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Providers for Zip Code 71852

LegalConsumer.com/obamacare

ObamacareByZipCode.com

Obamacare 2016 Marketplace Rates For Howard County, Arkansas

Thursday, April 18th, 2024


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 Howard County, Arkansas.

Obamacare Providers, Plans and 2016 Rates for Howard County

Howard County is in “Rating Area 6” of Arkansas.

Currently, there are 1 providers offering 11 plans to Rating Area 6. †

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 Nashville, AR area accept this insurance coverage as within the plan's "network".
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QualChoice Life & Health Insurance Company, Inc.

Local: 1-501-228-7111 | Toll Free: 1-800-235-7111

Plan: (PPO) Silver 2500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-235-7111 - Provider Directory for This Plan: (QualChoice Life & Health Insurance Company, Inc.)

Deductible: Individual: $2,500 : Family: $5,000
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		 $277.82
$315.32
$355.05
$496.18
$754.00		 $555.64
$630.64
$710.10
$992.36
$1508.00		 $732.05
$807.05
$886.51
$1168.77		 $908.46
$983.46
$1062.92
$1345.18		 $1084.87
$1159.87
$1239.33
$1521.59		 $454.23
$491.73
$531.46
$672.59		 $630.64
$668.14
$707.87
$849.00		 $807.05
$844.55
$884.28
$1025.41		 $176.41

Plan: (PPO) Gold 2000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-235-7111 - Provider Directory for This Plan: (QualChoice Life & Health Insurance Company, Inc.)

Deductible: Individual: $2,000 : Family: $4,000
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		 $306.95
$348.38
$392.28
$548.21
$833.05		 $613.90
$696.76
$784.56
$1096.42
$1666.10		 $808.81
$891.67
$979.47
$1291.33		 $1003.72
$1086.58
$1174.38
$1486.24		 $1198.63
$1281.49
$1369.29
$1681.15		 $501.86
$543.29
$587.19
$743.12		 $696.77
$738.20
$782.10
$938.03		 $891.68
$933.11
$977.01
$1132.94		 $194.91
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Celtic Insurance Company

Local: 1-877-617-0390 | Toll Free: 1-877-617-0390

TTY: 1-877-617-0392

Plan: (PPO) Ambetter Secure Care 2 (2016) with 3 Free PCP Visits

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-617-0390 - Provider Directory for This Plan: (Celtic Insurance Company)

Deductible: Individual: $1,000 : Family: $2,000
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
Gold 21
30
40
50
60		 $274.08
$311.07
$350.26
$489.49
$743.82		 $548.16
$622.14
$700.52
$978.98
$1487.64		 $722.19
$796.17
$874.55
$1153.01		 $896.22
$970.20
$1048.58
$1327.04		 $1070.25
$1144.23
$1222.61
$1501.07		 $448.11
$485.10
$524.29
$663.52		 $622.14
$659.13
$698.32
$837.55		 $796.17
$833.16
$872.35
$1011.58		 $174.03

Plan: (PPO) Ambetter Essential Care 6 (2016)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-617-0390 - Provider Directory for This Plan: (Celtic Insurance Company)

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
Bronze 21
30
40
50
60		 $195.67
$222.08
$250.06
$349.46
$531.03		 $391.34
$444.16
$500.12
$698.92
$1062.06		 $515.59
$568.41
$624.37
$823.17		 $639.84
$692.66
$748.62
$947.42		 $764.09
$816.91
$872.87
$1071.67		 $319.92
$346.33
$374.31
$473.71		 $444.17
$470.58
$498.56
$597.96		 $568.42
$594.83
$622.81
$722.21		 $124.25

Plan: (PPO) Ambetter Balanced Care 7 (2016)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-617-0390 - Provider Directory for This Plan: (Celtic Insurance Company)

Deductible: Individual: $3,000 : Family: $6,000
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		 $232.67
$264.06
$297.33
$415.52
$631.43		 $465.34
$528.12
$594.66
$831.04
$1262.86		 $613.08
$675.86
$742.40
$978.78		 $760.82
$823.60
$890.14
$1126.52		 $908.56
$971.34
$1037.88
$1274.26		 $380.41
$411.80
$445.07
$563.26		 $528.15
$559.54
$592.81
$711.00		 $675.89
$707.28
$740.55
$858.74		 $147.74

Plan: (PPO) Ambetter Essential Care 6 (2016) + Vision + Adult Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-617-0390 - Provider Directory for This Plan: (Celtic Insurance Company)

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
Bronze 21
30
40
50
60		 $212.70
$241.40
$271.82
$379.86
$577.23		 $425.40
$482.80
$543.64
$759.72
$1154.46		 $560.46
$617.86
$678.70
$894.78		 $695.52
$752.92
$813.76
$1029.84		 $830.58
$887.98
$948.82
$1164.90		 $347.76
$376.46
$406.88
$514.92		 $482.82
$511.52
$541.94
$649.98		 $617.88
$646.58
$677.00
$785.04		 $135.06

Plan: (PPO) Ambetter Balanced Care 7 (2016) + Vision + Adult Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-617-0390 - Provider Directory for This Plan: (Celtic Insurance Company)

Deductible: Individual: $3,000 : Family: $6,000
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		 $252.91
$287.04
$323.20
$451.68
$686.37		 $505.82
$574.08
$646.40
$903.36
$1372.74		 $666.41
$734.67
$806.99
$1063.95		 $827.00
$895.26
$967.58
$1224.54		 $987.59
$1055.85
$1128.17
$1385.13		 $413.50
$447.63
$483.79
$612.27		 $574.09
$608.22
$644.38
$772.86		 $734.68
$768.81
$804.97
$933.45		 $160.59
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UnitedHealthcare of Arkansas, Inc.

Local: 1-877-632-4195 | Toll Free: 1-877-632-4195

Plan: (POS) Gold Compass Plus 1000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, Inc.)

Deductible: Individual: $1,000 : Family: $2,000
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		 $422.77
$479.83
$540.29
$755.05
$1147.37		 $845.54
$959.66
$1080.58
$1510.10
$2294.74		 $1113.99
$1228.11
$1349.03
$1778.55		 $1382.44
$1496.56
$1617.48
$2047.00		 $1650.89
$1765.01
$1885.93
$2315.45		 $691.22
$748.28
$808.74
$1023.50		 $959.67
$1016.73
$1077.19
$1291.95		 $1228.12
$1285.18
$1345.64
$1560.40		 $268.45

Plan: (POS) Gold Compass Plus HSA 1600

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, Inc.)

Deductible: Individual: $1,600 : Family: $4,800
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		 $391.15
$443.95
$499.88
$698.58
$1061.56		 $782.30
$887.90
$999.76
$1397.16
$2123.12		 $1030.67
$1136.27
$1248.13
$1645.53		 $1279.04
$1384.64
$1496.50
$1893.90		 $1527.41
$1633.01
$1744.87
$2142.27		 $639.52
$692.32
$748.25
$946.95		 $887.89
$940.69
$996.62
$1195.32		 $1136.26
$1189.06
$1244.99
$1443.69		 $248.37

Plan: (POS) Silver Compass Plus 5000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, Inc.)

Deductible: Individual: $5,000 : Family: $10,000
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		 $349.33
$396.48
$446.44
$623.89
$948.07		 $698.66
$792.96
$892.88
$1247.78
$1896.14		 $920.48
$1014.78
$1114.70
$1469.60		 $1142.30
$1236.60
$1336.52
$1691.42		 $1364.12
$1458.42
$1558.34
$1913.24		 $571.15
$618.30
$668.26
$845.71		 $792.97
$840.12
$890.08
$1067.53		 $1014.79
$1061.94
$1111.90
$1289.35		 $221.82

Plan: (POS) Silver Compass Plus 2000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, Inc.)

Deductible: Individual: $2,000 : Family: $4,000
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		 $362.59
$411.53
$463.38
$647.57
$984.05		 $725.18
$823.06
$926.76
$1295.14
$1968.10		 $955.42
$1053.30
$1157.00
$1525.38		 $1185.66
$1283.54
$1387.24
$1755.62		 $1415.90
$1513.78
$1617.48
$1985.86		 $592.83
$641.77
$693.62
$877.81		 $823.07
$872.01
$923.86
$1108.05		 $1053.31
$1102.25
$1154.10
$1338.29		 $230.24

Plan: (POS) Silver Compass Plus HSA 3600

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, 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		 $361.57
$410.37
$462.08
$645.75
$981.28		 $723.14
$820.74
$924.16
$1291.50
$1962.56		 $952.73
$1050.33
$1153.75
$1521.09		 $1182.32
$1279.92
$1383.34
$1750.68		 $1411.91
$1509.51
$1612.93
$1980.27		 $591.16
$639.96
$691.67
$875.34		 $820.75
$869.55
$921.26
$1104.93		 $1050.34
$1099.14
$1150.85
$1334.52		 $229.59

Plan: (POS) Bronze Compass Plus HSA 5200

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, Inc.)

Deductible: Individual: $5,200 : Family: $10,400
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		 $305.99
$347.28
$391.04
$546.48
$830.42		 $611.98
$694.56
$782.08
$1092.96
$1660.84		 $806.28
$888.86
$976.38
$1287.26		 $1000.58
$1083.16
$1170.68
$1481.56		 $1194.88
$1277.46
$1364.98
$1675.86		 $500.29
$541.58
$585.34
$740.78		 $694.59
$735.88
$779.64
$935.08		 $888.89
$930.18
$973.94
$1129.38		 $194.30

Plan: (POS) Bronze Compass Plus 6400

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, Inc.)

Deductible: Individual: $6,400 : Family: $12,800
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		 $315.68
$358.28
$403.42
$563.78
$856.72		 $631.36
$716.56
$806.84
$1127.56
$1713.44		 $831.81
$917.01
$1007.29
$1328.01		 $1032.26
$1117.46
$1207.74
$1528.46		 $1232.71
$1317.91
$1408.19
$1728.91		 $516.13
$558.73
$603.87
$764.23		 $716.58
$759.18
$804.32
$964.68		 $917.03
$959.63
$1004.77
$1165.13		 $200.45

Plan: (POS) Bronze Compass Plus 4200

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, 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		 $305.99
$347.28
$391.04
$546.48
$830.42		 $611.98
$694.56
$782.08
$1092.96
$1660.84		 $806.28
$888.86
$976.38
$1287.26		 $1000.58
$1083.16
$1170.68
$1481.56		 $1194.88
$1277.46
$1364.98
$1675.86		 $500.29
$541.58
$585.34
$740.78		 $694.59
$735.88
$779.64
$935.08		 $888.89
$930.18
$973.94
$1129.38		 $194.30

Plan: (POS) Catastrophic Compass Plus 6850

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, 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		 $253.97
$288.25
$324.56
$453.58
$689.25		 $507.94
$576.50
$649.12
$907.16
$1378.50		 $669.21
$737.77
$810.39
$1068.43		 $830.48
$899.04
$971.66
$1229.70		 $991.75
$1060.31
$1132.93
$1390.97		 $415.24
$449.52
$485.83
$614.85		 $576.51
$610.79
$647.10
$776.12		 $737.78
$772.06
$808.37
$937.39		 $161.27

Plan: (POS) Silver Compass Plus 4500-1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, Inc.)

Deductible: Individual: $4,500 : Family: $9,000
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		 $375.34
$426.00
$479.67
$670.34
$1018.65		 $750.68
$852.00
$959.34
$1340.68
$2037.30		 $989.02
$1090.34
$1197.68
$1579.02		 $1227.36
$1328.68
$1436.02
$1817.36		 $1465.70
$1567.02
$1674.36
$2055.70		 $613.68
$664.34
$718.01
$908.68		 $852.02
$902.68
$956.35
$1147.02		 $1090.36
$1141.02
$1194.69
$1385.36		 $238.34

Plan: (POS) Gold Compass Plus 1000-1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, Inc.)

Deductible: Individual: $1,000 : Family: $2,000
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		 $419.71
$476.36
$536.38
$749.58
$1139.06		 $839.42
$952.72
$1072.76
$1499.16
$2278.12		 $1105.93
$1219.23
$1339.27
$1765.67		 $1372.44
$1485.74
$1605.78
$2032.18		 $1638.95
$1752.25
$1872.29
$2298.69		 $686.22
$742.87
$802.89
$1016.09		 $952.73
$1009.38
$1069.40
$1282.60		 $1219.24
$1275.89
$1335.91
$1549.11		 $266.51

Plan: (POS) Gold Compass Plus HSA 1600-1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, Inc.)

Deductible: Individual: $1,600 : Family: $4,800
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		 $388.09
$440.47
$495.97
$693.11
$1053.25		 $776.18
$880.94
$991.94
$1386.22
$2106.50		 $1022.61
$1127.37
$1238.37
$1632.65		 $1269.04
$1373.80
$1484.80
$1879.08		 $1515.47
$1620.23
$1731.23
$2125.51		 $634.52
$686.90
$742.40
$939.54		 $880.95
$933.33
$988.83
$1185.97		 $1127.38
$1179.76
$1235.26
$1432.40		 $246.43

Plan: (POS) Silver Compass Plus 5000-1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, Inc.)

Deductible: Individual: $5,000 : Family: $10,000
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		 $346.27
$393.01
$442.53
$618.43
$939.76		 $692.54
$786.02
$885.06
$1236.86
$1879.52		 $912.42
$1005.90
$1104.94
$1456.74		 $1132.30
$1225.78
$1324.82
$1676.62		 $1352.18
$1445.66
$1544.70
$1896.50		 $566.15
$612.89
$662.41
$838.31		 $786.03
$832.77
$882.29
$1058.19		 $1005.91
$1052.65
$1102.17
$1278.07		 $219.88

Plan: (POS) Silver Compass Plus 2000-1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, Inc.)

Deductible: Individual: $2,000 : Family: $4,000
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		 $360.04
$408.64
$460.12
$643.02
$977.13		 $720.08
$817.28
$920.24
$1286.04
$1954.26		 $948.70
$1045.90
$1148.86
$1514.66		 $1177.32
$1274.52
$1377.48
$1743.28		 $1405.94
$1503.14
$1606.10
$1971.90		 $588.66
$637.26
$688.74
$871.64		 $817.28
$865.88
$917.36
$1100.26		 $1045.90
$1094.50
$1145.98
$1328.88		 $228.62

Plan: (POS) Silver Compass Plus HSA 3600-1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, 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		 $358.51
$406.90
$458.17
$640.29
$972.98		 $717.02
$813.80
$916.34
$1280.58
$1945.96		 $944.67
$1041.45
$1143.99
$1508.23		 $1172.32
$1269.10
$1371.64
$1735.88		 $1399.97
$1496.75
$1599.29
$1963.53		 $586.16
$634.55
$685.82
$867.94		 $813.81
$862.20
$913.47
$1095.59		 $1041.46
$1089.85
$1141.12
$1323.24		 $227.65

Plan: (POS) Bronze Compass Plus HSA 5200-1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, Inc.)

Deductible: Individual: $5,200 : Family: $10,400
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		 $303.44
$344.39
$387.78
$541.92
$823.50		 $606.88
$688.78
$775.56
$1083.84
$1647.00		 $799.56
$881.46
$968.24
$1276.52		 $992.24
$1074.14
$1160.92
$1469.20		 $1184.92
$1266.82
$1353.60
$1661.88		 $496.12
$537.07
$580.46
$734.60		 $688.80
$729.75
$773.14
$927.28		 $881.48
$922.43
$965.82
$1119.96		 $192.68

Plan: (POS) Bronze Compass Plus 6400-1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, Inc.)

Deductible: Individual: $6,400 : Family: $12,800
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		 $313.13
$355.39
$400.16
$559.23
$849.80		 $626.26
$710.78
$800.32
$1118.46
$1699.60		 $825.09
$909.61
$999.15
$1317.29		 $1023.92
$1108.44
$1197.98
$1516.12		 $1222.75
$1307.27
$1396.81
$1714.95		 $511.96
$554.22
$598.99
$758.06		 $710.79
$753.05
$797.82
$956.89		 $909.62
$951.88
$996.65
$1155.72		 $198.83

Plan: (POS) Bronze Compass Plus 4200-1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, 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		 $303.44
$344.39
$387.78
$541.92
$823.50		 $606.88
$688.78
$775.56
$1083.84
$1647.00		 $799.56
$881.46
$968.24
$1276.52		 $992.24
$1074.14
$1160.92
$1469.20		 $1184.92
$1266.82
$1353.60
$1661.88		 $496.12
$537.07
$580.46
$734.60		 $688.80
$729.75
$773.14
$927.28		 $881.48
$922.43
$965.82
$1119.96		 $192.68

Plan: (POS) Catastrophic Compass Plus 6850-1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-632-4195 - Provider Directory for This Plan: (UnitedHealthcare of Arkansas, 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		 $253.46
$287.67
$323.91
$452.66
$687.87		 $506.92
$575.34
$647.82
$905.32
$1375.74		 $667.86
$736.28
$808.76
$1066.26		 $828.80
$897.22
$969.70
$1227.20		 $989.74
$1058.16
$1130.64
$1388.14		 $414.40
$448.61
$484.85
$613.60		 $575.34
$609.55
$645.79
$774.54		 $736.28
$770.49
$806.73
$935.48		 $160.94
ADVERTISEMENT

QCA Health Plan, Inc.

Local: 1-501-228-7111 x7006 | Toll Free: 1-800-235-7111

Plan: (POS) Bronze Classic Saver 5000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-235-7111 - Provider Directory for This Plan: (QCA Health Plan, Inc.)

Deductible: Individual: $5,000 : Family: $10,000
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		 $201.15
$228.30
$257.07
$359.25
$545.92		 $402.30
$456.60
$514.14
$718.50
$1091.84		 $530.03
$584.33
$641.87
$846.23		 $657.76
$712.06
$769.60
$973.96		 $785.49
$839.79
$897.33
$1101.69		 $328.88
$356.03
$384.80
$486.98		 $456.61
$483.76
$512.53
$614.71		 $584.34
$611.49
$640.26
$742.44		 $127.73

Plan: (POS) Bronze Classic Saver 3500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-235-7111 - Provider Directory for This Plan: (QCA Health Plan, Inc.)

Deductible: Individual: $3,500 : Family: $7,000
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		 $218.56
$248.06
$279.32
$390.34
$593.16		 $437.12
$496.12
$558.64
$780.68
$1186.32		 $575.90
$634.90
$697.42
$919.46		 $714.68
$773.68
$836.20
$1058.24		 $853.46
$912.46
$974.98
$1197.02		 $357.34
$386.84
$418.10
$529.12		 $496.12
$525.62
$556.88
$667.90		 $634.90
$664.40
$695.66
$806.68		 $138.78

Plan: (POS) Silver Classic 2500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-235-7111 - Provider Directory for This Plan: (QCA Health Plan, Inc.)

Deductible: Individual: $2,500 : Family: $5,000
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		 $277.82
$315.32
$355.05
$496.18
$754.00		 $555.64
$630.64
$710.10
$992.36
$1508.00		 $732.05
$807.05
$886.51
$1168.77		 $908.46
$983.46
$1062.92
$1345.18		 $1084.87
$1159.87
$1239.33
$1521.59		 $454.23
$491.73
$531.46
$672.59		 $630.64
$668.14
$707.87
$849.00		 $807.05
$844.55
$884.28
$1025.41		 $176.41

Plan: (POS) Catastrophic

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-235-7111 - Provider Directory for This Plan: (QCA Health 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		 $137.56
$156.13
$175.80
$245.67
$373.33		 $275.12
$312.26
$351.60
$491.34
$746.66		 $362.47
$399.61
$438.95
$578.69		 $449.82
$486.96
$526.30
$666.04		 $537.17
$574.31
$613.65
$753.39		 $224.91
$243.48
$263.15
$333.02		 $312.26
$330.83
$350.50
$420.37		 $399.61
$418.18
$437.85
$507.72		 ++

Plan: (POS) Gold Classic 2000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-235-7111 - Provider Directory for This Plan: (QCA Health Plan, Inc.)

Deductible: Individual: $2,000 : Family: $4,000
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		 $306.95
$348.38
$392.28
$548.21
$833.05		 $613.90
$696.76
$784.56
$1096.42
$1666.10		 $808.81
$891.67
$979.47
$1291.33		 $1003.72
$1086.58
$1174.38
$1486.24		 $1198.63
$1281.49
$1369.29
$1681.15		 $501.86
$543.29
$587.19
$743.12		 $696.77
$738.20
$782.10
$938.03		 $891.68
$933.11
$977.01
$1132.94		 $194.91

Plan: (POS) Silver Classic Saver 3000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-235-7111 - Provider Directory for This Plan: (QCA Health Plan, Inc.)

Deductible: Individual: $3,000 : Family: $6,000
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
Silver 21
30
40
50
60		 $260.41
$295.57
$332.81
$465.09
$706.76		 $520.82
$591.14
$665.62
$930.18
$1413.52		 $686.18
$756.50
$830.98
$1095.54		 $851.54
$921.86
$996.34
$1260.90		 $1016.90
$1087.22
$1161.70
$1426.26		 $425.77
$460.93
$498.17
$630.45		 $591.13
$626.29
$663.53
$795.81		 $756.49
$791.65
$828.89
$961.17		 $165.36
ADVERTISEMENT

USAble Mutual Insurance Company

Local: 1-501-378-2000 | Toll Free: 1-800-800-4298

Plan: (PPO) Gold 500 with PCP/Rx Copays

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-4298 - Provider Directory for This Plan: (USAble Mutual Insurance Company)

Deductible: Individual: $500 : Family: $1,000
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		 $307.28
$348.76
$392.70
$548.80
$833.96		 $614.56
$697.52
$785.40
$1097.60
$1667.92		 $809.68
$892.64
$980.52
$1292.72		 $1004.80
$1087.76
$1175.64
$1487.84		 $1199.92
$1282.88
$1370.76
$1682.96		 $502.40
$543.88
$587.82
$743.92		 $697.52
$739.00
$782.94
$939.04		 $892.64
$934.12
$978.06
$1134.16		 $195.12

Plan: (PPO) Gold 1000 with PCP/Specialist/Rx Copays

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-4298 - Provider Directory for This Plan: (USAble Mutual Insurance Company)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $4,500 : Family: $9,000

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		 $287.76
$326.61
$367.76
$513.94
$780.98		 $575.52
$653.22
$735.52
$1027.88
$1561.96		 $758.25
$835.95
$918.25
$1210.61		 $940.98
$1018.68
$1100.98
$1393.34		 $1123.71
$1201.41
$1283.71
$1576.07		 $470.49
$509.34
$550.49
$696.67		 $653.22
$692.07
$733.22
$879.40		 $835.95
$874.80
$915.95
$1062.13		 $182.73

Plan: (PPO) Silver 2500 with PCP/Rx Copays

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-4298 - Provider Directory for This Plan: (USAble Mutual Insurance Company)

Deductible: Individual: $2,500 : Family: $5,000
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		 $244.42
$277.42
$312.37
$436.53
$663.36		 $488.84
$554.84
$624.74
$873.06
$1326.72		 $644.05
$710.05
$779.95
$1028.27		 $799.26
$865.26
$935.16
$1183.48		 $954.47
$1020.47
$1090.37
$1338.69		 $399.63
$432.63
$467.58
$591.74		 $554.84
$587.84
$622.79
$746.95		 $710.05
$743.05
$778.00
$902.16		 $155.21

Plan: (PPO) Silver 3500 with PCP/Specialist/Rx Copays

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-4298 - Provider Directory for This Plan: (USAble Mutual Insurance Company)

Deductible: Individual: $3,500 : Family: $7,000
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		 $255.62
$290.13
$326.68
$456.54
$693.75		 $511.24
$580.26
$653.36
$913.08
$1387.50		 $673.56
$742.58
$815.68
$1075.40		 $835.88
$904.90
$978.00
$1237.72		 $998.20
$1067.22
$1140.32
$1400.04		 $417.94
$452.45
$489.00
$618.86		 $580.26
$614.77
$651.32
$781.18		 $742.58
$777.09
$813.64
$943.50		 $162.32

Plan: (PPO) Blue Cross Blue Shield 6200 HSA, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-4298 - Provider Directory for This Plan: (USAble Mutual Insurance Company)

Deductible: Individual: $6,200 : Family: $12,400
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		 $207.94
$236.01
$265.75
$371.38
$564.35		 $415.88
$472.02
$531.50
$742.76
$1128.70		 $547.92
$604.06
$663.54
$874.80		 $679.96
$736.10
$795.58
$1006.84		 $812.00
$868.14
$927.62
$1138.88		 $339.98
$368.05
$397.79
$503.42		 $472.02
$500.09
$529.83
$635.46		 $604.06
$632.13
$661.87
$767.50		 $132.04

Plan: (PPO) Bronze 6300 HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-4298 - Provider Directory for This Plan: (USAble Mutual Insurance Company)

Deductible: Individual: $6,300 : Family: $12,600
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
Bronze 21
30
40
50
60		 $201.05
$228.19
$256.94
$359.08
$545.65		 $402.10
$456.38
$513.88
$718.16
$1091.30		 $529.77
$584.05
$641.55
$845.83		 $657.44
$711.72
$769.22
$973.50		 $785.11
$839.39
$896.89
$1101.17		 $328.72
$355.86
$384.61
$486.75		 $456.39
$483.53
$512.28
$614.42		 $584.06
$611.20
$639.95
$742.09		 $127.67

Plan: (PPO) Catastrophic

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-4298 - Provider Directory for This Plan: (USAble Mutual Insurance Company)

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		 $188.79
$214.28
$241.27
$337.18
$512.38		 $377.58
$428.56
$482.54
$674.36
$1024.76		 $497.46
$548.44
$602.42
$794.24		 $617.34
$668.32
$722.30
$914.12		 $737.22
$788.20
$842.18
$1034.00		 $308.67
$334.16
$361.15
$457.06		 $428.55
$454.04
$481.03
$576.94		 $548.43
$573.92
$600.91
$696.82		 $119.88

Plan: (PPO) Blue Cross Blue Shield 500, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-4298 - Provider Directory for This Plan: (USAble Mutual Insurance Company)

Deductible: Individual: $500 : Family: $1,000
Out of Pocket Maximum per year: Individual: $4,500 : Family: $9,000

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		 $307.97
$349.55
$393.59
$550.03
$835.83		 $615.94
$699.10
$787.18
$1100.06
$1671.66		 $811.50
$894.66
$982.74
$1295.62		 $1007.06
$1090.22
$1178.30
$1491.18		 $1202.62
$1285.78
$1373.86
$1686.74		 $503.53
$545.11
$589.15
$745.59		 $699.09
$740.67
$784.71
$941.15		 $894.65
$936.23
$980.27
$1136.71		 $195.56

Plan: (PPO) Blue Cross Blue Shield 2600, a Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-4298 - Provider Directory for This Plan: (USAble Mutual Insurance Company)

Deductible: Individual: $2,600 : Family: $5,200
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		 $270.38
$306.88
$345.55
$482.90
$733.81		 $540.76
$613.76
$691.10
$965.80
$1467.62		 $712.45
$785.45
$862.79
$1137.49		 $884.14
$957.14
$1034.48
$1309.18		 $1055.83
$1128.83
$1206.17
$1480.87		 $442.07
$478.57
$517.24
$654.59		 $613.76
$650.26
$688.93
$826.28		 $785.45
$821.95
$860.62
$997.97		 $171.69

Plan: (PPO) Bronze 6350 with PCP/RX Copays

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-4298 - Provider Directory for This Plan: (USAble Mutual Insurance Company)

Deductible: Individual: $6,350 : Family: $12,700
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		 $205.27
$232.98
$262.34
$366.61
$557.10		 $410.54
$465.96
$524.68
$733.22
$1114.20		 $540.89
$596.31
$655.03
$863.57		 $671.24
$726.66
$785.38
$993.92		 $801.59
$857.01
$915.73
$1124.27		 $335.62
$363.33
$392.69
$496.96		 $465.97
$493.68
$523.04
$627.31		 $596.32
$624.03
$653.39
$757.66		 $130.35

Plan: (PPO) Silver 1500 with PCP/Rx Copays

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-4298 - Provider Directory for This Plan: (USAble Mutual Insurance Company)

Deductible: Individual: $1,500 : Family: $3,000
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		 $246.72
$280.03
$315.31
$440.64
$669.60		 $493.44
$560.06
$630.62
$881.28
$1339.20		 $650.11
$716.73
$787.29
$1037.95		 $806.78
$873.40
$943.96
$1194.62		 $963.45
$1030.07
$1100.63
$1351.29		 $403.39
$436.70
$471.98
$597.31		 $560.06
$593.37
$628.65
$753.98		 $716.73
$750.04
$785.32
$910.65		 $156.67

Plan: (PPO) Silver 3350

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-800-4298 - Provider Directory for This Plan: (USAble Mutual Insurance Company)

Deductible: Individual: $3,350 : Family: $6,700
Out of Pocket Maximum per year: Individual: $3,350 : Family: $6,700

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		 $241.93
$274.59
$309.19
$432.09
$656.60		 $483.86
$549.18
$618.38
$864.18
$1313.20		 $637.49
$702.81
$772.01
$1017.81		 $791.12
$856.44
$925.64
$1171.44		 $944.75
$1010.07
$1079.27
$1325.07		 $395.56
$428.22
$462.82
$585.72		 $549.19
$581.85
$616.45
$739.35		 $702.82
$735.48
$770.08
$892.98		 $153.63

†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 Howard County here.

 

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