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Providers for Zip Code 54755

Obamacare 2016 Marketplace Rates For Buffalo County, Wisconsin

Monday, April 15th, 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 Buffalo County, Wisconsin.

Obamacare Providers, Plans and 2016 Rates for Buffalo County

Buffalo County is in “Rating Area 6” of Wisconsin.

Currently, there are 3 providers offering 34 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 Mondovi, WI area accept this insurance coverage as within the plan's "network".
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All Savers Insurance Company

Local: 1-877-887-0450 | Toll Free: 1-877-887-0450

Plan: (EPO) Gold Compass 1000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0450 - Provider Directory for This Plan: (All Savers Insurance Company)

Deductible: Individual: $1,000 : Family: $2,000
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
Gold 21
30
40
50
60
$474.65
$538.72
$606.60
$847.72
$1288.19
$949.30
$1077.44
$1213.20
$1695.44
$2576.38
$1250.70
$1378.84
$1514.60
$1996.84
$1552.10
$1680.24
$1816.00
$2298.24
$1853.50
$1981.64
$2117.40
$2599.64
$776.05
$840.12
$908.00
$1149.12
$1077.45
$1141.52
$1209.40
$1450.52
$1378.85
$1442.92
$1510.80
$1751.92
$301.40

Plan: (EPO) Gold Compass 500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0450 - Provider Directory for This Plan: (All Savers Insurance Company)

Deductible: Individual: $500 : Family: $1,000
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
Gold 21
30
40
50
60
$472.62
$536.42
$604.00
$844.09
$1282.67
$945.24
$1072.84
$1208.00
$1688.18
$2565.34
$1245.35
$1372.95
$1508.11
$1988.29
$1545.46
$1673.06
$1808.22
$2288.40
$1845.57
$1973.17
$2108.33
$2588.51
$772.73
$836.53
$904.11
$1144.20
$1072.84
$1136.64
$1204.22
$1444.31
$1372.95
$1436.75
$1504.33
$1744.42
$300.11

Plan: (EPO) Silver Compass HSA 3000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0450 - Provider Directory for This Plan: (All Savers Insurance Company)

Deductible: Individual: $3,000 : Family: $6,000
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
$394.19
$447.40
$503.77
$704.01
$1069.81
$788.38
$894.80
$1007.54
$1408.02
$2139.62
$1038.69
$1145.11
$1257.85
$1658.33
$1289.00
$1395.42
$1508.16
$1908.64
$1539.31
$1645.73
$1758.47
$2158.95
$644.50
$697.71
$754.08
$954.32
$894.81
$948.02
$1004.39
$1204.63
$1145.12
$1198.33
$1254.70
$1454.94
$250.31

Plan: (EPO) Silver Compass 2000 1

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0450 - Provider Directory for This Plan: (All Savers Insurance Company)

Deductible: Individual: $2,000 : Family: $4,000
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
$410.45
$465.85
$524.54
$733.04
$1113.93
$820.90
$931.70
$1049.08
$1466.08
$2227.86
$1081.53
$1192.33
$1309.71
$1726.71
$1342.16
$1452.96
$1570.34
$1987.34
$1602.79
$1713.59
$1830.97
$2247.97
$671.08
$726.48
$785.17
$993.67
$931.71
$987.11
$1045.80
$1254.30
$1192.34
$1247.74
$1306.43
$1514.93
$260.63

Plan: (EPO) Silver Compass 2000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0450 - Provider Directory for This Plan: (All Savers Insurance Company)

Deductible: Individual: $2,000 : Family: $4,000
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
$413.70
$469.54
$528.69
$738.85
$1122.75
$827.40
$939.08
$1057.38
$1477.70
$2245.50
$1090.09
$1201.77
$1320.07
$1740.39
$1352.78
$1464.46
$1582.76
$2003.08
$1615.47
$1727.15
$1845.45
$2265.77
$676.39
$732.23
$791.38
$1001.54
$939.08
$994.92
$1054.07
$1264.23
$1201.77
$1257.61
$1316.76
$1526.92
$262.69

Plan: (EPO) Silver Compass 3500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0450 - Provider Directory for This Plan: (All Savers 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
$416.54
$472.77
$532.33
$743.93
$1130.47
$833.08
$945.54
$1064.66
$1487.86
$2260.94
$1097.58
$1210.04
$1329.16
$1752.36
$1362.08
$1474.54
$1593.66
$2016.86
$1626.58
$1739.04
$1858.16
$2281.36
$681.04
$737.27
$796.83
$1008.43
$945.54
$1001.77
$1061.33
$1272.93
$1210.04
$1266.27
$1325.83
$1537.43
$264.50

Plan: (EPO) Silver Compass 4500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0450 - Provider Directory for This Plan: (All Savers Insurance Company)

Deductible: Individual: $4,500 : Family: $9,000
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
$425.89
$483.37
$544.27
$760.62
$1155.84
$851.78
$966.74
$1088.54
$1521.24
$2311.68
$1122.21
$1237.17
$1358.97
$1791.67
$1392.64
$1507.60
$1629.40
$2062.10
$1663.07
$1778.03
$1899.83
$2332.53
$696.32
$753.80
$814.70
$1031.05
$966.75
$1024.23
$1085.13
$1301.48
$1237.18
$1294.66
$1355.56
$1571.91
$270.43

Plan: (EPO) Bronze Compass HSA 5500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0450 - Provider Directory for This Plan: (All Savers Insurance Company)

Deductible: Individual: $5,500 : Family: $11,000
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
$343.80
$390.20
$439.37
$614.01
$933.05
$687.60
$780.40
$878.74
$1228.02
$1866.10
$905.91
$998.71
$1097.05
$1446.33
$1124.22
$1217.02
$1315.36
$1664.64
$1342.53
$1435.33
$1533.67
$1882.95
$562.11
$608.51
$657.68
$832.32
$780.42
$826.82
$875.99
$1050.63
$998.73
$1045.13
$1094.30
$1268.94
$218.31

Plan: (EPO) Bronze Compass 6500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0450 - Provider Directory for This Plan: (All Savers Insurance Company)

Deductible: Individual: $6,500 : Family: $13,000
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
Bronze 21
30
40
50
60
$362.50
$411.42
$463.26
$647.40
$983.79
$725.00
$822.84
$926.52
$1294.80
$1967.58
$955.18
$1053.02
$1156.70
$1524.98
$1185.36
$1283.20
$1386.88
$1755.16
$1415.54
$1513.38
$1617.06
$1985.34
$592.68
$641.60
$693.44
$877.58
$822.86
$871.78
$923.62
$1107.76
$1053.04
$1101.96
$1153.80
$1337.94
$230.18

Plan: (EPO) Gold Compass 0

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-887-0450 - Provider Directory for This Plan: (All Savers Insurance Company)

Deductible: Individual: $0 : Family: $0
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
Gold 21
30
40
50
60
$467.34
$530.42
$597.25
$834.65
$1268.33
$934.68
$1060.84
$1194.50
$1669.30
$2536.66
$1231.43
$1357.59
$1491.25
$1966.05
$1528.18
$1654.34
$1788.00
$2262.80
$1824.93
$1951.09
$2084.75
$2559.55
$764.09
$827.17
$894.00
$1131.40
$1060.84
$1123.92
$1190.75
$1428.15
$1357.59
$1420.67
$1487.50
$1724.90
$296.75
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Health Tradition Health Plan

Local: 1-608-781-9692 | Toll Free: 1-888-459-3020

Plan: (HMO) Gold 1000/80

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

Deductible: Individual: $1,000 : Family: $2,000
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
$354.65
$402.53
$453.25
$633.41
$962.52
$709.30
$805.06
$906.50
$1266.82
$1925.04
$934.51
$1030.27
$1131.71
$1492.03
$1159.72
$1255.48
$1356.92
$1717.24
$1384.93
$1480.69
$1582.13
$1942.45
$579.86
$627.74
$678.46
$858.62
$805.07
$852.95
$903.67
$1083.83
$1030.28
$1078.16
$1128.88
$1309.04
$225.21

Plan: (HMO) Gold 2000/80 w/copay

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

Deductible: Individual: $2,000 : Family: $4,000
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
$357.14
$405.35
$456.42
$637.85
$969.27
$714.28
$810.70
$912.84
$1275.70
$1938.54
$941.07
$1037.49
$1139.63
$1502.49
$1167.86
$1264.28
$1366.42
$1729.28
$1394.65
$1491.07
$1593.21
$1956.07
$583.93
$632.14
$683.21
$864.64
$810.72
$858.93
$910.00
$1091.43
$1037.51
$1085.72
$1136.79
$1318.22
$226.79

Plan: (HMO) Bronze HDHP 100 Low

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

Deductible: Individual: $6,250 : Family: $12,500
Out of Pocket Maximum per year: Individual: $6,250 : Family: $12,500

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
$221.74
$251.67
$283.38
$396.02
$601.79
$443.48
$503.34
$566.76
$792.04
$1203.58
$584.29
$644.15
$707.57
$932.85
$725.10
$784.96
$848.38
$1073.66
$865.91
$925.77
$989.19
$1214.47
$362.55
$392.48
$424.19
$536.83
$503.36
$533.29
$565.00
$677.64
$644.17
$674.10
$705.81
$818.45
$140.81

Plan: (HMO) Bronze 6000/80

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

Deductible: Individual: $6,000 : Family: $12,000
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
Bronze 21
30
40
50
60
$245.90
$279.10
$314.26
$439.17
$667.36
$491.80
$558.20
$628.52
$878.34
$1334.72
$647.95
$714.35
$784.67
$1034.49
$804.10
$870.50
$940.82
$1190.64
$960.25
$1026.65
$1096.97
$1346.79
$402.05
$435.25
$470.41
$595.32
$558.20
$591.40
$626.56
$751.47
$714.35
$747.55
$782.71
$907.62
$156.15

Plan: (HMO) Bronze HDHP 100 High

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

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
$218.90
$248.45
$279.75
$390.95
$594.08
$437.80
$496.90
$559.50
$781.90
$1188.16
$576.80
$635.90
$698.50
$920.90
$715.80
$774.90
$837.50
$1059.90
$854.80
$913.90
$976.50
$1198.90
$357.90
$387.45
$418.75
$529.95
$496.90
$526.45
$557.75
$668.95
$635.90
$665.45
$696.75
$807.95
$139.00

Plan: (HMO) Essential HDHP

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

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
$195.27
$221.63
$249.56
$348.75
$529.96
$390.54
$443.26
$499.12
$697.50
$1059.92
$514.54
$567.26
$623.12
$821.50
$638.54
$691.26
$747.12
$945.50
$762.54
$815.26
$871.12
$1069.50
$319.27
$345.63
$373.56
$472.75
$443.27
$469.63
$497.56
$596.75
$567.27
$593.63
$621.56
$720.75
$124.00

Plan: (HMO) Silver 2000/80

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

Deductible: Individual: $2,000 : Family: $4,000
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
Silver 21
30
40
50
60
$309.67
$351.48
$395.76
$553.07
$840.45
$619.34
$702.96
$791.52
$1106.14
$1680.90
$815.98
$899.60
$988.16
$1302.78
$1012.62
$1096.24
$1184.80
$1499.42
$1209.26
$1292.88
$1381.44
$1696.06
$506.31
$548.12
$592.40
$749.71
$702.95
$744.76
$789.04
$946.35
$899.59
$941.40
$985.68
$1142.99
$196.64

Plan: (HMO) Silver 4000/80 w/copay

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

Deductible: Individual: $4,000 : Family: $8,000
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
$306.83
$348.25
$392.13
$548.00
$832.73
$613.66
$696.50
$784.26
$1096.00
$1665.46
$808.50
$891.34
$979.10
$1290.84
$1003.34
$1086.18
$1173.94
$1485.68
$1198.18
$1281.02
$1368.78
$1680.52
$501.67
$543.09
$586.97
$742.84
$696.51
$737.93
$781.81
$937.68
$891.35
$932.77
$976.65
$1132.52
$194.84

Plan: (HMO) Silver HDHP 85

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

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
$291.70
$331.07
$372.79
$520.97
$791.66
$583.40
$662.14
$745.58
$1041.94
$1583.32
$768.63
$847.37
$930.81
$1227.17
$953.86
$1032.60
$1116.04
$1412.40
$1139.09
$1217.83
$1301.27
$1597.63
$476.93
$516.30
$558.02
$706.20
$662.16
$701.53
$743.25
$891.43
$847.39
$886.76
$928.48
$1076.66
$185.23

Plan: (HMO) Gold 2375/100

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

Deductible: Individual: $2,375 : Family: $4,750
Out of Pocket Maximum per year: Individual: $2,375 : Family: $4,750

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
$342.40
$388.62
$437.58
$611.52
$929.25
$684.80
$777.24
$875.16
$1223.04
$1858.50
$902.22
$994.66
$1092.58
$1440.46
$1119.64
$1212.08
$1310.00
$1657.88
$1337.06
$1429.50
$1527.42
$1875.30
$559.82
$606.04
$655.00
$828.94
$777.24
$823.46
$872.42
$1046.36
$994.66
$1040.88
$1089.84
$1263.78
$217.42

Plan: (HMO) Silver 3000/70 w/copay

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

Deductible: Individual: $3,000 : Family: $6,000
Out of Pocket Maximum per year: Individual: $5,400 : Family: $10,800

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
$305.20
$346.40
$390.04
$545.08
$828.30
$610.40
$692.80
$780.08
$1090.16
$1656.60
$804.20
$886.60
$973.88
$1283.96
$998.00
$1080.40
$1167.68
$1477.76
$1191.80
$1274.20
$1361.48
$1671.56
$499.00
$540.20
$583.84
$738.88
$692.80
$734.00
$777.64
$932.68
$886.60
$927.80
$971.44
$1126.48
$193.80

Plan: (HMO) Silver HDHP 100

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

Deductible: Individual: $4,125 : Family: $8,250
Out of Pocket Maximum per year: Individual: $4,125 : Family: $8,250

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
$281.46
$319.46
$359.71
$502.69
$763.88
$562.92
$638.92
$719.42
$1005.38
$1527.76
$741.65
$817.65
$898.15
$1184.11
$920.38
$996.38
$1076.88
$1362.84
$1099.11
$1175.11
$1255.61
$1541.57
$460.19
$498.19
$538.44
$681.42
$638.92
$676.92
$717.17
$860.15
$817.65
$855.65
$895.90
$1038.88
$178.73

Plan: (HMO) Silver 3500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

Deductible: Individual: $3,500 : Family: $7,000
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
Silver 21
30
40
50
60
$281.46
$319.46
$359.71
$502.69
$763.88
$562.92
$638.92
$719.42
$1005.38
$1527.76
$741.65
$817.65
$898.15
$1184.11
$920.38
$996.38
$1076.88
$1362.84
$1099.11
$1175.11
$1255.61
$1541.57
$460.19
$498.19
$538.44
$681.42
$638.92
$676.92
$717.17
$860.15
$817.65
$855.65
$895.90
$1038.88
$178.73

Plan: (HMO) Bronze HDHP 80

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

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
$230.34
$261.43
$294.37
$411.38
$625.13
$460.68
$522.86
$588.74
$822.76
$1250.26
$606.95
$669.13
$735.01
$969.03
$753.22
$815.40
$881.28
$1115.30
$899.49
$961.67
$1027.55
$1261.57
$376.61
$407.70
$440.64
$557.65
$522.88
$553.97
$586.91
$703.92
$669.15
$700.24
$733.18
$850.19
$146.27

Plan: (HMO) Bronze HDHP 50

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

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
$232.40
$263.77
$297.00
$415.06
$630.72
$464.80
$527.54
$594.00
$830.12
$1261.44
$612.38
$675.12
$741.58
$977.70
$759.96
$822.70
$889.16
$1125.28
$907.54
$970.28
$1036.74
$1272.86
$379.98
$411.35
$444.58
$562.64
$527.56
$558.93
$592.16
$710.22
$675.14
$706.51
$739.74
$857.80
$147.58

Plan: (HMO) Bronze 6850/100 Rx

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

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
$240.14
$272.56
$306.90
$428.89
$651.74
$480.28
$545.12
$613.80
$857.78
$1303.48
$632.77
$697.61
$766.29
$1010.27
$785.26
$850.10
$918.78
$1162.76
$937.75
$1002.59
$1071.27
$1315.25
$392.63
$425.05
$459.39
$581.38
$545.12
$577.54
$611.88
$733.87
$697.61
$730.03
$764.37
$886.36
$152.49

Plan: (HMO) Bronze 6850/100

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-459-3020 - Provider Directory for This Plan: (Health Tradition Health Plan)

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
$213.57
$242.40
$272.94
$381.43
$579.62
$427.14
$484.80
$545.88
$762.86
$1159.24
$562.76
$620.42
$681.50
$898.48
$698.38
$756.04
$817.12
$1034.10
$834.00
$891.66
$952.74
$1169.72
$349.19
$378.02
$408.56
$517.05
$484.81
$513.64
$544.18
$652.67
$620.43
$649.26
$679.80
$788.29
$135.62
ADVERTISEMENT

Gundersen Health Plan, Inc.

Local: 1-608-775-8092 | Toll Free: 1-855-685-6404

Plan: (POS) Platinum $1000 - 0%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-685-6404 - Provider Directory for This Plan: (Gundersen Health Plan, Inc.)

Deductible: Individual: $1,000 : Family: $2,000
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
$450.34
$511.13
$575.53
$804.30
$1222.22
$900.68
$1022.26
$1151.06
$1608.60
$2444.44
$1186.64
$1308.22
$1437.02
$1894.56
$1472.60
$1594.18
$1722.98
$2180.52
$1758.56
$1880.14
$2008.94
$2466.48
$736.30
$797.09
$861.49
$1090.26
$1022.26
$1083.05
$1147.45
$1376.22
$1308.22
$1369.01
$1433.41
$1662.18
$285.96

Plan: (POS) Platinum $500 - 20%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-685-6404 - Provider Directory for This Plan: (Gundersen Health Plan, Inc.)

Deductible: Individual: $500 : Family: $1,000
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
$447.86
$508.32
$572.36
$799.87
$1215.49
$895.72
$1016.64
$1144.72
$1599.74
$2430.98
$1180.11
$1301.03
$1429.11
$1884.13
$1464.50
$1585.42
$1713.50
$2168.52
$1748.89
$1869.81
$1997.89
$2452.91
$732.25
$792.71
$856.75
$1084.26
$1016.64
$1077.10
$1141.14
$1368.65
$1301.03
$1361.49
$1425.53
$1653.04
$284.39

Plan: (POS) Gold $1500 - 30%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-685-6404 - Provider Directory for This Plan: (Gundersen Health Plan, 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
$395.96
$449.41
$506.03
$707.18
$1074.63
$791.92
$898.82
$1012.06
$1414.36
$2149.26
$1043.35
$1150.25
$1263.49
$1665.79
$1294.78
$1401.68
$1514.92
$1917.22
$1546.21
$1653.11
$1766.35
$2168.65
$647.39
$700.84
$757.46
$958.61
$898.82
$952.27
$1008.89
$1210.04
$1150.25
$1203.70
$1260.32
$1461.47
$251.43

Plan: (POS) Gold $3500 - 0%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-685-6404 - Provider Directory for This Plan: (Gundersen Health Plan, Inc.)

Deductible: Individual: $3,500 : Family: $7,000
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
$379.22
$430.41
$484.64
$677.28
$1029.20
$758.44
$860.82
$969.28
$1354.56
$2058.40
$999.24
$1101.62
$1210.08
$1595.36
$1240.04
$1342.42
$1450.88
$1836.16
$1480.84
$1583.22
$1691.68
$2076.96
$620.02
$671.21
$725.44
$918.08
$860.82
$912.01
$966.24
$1158.88
$1101.62
$1152.81
$1207.04
$1399.68
$240.80

Plan: (POS) Silver $3500 - 20%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-685-6404 - Provider Directory for This Plan: (Gundersen Health Plan, Inc.)

Deductible: Individual: $3,500 : Family: $7,000
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
Silver 21
30
40
50
60
$355.24
$403.19
$453.99
$634.45
$964.12
$710.48
$806.38
$907.98
$1268.90
$1928.24
$936.05
$1031.95
$1133.55
$1494.47
$1161.62
$1257.52
$1359.12
$1720.04
$1387.19
$1483.09
$1584.69
$1945.61
$580.81
$628.76
$679.56
$860.02
$806.38
$854.33
$905.13
$1085.59
$1031.95
$1079.90
$1130.70
$1311.16
$225.57

Plan: (POS) Silver $2500 - 50%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-685-6404 - Provider Directory for This Plan: (Gundersen Health Plan, Inc.)

Deductible: Individual: $2,500 : Family: $5,000
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
$355.50
$403.49
$454.32
$634.92
$964.82
$711.00
$806.98
$908.64
$1269.84
$1929.64
$936.74
$1032.72
$1134.38
$1495.58
$1162.48
$1258.46
$1360.12
$1721.32
$1388.22
$1484.20
$1585.86
$1947.06
$581.24
$629.23
$680.06
$860.66
$806.98
$854.97
$905.80
$1086.40
$1032.72
$1080.71
$1131.54
$1312.14
$225.74

Plan: (POS) Silver $2500 - 20%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-685-6404 - Provider Directory for This Plan: (Gundersen Health Plan, Inc.)

Deductible: Individual: $2,500 : Family: $5,000
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
Silver 21
30
40
50
60
$366.60
$416.09
$468.51
$654.74
$994.95
$733.20
$832.18
$937.02
$1309.48
$1989.90
$965.99
$1064.97
$1169.81
$1542.27
$1198.78
$1297.76
$1402.60
$1775.06
$1431.57
$1530.55
$1635.39
$2007.85
$599.39
$648.88
$701.30
$887.53
$832.18
$881.67
$934.09
$1120.32
$1064.97
$1114.46
$1166.88
$1353.11
$232.79

Plan: (POS) Bronze $3000 - 50%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-685-6404 - Provider Directory for This Plan: (Gundersen Health Plan, Inc.)

Deductible: Individual: $3,000 : Family: $6,000
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
Bronze 21
30
40
50
60
$291.89
$331.29
$373.03
$521.31
$792.18
$583.78
$662.58
$746.06
$1042.62
$1584.36
$769.13
$847.93
$931.41
$1227.97
$954.48
$1033.28
$1116.76
$1413.32
$1139.83
$1218.63
$1302.11
$1598.67
$477.24
$516.64
$558.38
$706.66
$662.59
$701.99
$743.73
$892.01
$847.94
$887.34
$929.08
$1077.36
$185.35

Plan: (POS) Bronze $4000 - 30%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-685-6404 - Provider Directory for This Plan: (Gundersen Health Plan, Inc.)

Deductible: Individual: $4,000 : Family: $8,000
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
Bronze 21
30
40
50
60
$297.97
$338.19
$380.80
$532.17
$808.69
$595.94
$676.38
$761.60
$1064.34
$1617.38
$785.15
$865.59
$950.81
$1253.55
$974.36
$1054.80
$1140.02
$1442.76
$1163.57
$1244.01
$1329.23
$1631.97
$487.18
$527.40
$570.01
$721.38
$676.39
$716.61
$759.22
$910.59
$865.60
$905.82
$948.43
$1099.80
$189.21

Plan: (POS) Bronze $6250 - 30%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-685-6404 - Provider Directory for This Plan: (Gundersen Health Plan, Inc.)

Deductible: Individual: $6,250 : Family: $12,500
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
Bronze 21
30
40
50
60
$313.45
$355.76
$400.58
$559.82
$850.70
$626.90
$711.52
$801.16
$1119.64
$1701.40
$825.94
$910.56
$1000.20
$1318.68
$1024.98
$1109.60
$1199.24
$1517.72
$1224.02
$1308.64
$1398.28
$1716.76
$512.49
$554.80
$599.62
$758.86
$711.53
$753.84
$798.66
$957.90
$910.57
$952.88
$997.70
$1156.94
$199.04

Plan: (POS) Catastrophic $6,850 - 0%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-685-6404 - Provider Directory for This Plan: (Gundersen 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
$221.92
$251.87
$283.61
$396.34
$602.29
$443.84
$503.74
$567.22
$792.68
$1204.58
$584.75
$644.65
$708.13
$933.59
$725.66
$785.56
$849.04
$1074.50
$866.57
$926.47
$989.95
$1215.41
$362.83
$392.78
$424.52
$537.25
$503.74
$533.69
$565.43
$678.16
$644.65
$674.60
$706.34
$819.07
$140.91

Plan: (POS) Silver HSA $3500 - 0%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-685-6404 - Provider Directory for This Plan: (Gundersen Health Plan, Inc.)

Deductible: Individual: $3,500 : Family: $7,000
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
Silver 21
30
40
50
60
$334.80
$379.99
$427.87
$597.95
$908.64
$669.60
$759.98
$855.74
$1195.90
$1817.28
$882.19
$972.57
$1068.33
$1408.49
$1094.78
$1185.16
$1280.92
$1621.08
$1307.37
$1397.75
$1493.51
$1833.67
$547.39
$592.58
$640.46
$810.54
$759.98
$805.17
$853.05
$1023.13
$972.57
$1017.76
$1065.64
$1235.72
$212.59

Plan: (POS) Silver HSA $2000 - 50%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-685-6404 - Provider Directory for This Plan: (Gundersen Health Plan, 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
Silver 21
30
40
50
60
$323.99
$367.72
$414.05
$578.64
$879.30
$647.98
$735.44
$828.10
$1157.28
$1758.60
$853.71
$941.17
$1033.83
$1363.01
$1059.44
$1146.90
$1239.56
$1568.74
$1265.17
$1352.63
$1445.29
$1774.47
$529.72
$573.45
$619.78
$784.37
$735.45
$779.18
$825.51
$990.10
$941.18
$984.91
$1031.24
$1195.83
$205.73

Plan: (POS) Bronze HSA $3250 - 50%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-685-6404 - Provider Directory for This Plan: (Gundersen Health Plan, Inc.)

Deductible: Individual: $3,250 : Family: $6,500
Out of Pocket Maximum per year: Individual: $6,550 : Family: $13,100

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
$287.34
$326.13
$367.22
$513.18
$779.84
$574.68
$652.26
$734.44
$1026.36
$1559.68
$757.14
$834.72
$916.90
$1208.82
$939.60
$1017.18
$1099.36
$1391.28
$1122.06
$1199.64
$1281.82
$1573.74
$469.80
$508.59
$549.68
$695.64
$652.26
$691.05
$732.14
$878.10
$834.72
$873.51
$914.60
$1060.56
$182.46

Plan: (POS) Bronze HSA $6000 - 0%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-685-6404 - Provider Directory for This Plan: (Gundersen Health Plan, 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
$276.28
$313.57
$353.08
$493.43
$749.82
$552.56
$627.14
$706.16
$986.86
$1499.64
$727.99
$802.57
$881.59
$1162.29
$903.42
$978.00
$1057.02
$1337.72
$1078.85
$1153.43
$1232.45
$1513.15
$451.71
$489.00
$528.51
$668.86
$627.14
$664.43
$703.94
$844.29
$802.57
$839.86
$879.37
$1019.72
$175.43

Plan: (POS) Bronze HSA $5000 - 20%

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-685-6404 - Provider Directory for This Plan: (Gundersen Health Plan, Inc.)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $6,550 : Family: $13,100

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
$267.52
$303.63
$341.89
$477.79
$726.04
$535.04
$607.26
$683.78
$955.58
$1452.08
$704.91
$777.13
$853.65
$1125.45
$874.78
$947.00
$1023.52
$1295.32
$1044.65
$1116.87
$1193.39
$1465.19
$437.39
$473.50
$511.76
$647.66
$607.26
$643.37
$681.63
$817.53
$777.13
$813.24
$851.50
$987.40
$169.87

†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 Buffalo County here.

 

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