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 Crawford County, Wisconsin.
Obamacare Providers, Plans and 2016 Rates for Crawford County
Crawford County is in “Rating Area 7” of Wisconsin.
Currently, there are 5 providers offering 100 plans to Rating Area 7. †
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 Prairie Du Chien, WI area accept this insurance coverage as within the plan's "network".
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Unity Health Plans Insurance CorporationLocal: 1-608-643-2491 | Toll Free: 1-800-362-3310 TTY: 1-608-643-1421 |
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Plan: (HMO) Unity Elite Platinum 30/60 with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$500
: Family:
$1,000 Monthly Premiums: |
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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 |
$371.89 $422.09 $475.27 $664.19 $1009.30 |
$743.78 $844.18 $950.54 $1328.38 $2018.60 |
$979.93 $1080.33 $1186.69 $1564.53 |
$1216.08 $1316.48 $1422.84 $1800.68 |
$1452.23 $1552.63 $1658.99 $2036.83 |
$608.04 $658.24 $711.42 $900.34 |
$844.19 $894.39 $947.57 $1136.49 |
$1080.34 $1130.54 $1183.72 $1372.64 |
$236.15 |
Plan: (HMO) Unity Elite Platinum 25/50 with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
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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 |
$416.20 $472.38 $531.89 $743.32 $1129.55 |
$832.40 $944.76 $1063.78 $1486.64 $2259.10 |
$1096.68 $1209.04 $1328.06 $1750.92 |
$1360.96 $1473.32 $1592.34 $2015.20 |
$1625.24 $1737.60 $1856.62 $2279.48 |
$680.48 $736.66 $796.17 $1007.60 |
$944.76 $1000.94 $1060.45 $1271.88 |
$1209.04 $1265.22 $1324.73 $1536.16 |
$264.28 |
Plan: (HMO) Unity Elite Gold 30/60 with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$1,350
: Family:
$2,700 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 |
$317.82 $360.72 $406.17 $567.62 $862.55 |
$635.64 $721.44 $812.34 $1135.24 $1725.10 |
$837.45 $923.25 $1014.15 $1337.05 |
$1039.26 $1125.06 $1215.96 $1538.86 |
$1241.07 $1326.87 $1417.77 $1740.67 |
$519.63 $562.53 $607.98 $769.43 |
$721.44 $764.34 $809.79 $971.24 |
$923.25 $966.15 $1011.60 $1173.05 |
$201.81 |
Plan: (HMO) Unity Elite Gold 20/40 with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$1,000
: Family:
$2,000 Monthly Premiums: |
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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 |
$335.26 $380.52 $428.46 $598.77 $909.89 |
$670.52 $761.04 $856.92 $1197.54 $1819.78 |
$883.41 $973.93 $1069.81 $1410.43 |
$1096.30 $1186.82 $1282.70 $1623.32 |
$1309.19 $1399.71 $1495.59 $1836.21 |
$548.15 $593.41 $641.35 $811.66 |
$761.04 $806.30 $854.24 $1024.55 |
$973.93 $1019.19 $1067.13 $1237.44 |
$212.89 |
Plan: (HMO) Unity Elite Silver Plus with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$4,550
: Family:
$9,100 Monthly Premiums: |
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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 |
$265.01 $300.78 $338.68 $473.31 $719.23 |
$530.02 $601.56 $677.36 $946.62 $1438.46 |
$698.30 $769.84 $845.64 $1114.90 |
$866.58 $938.12 $1013.92 $1283.18 |
$1034.86 $1106.40 $1182.20 $1451.46 |
$433.29 $469.06 $506.96 $641.59 |
$601.57 $637.34 $675.24 $809.87 |
$769.85 $805.62 $843.52 $978.15 |
$168.28 |
Plan: (HMO) Unity Elite Silver Choice Value with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: 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 |
Silver | 21 30 40 50 60 |
$281.14 $319.09 $359.29 $502.11 $763.01 |
$562.28 $638.18 $718.58 $1004.22 $1526.02 |
$740.80 $816.70 $897.10 $1182.74 |
$919.32 $995.22 $1075.62 $1361.26 |
$1097.84 $1173.74 $1254.14 $1539.78 |
$459.66 $497.61 $537.81 $680.63 |
$638.18 $676.13 $716.33 $859.15 |
$816.70 $854.65 $894.85 $1037.67 |
$178.52 |
Plan: (HMO) Unity Elite Silver Exclusive Value with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$4,000
: Family:
$8,000 Monthly Premiums: |
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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 |
$260.06 $295.16 $332.35 $464.46 $705.78 |
$520.12 $590.32 $664.70 $928.92 $1411.56 |
$685.25 $755.45 $829.83 $1094.05 |
$850.38 $920.58 $994.96 $1259.18 |
$1015.51 $1085.71 $1160.09 $1424.31 |
$425.19 $460.29 $497.48 $629.59 |
$590.32 $625.42 $662.61 $794.72 |
$755.45 $790.55 $827.74 $959.85 |
$165.13 |
Plan: (HMO) Unity Elite Bronze 55/150 with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: 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 |
$246.12 $279.34 $314.53 $439.55 $667.94 |
$492.24 $558.68 $629.06 $879.10 $1335.88 |
$648.52 $714.96 $785.34 $1035.38 |
$804.80 $871.24 $941.62 $1191.66 |
$961.08 $1027.52 $1097.90 $1347.94 |
$402.40 $435.62 $470.81 $595.83 |
$558.68 $591.90 $627.09 $752.11 |
$714.96 $748.18 $783.37 $908.39 |
$156.28 |
Plan: (HMO) Unity Elite Silver Maintenance with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: 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 |
Silver | 21 30 40 50 60 |
$287.31 $326.09 $367.18 $513.13 $779.75 |
$574.62 $652.18 $734.36 $1026.26 $1559.50 |
$757.06 $834.62 $916.80 $1208.70 |
$939.50 $1017.06 $1099.24 $1391.14 |
$1121.94 $1199.50 $1281.68 $1573.58 |
$469.75 $508.53 $549.62 $695.57 |
$652.19 $690.97 $732.06 $878.01 |
$834.63 $873.41 $914.50 $1060.45 |
$182.44 |
Plan: (HMO) Unity Elite Platinum 20/40 with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$200
: Family:
$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 |
$391.23 $444.04 $499.98 $698.72 $1061.78 |
$782.46 $888.08 $999.96 $1397.44 $2123.56 |
$1030.89 $1136.51 $1248.39 $1645.87 |
$1279.32 $1384.94 $1496.82 $1894.30 |
$1527.75 $1633.37 $1745.25 $2142.73 |
$639.66 $692.47 $748.41 $947.15 |
$888.09 $940.90 $996.84 $1195.58 |
$1136.52 $1189.33 $1245.27 $1444.01 |
$248.43 |
Plan: (HMO) Unity Elite Bronze 45/125 Value with DentalSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$6,600
: Family:
$13,200 Monthly Premiums: |
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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 |
$243.93 $276.85 $311.74 $435.65 $662.01 |
$487.86 $553.70 $623.48 $871.30 $1324.02 |
$642.75 $708.59 $778.37 $1026.19 |
$797.64 $863.48 $933.26 $1181.08 |
$952.53 $1018.37 $1088.15 $1335.97 |
$398.82 $431.74 $466.63 $590.54 |
$553.71 $586.63 $621.52 $745.43 |
$708.60 $741.52 $776.41 $900.32 |
$154.89 |
Plan: (HMO) Unity Elite Platinum 30/60Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$500
: Family:
$1,000 Monthly Premiums: |
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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 |
$347.45 $394.35 $444.03 $620.53 $942.96 |
$694.90 $788.70 $888.06 $1241.06 $1885.92 |
$915.53 $1009.33 $1108.69 $1461.69 |
$1136.16 $1229.96 $1329.32 $1682.32 |
$1356.79 $1450.59 $1549.95 $1902.95 |
$568.08 $614.98 $664.66 $841.16 |
$788.71 $835.61 $885.29 $1061.79 |
$1009.34 $1056.24 $1105.92 $1282.42 |
$220.63 |
Plan: (HMO) Unity Elite Platinum 25/50Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
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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 |
$388.84 $441.33 $496.93 $694.46 $1055.30 |
$777.68 $882.66 $993.86 $1388.92 $2110.60 |
$1024.59 $1129.57 $1240.77 $1635.83 |
$1271.50 $1376.48 $1487.68 $1882.74 |
$1518.41 $1623.39 $1734.59 $2129.65 |
$635.75 $688.24 $743.84 $941.37 |
$882.66 $935.15 $990.75 $1188.28 |
$1129.57 $1182.06 $1237.66 $1435.19 |
$246.91 |
Plan: (HMO) Unity Elite Gold 30/60Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$1,350
: Family:
$2,700 Monthly Premiums: |
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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 |
$296.93 $337.01 $379.47 $530.31 $805.86 |
$593.86 $674.02 $758.94 $1060.62 $1611.72 |
$782.41 $862.57 $947.49 $1249.17 |
$970.96 $1051.12 $1136.04 $1437.72 |
$1159.51 $1239.67 $1324.59 $1626.27 |
$485.48 $525.56 $568.02 $718.86 |
$674.03 $714.11 $756.57 $907.41 |
$862.58 $902.66 $945.12 $1095.96 |
$188.55 |
Plan: (HMO) Unity Elite Gold 20/40Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$1,000
: Family:
$2,000 Monthly Premiums: |
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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 |
$313.22 $355.50 $400.29 $559.41 $850.08 |
$626.44 $711.00 $800.58 $1118.82 $1700.16 |
$825.33 $909.89 $999.47 $1317.71 |
$1024.22 $1108.78 $1198.36 $1516.60 |
$1223.11 $1307.67 $1397.25 $1715.49 |
$512.11 $554.39 $599.18 $758.30 |
$711.00 $753.28 $798.07 $957.19 |
$909.89 $952.17 $996.96 $1156.08 |
$198.89 |
Plan: (HMO) Unity Elite Silver PlusSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$4,550
: Family:
$9,100 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 |
Silver | 21 30 40 50 60 |
$247.59 $281.01 $316.42 $442.19 $671.96 |
$495.18 $562.02 $632.84 $884.38 $1343.92 |
$652.40 $719.24 $790.06 $1041.60 |
$809.62 $876.46 $947.28 $1198.82 |
$966.84 $1033.68 $1104.50 $1356.04 |
$404.81 $438.23 $473.64 $599.41 |
$562.03 $595.45 $630.86 $756.63 |
$719.25 $752.67 $788.08 $913.85 |
$157.22 |
Plan: (HMO) Unity Elite Silver Choice ValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: 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 |
Silver | 21 30 40 50 60 |
$262.66 $298.12 $335.68 $469.11 $712.85 |
$525.32 $596.24 $671.36 $938.22 $1425.70 |
$692.11 $763.03 $838.15 $1105.01 |
$858.90 $929.82 $1004.94 $1271.80 |
$1025.69 $1096.61 $1171.73 $1438.59 |
$429.45 $464.91 $502.47 $635.90 |
$596.24 $631.70 $669.26 $802.69 |
$763.03 $798.49 $836.05 $969.48 |
$166.79 |
Plan: (HMO) Unity Elite Silver Exclusive ValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: 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 |
$242.96 $275.76 $310.50 $433.93 $659.39 |
$485.92 $551.52 $621.00 $867.86 $1318.78 |
$640.20 $705.80 $775.28 $1022.14 |
$794.48 $860.08 $929.56 $1176.42 |
$948.76 $1014.36 $1083.84 $1330.70 |
$397.24 $430.04 $464.78 $588.21 |
$551.52 $584.32 $619.06 $742.49 |
$705.80 $738.60 $773.34 $896.77 |
$154.28 |
Plan: (HMO) Unity Elite Bronze 55/150Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: 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 |
$229.94 $260.97 $293.85 $410.66 $624.04 |
$459.88 $521.94 $587.70 $821.32 $1248.08 |
$605.89 $667.95 $733.71 $967.33 |
$751.90 $813.96 $879.72 $1113.34 |
$897.91 $959.97 $1025.73 $1259.35 |
$375.95 $406.98 $439.86 $556.67 |
$521.96 $552.99 $585.87 $702.68 |
$667.97 $699.00 $731.88 $848.69 |
$146.01 |
Plan: (HMO) Unity Elite Silver MaintenanceSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: 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 |
Silver | 21 30 40 50 60 |
$268.43 $304.66 $343.04 $479.40 $728.50 |
$536.86 $609.32 $686.08 $958.80 $1457.00 |
$707.31 $779.77 $856.53 $1129.25 |
$877.76 $950.22 $1026.98 $1299.70 |
$1048.21 $1120.67 $1197.43 $1470.15 |
$438.88 $475.11 $513.49 $649.85 |
$609.33 $645.56 $683.94 $820.30 |
$779.78 $816.01 $854.39 $990.75 |
$170.45 |
Plan: (HMO) Unity Elite Platinum 20/40Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$200
: Family:
$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 |
$365.51 $414.85 $467.12 $652.79 $991.98 |
$731.02 $829.70 $934.24 $1305.58 $1983.96 |
$963.12 $1061.80 $1166.34 $1537.68 |
$1195.22 $1293.90 $1398.44 $1769.78 |
$1427.32 $1526.00 $1630.54 $2001.88 |
$597.61 $646.95 $699.22 $884.89 |
$829.71 $879.05 $931.32 $1116.99 |
$1061.81 $1111.15 $1163.42 $1349.09 |
$232.10 |
Plan: (HMO) Unity Elite Bronze 45/125 ValueSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: 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 |
$227.90 $258.66 $291.24 $407.01 $618.50 |
$455.80 $517.32 $582.48 $814.02 $1237.00 |
$600.51 $662.03 $727.19 $958.73 |
$745.22 $806.74 $871.90 $1103.44 |
$889.93 $951.45 $1016.61 $1248.15 |
$372.61 $403.37 $435.95 $551.72 |
$517.32 $548.08 $580.66 $696.43 |
$662.03 $692.79 $725.37 $841.14 |
$144.71 |
Plan: (HMO) Unity Elite Gold DeductibleSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: Individual:
$1,400
: Family:
$2,800 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 |
Gold | 21 30 40 50 60 |
$306.10 $347.42 $391.19 $546.68 $830.74 |
$612.20 $694.84 $782.38 $1093.36 $1661.48 |
$806.57 $889.21 $976.75 $1287.73 |
$1000.94 $1083.58 $1171.12 $1482.10 |
$1195.31 $1277.95 $1365.49 $1676.47 |
$500.47 $541.79 $585.56 $741.05 |
$694.84 $736.16 $779.93 $935.42 |
$889.21 $930.53 $974.30 $1129.79 |
$194.37 |
Plan: (HMO) Unity Elite Silver DeductibleSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: 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 |
Silver | 21 30 40 50 60 |
$255.85 $290.39 $326.98 $456.95 $694.38 |
$511.70 $580.78 $653.96 $913.90 $1388.76 |
$674.16 $743.24 $816.42 $1076.36 |
$836.62 $905.70 $978.88 $1238.82 |
$999.08 $1068.16 $1141.34 $1401.28 |
$418.31 $452.85 $489.44 $619.41 |
$580.77 $615.31 $651.90 $781.87 |
$743.23 $777.77 $814.36 $944.33 |
$162.46 |
Plan: (HMO) Unity Elite Bronze HSASummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: 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 |
$194.08 $220.28 $248.03 $346.62 $526.73 |
$388.16 $440.56 $496.06 $693.24 $1053.46 |
$511.40 $563.80 $619.30 $816.48 |
$634.64 $687.04 $742.54 $939.72 |
$757.88 $810.28 $865.78 $1062.96 |
$317.32 $343.52 $371.27 $469.86 |
$440.56 $466.76 $494.51 $593.10 |
$563.80 $590.00 $617.75 $716.34 |
$123.24 |
Plan: (HMO) Unity Elite CatastrophicSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-362-3310 - Provider Directory for This Plan: (Unity Health Plans Insurance Corporation)
Deductible: 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 |
$156.14 $177.21 $199.54 $278.85 $423.75 |
$312.28 $354.42 $399.08 $557.70 $847.50 |
$411.42 $453.56 $498.22 $656.84 |
$510.56 $552.70 $597.36 $755.98 |
$609.70 $651.84 $696.50 $855.12 |
$255.28 $276.35 $298.68 $377.99 |
$354.42 $375.49 $397.82 $477.13 |
$453.56 $474.63 $496.96 $576.27 |
++ |
ADVERTISEMENT
|
||||||||||
Dean Health PlanLocal: 1-608-828-1301 | Toll Free: 1-800-279-1301 TTY: 1-608-827-4086 |
||||||||||
Plan: (HMO) Dean Catastrophic Safety NetSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1301 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: 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 |
$128.24 $145.55 $163.89 $229.04 $348.05 |
$256.48 $291.10 $327.78 $458.08 $696.10 |
$337.91 $372.53 $409.21 $539.51 |
$419.34 $453.96 $490.64 $620.94 |
$500.77 $535.39 $572.07 $702.37 |
$209.67 $226.98 $245.32 $310.47 |
$291.10 $308.41 $326.75 $391.90 |
$372.53 $389.84 $408.18 $473.33 |
$81.43 |
Plan: (HMO) Dean Silver Copay Plus 2000XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1301 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: 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 |
Silver | 21 30 40 50 60 |
$260.19 $295.31 $332.52 $464.70 $706.16 |
$520.38 $590.62 $665.04 $929.40 $1412.32 |
$685.60 $755.84 $830.26 $1094.62 |
$850.82 $921.06 $995.48 $1259.84 |
$1016.04 $1086.28 $1160.70 $1425.06 |
$425.41 $460.53 $497.74 $629.92 |
$590.63 $625.75 $662.96 $795.14 |
$755.85 $790.97 $828.18 $960.36 |
$165.22 |
Plan: (HMO) Dean Silver Classic 2500XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1301 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: 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 |
Silver | 21 30 40 50 60 |
$249.10 $282.73 $318.36 $444.90 $676.08 |
$498.20 $565.46 $636.72 $889.80 $1352.16 |
$656.38 $723.64 $794.90 $1047.98 |
$814.56 $881.82 $953.08 $1206.16 |
$972.74 $1040.00 $1111.26 $1364.34 |
$407.28 $440.91 $476.54 $603.08 |
$565.46 $599.09 $634.72 $761.26 |
$723.64 $757.27 $792.90 $919.44 |
$158.18 |
Plan: (HMO) Dean Silver Classic 4500XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1301 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: 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 |
$225.56 $256.01 $288.27 $402.85 $612.17 |
$451.12 $512.02 $576.54 $805.70 $1224.34 |
$594.35 $655.25 $719.77 $948.93 |
$737.58 $798.48 $863.00 $1092.16 |
$880.81 $941.71 $1006.23 $1235.39 |
$368.79 $399.24 $431.50 $546.08 |
$512.02 $542.47 $574.73 $689.31 |
$655.25 $685.70 $717.96 $832.54 |
$143.23 |
Plan: (HMO) Dean Silver Value Copay 5150XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1301 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: Individual:
$5,150
: Family:
$10,300 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 |
$216.70 $245.95 $276.94 $387.03 $588.13 |
$433.40 $491.90 $553.88 $774.06 $1176.26 |
$571.00 $629.50 $691.48 $911.66 |
$708.60 $767.10 $829.08 $1049.26 |
$846.20 $904.70 $966.68 $1186.86 |
$354.30 $383.55 $414.54 $524.63 |
$491.90 $521.15 $552.14 $662.23 |
$629.50 $658.75 $689.74 $799.83 |
$137.60 |
Plan: (HMO) Dean Bronze Value Copay 5500XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1301 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: 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 |
Bronze | 21 30 40 50 60 |
$198.41 $225.20 $253.57 $354.37 $538.50 |
$396.82 $450.40 $507.14 $708.74 $1077.00 |
$522.81 $576.39 $633.13 $834.73 |
$648.80 $702.38 $759.12 $960.72 |
$774.79 $828.37 $885.11 $1086.71 |
$324.40 $351.19 $379.56 $480.36 |
$450.39 $477.18 $505.55 $606.35 |
$576.38 $603.17 $631.54 $732.34 |
$125.99 |
Plan: (HMO) Dean Gold Classic 1500XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1301 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: 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 |
Gold | 21 30 40 50 60 |
$282.86 $321.05 $361.49 $505.19 $767.69 |
$565.72 $642.10 $722.98 $1010.38 $1535.38 |
$745.33 $821.71 $902.59 $1189.99 |
$924.94 $1001.32 $1082.20 $1369.60 |
$1104.55 $1180.93 $1261.81 $1549.21 |
$462.47 $500.66 $541.10 $684.80 |
$642.08 $680.27 $720.71 $864.41 |
$821.69 $859.88 $900.32 $1044.02 |
$179.61 |
Plan: (HMO) Dean Gold Value Copay 2250XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1301 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: Individual:
$2,250
: Family:
$4,500 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 |
Gold | 21 30 40 50 60 |
$268.64 $304.90 $343.32 $479.79 $729.08 |
$537.28 $609.80 $686.64 $959.58 $1458.16 |
$707.86 $780.38 $857.22 $1130.16 |
$878.44 $950.96 $1027.80 $1300.74 |
$1049.02 $1121.54 $1198.38 $1471.32 |
$439.22 $475.48 $513.90 $650.37 |
$609.80 $646.06 $684.48 $820.95 |
$780.38 $816.64 $855.06 $991.53 |
$170.58 |
Plan: (HMO) Dean Gold HSA 2000XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1301 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: 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 |
Gold | 21 30 40 50 60 |
$276.15 $313.43 $352.92 $493.21 $749.48 |
$552.30 $626.86 $705.84 $986.42 $1498.96 |
$727.65 $802.21 $881.19 $1161.77 |
$903.00 $977.56 $1056.54 $1337.12 |
$1078.35 $1152.91 $1231.89 $1512.47 |
$451.50 $488.78 $528.27 $668.56 |
$626.85 $664.13 $703.62 $843.91 |
$802.20 $839.48 $878.97 $1019.26 |
$175.35 |
Plan: (HMO) Dean Bronze Value Copay 6750XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1301 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: Individual:
$6,750
: Family:
$13,500 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 |
$192.02 $217.95 $245.41 $342.96 $521.16 |
$384.04 $435.90 $490.82 $685.92 $1042.32 |
$505.97 $557.83 $612.75 $807.85 |
$627.90 $679.76 $734.68 $929.78 |
$749.83 $801.69 $856.61 $1051.71 |
$313.95 $339.88 $367.34 $464.89 |
$435.88 $461.81 $489.27 $586.82 |
$557.81 $583.74 $611.20 $708.75 |
$121.93 |
Plan: (HMO) Dean Bronze HSA-E 6000XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1301 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: 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 |
$192.67 $218.69 $246.24 $344.12 $522.93 |
$385.34 $437.38 $492.48 $688.24 $1045.86 |
$507.69 $559.73 $614.83 $810.59 |
$630.04 $682.08 $737.18 $932.94 |
$752.39 $804.43 $859.53 $1055.29 |
$315.02 $341.04 $368.59 $466.47 |
$437.37 $463.39 $490.94 $588.82 |
$559.72 $585.74 $613.29 $711.17 |
$122.35 |
Plan: (HMO) Dean Bronze HSA-E 6450XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1301 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: 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 |
$184.26 $209.14 $235.49 $329.10 $500.10 |
$368.52 $418.28 $470.98 $658.20 $1000.20 |
$485.53 $535.29 $587.99 $775.21 |
$602.54 $652.30 $705.00 $892.22 |
$719.55 $769.31 $822.01 $1009.23 |
$301.27 $326.15 $352.50 $446.11 |
$418.28 $443.16 $469.51 $563.12 |
$535.29 $560.17 $586.52 $680.13 |
$117.01 |
Plan: (HMO) Dean Silver HSA-E 3400XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1301 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: Individual:
$3,400
: Family:
$6,800 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 |
$243.77 $276.68 $311.54 $435.38 $661.61 |
$487.54 $553.36 $623.08 $870.76 $1323.22 |
$642.33 $708.15 $777.87 $1025.55 |
$797.12 $862.94 $932.66 $1180.34 |
$951.91 $1017.73 $1087.45 $1335.13 |
$398.56 $431.47 $466.33 $590.17 |
$553.35 $586.26 $621.12 $744.96 |
$708.14 $741.05 $775.91 $899.75 |
$154.79 |
Plan: (HMO) Dean Platinum Copay Plus 500XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1301 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: Individual:
$500
: Family:
$1,000 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 |
$331.88 $376.68 $424.14 $592.74 $900.73 |
$663.76 $753.36 $848.28 $1185.48 $1801.46 |
$874.50 $964.10 $1059.02 $1396.22 |
$1085.24 $1174.84 $1269.76 $1606.96 |
$1295.98 $1385.58 $1480.50 $1817.70 |
$542.62 $587.42 $634.88 $803.48 |
$753.36 $798.16 $845.62 $1014.22 |
$964.10 $1008.90 $1056.36 $1224.96 |
$210.74 |
Plan: (HMO) Dean Gold Copay Plus 1000XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1301 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: 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 |
Gold | 21 30 40 50 60 |
$297.12 $337.23 $379.72 $530.66 $806.38 |
$594.24 $674.46 $759.44 $1061.32 $1612.76 |
$782.91 $863.13 $948.11 $1249.99 |
$971.58 $1051.80 $1136.78 $1438.66 |
$1160.25 $1240.47 $1325.45 $1627.33 |
$485.79 $525.90 $568.39 $719.33 |
$674.46 $714.57 $757.06 $908.00 |
$863.13 $903.24 $945.73 $1096.67 |
$188.67 |
Plan: (HMO) Dean Silver Copay Plus 3500XSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-279-1301 - Provider Directory for This Plan: (Dean Health Plan)
Deductible: 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 |
$262.06 $297.44 $334.91 $468.04 $711.24 |
$524.12 $594.88 $669.82 $936.08 $1422.48 |
$690.53 $761.29 $836.23 $1102.49 |
$856.94 $927.70 $1002.64 $1268.90 |
$1023.35 $1094.11 $1169.05 $1435.31 |
$428.47 $463.85 $501.32 $634.45 |
$594.88 $630.26 $667.73 $800.86 |
$761.29 $796.67 $834.14 $967.27 |
$166.41 |
ADVERTISEMENT
|
||||||||||
Health Tradition Health PlanLocal: 1-608-781-9692 | Toll Free: 1-888-459-3020 |
||||||||||
Plan: (HMO) Gold 1000/80Summary 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 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/copaySummary 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 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 LowSummary 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 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 6000/80Summary 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 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 HighSummary 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 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 HDHPSummary 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 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 2000/80Summary 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 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/copaySummary 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 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 85Summary 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 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 2375/100Summary 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 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/copaySummary 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 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 100Summary 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 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 3500Summary 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 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 80Summary 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 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 50Summary 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 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 RxSummary 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 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 6850/100Summary 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 Crawford County here.