682.76 $774.94 $872.56 $1219.40 $1853.02	$899.54 $991.72 $1089.34 $1436.18	$1116.32 $1208.50 $1306.12 $1652.96	$1333.10 $1425.28 $1522.90 $1869.74	$558.16 $604.25 $653.06 $826.48	$774.94 $821.03 $869.84 $1043.26	$991.72 $1037.81 $1086.62 $1260.04	$216.78
Plan: (EPO) BlueOptions Everyday Health 1418 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida) Deductible: Individual: $800 : Family: $1,600 Out of Pocket Maximum per year: Individual: $2,500 : Family: $5,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$456.19 $517.78 $583.01 $814.76 $1238.10	$912.38 $1035.56 $1166.02 $1629.52 $2476.20	$1202.06 $1325.24 $1455.70 $1919.20	$1491.74 $1614.92 $1745.38 $2208.88	$1781.42 $1904.60 $2035.06 $2498.56	$745.87 $807.46 $872.69 $1104.44	$1035.55 $1097.14 $1162.37 $1394.12	$1325.23 $1386.82 $1452.05 $1683.80	$289.68
Plan: (EPO) BlueOptions Everyday Health Premier 1418V Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida) Deductible: Individual: $800 : Family: $1,600 Out of Pocket Maximum per year: Individual: $2,500 : Family: $5,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$492.05 $558.48 $628.84 $878.80 $1335.42	$984.10 $1116.96 $1257.68 $1757.60 $2670.84	$1296.55 $1429.41 $1570.13 $2070.05	$1609.00 $1741.86 $1882.58 $2382.50	$1921.45 $2054.31 $2195.03 $2694.95	$804.50 $870.93 $941.29 $1191.25	$1116.95 $1183.38 $1253.74 $1503.70	$1429.40 $1495.83 $1566.19 $1816.15	$312.45
Plan: (EPO) BlueOptions Everyday Health 1416 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida) Deductible: Individual: $6,700 : Family: $13,400 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$291.81 $331.20 $372.93 $521.17 $791.97	$583.62 $662.40 $745.86 $1042.34 $1583.94	$768.92 $847.70 $931.16 $1227.64	$954.22 $1033.00 $1116.46 $1412.94	$1139.52 $1218.30 $1301.76 $1598.24	$477.11 $516.50 $558.23 $706.47	$662.41 $701.80 $743.53 $891.77	$847.71 $887.10 $928.83 $1077.07	$185.30
Plan: (EPO) BlueOptions All Copay 1424 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $2,000 : Family: $4,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$474.06 $538.06 $605.85 $846.67 $1286.60	$948.12 $1076.12 $1211.70 $1693.34 $2573.20	$1249.15 $1377.15 $1512.73 $1994.37	$1550.18 $1678.18 $1813.76 $2295.40	$1851.21 $1979.21 $2114.79 $2596.43	$775.09 $839.09 $906.88 $1147.70	$1076.12 $1140.12 $1207.91 $1448.73	$1377.15 $1441.15 $1508.94 $1749.76	$301.03
Plan: (EPO) BlueOptions Everyday Health 1410 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida) Deductible: Individual: $6,100 : Family: $12,200 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$288.91 $327.91 $369.23 $515.99 $784.10	$577.82 $655.82 $738.46 $1031.98 $1568.20	$761.28 $839.28 $921.92 $1215.44	$944.74 $1022.74 $1105.38 $1398.90	$1128.20 $1206.20 $1288.84 $1582.36	$472.37 $511.37 $552.69 $699.45	$655.83 $694.83 $736.15 $882.91	$839.29 $878.29 $919.61 $1066.37	$183.46
Plan: (EPO) BlueOptions All Copay 1505 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$404.43 $459.03 $516.86 $722.31 $1097.62	$808.86 $918.06 $1033.72 $1444.62 $2195.24	$1065.67 $1174.87 $1290.53 $1701.43	$1322.48 $1431.68 $1547.34 $1958.24	$1579.29 $1688.49 $1804.15 $2215.05	$661.24 $715.84 $773.67 $979.12	$918.05 $972.65 $1030.48 $1235.93	$1174.86 $1229.46 $1287.29 $1492.74	$256.81
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Health First Health Plans, Inc. Local: 1-855-443-4735 \| Toll Free: 1-855-443-4735 TTY: 1-800-955-8771
Plan: (HMO) Florida Hospital Platinum HMO 100 1500 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $800 : Family: $1,600 Out of Pocket Maximum per year: Individual: $1,000 : Family: $2,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$360.30 $408.93 $460.45 $643.48 $977.83	$720.60 $817.86 $920.90 $1286.96 $1955.66	$949.38 $1046.64 $1149.68 $1515.74	$1178.16 $1275.42 $1378.46 $1744.52	$1406.94 $1504.20 $1607.24 $1973.30	$589.08 $637.71 $689.23 $872.26	$817.86 $866.49 $918.01 $1101.04	$1046.64 $1095.27 $1146.79 $1329.82	$228.78
Plan: (HMO) Florida Hospital Platinum HMO 90 1501 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $750 : Family: $1,500 Out of Pocket Maximum per year: Individual: $1,500 : Family: $3,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$360.53 $409.19 $460.74 $643.89 $978.45	$721.06 $818.38 $921.48 $1287.78 $1956.90	$949.99 $1047.31 $1150.41 $1516.71	$1178.92 $1276.24 $1379.34 $1745.64	$1407.85 $1505.17 $1608.27 $1974.57	$589.46 $638.12 $689.67 $872.82	$818.39 $867.05 $918.60 $1101.75	$1047.32 $1095.98 $1147.53 $1330.68	$228.93
Plan: (HMO) Florida Hospital Platinum HMO 80 1502 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $450 : Family: $900 Out of Pocket Maximum per year: Individual: $1,700 : Family: $3,400 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$360.06 $408.66 $460.14 $643.05 $977.18	$720.12 $817.32 $920.28 $1286.10 $1954.36	$948.75 $1045.95 $1148.91 $1514.73	$1177.38 $1274.58 $1377.54 $1743.36	$1406.01 $1503.21 $1606.17 $1971.99	$588.69 $637.29 $688.77 $871.68	$817.32 $865.92 $917.40 $1100.31	$1045.95 $1094.55 $1146.03 $1328.94	$228.63
Plan: (HMO) Florida Hospital Gold HMO 100 1503 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $2,500 : Family: $5,000 Out of Pocket Maximum per year: Individual: $2,800 : Family: $5,600 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$307.02 $348.46 $392.36 $548.32 $833.23	$614.04 $696.92 $784.72 $1096.64 $1666.46	$808.99 $891.87 $979.67 $1291.59	$1003.94 $1086.82 $1174.62 $1486.54	$1198.89 $1281.77 $1369.57 $1681.49	$501.97 $543.41 $587.31 $743.27	$696.92 $738.36 $782.26 $938.22	$891.87 $933.31 $977.21 $1133.17	$194.95
Plan: (HMO) Florida Hospital Gold HMO 90 1505 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $1,500 : Family: $3,000 Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$297.02 $337.11 $379.58 $530.46 $806.09	$594.04 $674.22 $759.16 $1060.92 $1612.18	$782.64 $862.82 $947.76 $1249.52	$971.24 $1051.42 $1136.36 $1438.12	$1159.84 $1240.02 $1324.96 $1626.72	$485.62 $525.71 $568.18 $719.06	$674.22 $714.31 $756.78 $907.66	$862.82 $902.91 $945.38 $1096.26	$188.60
Plan: (HMO) Florida Hospital Gold HMO 80 1507 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $1,500 : Family: $3,000 Out of Pocket Maximum per year: Individual: $4,000 : Family: $8,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$320.06 $363.26 $409.02 $571.61 $868.62	$640.12 $726.52 $818.04 $1143.22 $1737.24	$843.35 $929.75 $1021.27 $1346.45	$1046.58 $1132.98 $1224.50 $1549.68	$1249.81 $1336.21 $1427.73 $1752.91	$523.29 $566.49 $612.25 $774.84	$726.52 $769.72 $815.48 $978.07	$929.75 $972.95 $1018.71 $1181.30	$203.23
Plan: (HMO) Florida Hospital Gold HMO 80 1509 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $1,000 : Family: $2,000 Out of Pocket Maximum per year: Individual: $2,500 : Family: $5,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$314.79 $357.28 $402.29 $562.20 $854.31	$629.58 $714.56 $804.58 $1124.40 $1708.62	$829.47 $914.45 $1004.47 $1324.29	$1029.36 $1114.34 $1204.36 $1524.18	$1229.25 $1314.23 $1404.25 $1724.07	$514.68 $557.17 $602.18 $762.09	$714.57 $757.06 $802.07 $961.98	$914.46 $956.95 $1001.96 $1161.87	$199.89
Plan: (HMO) Florida Hospital Gold HMO 80 1510 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $2,000 : Family: $4,000 Out of Pocket Maximum per year: Individual: $4,000 : Family: $8,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$305.36 $346.57 $390.24 $545.36 $828.72	$610.72 $693.14 $780.48 $1090.72 $1657.44	$804.62 $887.04 $974.38 $1284.62	$998.52 $1080.94 $1168.28 $1478.52	$1192.42 $1274.84 $1362.18 $1672.42	$499.26 $540.47 $584.14 $739.26	$693.16 $734.37 $778.04 $933.16	$887.06 $928.27 $971.94 $1127.06	$193.90
Plan: (HMO) Florida Hospital Gold HMO 70 1512 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $1,000 : Family: $2,000 Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$312.68 $354.88 $399.59 $558.43 $848.59	$625.36 $709.76 $799.18 $1116.86 $1697.18	$823.91 $908.31 $997.73 $1315.41	$1022.46 $1106.86 $1196.28 $1513.96	$1221.01 $1305.41 $1394.83 $1712.51	$511.23 $553.43 $598.14 $756.98	$709.78 $751.98 $796.69 $955.53	$908.33 $950.53 $995.24 $1154.08	$198.55
Plan: (HMO) Florida Hospital Silver HMO 100 1514 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $4,400 : Family: $8,800 Out of Pocket Maximum per year: Individual: $4,600 : Family: $9,200 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$261.27 $296.53 $333.89 $466.61 $709.06	$522.54 $593.06 $667.78 $933.22 $1418.12	$688.44 $758.96 $833.68 $1099.12	$854.34 $924.86 $999.58 $1265.02	$1020.24 $1090.76 $1165.48 $1430.92	$427.17 $462.43 $499.79 $632.51	$593.07 $628.33 $665.69 $798.41	$758.97 $794.23 $831.59 $964.31	$165.90
Plan: (HMO) Florida Hospital Silver HMO 100 1522 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $3,800 : Family: $7,600 Out of Pocket Maximum per year: Individual: $4,000 : Family: $8,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$262.63 $298.07 $335.63 $469.04 $712.75	$525.26 $596.14 $671.26 $938.08 $1425.50	$692.02 $762.90 $838.02 $1104.84	$858.78 $929.66 $1004.78 $1271.60	$1025.54 $1096.42 $1171.54 $1438.36	$429.39 $464.83 $502.39 $635.80	$596.15 $631.59 $669.15 $802.56	$762.91 $798.35 $835.91 $969.32	$166.76
Plan: (HMO) Florida Hospital Silver HMO 90 1526 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $3,900 : Family: $7,800 Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$264.16 $299.81 $337.58 $471.77 $716.90	$528.32 $599.62 $675.16 $943.54 $1433.80	$696.06 $767.36 $842.90 $1111.28	$863.80 $935.10 $1010.64 $1279.02	$1031.54 $1102.84 $1178.38 $1446.76	$431.90 $467.55 $505.32 $639.51	$599.64 $635.29 $673.06 $807.25	$767.38 $803.03 $840.80 $974.99	$167.74
Plan: (HMO) Florida Hospital Silver HMO 80 1534 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $2,500 : Family: $5,000 Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$251.61 $285.57 $321.54 $449.36 $682.84	$503.22 $571.14 $643.08 $898.72 $1365.68	$662.99 $730.91 $802.85 $1058.49	$822.76 $890.68 $962.62 $1218.26	$982.53 $1050.45 $1122.39 $1378.03	$411.38 $445.34 $481.31 $609.13	$571.15 $605.11 $641.08 $768.90	$730.92 $764.88 $800.85 $928.67	$159.77
Plan: (HMO) Florida Hospital Silver HMO 80 1542 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $2,500 : Family: $5,000 Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$253.49 $287.70 $323.95 $452.72 $687.94	$506.98 $575.40 $647.90 $905.44 $1375.88	$667.94 $736.36 $808.86 $1066.40	$828.90 $897.32 $969.82 $1227.36	$989.86 $1058.28 $1130.78 $1388.32	$414.45 $448.66 $484.91 $613.68	$575.41 $609.62 $645.87 $774.64	$736.37 $770.58 $806.83 $935.60	$160.96
Plan: (HMO) Florida Hospital Silver HMO 70 1546 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $3,500 : Family: $7,000 Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$256.08 $290.64 $327.26 $457.34 $694.97	$512.16 $581.28 $654.52 $914.68 $1389.94	$674.76 $743.88 $817.12 $1077.28	$837.36 $906.48 $979.72 $1239.88	$999.96 $1069.08 $1142.32 $1402.48	$418.68 $453.24 $489.86 $619.94	$581.28 $615.84 $652.46 $782.54	$743.88 $778.44 $815.06 $945.14	$162.60
Plan: (HMO) Florida Hospital Silver HMO 70 1554 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $2,000 : Family: $4,000 Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$253.05 $287.20 $323.39 $451.93 $686.75	$506.10 $574.40 $646.78 $903.86 $1373.50	$666.78 $735.08 $807.46 $1064.54	$827.46 $895.76 $968.14 $1225.22	$988.14 $1056.44 $1128.82 $1385.90	$413.73 $447.88 $484.07 $612.61	$574.41 $608.56 $644.75 $773.29	$735.09 $769.24 $805.43 $933.97	$160.68
Plan: (HMO) Florida Hospital Bronze HMO 100 1562 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $6,000 : Family: $12,000 Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$211.17 $239.67 $269.86 $377.13 $573.09	$422.34 $479.34 $539.72 $754.26 $1146.18	$556.43 $613.43 $673.81 $888.35	$690.52 $747.52 $807.90 $1022.44	$824.61 $881.61 $941.99 $1156.53	$345.26 $373.76 $403.95 $511.22	$479.35 $507.85 $538.04 $645.31	$613.44 $641.94 $672.13 $779.40	$134.09
Plan: (HMO) Florida Hospital Bronze HMO 90 1564 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $6,000 : Family: $12,000 Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$225.78 $256.25 $288.53 $403.23 $612.74	$451.56 $512.50 $577.06 $806.46 $1225.48	$594.92 $655.86 $720.42 $949.82	$738.28 $799.22 $863.78 $1093.18	$881.64 $942.58 $1007.14 $1236.54	$369.14 $399.61 $431.89 $546.59	$512.50 $542.97 $575.25 $689.95	$655.86 $686.33 $718.61 $833.31	$143.36
Plan: (HMO) Florida Hospital Bronze HMO 70 1565 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $4,500 : Family: $9,000 Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$211.35 $239.87 $270.09 $377.45 $573.58	$422.70 $479.74 $540.18 $754.90 $1147.16	$556.90 $613.94 $674.38 $889.10	$691.10 $748.14 $808.58 $1023.30	$825.30 $882.34 $942.78 $1157.50	$345.55 $374.07 $404.29 $511.65	$479.75 $508.27 $538.49 $645.85	$613.95 $642.47 $672.69 $780.05	$134.20
Plan: (HMO) Florida Hospital Bronze HMO 70 1567 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $5,300 : Family: $10,600 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$208.58 $236.73 $266.55 $372.51 $566.06	$417.16 $473.46 $533.10 $745.02 $1132.12	$549.60 $605.90 $665.54 $877.46	$682.04 $738.34 $797.98 $1009.90	$814.48 $870.78 $930.42 $1142.34	$341.02 $369.17 $398.99 $504.95	$473.46 $501.61 $531.43 $637.39	$605.90 $634.05 $663.87 $769.83	$132.44
Plan: (HMO) Florida Hospital Catastrophic HMO 1569 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $6,850 : Family: $13,700 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Catastrophic	21 30 40 50 60	$197.79 $224.48 $252.76 $353.24 $536.77	$395.58 $448.96 $505.52 $706.48 $1073.54	$521.17 $574.55 $631.11 $832.07	$646.76 $700.14 $756.70 $957.66	$772.35 $825.73 $882.29 $1083.25	$323.38 $350.07 $378.35 $478.83	$448.97 $475.66 $503.94 $604.42	$574.56 $601.25 $629.53 $730.01	$125.59
Plan: (POS) Florida Hospital Gold POS 100 1504 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $2,500 : Family: $5,000 Out of Pocket Maximum per year: Individual: $2,800 : Family: $5,600 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$315.70 $358.31 $403.45 $563.82 $856.78	$631.40 $716.62 $806.90 $1127.64 $1713.56	$831.86 $917.08 $1007.36 $1328.10	$1032.32 $1117.54 $1207.82 $1528.56	$1232.78 $1318.00 $1408.28 $1729.02	$516.16 $558.77 $603.91 $764.28	$716.62 $759.23 $804.37 $964.74	$917.08 $959.69 $1004.83 $1165.20	$200.46
Plan: (POS) Florida Hospital Gold POS 90 1506 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $1,500 : Family: $3,000 Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$306.80 $348.21 $392.08 $547.93 $832.63	$613.60 $696.42 $784.16 $1095.86 $1665.26	$808.41 $891.23 $978.97 $1290.67	$1003.22 $1086.04 $1173.78 $1485.48	$1198.03 $1280.85 $1368.59 $1680.29	$501.61 $543.02 $586.89 $742.74	$696.42 $737.83 $781.70 $937.55	$891.23 $932.64 $976.51 $1132.36	$194.81
Plan: (POS) Florida Hospital Gold POS 80 1508 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $1,500 : Family: $3,000 Out of Pocket Maximum per year: Individual: $4,000 : Family: $8,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$328.35 $372.67 $419.62 $586.42 $891.11	$656.70 $745.34 $839.24 $1172.84 $1782.22	$865.20 $953.84 $1047.74 $1381.34	$1073.70 $1162.34 $1256.24 $1589.84	$1282.20 $1370.84 $1464.74 $1798.34	$536.85 $581.17 $628.12 $794.92	$745.35 $789.67 $836.62 $1003.42	$953.85 $998.17 $1045.12 $1211.92	$208.50
Plan: (POS) Florida Hospital Gold POS 80 1511 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $2,000 : Family: $4,000 Out of Pocket Maximum per year: Individual: $4,000 : Family: $8,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$312.58 $354.77 $399.46 $558.25 $848.31	$625.16 $709.54 $798.92 $1116.50 $1696.62	$823.64 $908.02 $997.40 $1314.98	$1022.12 $1106.50 $1195.88 $1513.46	$1220.60 $1304.98 $1394.36 $1711.94	$511.06 $553.25 $597.94 $756.73	$709.54 $751.73 $796.42 $955.21	$908.02 $950.21 $994.90 $1153.69	$198.48
Plan: (POS) Florida Hospital Gold POS 70 1513 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $1,000 : Family: $2,000 Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$322.48 $366.00 $412.12 $575.93 $875.18	$644.96 $732.00 $824.24 $1151.86 $1750.36	$849.73 $936.77 $1029.01 $1356.63	$1054.50 $1141.54 $1233.78 $1561.40	$1259.27 $1346.31 $1438.55 $1766.17	$527.25 $570.77 $616.89 $780.70	$732.02 $775.54 $821.66 $985.47	$936.79 $980.31 $1026.43 $1190.24	$204.77
Plan: (POS) Florida Hospital Silver POS 100 1515 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $4,400 : Family: $8,800 Out of Pocket Maximum per year: Individual: $4,600 : Family: $9,200 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$267.49 $303.59 $341.84 $477.72 $725.94	$534.98 $607.18 $683.68 $955.44 $1451.88	$704.83 $777.03 $853.53 $1125.29	$874.68 $946.88 $1023.38 $1295.14	$1044.53 $1116.73 $1193.23 $1464.99	$437.34 $473.44 $511.69 $647.57	$607.19 $643.29 $681.54 $817.42	$777.04 $813.14 $851.39 $987.27	$169.85
Plan: (POS) Florida Hospital Silver POS 90 1527 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $3,900 : Family: $7,800 Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$269.54 $305.92 $344.46 $481.38 $731.50	$539.08 $611.84 $688.92 $962.76 $1463.00	$710.23 $782.99 $860.07 $1133.91	$881.38 $954.14 $1031.22 $1305.06	$1052.53 $1125.29 $1202.37 $1476.21	$440.69 $477.07 $515.61 $652.53	$611.84 $648.22 $686.76 $823.68	$782.99 $819.37 $857.91 $994.83	$171.15
Plan: (POS) Florida Hospital Silver POS 80 1535 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $2,500 : Family: $5,000 Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$258.81 $293.74 $330.75 $462.22 $702.38	$517.62 $587.48 $661.50 $924.44 $1404.76	$681.96 $751.82 $825.84 $1088.78	$846.30 $916.16 $990.18 $1253.12	$1010.64 $1080.50 $1154.52 $1417.46	$423.15 $458.08 $495.09 $626.56	$587.49 $622.42 $659.43 $790.90	$751.83 $786.76 $823.77 $955.24	$164.34
Plan: (POS) Florida Hospital Silver POS 70 1547 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $3,500 : Family: $7,000 Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$261.03 $296.26 $333.58 $466.18 $708.41	$522.06 $592.52 $667.16 $932.36 $1416.82	$687.81 $758.27 $832.91 $1098.11	$853.56 $924.02 $998.66 $1263.86	$1019.31 $1089.77 $1164.41 $1429.61	$426.78 $462.01 $499.33 $631.93	$592.53 $627.76 $665.08 $797.68	$758.28 $793.51 $830.83 $963.43	$165.75
Plan: (POS) Florida Hospital Silver POS 70 1555 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $2,000 : Family: $4,000 Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$259.88 $294.95 $332.11 $464.13 $705.29	$519.76 $589.90 $664.22 $928.26 $1410.58	$684.78 $754.92 $829.24 $1093.28	$849.80 $919.94 $994.26 $1258.30	$1014.82 $1084.96 $1159.28 $1423.32	$424.90 $459.97 $497.13 $629.15	$589.92 $624.99 $662.15 $794.17	$754.94 $790.01 $827.17 $959.19	$165.02
Plan: (POS) Florida Hospital Bronze POS 100 1563 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $6,000 : Family: $12,000 Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$216.47 $245.68 $276.64 $386.60 $587.47	$432.94 $491.36 $553.28 $773.20 $1174.94	$570.39 $628.81 $690.73 $910.65	$707.84 $766.26 $828.18 $1048.10	$845.29 $903.71 $965.63 $1185.55	$353.92 $383.13 $414.09 $524.05	$491.37 $520.58 $551.54 $661.50	$628.82 $658.03 $688.99 $798.95	$137.45
Plan: (POS) Florida Hospital Bronze POS 70 1566 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $4,500 : Family: $9,000 Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$216.98 $246.26 $277.29 $387.51 $588.86	$433.96 $492.52 $554.58 $775.02 $1177.72	$571.74 $630.30 $692.36 $912.80	$709.52 $768.08 $830.14 $1050.58	$847.30 $905.86 $967.92 $1188.36	$354.76 $384.04 $415.07 $525.29	$492.54 $521.82 $552.85 $663.07	$630.32 $659.60 $690.63 $800.85	$137.78
Plan: (POS) Florida Hospital Bronze POS 70 1568 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $5,300 : Family: $10,600 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$213.79 $242.64 $273.21 $381.81 $580.20	$427.58 $485.28 $546.42 $763.62 $1160.40	$563.33 $621.03 $682.17 $899.37	$699.08 $756.78 $817.92 $1035.12	$834.83 $892.53 $953.67 $1170.87	$349.54 $378.39 $408.96 $517.56	$485.29 $514.14 $544.71 $653.31	$621.04 $649.89 $680.46 $789.06	$135.75
Plan: (POS) Florida Hospital Catastrophic POS 1570 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Health Plans, Inc.) Deductible: Individual: $6,850 : Family: $13,700 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Catastrophic	21 30 40 50 60	$202.27 $229.57 $258.49 $361.24 $548.93	$404.54 $459.14 $516.98 $722.48 $1097.86	$532.98 $587.58 $645.42 $850.92	$661.42 $716.02 $773.86 $979.36	$789.86 $844.46 $902.30 $1107.80	$330.71 $358.01 $386.93 $489.68	$459.15 $486.45 $515.37 $618.12	$587.59 $614.89 $643.81 $746.56	$128.44
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Health Options, Inc. Local: 1-855-805-8175 \| Toll Free: 1-855-805-8175
Plan: (HMO) BlueCare Everyday Health 1490 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, Inc.) Deductible: Individual: $5,500 : Family: $11,000 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$251.95 $285.96 $321.99 $449.98 $683.79	$503.90 $571.92 $643.98 $899.96 $1367.58	$663.89 $731.91 $803.97 $1059.95	$823.88 $891.90 $963.96 $1219.94	$983.87 $1051.89 $1123.95 $1379.93	$411.94 $445.95 $481.98 $609.97	$571.93 $605.94 $641.97 $769.96	$731.92 $765.93 $801.96 $929.95	$159.99
Plan: (HMO) BlueCare Essential 1486 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, Inc.) Deductible: Individual: $6,850 : Family: $13,700 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$214.67 $243.65 $274.35 $383.40 $582.61	$429.34 $487.30 $548.70 $766.80 $1165.22	$565.66 $623.62 $685.02 $903.12	$701.98 $759.94 $821.34 $1039.44	$838.30 $896.26 $957.66 $1175.76	$350.99 $379.97 $410.67 $519.72	$487.31 $516.29 $546.99 $656.04	$623.63 $652.61 $683.31 $792.36	$136.32
Plan: (HMO) BlueCare Everyday Health 1498 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, Inc.) Deductible: Individual: $5,000 : Family: $10,000 Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$284.70 $323.13 $363.85 $508.47 $772.68	$569.40 $646.26 $727.70 $1016.94 $1545.36	$750.18 $827.04 $908.48 $1197.72	$930.96 $1007.82 $1089.26 $1378.50	$1111.74 $1188.60 $1270.04 $1559.28	$465.48 $503.91 $544.63 $689.25	$646.26 $684.69 $725.41 $870.03	$827.04 $865.47 $906.19 $1050.81	$180.78
Plan: (HMO) BlueCare Everyday Health 1485 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, Inc.) Deductible: Individual: $800 : Family: $1,600 Out of Pocket Maximum per year: Individual: $2,500 : Family: $5,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$369.35 $419.21 $472.03 $659.66 $1002.42	$738.70 $838.42 $944.06 $1319.32 $2004.84	$973.24 $1072.96 $1178.60 $1553.86	$1207.78 $1307.50 $1413.14 $1788.40	$1442.32 $1542.04 $1647.68 $2022.94	$603.89 $653.75 $706.57 $894.20	$838.43 $888.29 $941.11 $1128.74	$1072.97 $1122.83 $1175.65 $1363.28	$234.54
Plan: (HMO) BlueCare Everyday Health 1483 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, Inc.) Deductible: Individual: $6,700 : Family: $13,400 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$245.05 $278.13 $313.17 $437.66 $665.07	$490.10 $556.26 $626.34 $875.32 $1330.14	$645.71 $711.87 $781.95 $1030.93	$801.32 $867.48 $937.56 $1186.54	$956.93 $1023.09 $1093.17 $1342.15	$400.66 $433.74 $468.78 $593.27	$556.27 $589.35 $624.39 $748.88	$711.88 $744.96 $780.00 $904.49	$155.61
Plan: (HMO) BlueCare All Copay 1491 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $2,000 : Family: $4,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$384.53 $436.44 $491.43 $686.77 $1043.61	$769.06 $872.88 $982.86 $1373.54 $2087.22	$1013.24 $1117.06 $1227.04 $1617.72	$1257.42 $1361.24 $1471.22 $1861.90	$1501.60 $1605.42 $1715.40 $2106.08	$628.71 $680.62 $735.61 $930.95	$872.89 $924.80 $979.79 $1175.13	$1117.07 $1168.98 $1223.97 $1419.31	$244.18
Plan: (HMO) BlueCare Everyday Health 1477 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, Inc.) Deductible: Individual: $6,100 : Family: $12,200 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$241.56 $274.17 $308.71 $431.43 $655.59	$483.12 $548.34 $617.42 $862.86 $1311.18	$636.51 $701.73 $770.81 $1016.25	$789.90 $855.12 $924.20 $1169.64	$943.29 $1008.51 $1077.59 $1323.03	$394.95 $427.56 $462.10 $584.82	$548.34 $580.95 $615.49 $738.21	$701.73 $734.34 $768.88 $891.60	$153.39
Plan: (HMO) BlueCare All Copay 1565 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-805-8175 - Provider Directory for This Plan: (Health Options, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$335.35 $380.62 $428.58 $598.94 $910.14	$670.70 $761.24 $857.16 $1197.88 $1820.28	$883.65 $974.19 $1070.11 $1410.83	$1096.60 $1187.14 $1283.06 $1623.78	$1309.55 $1400.09 $1496.01 $1836.73	$548.30 $593.57 $641.53 $811.89	$761.25 $806.52 $854.48 $1024.84	$974.20 $1019.47 $1067.43 $1237.79	$212.95
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Humana Medical Plan, Inc. Local: 1-877-720-4854 \| Toll Free: 1-877-720-4854 TTY: 1-800-325-2028
Plan: (HMO) Humana Basic 6850/Volusia HUMx (HMOx) Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan, Inc.) Deductible: Individual: $6,850 : Family: $13,700 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Catastrophic	21 30 40 50 60	$145.17 $164.77 $185.53 $259.27 $393.99	$290.34 $329.54 $371.06 $518.54 $787.98	$382.52 $421.72 $463.24 $610.72	$474.70 $513.90 $555.42 $702.90	$566.88 $606.08 $647.60 $795.08	$237.35 $256.95 $277.71 $351.45	$329.53 $349.13 $369.89 $443.63	$421.71 $441.31 $462.07 $535.81	$92.18
Plan: (HMO) Humana Bronze 6450/Volusia HUMx (HMOx) Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan, Inc.) Deductible: Individual: $6,450 : Family: $12,900 Out of Pocket Maximum per year: Individual: $6,450 : Family: $12,900 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$194.97 $221.29 $249.17 $348.22 $529.15	$389.94 $442.58 $498.34 $696.44 $1058.30	$513.75 $566.39 $622.15 $820.25	$637.56 $690.20 $745.96 $944.06	$761.37 $814.01 $869.77 $1067.87	$318.78 $345.10 $372.98 $472.03	$442.59 $468.91 $496.79 $595.84	$566.40 $592.72 $620.60 $719.65	$123.81
Plan: (HMO) Humana Silver 3800/Volusia HUMx (HMOx) Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan, Inc.) Deductible: Individual: $3,800 : Family: $7,600 Out of Pocket Maximum per year: Individual: $6,300 : Family: $12,600 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$229.90 $260.94 $293.81 $410.60 $623.95	$459.80 $521.88 $587.62 $821.20 $1247.90	$605.79 $667.87 $733.61 $967.19	$751.78 $813.86 $879.60 $1113.18	$897.77 $959.85 $1025.59 $1259.17	$375.89 $406.93 $439.80 $556.59	$521.88 $552.92 $585.79 $702.58	$667.87 $698.91 $731.78 $848.57	$145.99
Plan: (HMO) Humana Gold 2250/Volusia HUMx (HMOx) Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan, Inc.) Deductible: Individual: $2,250 : Family: $4,500 Out of Pocket Maximum per year: Individual: $3,500 : Family: $7,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$272.62 $309.42 $348.41 $486.90 $739.89	$545.24 $618.84 $696.82 $973.80 $1479.78	$718.35 $791.95 $869.93 $1146.91	$891.46 $965.06 $1043.04 $1320.02	$1064.57 $1138.17 $1216.15 $1493.13	$445.73 $482.53 $521.52 $660.01	$618.84 $655.64 $694.63 $833.12	$791.95 $828.75 $867.74 $1006.23	$173.11
Plan: (HMO) Humana Platinum 500/Volusia HUMx (HMOx) Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-720-4854 - Provider Directory for This Plan: (Humana Medical Plan, Inc.) Deductible: Individual: $500 : Family: $1,000 Out of Pocket Maximum per year: Individual: $1,500 : Family: $3,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$324.85 $368.70 $415.16 $580.18 $881.64	$649.70 $737.40 $830.32 $1160.36 $1763.28	$855.98 $943.68 $1036.60 $1366.64	$1062.26 $1149.96 $1242.88 $1572.92	$1268.54 $1356.24 $1449.16 $1779.20	$531.13 $574.98 $621.44 $786.46	$737.41 $781.26 $827.72 $992.74	$943.69 $987.54 $1034.00 $1199.02	$206.28
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Florida Health Care Plan, Inc. Local: 1-386-676-7110 \| Toll Free: 1-800-232-0578 TTY: 1-800-955-8771
Plan: (HMO) Gym Access IND Essential Plus Catastrophic HMO 36 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $6,850 : Family: $13,700 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Catastrophic	21 30 40 50 60	$169.08 $191.90 $216.08 $301.97 $458.87	$338.16 $383.80 $432.16 $603.94 $917.74	$445.52 $491.16 $539.52 $711.30	$552.88 $598.52 $646.88 $818.66	$660.24 $705.88 $754.24 $926.02	$276.44 $299.26 $323.44 $409.33	$383.80 $406.62 $430.80 $516.69	$491.16 $513.98 $538.16 $624.05	$107.36
Plan: (HMO) IND Essential Plus Catastrophic HMO 36 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $6,850 : Family: $13,700 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Catastrophic	21 30 40 50 60	$166.75 $189.27 $213.11 $297.82 $452.57	$333.50 $378.54 $426.22 $595.64 $905.14	$439.39 $484.43 $532.11 $701.53	$545.28 $590.32 $638.00 $807.42	$651.17 $696.21 $743.89 $913.31	$272.64 $295.16 $319.00 $403.71	$378.53 $401.05 $424.89 $509.60	$484.42 $506.94 $530.78 $615.49	$105.89
Plan: (POS) Gym Access IND Essential Plus Catastrophic POS 37 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $6,850 : Family: $13,700 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Catastrophic	21 30 40 50 60	$187.74 $213.08 $239.93 $335.30 $509.51	$375.48 $426.16 $479.86 $670.60 $1019.02	$494.69 $545.37 $599.07 $789.81	$613.90 $664.58 $718.28 $909.02	$733.11 $783.79 $837.49 $1028.23	$306.95 $332.29 $359.14 $454.51	$426.16 $451.50 $478.35 $573.72	$545.37 $570.71 $597.56 $692.93	$119.21
Plan: (POS) IND Essential Plus Catastrophic POS 37 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $6,850 : Family: $13,700 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Catastrophic	21 30 40 50 60	$185.18 $210.18 $236.66 $330.73 $502.58	$370.36 $420.36 $473.32 $661.46 $1005.16	$487.95 $537.95 $590.91 $779.05	$605.54 $655.54 $708.50 $896.64	$723.13 $773.13 $826.09 $1014.23	$302.77 $327.77 $354.25 $448.32	$420.36 $445.36 $471.84 $565.91	$537.95 $562.95 $589.43 $683.50	$117.59
Plan: (HMO) Gym Access IND Essential Plus Silver HMO 53 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $1,700 : Family: $3,400 Out of Pocket Maximum per year: Individual: $4,300 : Family: $8,600 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$244.30 $277.28 $312.22 $436.32 $663.04	$488.60 $554.56 $624.44 $872.64 $1326.08	$643.73 $709.69 $779.57 $1027.77	$798.86 $864.82 $934.70 $1182.90	$953.99 $1019.95 $1089.83 $1338.03	$399.43 $432.41 $467.35 $591.45	$554.56 $587.54 $622.48 $746.58	$709.69 $742.67 $777.61 $901.71	$155.13
Plan: (HMO) IND Essential Plus Silver HMO 53 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $1,700 : Family: $3,400 Out of Pocket Maximum per year: Individual: $4,300 : Family: $8,600 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$241.05 $273.59 $308.06 $430.51 $654.20	$482.10 $547.18 $616.12 $861.02 $1308.40	$635.16 $700.24 $769.18 $1014.08	$788.22 $853.30 $922.24 $1167.14	$941.28 $1006.36 $1075.30 $1320.20	$394.11 $426.65 $461.12 $583.57	$547.17 $579.71 $614.18 $736.63	$700.23 $732.77 $767.24 $889.69	$153.06
Plan: (HMO) Gym Access IND Essential Plus Bronze HMO 41 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $4,500 : Family: $9,000 Out of Pocket Maximum per year: Individual: $6,800 : Family: $13,600 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$185.47 $210.51 $237.04 $331.26 $503.38	$370.94 $421.02 $474.08 $662.52 $1006.76	$488.72 $538.80 $591.86 $780.30	$606.50 $656.58 $709.64 $898.08	$724.28 $774.36 $827.42 $1015.86	$303.25 $328.29 $354.82 $449.04	$421.03 $446.07 $472.60 $566.82	$538.81 $563.85 $590.38 $684.60	$117.78
Plan: (HMO) IND Essential Plus Bronze HMO 41 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $4,500 : Family: $9,000 Out of Pocket Maximum per year: Individual: $6,800 : Family: $13,600 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$182.95 $207.65 $233.81 $326.74 $496.52	$365.90 $415.30 $467.62 $653.48 $993.04	$482.07 $531.47 $583.79 $769.65	$598.24 $647.64 $699.96 $885.82	$714.41 $763.81 $816.13 $1001.99	$299.12 $323.82 $349.98 $442.91	$415.29 $439.99 $466.15 $559.08	$531.46 $556.16 $582.32 $675.25	$116.17
Plan: (HMO) Gym Access IND Essential Plus Gold HMO 63 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $1,000 : Family: $2,000 Out of Pocket Maximum per year: Individual: $2,500 : Family: $5,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$287.88 $326.75 $367.91 $514.16 $781.32	$575.76 $653.50 $735.82 $1028.32 $1562.64	$758.57 $836.31 $918.63 $1211.13	$941.38 $1019.12 $1101.44 $1393.94	$1124.19 $1201.93 $1284.25 $1576.75	$470.69 $509.56 $550.72 $696.97	$653.50 $692.37 $733.53 $879.78	$836.31 $875.18 $916.34 $1062.59	$182.81
Plan: (HMO) IND Essential Plus Gold HMO 63 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $1,000 : Family: $2,000 Out of Pocket Maximum per year: Individual: $2,500 : Family: $5,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$284.08 $322.43 $363.06 $507.37 $771.00	$568.16 $644.86 $726.12 $1014.74 $1542.00	$748.55 $825.25 $906.51 $1195.13	$928.94 $1005.64 $1086.90 $1375.52	$1109.33 $1186.03 $1267.29 $1555.91	$464.47 $502.82 $543.45 $687.76	$644.86 $683.21 $723.84 $868.15	$825.25 $863.60 $904.23 $1048.54	$180.39
Plan: (HMO) Gym Access IND Essential Plus Platinum HMO 65 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $1,500 : Family: $3,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$343.45 $389.82 $438.93 $613.41 $932.13	$686.90 $779.64 $877.86 $1226.82 $1864.26	$904.99 $997.73 $1095.95 $1444.91	$1123.08 $1215.82 $1314.04 $1663.00	$1341.17 $1433.91 $1532.13 $1881.09	$561.54 $607.91 $657.02 $831.50	$779.63 $826.00 $875.11 $1049.59	$997.72 $1044.09 $1093.20 $1267.68	$218.09
Plan: (HMO) IND Essential Plus Platinum HMO 65 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $1,500 : Family: $3,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$338.96 $384.72 $433.20 $605.39 $919.95	$677.92 $769.44 $866.40 $1210.78 $1839.90	$893.16 $984.68 $1081.64 $1426.02	$1108.40 $1199.92 $1296.88 $1641.26	$1323.64 $1415.16 $1512.12 $1856.50	$554.20 $599.96 $648.44 $820.63	$769.44 $815.20 $863.68 $1035.87	$984.68 $1030.44 $1078.92 $1251.11	$215.24
Plan: (POS) Gym Access IND Essential Plus Silver POS 54 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $2,000 : Family: $4,000 Out of Pocket Maximum per year: Individual: $4,300 : Family: $8,600 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$271.83 $308.53 $347.40 $485.49 $737.74	$543.66 $617.06 $694.80 $970.98 $1475.48	$716.27 $789.67 $867.41 $1143.59	$888.88 $962.28 $1040.02 $1316.20	$1061.49 $1134.89 $1212.63 $1488.81	$444.44 $481.14 $520.01 $658.10	$617.05 $653.75 $692.62 $830.71	$789.66 $826.36 $865.23 $1003.32	$172.61
Plan: (POS) IND Essential Plus Silver POS 54 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $2,000 : Family: $4,000 Out of Pocket Maximum per year: Individual: $4,300 : Family: $8,600 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$268.23 $304.44 $342.79 $479.05 $727.97	$536.46 $608.88 $685.58 $958.10 $1455.94	$706.78 $779.20 $855.90 $1128.42	$877.10 $949.52 $1026.22 $1298.74	$1047.42 $1119.84 $1196.54 $1469.06	$438.55 $474.76 $513.11 $649.37	$608.87 $645.08 $683.43 $819.69	$779.19 $815.40 $853.75 $990.01	$170.32
Plan: (POS) Gym Access IND Essential Plus Bronze POS 42 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $4,500 : Family: $9,000 Out of Pocket Maximum per year: Individual: $6,800 : Family: $13,600 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$206.61 $234.50 $264.05 $369.01 $560.74	$413.22 $469.00 $528.10 $738.02 $1121.48	$544.42 $600.20 $659.30 $869.22	$675.62 $731.40 $790.50 $1000.42	$806.82 $862.60 $921.70 $1131.62	$337.81 $365.70 $395.25 $500.21	$469.01 $496.90 $526.45 $631.41	$600.21 $628.10 $657.65 $762.61	$131.20
Plan: (POS) IND Essential Plus Bronze POS 42 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $4,500 : Family: $9,000 Out of Pocket Maximum per year: Individual: $6,800 : Family: $13,600 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$203.82 $231.34 $260.48 $364.02 $553.17	$407.64 $462.68 $520.96 $728.04 $1106.34	$537.07 $592.11 $650.39 $857.47	$666.50 $721.54 $779.82 $986.90	$795.93 $850.97 $909.25 $1116.33	$333.25 $360.77 $389.91 $493.45	$462.68 $490.20 $519.34 $622.88	$592.11 $619.63 $648.77 $752.31	$129.43
Plan: (POS) Gym Access IND Essential Plus Gold POS 64 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $1,600 : Family: $3,200 Out of Pocket Maximum per year: Individual: $3,500 : Family: $7,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$328.65 $373.02 $420.02 $586.98 $891.97	$657.30 $746.04 $840.04 $1173.96 $1783.94	$865.99 $954.73 $1048.73 $1382.65	$1074.68 $1163.42 $1257.42 $1591.34	$1283.37 $1372.11 $1466.11 $1800.03	$537.34 $581.71 $628.71 $795.67	$746.03 $790.40 $837.40 $1004.36	$954.72 $999.09 $1046.09 $1213.05	$208.69
Plan: (POS) IND Essential Plus Gold POS 64 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $1,600 : Family: $3,200 Out of Pocket Maximum per year: Individual: $3,500 : Family: $7,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$324.35 $368.14 $414.52 $579.29 $880.28	$648.70 $736.28 $829.04 $1158.58 $1760.56	$854.66 $942.24 $1035.00 $1364.54	$1060.62 $1148.20 $1240.96 $1570.50	$1266.58 $1354.16 $1446.92 $1776.46	$530.31 $574.10 $620.48 $785.25	$736.27 $780.06 $826.44 $991.21	$942.23 $986.02 $1032.40 $1197.17	$205.96
Plan: (POS) Gym Access IND Essential Plus Platinum POS 66 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $1,000 : Family: $2,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$379.81 $431.09 $485.40 $678.34 $1030.81	$759.62 $862.18 $970.80 $1356.68 $2061.62	$1000.80 $1103.36 $1211.98 $1597.86	$1241.98 $1344.54 $1453.16 $1839.04	$1483.16 $1585.72 $1694.34 $2080.22	$620.99 $672.27 $726.58 $919.52	$862.17 $913.45 $967.76 $1160.70	$1103.35 $1154.63 $1208.94 $1401.88	$241.18
Plan: (POS) IND Essential Plus Platinum POS 66 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $1,000 : Family: $2,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$374.87 $425.48 $479.08 $669.52 $1017.40	$749.74 $850.96 $958.16 $1339.04 $2034.80	$987.78 $1089.00 $1196.20 $1577.08	$1225.82 $1327.04 $1434.24 $1815.12	$1463.86 $1565.08 $1672.28 $2053.16	$612.91 $663.52 $717.12 $907.56	$850.95 $901.56 $955.16 $1145.60	$1088.99 $1139.60 $1193.20 $1383.64	$238.04
Plan: (HMO) Gym Access IND Platinum HMO 4000 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $4,000 : Family: $8,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$336.84 $382.32 $430.48 $601.60 $914.19	$673.68 $764.64 $860.96 $1203.20 $1828.38	$887.57 $978.53 $1074.85 $1417.09	$1101.46 $1192.42 $1288.74 $1630.98	$1315.35 $1406.31 $1502.63 $1844.87	$550.73 $596.21 $644.37 $815.49	$764.62 $810.10 $858.26 $1029.38	$978.51 $1023.99 $1072.15 $1243.27	$213.89
Plan: (HMO) IND Platinum HMO 4000 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $4,000 : Family: $8,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$332.43 $377.31 $424.85 $593.73 $902.23	$664.86 $754.62 $849.70 $1187.46 $1804.46	$875.96 $965.72 $1060.80 $1398.56	$1087.06 $1176.82 $1271.90 $1609.66	$1298.16 $1387.92 $1483.00 $1820.76	$543.53 $588.41 $635.95 $804.83	$754.63 $799.51 $847.05 $1015.93	$965.73 $1010.61 $1058.15 $1227.03	$211.10
Plan: (POS) Gym Access Platinum POS 4000 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $4,000 : Family: $8,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$372.28 $422.54 $475.77 $664.89 $1010.37	$744.56 $845.08 $951.54 $1329.78 $2020.74	$980.96 $1081.48 $1187.94 $1566.18	$1217.36 $1317.88 $1424.34 $1802.58	$1453.76 $1554.28 $1660.74 $2038.98	$608.68 $658.94 $712.17 $901.29	$845.08 $895.34 $948.57 $1137.69	$1081.48 $1131.74 $1184.97 $1374.09	$236.40
Plan: (POS) IND Platinum POS 4000 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $4,000 : Family: $8,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$367.43 $417.03 $469.58 $656.23 $997.21	$734.86 $834.06 $939.16 $1312.46 $1994.42	$968.18 $1067.38 $1172.48 $1545.78	$1201.50 $1300.70 $1405.80 $1779.10	$1434.82 $1534.02 $1639.12 $2012.42	$600.75 $650.35 $702.90 $889.55	$834.07 $883.67 $936.22 $1122.87	$1067.39 $1116.99 $1169.54 $1356.19	$233.32
Plan: (HMO) Gym Access IND Gold HMO 5500 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $2,000 : Family: $4,000 Out of Pocket Maximum per year: Individual: $5,500 : Family: $11,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$295.11 $334.95 $377.15 $527.07 $800.93	$590.22 $669.90 $754.30 $1054.14 $1601.86	$777.62 $857.30 $941.70 $1241.54	$965.02 $1044.70 $1129.10 $1428.94	$1152.42 $1232.10 $1316.50 $1616.34	$482.51 $522.35 $564.55 $714.47	$669.91 $709.75 $751.95 $901.87	$857.31 $897.15 $939.35 $1089.27	$187.40
Plan: (HMO) IND Gold HMO 5500 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $2,000 : Family: $4,000 Out of Pocket Maximum per year: Individual: $5,500 : Family: $11,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$291.22 $330.53 $372.18 $520.11 $790.36	$582.44 $661.06 $744.36 $1040.22 $1580.72	$767.36 $845.98 $929.28 $1225.14	$952.28 $1030.90 $1114.20 $1410.06	$1137.20 $1215.82 $1299.12 $1594.98	$476.14 $515.45 $557.10 $705.03	$661.06 $700.37 $742.02 $889.95	$845.98 $885.29 $926.94 $1074.87	$184.92
Plan: (POS) Gym Access IND Gold POS 5500 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $2,000 : Family: $4,000 Out of Pocket Maximum per year: Individual: $5,500 : Family: $11,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$326.38 $370.44 $417.11 $582.91 $885.79	$652.76 $740.88 $834.22 $1165.82 $1771.58	$860.01 $948.13 $1041.47 $1373.07	$1067.26 $1155.38 $1248.72 $1580.32	$1274.51 $1362.63 $1455.97 $1787.57	$533.63 $577.69 $624.36 $790.16	$740.88 $784.94 $831.61 $997.41	$948.13 $992.19 $1038.86 $1204.66	$207.25
Plan: (POS) IND Gold POS 5500 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $2,000 : Family: $4,000 Out of Pocket Maximum per year: Individual: $5,500 : Family: $11,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$322.10 $365.58 $411.64 $575.27 $874.17	$644.20 $731.16 $823.28 $1150.54 $1748.34	$848.73 $935.69 $1027.81 $1355.07	$1053.26 $1140.22 $1232.34 $1559.60	$1257.79 $1344.75 $1436.87 $1764.13	$526.63 $570.11 $616.17 $779.80	$731.16 $774.64 $820.70 $984.33	$935.69 $979.17 $1025.23 $1188.86	$204.53
Plan: (HMO) Gym Access IND Silver HMO 6400 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $5,000 : Family: $10,000 Out of Pocket Maximum per year: Individual: $6,400 : Family: $12,800 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$264.95 $300.72 $338.61 $473.20 $719.07	$529.90 $601.44 $677.22 $946.40 $1438.14	$698.14 $769.68 $845.46 $1114.64	$866.38 $937.92 $1013.70 $1282.88	$1034.62 $1106.16 $1181.94 $1451.12	$433.19 $468.96 $506.85 $641.44	$601.43 $637.20 $675.09 $809.68	$769.67 $805.44 $843.33 $977.92	$168.24
Plan: (HMO) IND Silver HMO 6400 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $5,000 : Family: $10,000 Out of Pocket Maximum per year: Individual: $6,400 : Family: $12,800 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$261.44 $296.73 $334.12 $466.92 $709.54	$522.88 $593.46 $668.24 $933.84 $1419.08	$688.89 $759.47 $834.25 $1099.85	$854.90 $925.48 $1000.26 $1265.86	$1020.91 $1091.49 $1166.27 $1431.87	$427.45 $462.74 $500.13 $632.93	$593.46 $628.75 $666.14 $798.94	$759.47 $794.76 $832.15 $964.95	$166.01
Plan: (HMO) Gym Access IND Silver HMO 6600 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $5,500 : Family: $11,000 Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$244.45 $277.45 $312.41 $436.59 $663.44	$488.90 $554.90 $624.82 $873.18 $1326.88	$644.13 $710.13 $780.05 $1028.41	$799.36 $865.36 $935.28 $1183.64	$954.59 $1020.59 $1090.51 $1338.87	$399.68 $432.68 $467.64 $591.82	$554.91 $587.91 $622.87 $747.05	$710.14 $743.14 $778.10 $902.28	$155.23
Plan: (HMO) IND Silver HMO 6600 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $5,500 : Family: $11,000 Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$241.19 $273.75 $308.24 $430.76 $654.59	$482.38 $547.50 $616.48 $861.52 $1309.18	$635.54 $700.66 $769.64 $1014.68	$788.70 $853.82 $922.80 $1167.84	$941.86 $1006.98 $1075.96 $1321.00	$394.35 $426.91 $461.40 $583.92	$547.51 $580.07 $614.56 $737.08	$700.67 $733.23 $767.72 $890.24	$153.16
Plan: (HMO) Gym Access IND Bronze HMO 6850 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $6,850 : Family: $13,700 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$190.13 $215.80 $242.99 $339.57 $516.01	$380.26 $431.60 $485.98 $679.14 $1032.02	$500.99 $552.33 $606.71 $799.87	$621.72 $673.06 $727.44 $920.60	$742.45 $793.79 $848.17 $1041.33	$310.86 $336.53 $363.72 $460.30	$431.59 $457.26 $484.45 $581.03	$552.32 $577.99 $605.18 $701.76	$120.73
Plan: (HMO) IND Bronze HMO 6850 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $6,850 : Family: $13,700 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$187.55 $212.86 $239.68 $334.96 $509.00	$375.10 $425.72 $479.36 $669.92 $1018.00	$494.19 $544.81 $598.45 $789.01	$613.28 $663.90 $717.54 $908.10	$732.37 $782.99 $836.63 $1027.19	$306.64 $331.95 $358.77 $454.05	$425.73 $451.04 $477.86 $573.14	$544.82 $570.13 $596.95 $692.23	$119.09
Plan: (HMO) Gym Access IND Bronze HMO HSA 4700/6450 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $4,700 : Family: $9,400 Out of Pocket Maximum per year: Individual: $6,450 : Family: $12,900 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$191.49 $217.34 $244.73 $342.00 $519.71	$382.98 $434.68 $489.46 $684.00 $1039.42	$504.58 $556.28 $611.06 $805.60	$626.18 $677.88 $732.66 $927.20	$747.78 $799.48 $854.26 $1048.80	$313.09 $338.94 $366.33 $463.60	$434.69 $460.54 $487.93 $585.20	$556.29 $582.14 $609.53 $706.80	$121.60
Plan: (HMO) IND Bronze HMO HSA 4700/6450 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $4,700 : Family: $9,400 Out of Pocket Maximum per year: Individual: $6,450 : Family: $12,900 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$188.89 $214.39 $241.40 $337.36 $512.65	$377.78 $428.78 $482.80 $674.72 $1025.30	$497.73 $548.73 $602.75 $794.67	$617.68 $668.68 $722.70 $914.62	$737.63 $788.63 $842.65 $1034.57	$308.84 $334.34 $361.35 $457.31	$428.79 $454.29 $481.30 $577.26	$548.74 $574.24 $601.25 $697.21	$119.95
Plan: (HMO) Gym Access IND Bronze HMO HSA 6000/6450 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $6,000 : Family: $12,000 Out of Pocket Maximum per year: Individual: $6,450 : Family: $12,900 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$188.90 $214.40 $241.42 $337.38 $512.68	$377.80 $428.80 $482.84 $674.76 $1025.36	$497.75 $548.75 $602.79 $794.71	$617.70 $668.70 $722.74 $914.66	$737.65 $788.65 $842.69 $1034.61	$308.85 $334.35 $361.37 $457.33	$428.80 $454.30 $481.32 $577.28	$548.75 $574.25 $601.27 $697.23	$119.95
Plan: (HMO) IND Bronze HMO HSA 6000/6450 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $6,000 : Family: $12,000 Out of Pocket Maximum per year: Individual: $6,450 : Family: $12,900 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$186.33 $211.49 $238.13 $332.79 $505.71	$372.66 $422.98 $476.26 $665.58 $1011.42	$490.98 $541.30 $594.58 $783.90	$609.30 $659.62 $712.90 $902.22	$727.62 $777.94 $831.22 $1020.54	$304.65 $329.81 $356.45 $451.11	$422.97 $448.13 $474.77 $569.43	$541.29 $566.45 $593.09 $687.75	$118.32
Plan: (HMO) IND Bronze HMO BC 3841 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $6,700 : Family: $13,400 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$194.91 $221.22 $249.09 $348.10 $528.98	$389.82 $442.44 $498.18 $696.20 $1057.96	$513.59 $566.21 $621.95 $819.97	$637.36 $689.98 $745.72 $943.74	$761.13 $813.75 $869.49 $1067.51	$318.68 $344.99 $372.86 $471.87	$442.45 $468.76 $496.63 $595.64	$566.22 $592.53 $620.40 $719.41	$123.77
Plan: (HMO) Gym Access IND Bronze HMO BC 3841 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $6,700 : Family: $13,400 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$197.58 $224.26 $252.51 $352.88 $536.24	$395.16 $448.52 $505.02 $705.76 $1072.48	$520.63 $573.99 $630.49 $831.23	$646.10 $699.46 $755.96 $956.70	$771.57 $824.93 $881.43 $1082.17	$323.05 $349.73 $377.98 $478.35	$448.52 $475.20 $503.45 $603.82	$573.99 $600.67 $628.92 $729.29	$125.47
Plan: (POS) IND Bronze POS BC 3841 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $6,700 : Family: $13,400 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$216.15 $245.33 $276.24 $386.04 $586.63	$432.30 $490.66 $552.48 $772.08 $1173.26	$569.56 $627.92 $689.74 $909.34	$706.82 $765.18 $827.00 $1046.60	$844.08 $902.44 $964.26 $1183.86	$353.41 $382.59 $413.50 $523.30	$490.67 $519.85 $550.76 $660.56	$627.93 $657.11 $688.02 $797.82	$137.26
Plan: (POS) Gym Access IND Bronze POS BC 3841 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $6,700 : Family: $13,400 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$219.09 $248.67 $280.00 $391.30 $594.62	$438.18 $497.34 $560.00 $782.60 $1189.24	$577.30 $636.46 $699.12 $921.72	$716.42 $775.58 $838.24 $1060.84	$855.54 $914.70 $977.36 $1199.96	$358.21 $387.79 $419.12 $530.42	$497.33 $526.91 $558.24 $669.54	$636.45 $666.03 $697.36 $808.66	$139.12
Plan: (HMO) IND Silver HMO BC 0941 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $5,500 : Family: $11,000 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$232.61 $264.01 $297.27 $415.43 $631.29	$465.22 $528.02 $594.54 $830.86 $1262.58	$612.92 $675.72 $742.24 $978.56	$760.62 $823.42 $889.94 $1126.26	$908.32 $971.12 $1037.64 $1273.96	$380.31 $411.71 $444.97 $563.13	$528.01 $559.41 $592.67 $710.83	$675.71 $707.11 $740.37 $858.53	$147.70
Plan: (HMO) Gym Access IND Silver HMO BC 0941 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $5,500 : Family: $11,000 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$235.75 $267.58 $301.29 $421.06 $639.84	$471.50 $535.16 $602.58 $842.12 $1279.68	$621.20 $684.86 $752.28 $991.82	$770.90 $834.56 $901.98 $1141.52	$920.60 $984.26 $1051.68 $1291.22	$385.45 $417.28 $450.99 $570.76	$535.15 $566.98 $600.69 $720.46	$684.85 $716.68 $750.39 $870.16	$149.70
Plan: (POS) IND Silver POS BC 0941 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $5,500 : Family: $11,000 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$257.62 $292.40 $329.24 $460.11 $699.18	$515.24 $584.80 $658.48 $920.22 $1398.36	$678.83 $748.39 $822.07 $1083.81	$842.42 $911.98 $985.66 $1247.40	$1006.01 $1075.57 $1149.25 $1410.99	$421.21 $455.99 $492.83 $623.70	$584.80 $619.58 $656.42 $787.29	$748.39 $783.17 $820.01 $950.88	$163.59
Plan: (POS) Gym Access IND Silver POS BC 0941 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $5,500 : Family: $11,000 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$261.09 $296.33 $333.67 $466.30 $708.59	$522.18 $592.66 $667.34 $932.60 $1417.18	$687.97 $758.45 $833.13 $1098.39	$853.76 $924.24 $998.92 $1264.18	$1019.55 $1090.03 $1164.71 $1429.97	$426.88 $462.12 $499.46 $632.09	$592.67 $627.91 $665.25 $797.88	$758.46 $793.70 $831.04 $963.67	$165.79
Plan: (HMO) IND Silver HMO BC 7741 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $5,200 : Family: $10,400 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$240.11 $272.53 $306.86 $428.84 $651.66	$480.22 $545.06 $613.72 $857.68 $1303.32	$632.69 $697.53 $766.19 $1010.15	$785.16 $850.00 $918.66 $1162.62	$937.63 $1002.47 $1071.13 $1315.09	$392.58 $425.00 $459.33 $581.31	$545.05 $577.47 $611.80 $733.78	$697.52 $729.94 $764.27 $886.25	$152.47
Plan: (HMO) Gym Access IND Silver HMO BC 7741 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $5,200 : Family: $10,400 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$243.36 $276.21 $311.01 $434.64 $660.47	$486.72 $552.42 $622.02 $869.28 $1320.94	$641.25 $706.95 $776.55 $1023.81	$795.78 $861.48 $931.08 $1178.34	$950.31 $1016.01 $1085.61 $1332.87	$397.89 $430.74 $465.54 $589.17	$552.42 $585.27 $620.07 $743.70	$706.95 $739.80 $774.60 $898.23	$154.53
Plan: (POS) IND Silver POS BC 7741 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $5,200 : Family: $10,400 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$265.87 $301.77 $339.79 $474.85 $721.58	$531.74 $603.54 $679.58 $949.70 $1443.16	$700.57 $772.37 $848.41 $1118.53	$869.40 $941.20 $1017.24 $1287.36	$1038.23 $1110.03 $1186.07 $1456.19	$434.70 $470.60 $508.62 $643.68	$603.53 $639.43 $677.45 $812.51	$772.36 $808.26 $846.28 $981.34	$168.83
Plan: (POS) Gym Access IND Silver POS BC 7741 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $5,200 : Family: $10,400 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$269.45 $305.82 $344.35 $481.23 $731.27	$538.90 $611.64 $688.70 $962.46 $1462.54	$710.00 $782.74 $859.80 $1133.56	$881.10 $953.84 $1030.90 $1304.66	$1052.20 $1124.94 $1202.00 $1475.76	$440.55 $476.92 $515.45 $652.33	$611.65 $648.02 $686.55 $823.43	$782.75 $819.12 $857.65 $994.53	$171.10
Plan: (HMO) IND Gold HMO BC 5651 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$320.70 $363.99 $409.85 $572.76 $870.37	$641.40 $727.98 $819.70 $1145.52 $1740.74	$845.04 $931.62 $1023.34 $1349.16	$1048.68 $1135.26 $1226.98 $1552.80	$1252.32 $1338.90 $1430.62 $1756.44	$524.34 $567.63 $613.49 $776.40	$727.98 $771.27 $817.13 $980.04	$931.62 $974.91 $1020.77 $1183.68	$203.64
Plan: (HMO) Gym Access IND Gold HMO BC 5651 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$324.95 $368.82 $415.29 $580.37 $881.93	$649.90 $737.64 $830.58 $1160.74 $1763.86	$856.25 $943.99 $1036.93 $1367.09	$1062.60 $1150.34 $1243.28 $1573.44	$1268.95 $1356.69 $1449.63 $1779.79	$531.30 $575.17 $621.64 $786.72	$737.65 $781.52 $827.99 $993.07	$944.00 $987.87 $1034.34 $1199.42	$206.35
Plan: (POS) IND Gold POS BC 5651 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$355.98 $404.04 $454.94 $635.78 $966.13	$711.96 $808.08 $909.88 $1271.56 $1932.26	$938.01 $1034.13 $1135.93 $1497.61	$1164.06 $1260.18 $1361.98 $1723.66	$1390.11 $1486.23 $1588.03 $1949.71	$582.03 $630.09 $680.99 $861.83	$808.08 $856.14 $907.04 $1087.88	$1034.13 $1082.19 $1133.09 $1313.93	$226.05
Plan: (POS) Gym Access IND Gold POS BC 5651 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$360.69 $409.38 $460.96 $644.18 $978.90	$721.38 $818.76 $921.92 $1288.36 $1957.80	$950.42 $1047.80 $1150.96 $1517.40	$1179.46 $1276.84 $1380.00 $1746.44	$1408.50 $1505.88 $1609.04 $1975.48	$589.73 $638.42 $690.00 $873.22	$818.77 $867.46 $919.04 $1102.26	$1047.81 $1096.50 $1148.08 $1331.30	$229.04
Plan: (HMO) IND Platinum HMO BC 5841 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $800 : Family: $1,600 Out of Pocket Maximum per year: Individual: $2,500 : Family: $5,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$321.06 $364.40 $410.31 $573.40 $871.34	$642.12 $728.80 $820.62 $1146.80 $1742.68	$845.99 $932.67 $1024.49 $1350.67	$1049.86 $1136.54 $1228.36 $1554.54	$1253.73 $1340.41 $1432.23 $1758.41	$524.93 $568.27 $614.18 $777.27	$728.80 $772.14 $818.05 $981.14	$932.67 $976.01 $1021.92 $1185.01	$203.87
Plan: (HMO) Gym Access IND Platinum HMO BC 5841 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $800 : Family: $1,600 Out of Pocket Maximum per year: Individual: $2,500 : Family: $5,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$325.32 $369.24 $415.76 $581.02 $882.92	$650.64 $738.48 $831.52 $1162.04 $1765.84	$857.22 $945.06 $1038.10 $1368.62	$1063.80 $1151.64 $1244.68 $1575.20	$1270.38 $1358.22 $1451.26 $1781.78	$531.90 $575.82 $622.34 $787.60	$738.48 $782.40 $828.92 $994.18	$945.06 $988.98 $1035.50 $1200.76	$206.58
Plan: (POS) IND Platinum POS BC 5841 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $800 : Family: $1,600 Out of Pocket Maximum per year: Individual: $2,500 : Family: $5,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$356.37 $404.49 $455.45 $636.49 $967.20	$712.74 $808.98 $910.90 $1272.98 $1934.40	$939.04 $1035.28 $1137.20 $1499.28	$1165.34 $1261.58 $1363.50 $1725.58	$1391.64 $1487.88 $1589.80 $1951.88	$582.67 $630.79 $681.75 $862.79	$808.97 $857.09 $908.05 $1089.09	$1035.27 $1083.39 $1134.35 $1315.39	$226.30
Plan: (POS) Gym Access IND Platinum POS BC 5841 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $800 : Family: $1,600 Out of Pocket Maximum per year: Individual: $2,500 : Family: $5,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$361.09 $409.83 $461.47 $644.90 $979.99	$722.18 $819.66 $922.94 $1289.80 $1959.98	$951.47 $1048.95 $1152.23 $1519.09	$1180.76 $1278.24 $1381.52 $1748.38	$1410.05 $1507.53 $1610.81 $1977.67	$590.38 $639.12 $690.76 $874.19	$819.67 $868.41 $920.05 $1103.48	$1048.96 $1097.70 $1149.34 $1332.77	$229.29
Plan: (HMO) IND Platinum HMO BC 1941 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $2,000 : Family: $4,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$338.32 $383.99 $432.37 $604.23 $918.19	$676.64 $767.98 $864.74 $1208.46 $1836.38	$891.47 $982.81 $1079.57 $1423.29	$1106.30 $1197.64 $1294.40 $1638.12	$1321.13 $1412.47 $1509.23 $1852.95	$553.15 $598.82 $647.20 $819.06	$767.98 $813.65 $862.03 $1033.89	$982.81 $1028.48 $1076.86 $1248.72	$214.83
Plan: (HMO) Gym Access IND Platinum HMO BC 1941 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $2,000 : Family: $4,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$342.80 $389.08 $438.10 $612.24 $930.36	$685.60 $778.16 $876.20 $1224.48 $1860.72	$903.28 $995.84 $1093.88 $1442.16	$1120.96 $1213.52 $1311.56 $1659.84	$1338.64 $1431.20 $1529.24 $1877.52	$560.48 $606.76 $655.78 $829.92	$778.16 $824.44 $873.46 $1047.60	$995.84 $1042.12 $1091.14 $1265.28	$217.68
Plan: (POS) IND Platinum POS BC 1941 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $2,000 : Family: $4,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$375.44 $426.13 $479.82 $670.54 $1018.96	$750.88 $852.26 $959.64 $1341.08 $2037.92	$989.29 $1090.67 $1198.05 $1579.49	$1227.70 $1329.08 $1436.46 $1817.90	$1466.11 $1567.49 $1674.87 $2056.31	$613.85 $664.54 $718.23 $908.95	$852.26 $902.95 $956.64 $1147.36	$1090.67 $1141.36 $1195.05 $1385.77	$238.41
Plan: (POS) Gym Access IND Platinum POS BC 1941 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $0 : Family: $0 Out of Pocket Maximum per year: Individual: $2,000 : Family: $4,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$380.39 $431.74 $486.14 $679.38 $1032.38	$760.78 $863.48 $972.28 $1358.76 $2064.76	$1002.33 $1105.03 $1213.83 $1600.31	$1243.88 $1346.58 $1455.38 $1841.86	$1485.43 $1588.13 $1696.93 $2083.41	$621.94 $673.29 $727.69 $920.93	$863.49 $914.84 $969.24 $1162.48	$1105.04 $1156.39 $1210.79 $1404.03	$241.55
Plan: (HMO) IND Platinum HMO 91 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $250 : Family: $750 Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$330.31 $374.90 $422.13 $589.93 $896.46	$660.62 $749.80 $844.26 $1179.86 $1792.92	$870.37 $959.55 $1054.01 $1389.61	$1080.12 $1169.30 $1263.76 $1599.36	$1289.87 $1379.05 $1473.51 $1809.11	$540.06 $584.65 $631.88 $799.68	$749.81 $794.40 $841.63 $1009.43	$959.56 $1004.15 $1051.38 $1219.18	$209.75
Plan: (HMO) Gym Access IND Platinum HMO 91 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $250 : Family: $750 Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$334.70 $379.88 $427.74 $597.77 $908.36	$669.40 $759.76 $855.48 $1195.54 $1816.72	$881.93 $972.29 $1068.01 $1408.07	$1094.46 $1184.82 $1280.54 $1620.60	$1306.99 $1397.35 $1493.07 $1833.13	$547.23 $592.41 $640.27 $810.30	$759.76 $804.94 $852.80 $1022.83	$972.29 $1017.47 $1065.33 $1235.36	$212.53
Plan: (HMO) IND Platinum HMO 92 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $500 : Family: $1,000 Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$325.75 $369.73 $416.31 $581.79 $884.09	$651.50 $739.46 $832.62 $1163.58 $1768.18	$858.35 $946.31 $1039.47 $1370.43	$1065.20 $1153.16 $1246.32 $1577.28	$1272.05 $1360.01 $1453.17 $1784.13	$532.60 $576.58 $623.16 $788.64	$739.45 $783.43 $830.01 $995.49	$946.30 $990.28 $1036.86 $1202.34	$206.85
Plan: (HMO) Gym Acccess IND Platinum HMO 92 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.) Deductible: Individual: $500 : Family: $1,000 Out of Pocket Maximum per year: Individual: $3,000 : Family: $6,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Platinum	21 30 40 50 60	$330.08 $374.64 $421.84 $589.52 $895.83	$660.16 $749.28 $843.68 $1179.04 $1791.66	$869.76 $958.88 $1053.28 $1388.64	$1079.36 $1168.48 $1262.88 $1598.24	$1288.96 $1378.08 $1472.48 $1807.84	$539.68 $584.24 $631.44 $799.12	$749.28 $793.84 $841.04 $1008.72	$958.88 $1003.44 $1050.64 $1218.32	$209.60
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Coventry Health Care of Florida, Inc. Local: 1-855-449-2889 \| Toll Free: 1-855-449-2889 TTY: 1-888-444-7352
Plan: (HMO) Coventry Gold $10 Copay Carelink HMO Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-449-2889 - Provider Directory for This Plan: (Coventry Health Care of Florida, Inc.) Deductible: Individual: $1,400 : Family: $2,800 Out of Pocket Maximum per year: Individual: $5,000 : Family: $10,000 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$283.78 $322.09 $362.67 $506.83 $770.17	$567.56 $644.18 $725.34 $1013.66 $1540.34	$747.76 $824.38 $905.54 $1193.86	$927.96 $1004.58 $1085.74 $1374.06	$1108.16 $1184.78 $1265.94 $1554.26	$463.98 $502.29 $542.87 $687.03	$644.18 $682.49 $723.07 $867.23	$824.38 $862.69 $903.27 $1047.43	$180.20
Plan: (HMO) Coventry Bronze $15 Copay Carelink HMO Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-449-2889 - Provider Directory for This Plan: (Coventry Health Care of Florida, Inc.) Deductible: Individual: $6,850 : Family: $13,700 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$200.27 $227.31 $255.95 $357.69 $543.54	$400.54 $454.62 $511.90 $715.38 $1087.08	$527.71 $581.79 $639.07 $842.55	$654.88 $708.96 $766.24 $969.72	$782.05 $836.13 $893.41 $1096.89	$327.44 $354.48 $383.12 $484.86	$454.61 $481.65 $510.29 $612.03	$581.78 $608.82 $637.46 $739.20	$127.17
Plan: (HMO) Coventry Bronze Ded Only HSA Eligible Carelink HMO Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-449-2889 - Provider Directory for This Plan: (Coventry Health Care of Florida, Inc.) Deductible: Individual: $6,450 : Family: $12,900 Out of Pocket Maximum per year: Individual: $6,450 : Family: $12,900 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$195.95 $222.41 $250.43 $349.97 $531.81	$391.90 $444.82 $500.86 $699.94 $1063.62	$516.33 $569.25 $625.29 $824.37	$640.76 $693.68 $749.72 $948.80	$765.19 $818.11 $874.15 $1073.23	$320.38 $346.84 $374.86 $474.40	$444.81 $471.27 $499.29 $598.83	$569.24 $595.70 $623.72 $723.26	$124.43
Plan: (HMO) Coventry Silver $10 Copay 2750 Carelink HMO Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-449-2889 - Provider Directory for This Plan: (Coventry Health Care of Florida, Inc.) Deductible: Individual: $2,750 : Family: $5,500 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$238.73 $270.96 $305.10 $426.38 $647.92	$477.46 $541.92 $610.20 $852.76 $1295.84	$629.05 $693.51 $761.79 $1004.35	$780.64 $845.10 $913.38 $1155.94	$932.23 $996.69 $1064.97 $1307.53	$390.32 $422.55 $456.69 $577.97	$541.91 $574.14 $608.28 $729.56	$693.50 $725.73 $759.87 $881.15	$151.59
Plan: (HMO) Coventry Catastrophic Carelink HMO Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-449-2889 - Provider Directory for This Plan: (Coventry Health Care of Florida, Inc.) Deductible: Individual: $6,850 : Family: $13,700 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Catastrophic	21 30 40 50 60	$172.36 $195.63 $220.27 $307.83 $467.78	$344.72 $391.26 $440.54 $615.66 $935.56	$454.17 $500.71 $549.99 $725.11	$563.62 $610.16 $659.44 $834.56	$673.07 $719.61 $768.89 $944.01	$281.81 $305.08 $329.72 $417.28	$391.26 $414.53 $439.17 $526.73	$500.71 $523.98 $548.62 $636.18	$109.45
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UnitedHealthcare of Florida, Inc. Local: 1-877-887-0441 \| Toll Free: 1-877-887-0441
Plan: (HMO) Gold Compass 1500 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.) Deductible: Individual: $1,500 : Family: $3,000 Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$321.82 $365.25 $411.27 $574.75 $873.38	$643.64 $730.50 $822.54 $1149.50 $1746.76	$847.99 $934.85 $1026.89 $1353.85	$1052.34 $1139.20 $1231.24 $1558.20	$1256.69 $1343.55 $1435.59 $1762.55	$526.17 $569.60 $615.62 $779.10	$730.52 $773.95 $819.97 $983.45	$934.87 $978.30 $1024.32 $1187.80	$204.35
Plan: (HMO) Gold Compass HSA 1600 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.) Deductible: Individual: $1,600 : Family: $3,200 Out of Pocket Maximum per year: Individual: $3,500 : Family: $6,850 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Gold	21 30 40 50 60	$295.71 $335.62 $377.91 $528.13 $802.54	$591.42 $671.24 $755.82 $1056.26 $1605.08	$779.19 $859.01 $943.59 $1244.03	$966.96 $1046.78 $1131.36 $1431.80	$1154.73 $1234.55 $1319.13 $1619.57	$483.48 $523.39 $565.68 $715.90	$671.25 $711.16 $753.45 $903.67	$859.02 $898.93 $941.22 $1091.44	$187.77
Plan: (HMO) Silver Compass 4000 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.) Deductible: Individual: $4,000 : Family: $8,000 Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$270.78 $307.32 $346.04 $483.59 $734.87	$541.56 $614.64 $692.08 $967.18 $1469.74	$713.50 $786.58 $864.02 $1139.12	$885.44 $958.52 $1035.96 $1311.06	$1057.38 $1130.46 $1207.90 $1483.00	$442.72 $479.26 $517.98 $655.53	$614.66 $651.20 $689.92 $827.47	$786.60 $823.14 $861.86 $999.41	$171.94
Plan: (HMO) Silver Compass HSA 3600 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.) Deductible: Individual: $3,600 : Family: $7,200 Out of Pocket Maximum per year: Individual: $3,600 : Family: $7,200 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Silver	21 30 40 50 60	$272.73 $309.53 $348.53 $487.07 $740.16	$545.46 $619.06 $697.06 $974.14 $1480.32	$718.64 $792.24 $870.24 $1147.32	$891.82 $965.42 $1043.42 $1320.50	$1065.00 $1138.60 $1216.60 $1493.68	$445.91 $482.71 $521.71 $660.25	$619.09 $655.89 $694.89 $833.43	$792.27 $829.07 $868.07 $1006.61	$173.18
Plan: (HMO) Bronze Compass 4200 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.) Deductible: Individual: $4,200 : Family: $8,400 Out of Pocket Maximum per year: Individual: $6,600 : Family: $13,200 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$231.04 $262.22 $295.26 $412.62 $627.02	$462.08 $524.44 $590.52 $825.24 $1254.04	$608.78 $671.14 $737.22 $971.94	$755.48 $817.84 $883.92 $1118.64	$902.18 $964.54 $1030.62 $1265.34	$377.74 $408.92 $441.96 $559.32	$524.44 $555.62 $588.66 $706.02	$671.14 $702.32 $735.36 $852.72	$146.70
Plan: (HMO) Bronze Compass 6400 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.) Deductible: Individual: $6,400 : Family: $12,800 Out of Pocket Maximum per year: Individual: $6,800 : Family: $13,600 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Bronze	21 30 40 50 60	$237.27 $269.30 $303.22 $423.75 $643.94	$474.54 $538.60 $606.44 $847.50 $1287.88	$625.20 $689.26 $757.10 $998.16	$775.86 $839.92 $907.76 $1148.82	$926.52 $990.58 $1058.42 $1299.48	$387.93 $419.96 $453.88 $574.41	$538.59 $570.62 $604.54 $725.07	$689.25 $721.28 $755.20 $875.73	$150.66
Plan: (HMO) Catastrophic Compass 6850 Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0441 - Provider Directory for This Plan: (UnitedHealthcare of Florida, Inc.) Deductible: Individual: $6,850 : Family: $13,700 Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700 Monthly Premiums:
Metal level	Age	Individual	Couple	Couple w 1 Kid	Couple w 2 Kids	Couple w3+Kids	Single w 1 Kid	Single w 2 Kids	Single w3+Kids	Child any age
Catastrophic	21 30 40 50 60	$190.91 $216.67 $243.97 $340.95 $518.11	$381.82 $433.34 $487.94 $681.90 $1036.22	$503.04 $554.56 $609.16 $803.12	$624.26 $675.78 $730.38 $924.34	$745.48 $797.00 $851.60 $1045.56	$312.13 $337.89 $365.19 $462.17	$433.35 $459.11 $486.41 $583.39	$554.57 $580.33 $607.63 $704.61	$121.22

†Source: Our summary of lowest costs and numbers of providers is based on a government report released September 25, 2013. For more detailed information about specific plans and providers, see HealthCare.gov.

‡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 Volusia County here.

LegalConsumer.com/obamacare

ObamacareByZipCode.com

Obamacare 2016 Marketplace Rates For Deltona, FL

2016 Rates and Providers

Obamacare Providers, Plans and 2016 Rates for Volusia County

Blue Cross and Blue Shield of Florida

Plan: (EPO) BlueOptions Everyday Health 1423

Plan: (EPO) BlueOptions Essential 1419

Plan: (EPO) BlueOptions Everyday Health 1431

Plan: (EPO) BlueOptions Everyday Health 1418

Plan: (EPO) BlueOptions Everyday Health Premier 1418V

Plan: (EPO) BlueOptions Everyday Health 1416

Plan: (EPO) BlueOptions All Copay 1424

Plan: (EPO) BlueOptions Everyday Health 1410

Plan: (EPO) BlueOptions All Copay 1505

Health First Health Plans, Inc.

Plan: (HMO) Florida Hospital Platinum HMO 100 1500

Plan: (HMO) Florida Hospital Platinum HMO 90 1501

Plan: (HMO) Florida Hospital Platinum HMO 80 1502

Plan: (HMO) Florida Hospital Gold HMO 100 1503

Plan: (HMO) Florida Hospital Gold HMO 90 1505

Plan: (HMO) Florida Hospital Gold HMO 80 1507

Plan: (HMO) Florida Hospital Gold HMO 80 1509

Plan: (HMO) Florida Hospital Gold HMO 80 1510

Plan: (HMO) Florida Hospital Gold HMO 70 1512

Plan: (HMO) Florida Hospital Silver HMO 100 1514

Plan: (HMO) Florida Hospital Silver HMO 100 1522

Plan: (HMO) Florida Hospital Silver HMO 90 1526

Plan: (HMO) Florida Hospital Silver HMO 80 1534

Plan: (HMO) Florida Hospital Silver HMO 80 1542

Plan: (HMO) Florida Hospital Silver HMO 70 1546

Plan: (HMO) Florida Hospital Silver HMO 70 1554

Plan: (HMO) Florida Hospital Bronze HMO 100 1562

Plan: (HMO) Florida Hospital Bronze HMO 90 1564

Plan: (HMO) Florida Hospital Bronze HMO 70 1565

Plan: (HMO) Florida Hospital Bronze HMO 70 1567

Plan: (HMO) Florida Hospital Catastrophic HMO 1569

Plan: (POS) Florida Hospital Gold POS 100 1504

Plan: (POS) Florida Hospital Gold POS 90 1506

Plan: (POS) Florida Hospital Gold POS 80 1508

Plan: (POS) Florida Hospital Gold POS 80 1511

Plan: (POS) Florida Hospital Gold POS 70 1513

Plan: (POS) Florida Hospital Silver POS 100 1515

Plan: (POS) Florida Hospital Silver POS 90 1527

Plan: (POS) Florida Hospital Silver POS 80 1535

Plan: (POS) Florida Hospital Silver POS 70 1547

Plan: (POS) Florida Hospital Silver POS 70 1555

Plan: (POS) Florida Hospital Bronze POS 100 1563

Plan: (POS) Florida Hospital Bronze POS 70 1566

Plan: (POS) Florida Hospital Bronze POS 70 1568

Plan: (POS) Florida Hospital Catastrophic POS 1570

Health Options, Inc.

Plan: (HMO) BlueCare Everyday Health 1490

Plan: (HMO) BlueCare Essential 1486

Plan: (HMO) BlueCare Everyday Health 1498

Plan: (HMO) BlueCare Everyday Health 1485

Plan: (HMO) BlueCare Everyday Health 1483

Plan: (HMO) BlueCare All Copay 1491

Plan: (HMO) BlueCare Everyday Health 1477

Plan: (HMO) BlueCare All Copay 1565

Humana Medical Plan, Inc.

Plan: (HMO) Humana Basic 6850/Volusia HUMx (HMOx)

Plan: (HMO) Humana Bronze 6450/Volusia HUMx (HMOx)

Plan: (HMO) Humana Silver 3800/Volusia HUMx (HMOx)

Plan: (HMO) Humana Gold 2250/Volusia HUMx (HMOx)

Plan: (HMO) Humana Platinum 500/Volusia HUMx (HMOx)

Florida Health Care Plan, Inc.

Plan: (HMO) Gym Access IND Essential Plus Catastrophic HMO 36

Plan: (HMO) IND Essential Plus Catastrophic HMO 36

Plan: (POS) Gym Access IND Essential Plus Catastrophic POS 37

Plan: (POS) IND Essential Plus Catastrophic POS 37

Plan: (HMO) Gym Access IND Essential Plus Silver HMO 53

Plan: (HMO) IND Essential Plus Silver HMO 53

Plan: (HMO) Gym Access IND Essential Plus Bronze HMO 41

Plan: (HMO) IND Essential Plus Bronze HMO 41

Plan: (HMO) Gym Access IND Essential Plus Gold HMO 63

Plan: (HMO) IND Essential Plus Gold HMO 63

Plan: (HMO) Gym Access IND Essential Plus Platinum HMO 65

Plan: (HMO) IND Essential Plus Platinum HMO 65

Plan: (POS) Gym Access IND Essential Plus Silver POS 54