Obamacare Providers, Plans and 2017 Rates for Brevard County
The health insurance rates listed below are for calendar year 2017.
2017 Rates and Providers
(click here for 2014)
(click here for 2015)
(click here for 2016)
This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for Brevard County, Florida.
Currently, there are 101 plans offered in Brevard County.
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:
- 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 Melbourne, FL area accept this insurance coverage as within the plan's "network".
‡Source: HealthCare.gov has released sample rates for all counties in those states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Brevard County here.
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Florida Health Care Plan, Inc.Local: 1-386-676-7110 | Toll Free: 1-800-232-0578 TTY: 1-800-955-8771 |
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Plan: (HMO) Gym Acccess IND Platinum HMO 92Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$500
: Family:
$1,000 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 |
$395.84 $449.28 $505.89 $706.98 $1074.32 |
$791.68 $898.56 $1011.78 $1413.96 $2148.64 |
$1043.04 $1149.92 $1263.14 $1665.32 |
$1294.40 $1401.28 $1514.50 $1916.68 |
$1545.76 $1652.64 $1765.86 $2168.04 |
$647.20 $700.64 $757.25 $958.34 |
$898.56 $952.00 $1008.61 $1209.70 |
$1149.92 $1203.36 $1259.97 $1461.06 |
$251.36 |
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Blue Cross and Blue Shield of FloridaLocal: 1-800-352-2583 | Toll Free: 1-800-352-2583 TTY: 1-800-955-8771 |
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Plan: (EPO) BlueOptions Silver 1423Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$5,950
: Family:
$11,900 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 |
$355.01 $402.94 $453.70 $634.05 $963.50 |
$710.02 $805.88 $907.40 $1268.10 $1927.00 |
$935.45 $1031.31 $1132.83 $1493.53 |
$1160.88 $1256.74 $1358.26 $1718.96 |
$1386.31 $1482.17 $1583.69 $1944.39 |
$580.44 $628.37 $679.13 $859.48 |
$805.87 $853.80 $904.56 $1084.91 |
$1031.30 $1079.23 $1129.99 $1310.34 |
$225.43 |
Plan: (EPO) BlueOptions Bronze 1419Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
$288.74 $327.72 $369.01 $515.69 $783.64 |
$577.48 $655.44 $738.02 $1031.38 $1567.28 |
$760.83 $838.79 $921.37 $1214.73 |
$944.18 $1022.14 $1104.72 $1398.08 |
$1127.53 $1205.49 $1288.07 $1581.43 |
$472.09 $511.07 $552.36 $699.04 |
$655.44 $694.42 $735.71 $882.39 |
$838.79 $877.77 $919.06 $1065.74 |
$183.35 |
Plan: (EPO) BlueOptions Silver 1431Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$5,000
: Family:
$10,000 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 |
$383.96 $435.79 $490.70 $685.75 $1042.07 |
$767.92 $871.58 $981.40 $1371.50 $2084.14 |
$1011.73 $1115.39 $1225.21 $1615.31 |
$1255.54 $1359.20 $1469.02 $1859.12 |
$1499.35 $1603.01 $1712.83 $2102.93 |
$627.77 $679.60 $734.51 $929.56 |
$871.58 $923.41 $978.32 $1173.37 |
$1115.39 $1167.22 $1222.13 $1417.18 |
$243.81 |
Plan: (EPO) BlueOptions Platinum 1418Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$800
: Family:
$1,600 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 |
$561.74 $637.57 $717.90 $1003.27 $1524.56 |
$1123.48 $1275.14 $1435.80 $2006.54 $3049.12 |
$1480.18 $1631.84 $1792.50 $2363.24 |
$1836.88 $1988.54 $2149.20 $2719.94 |
$2193.58 $2345.24 $2505.90 $3076.64 |
$918.44 $994.27 $1074.60 $1359.97 |
$1275.14 $1350.97 $1431.30 $1716.67 |
$1631.84 $1707.67 $1788.00 $2073.37 |
$356.70 |
Plan: (EPO) BlueOptions Platinum Premier 1418VSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$800
: Family:
$1,600 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 |
$584.26 $663.14 $746.68 $1043.49 $1585.68 |
$1168.52 $1326.28 $1493.36 $2086.98 $3171.36 |
$1539.53 $1697.29 $1864.37 $2457.99 |
$1910.54 $2068.30 $2235.38 $2829.00 |
$2281.55 $2439.31 $2606.39 $3200.01 |
$955.27 $1034.15 $1117.69 $1414.50 |
$1326.28 $1405.16 $1488.70 $1785.51 |
$1697.29 $1776.17 $1859.71 $2156.52 |
$371.01 |
Plan: (EPO) BlueOptions Bronze 1416Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$6,900
: Family:
$13,800 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 |
$312.67 $354.88 $399.59 $558.43 $848.59 |
$625.34 $709.76 $799.18 $1116.86 $1697.18 |
$823.89 $908.31 $997.73 $1315.41 |
$1022.44 $1106.86 $1196.28 $1513.96 |
$1220.99 $1305.41 $1394.83 $1712.51 |
$511.22 $553.43 $598.14 $756.98 |
$709.77 $751.98 $796.69 $955.53 |
$908.32 $950.53 $995.24 $1154.08 |
$198.55 |
Plan: (EPO) BlueOptions Platinum 1424Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
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 |
$579.16 $657.35 $740.17 $1034.38 $1571.84 |
$1158.32 $1314.70 $1480.34 $2068.76 $3143.68 |
$1526.09 $1682.47 $1848.11 $2436.53 |
$1893.86 $2050.24 $2215.88 $2804.30 |
$2261.63 $2418.01 $2583.65 $3172.07 |
$946.93 $1025.12 $1107.94 $1402.15 |
$1314.70 $1392.89 $1475.71 $1769.92 |
$1682.47 $1760.66 $1843.48 $2137.69 |
$367.77 |
Plan: (EPO) BlueOptions Silver 1410Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$6,500
: Family:
$13,000 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 |
$336.55 $381.98 $430.11 $601.08 $913.40 |
$673.10 $763.96 $860.22 $1202.16 $1826.80 |
$886.81 $977.67 $1073.93 $1415.87 |
$1100.52 $1191.38 $1287.64 $1629.58 |
$1314.23 $1405.09 $1501.35 $1843.29 |
$550.26 $595.69 $643.82 $814.79 |
$763.97 $809.40 $857.53 $1028.50 |
$977.68 $1023.11 $1071.24 $1242.21 |
$213.71 |
Plan: (EPO) BlueOptions Gold 1505Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
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 |
Gold | 21 30 40 50 60 |
$495.72 $562.64 $633.53 $885.36 $1345.38 |
$991.44 $1125.28 $1267.06 $1770.72 $2690.76 |
$1306.22 $1440.06 $1581.84 $2085.50 |
$1621.00 $1754.84 $1896.62 $2400.28 |
$1935.78 $2069.62 $2211.40 $2715.06 |
$810.50 $877.42 $948.31 $1200.14 |
$1125.28 $1192.20 $1263.09 $1514.92 |
$1440.06 $1506.98 $1577.87 $1829.70 |
$314.78 |
Plan: (EPO) BlueOptions Bronze (HSA) 1705Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$6,350
: Family:
$12,700 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 |
Bronze | 21 30 40 50 60 |
$297.26 $337.39 $379.90 $530.91 $806.76 |
$594.52 $674.78 $759.80 $1061.82 $1613.52 |
$783.28 $863.54 $948.56 $1250.58 |
$972.04 $1052.30 $1137.32 $1439.34 |
$1160.80 $1241.06 $1326.08 $1628.10 |
$486.02 $526.15 $568.66 $719.67 |
$674.78 $714.91 $757.42 $908.43 |
$863.54 $903.67 $946.18 $1097.19 |
$188.76 |
Plan: (EPO) BlueOptions Silver 1706SSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$3,500
: Family:
$7,000 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 |
$372.86 $423.20 $476.52 $665.93 $1011.94 |
$745.72 $846.40 $953.04 $1331.86 $2023.88 |
$982.49 $1083.17 $1189.81 $1568.63 |
$1219.26 $1319.94 $1426.58 $1805.40 |
$1456.03 $1556.71 $1663.35 $2042.17 |
$609.63 $659.97 $713.29 $902.70 |
$846.40 $896.74 $950.06 $1139.47 |
$1083.17 $1133.51 $1186.83 $1376.24 |
$236.77 |
Plan: (EPO) BlueOptions Bronze 1707SSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$6,650
: Family:
$13,300 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 |
$292.40 $331.87 $373.69 $522.23 $793.57 |
$584.80 $663.74 $747.38 $1044.46 $1587.14 |
$770.47 $849.41 $933.05 $1230.13 |
$956.14 $1035.08 $1118.72 $1415.80 |
$1141.81 $1220.75 $1304.39 $1601.47 |
$478.07 $517.54 $559.36 $707.90 |
$663.74 $703.21 $745.03 $893.57 |
$849.41 $888.88 $930.70 $1079.24 |
$185.67 |
Plan: (EPO) BlueOptions Gold 1708SSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$1,250
: Family:
$2,500 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 |
$482.25 $547.35 $616.32 $861.30 $1308.83 |
$964.50 $1094.70 $1232.64 $1722.60 $2617.66 |
$1270.73 $1400.93 $1538.87 $2028.83 |
$1576.96 $1707.16 $1845.10 $2335.06 |
$1883.19 $2013.39 $2151.33 $2641.29 |
$788.48 $853.58 $922.55 $1167.53 |
$1094.71 $1159.81 $1228.78 $1473.76 |
$1400.94 $1466.04 $1535.01 $1779.99 |
$306.23 |
Plan: (EPO) BlueSelect Silver 1456Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$5,950
: Family:
$11,900 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 |
$266.10 $302.02 $340.08 $475.25 $722.20 |
$532.20 $604.04 $680.16 $950.50 $1444.40 |
$701.17 $773.01 $849.13 $1119.47 |
$870.14 $941.98 $1018.10 $1288.44 |
$1039.11 $1110.95 $1187.07 $1457.41 |
$435.07 $470.99 $509.05 $644.22 |
$604.04 $639.96 $678.02 $813.19 |
$773.01 $808.93 $846.99 $982.16 |
$168.97 |
Plan: (EPO) BlueSelect Bronze 1452Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
$211.32 $239.85 $270.07 $377.42 $573.52 |
$422.64 $479.70 $540.14 $754.84 $1147.04 |
$556.83 $613.89 $674.33 $889.03 |
$691.02 $748.08 $808.52 $1023.22 |
$825.21 $882.27 $942.71 $1157.41 |
$345.51 $374.04 $404.26 $511.61 |
$479.70 $508.23 $538.45 $645.80 |
$613.89 $642.42 $672.64 $779.99 |
$134.19 |
Plan: (EPO) BlueSelect Silver 1464Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$5,000
: Family:
$10,000 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 |
$292.49 $331.98 $373.80 $522.39 $793.82 |
$584.98 $663.96 $747.60 $1044.78 $1587.64 |
$770.71 $849.69 $933.33 $1230.51 |
$956.44 $1035.42 $1119.06 $1416.24 |
$1142.17 $1221.15 $1304.79 $1601.97 |
$478.22 $517.71 $559.53 $708.12 |
$663.95 $703.44 $745.26 $893.85 |
$849.68 $889.17 $930.99 $1079.58 |
$185.73 |
Plan: (EPO) BlueSelect Platinum 1451Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$800
: Family:
$1,600 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 |
Platinum | 21 30 40 50 60 |
$413.17 $468.95 $528.03 $737.92 $1121.34 |
$826.34 $937.90 $1056.06 $1475.84 $2242.68 |
$1088.70 $1200.26 $1318.42 $1738.20 |
$1351.06 $1462.62 $1580.78 $2000.56 |
$1613.42 $1724.98 $1843.14 $2262.92 |
$675.53 $731.31 $790.39 $1000.28 |
$937.89 $993.67 $1052.75 $1262.64 |
$1200.25 $1256.03 $1315.11 $1525.00 |
$262.36 |
Plan: (EPO) BlueSelect Platinum Premier 1451VSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$800
: Family:
$1,600 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 |
Platinum | 21 30 40 50 60 |
$429.74 $487.75 $549.21 $767.52 $1166.31 |
$859.48 $975.50 $1098.42 $1535.04 $2332.62 |
$1132.36 $1248.38 $1371.30 $1807.92 |
$1405.24 $1521.26 $1644.18 $2080.80 |
$1678.12 $1794.14 $1917.06 $2353.68 |
$702.62 $760.63 $822.09 $1040.40 |
$975.50 $1033.51 $1094.97 $1313.28 |
$1248.38 $1306.39 $1367.85 $1586.16 |
$272.88 |
Plan: (EPO) BlueSelect Bronze 1449Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$6,900
: Family:
$13,800 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 |
Bronze | 21 30 40 50 60 |
$231.24 $262.46 $295.52 $412.99 $627.59 |
$462.48 $524.92 $591.04 $825.98 $1255.18 |
$609.32 $671.76 $737.88 $972.82 |
$756.16 $818.60 $884.72 $1119.66 |
$903.00 $965.44 $1031.56 $1266.50 |
$378.08 $409.30 $442.36 $559.83 |
$524.92 $556.14 $589.20 $706.67 |
$671.76 $702.98 $736.04 $853.51 |
$146.84 |
Plan: (EPO) BlueSelect Platinum 1457Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$426.97 $484.61 $545.67 $762.57 $1158.80 |
$853.94 $969.22 $1091.34 $1525.14 $2317.60 |
$1125.07 $1240.35 $1362.47 $1796.27 |
$1396.20 $1511.48 $1633.60 $2067.40 |
$1667.33 $1782.61 $1904.73 $2338.53 |
$698.10 $755.74 $816.80 $1033.70 |
$969.23 $1026.87 $1087.93 $1304.83 |
$1240.36 $1298.00 $1359.06 $1575.96 |
$271.13 |
Plan: (EPO) BlueSelect Silver 1443Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: 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 |
$251.62 $285.59 $321.57 $449.39 $682.90 |
$503.24 $571.18 $643.14 $898.78 $1365.80 |
$663.02 $730.96 $802.92 $1058.56 |
$822.80 $890.74 $962.70 $1218.34 |
$982.58 $1050.52 $1122.48 $1378.12 |
$411.40 $445.37 $481.35 $609.17 |
$571.18 $605.15 $641.13 $768.95 |
$730.96 $764.93 $800.91 $928.73 |
$159.78 |
Plan: (EPO) BlueSelect Gold 1535Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$380.99 $432.42 $486.91 $680.45 $1034.01 |
$761.98 $864.84 $973.82 $1360.90 $2068.02 |
$1003.91 $1106.77 $1215.75 $1602.83 |
$1245.84 $1348.70 $1457.68 $1844.76 |
$1487.77 $1590.63 $1699.61 $2086.69 |
$622.92 $674.35 $728.84 $922.38 |
$864.85 $916.28 $970.77 $1164.31 |
$1106.78 $1158.21 $1212.70 $1406.24 |
$241.93 |
Plan: (EPO) BlueSelect Bronze (HSA) 1735Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$6,350
: Family:
$12,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$217.58 $246.95 $278.07 $388.60 $590.51 |
$435.16 $493.90 $556.14 $777.20 $1181.02 |
$573.32 $632.06 $694.30 $915.36 |
$711.48 $770.22 $832.46 $1053.52 |
$849.64 $908.38 $970.62 $1191.68 |
$355.74 $385.11 $416.23 $526.76 |
$493.90 $523.27 $554.39 $664.92 |
$632.06 $661.43 $692.55 $803.08 |
$138.16 |
Plan: (EPO) BlueSelect Silver 1736SSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
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 |
$283.90 $322.23 $362.82 $507.05 $770.50 |
$567.80 $644.46 $725.64 $1014.10 $1541.00 |
$748.08 $824.74 $905.92 $1194.38 |
$928.36 $1005.02 $1086.20 $1374.66 |
$1108.64 $1185.30 $1266.48 $1554.94 |
$464.18 $502.51 $543.10 $687.33 |
$644.46 $682.79 $723.38 $867.61 |
$824.74 $863.07 $903.66 $1047.89 |
$180.28 |
Plan: (EPO) BlueSelect Bronze 1737SSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$6,650
: Family:
$13,300 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 |
Bronze | 21 30 40 50 60 |
$215.95 $245.10 $275.98 $385.69 $586.09 |
$431.90 $490.20 $551.96 $771.38 $1172.18 |
$569.03 $627.33 $689.09 $908.51 |
$706.16 $764.46 $826.22 $1045.64 |
$843.29 $901.59 $963.35 $1182.77 |
$353.08 $382.23 $413.11 $522.82 |
$490.21 $519.36 $550.24 $659.95 |
$627.34 $656.49 $687.37 $797.08 |
$137.13 |
Plan: (EPO) BlueSelect Gold 1738SSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Blue Cross and Blue Shield of Florida)
Deductible: Individual:
$1,250
: Family:
$2,500 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 |
$370.96 $421.04 $474.09 $662.53 $1006.79 |
$741.92 $842.08 $948.18 $1325.06 $2013.58 |
$977.48 $1077.64 $1183.74 $1560.62 |
$1213.04 $1313.20 $1419.30 $1796.18 |
$1448.60 $1548.76 $1654.86 $2031.74 |
$606.52 $656.60 $709.65 $898.09 |
$842.08 $892.16 $945.21 $1133.65 |
$1077.64 $1127.72 $1180.77 $1369.21 |
$235.56 |
ADVERTISEMENT
|
||||||||||
Health Options, Inc.Local: 1-800-352-2583 | Toll Free: 1-800-352-2583 TTY: 1-800-955-8771 |
||||||||||
Plan: (HMO) BlueCare Silver 1490Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)
Deductible: Individual:
$5,950
: Family:
$11,900 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 |
Silver | 21 30 40 50 60 |
$359.87 $408.45 $459.91 $642.73 $976.69 |
$719.74 $816.90 $919.82 $1285.46 $1953.38 |
$948.26 $1045.42 $1148.34 $1513.98 |
$1176.78 $1273.94 $1376.86 $1742.50 |
$1405.30 $1502.46 $1605.38 $1971.02 |
$588.39 $636.97 $688.43 $871.25 |
$816.91 $865.49 $916.95 $1099.77 |
$1045.43 $1094.01 $1145.47 $1328.29 |
$228.52 |
Plan: (HMO) BlueCare Bronze 1486Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
Bronze | 21 30 40 50 60 |
$283.30 $321.55 $362.06 $505.97 $768.88 |
$566.60 $643.10 $724.12 $1011.94 $1537.76 |
$746.50 $823.00 $904.02 $1191.84 |
$926.40 $1002.90 $1083.92 $1371.74 |
$1106.30 $1182.80 $1263.82 $1551.64 |
$463.20 $501.45 $541.96 $685.87 |
$643.10 $681.35 $721.86 $865.77 |
$823.00 $861.25 $901.76 $1045.67 |
$179.90 |
Plan: (HMO) BlueCare Silver 1498Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, 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 |
Silver | 21 30 40 50 60 |
$377.26 $428.19 $482.14 $673.79 $1023.88 |
$754.52 $856.38 $964.28 $1347.58 $2047.76 |
$994.08 $1095.94 $1203.84 $1587.14 |
$1233.64 $1335.50 $1443.40 $1826.70 |
$1473.20 $1575.06 $1682.96 $2066.26 |
$616.82 $667.75 $721.70 $913.35 |
$856.38 $907.31 $961.26 $1152.91 |
$1095.94 $1146.87 $1200.82 $1392.47 |
$239.56 |
Plan: (HMO) BlueCare Platinum 1485Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)
Deductible: Individual:
$800
: Family:
$1,600 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 |
Platinum | 21 30 40 50 60 |
$525.70 $596.67 $671.84 $938.90 $1426.75 |
$1051.40 $1193.34 $1343.68 $1877.80 $2853.50 |
$1385.22 $1527.16 $1677.50 $2211.62 |
$1719.04 $1860.98 $2011.32 $2545.44 |
$2052.86 $2194.80 $2345.14 $2879.26 |
$859.52 $930.49 $1005.66 $1272.72 |
$1193.34 $1264.31 $1339.48 $1606.54 |
$1527.16 $1598.13 $1673.30 $1940.36 |
$333.82 |
Plan: (HMO) BlueCare Bronze 1483Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)
Deductible: Individual:
$6,900
: Family:
$13,800 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 |
Bronze | 21 30 40 50 60 |
$311.63 $353.70 $398.26 $556.57 $845.76 |
$623.26 $707.40 $796.52 $1113.14 $1691.52 |
$821.15 $905.29 $994.41 $1311.03 |
$1019.04 $1103.18 $1192.30 $1508.92 |
$1216.93 $1301.07 $1390.19 $1706.81 |
$509.52 $551.59 $596.15 $754.46 |
$707.41 $749.48 $794.04 $952.35 |
$905.30 $947.37 $991.93 $1150.24 |
$197.89 |
Plan: (HMO) BlueCare Platinum 1491Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$543.36 $616.71 $694.41 $970.44 $1474.68 |
$1086.72 $1233.42 $1388.82 $1940.88 $2949.36 |
$1431.75 $1578.45 $1733.85 $2285.91 |
$1776.78 $1923.48 $2078.88 $2630.94 |
$2121.81 $2268.51 $2423.91 $2975.97 |
$888.39 $961.74 $1039.44 $1315.47 |
$1233.42 $1306.77 $1384.47 $1660.50 |
$1578.45 $1651.80 $1729.50 $2005.53 |
$345.03 |
Plan: (HMO) BlueCare Silver 1477Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)
Deductible: 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 |
$325.10 $368.99 $415.48 $580.63 $882.32 |
$650.20 $737.98 $830.96 $1161.26 $1764.64 |
$856.64 $944.42 $1037.40 $1367.70 |
$1063.08 $1150.86 $1243.84 $1574.14 |
$1269.52 $1357.30 $1450.28 $1780.58 |
$531.54 $575.43 $621.92 $787.07 |
$737.98 $781.87 $828.36 $993.51 |
$944.42 $988.31 $1034.80 $1199.95 |
$206.44 |
Plan: (HMO) BlueCare Gold 1565Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$468.46 $531.70 $598.69 $836.67 $1271.40 |
$936.92 $1063.40 $1197.38 $1673.34 $2542.80 |
$1234.39 $1360.87 $1494.85 $1970.81 |
$1531.86 $1658.34 $1792.32 $2268.28 |
$1829.33 $1955.81 $2089.79 $2565.75 |
$765.93 $829.17 $896.16 $1134.14 |
$1063.40 $1126.64 $1193.63 $1431.61 |
$1360.87 $1424.11 $1491.10 $1729.08 |
$297.47 |
Plan: (HMO) BlueCare Bronze (HSA) 1765Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)
Deductible: Individual:
$6,350
: Family:
$12,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$292.34 $331.81 $373.61 $522.12 $793.41 |
$584.68 $663.62 $747.22 $1044.24 $1586.82 |
$770.32 $849.26 $932.86 $1229.88 |
$955.96 $1034.90 $1118.50 $1415.52 |
$1141.60 $1220.54 $1304.14 $1601.16 |
$477.98 $517.45 $559.25 $707.76 |
$663.62 $703.09 $744.89 $893.40 |
$849.26 $888.73 $930.53 $1079.04 |
$185.64 |
Plan: (HMO) BlueCare Silver 1766SSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, 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 |
$365.13 $414.42 $466.64 $652.12 $990.96 |
$730.26 $828.84 $933.28 $1304.24 $1981.92 |
$962.12 $1060.70 $1165.14 $1536.10 |
$1193.98 $1292.56 $1397.00 $1767.96 |
$1425.84 $1524.42 $1628.86 $1999.82 |
$596.99 $646.28 $698.50 $883.98 |
$828.85 $878.14 $930.36 $1115.84 |
$1060.71 $1110.00 $1162.22 $1347.70 |
$231.86 |
Plan: (HMO) BlueCare Bronze 1767SSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)
Deductible: Individual:
$6,650
: Family:
$13,300 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 |
Bronze | 21 30 40 50 60 |
$288.54 $327.49 $368.75 $515.33 $783.10 |
$577.08 $654.98 $737.50 $1030.66 $1566.20 |
$760.30 $838.20 $920.72 $1213.88 |
$943.52 $1021.42 $1103.94 $1397.10 |
$1126.74 $1204.64 $1287.16 $1580.32 |
$471.76 $510.71 $551.97 $698.55 |
$654.98 $693.93 $735.19 $881.77 |
$838.20 $877.15 $918.41 $1064.99 |
$183.22 |
Plan: (HMO) BlueCare Gold 1768SSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-352-2583 - Provider Directory for This Plan: (Health Options, Inc.)
Deductible: Individual:
$1,250
: Family:
$2,500 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 |
$455.57 $517.07 $582.22 $813.65 $1236.42 |
$911.14 $1034.14 $1164.44 $1627.30 $2472.84 |
$1200.43 $1323.43 $1453.73 $1916.59 |
$1489.72 $1612.72 $1743.02 $2205.88 |
$1779.01 $1902.01 $2032.31 $2495.17 |
$744.86 $806.36 $871.51 $1102.94 |
$1034.15 $1095.65 $1160.80 $1392.23 |
$1323.44 $1384.94 $1450.09 $1681.52 |
$289.29 |
ADVERTISEMENT
|
||||||||||
Health First Commercial Plans, Inc.Local: 1-855-443-4735 | Toll Free: 1-855-443-4735 TTY: 1-800-955-8771 |
||||||||||
Plan: (HMO) Health First GYM ACCESS Bronze HMO 70 1271Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: 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 |
$253.99 $288.28 $324.60 $453.63 $689.34 |
$507.98 $576.56 $649.20 $907.26 $1378.68 |
$669.27 $737.85 $810.49 $1068.55 |
$830.56 $899.14 $971.78 $1229.84 |
$991.85 $1060.43 $1133.07 $1391.13 |
$415.28 $449.57 $485.89 $614.92 |
$576.57 $610.86 $647.18 $776.21 |
$737.86 $772.15 $808.47 $937.50 |
$161.29 |
Plan: (POS) Health First GYM ACCESS Bronze POS 100 HSA 1275Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: Individual:
$6,350
: Family:
$12,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$243.50 $276.37 $311.19 $434.89 $660.85 |
$487.00 $552.74 $622.38 $869.78 $1321.70 |
$641.62 $707.36 $777.00 $1024.40 |
$796.24 $861.98 $931.62 $1179.02 |
$950.86 $1016.60 $1086.24 $1333.64 |
$398.12 $430.99 $465.81 $589.51 |
$552.74 $585.61 $620.43 $744.13 |
$707.36 $740.23 $775.05 $898.75 |
$154.62 |
Plan: (POS) Health First GYM ACCESS Silver POS 80 1297Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: Individual:
$3,100
: Family:
$6,200 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$288.32 $327.25 $368.48 $514.95 $782.51 |
$576.64 $654.50 $736.96 $1029.90 $1565.02 |
$759.73 $837.59 $920.05 $1212.99 |
$942.82 $1020.68 $1103.14 $1396.08 |
$1125.91 $1203.77 $1286.23 $1579.17 |
$471.41 $510.34 $551.57 $698.04 |
$654.50 $693.43 $734.66 $881.13 |
$837.59 $876.52 $917.75 $1064.22 |
$183.09 |
Plan: (POS) Health First GYM ACCESS Silver POS 70 1311Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, 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 |
$290.80 $330.06 $371.65 $519.37 $789.24 |
$581.60 $660.12 $743.30 $1038.74 $1578.48 |
$766.26 $844.78 $927.96 $1223.40 |
$950.92 $1029.44 $1112.62 $1408.06 |
$1135.58 $1214.10 $1297.28 $1592.72 |
$475.46 $514.72 $556.31 $704.03 |
$660.12 $699.38 $740.97 $888.69 |
$844.78 $884.04 $925.63 $1073.35 |
$184.66 |
Plan: (POS) Health First GYM ACCESS Gold POS 100 1324Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, 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 |
Gold | 21 30 40 50 60 |
$356.87 $405.05 $456.08 $637.38 $968.55 |
$713.74 $810.10 $912.16 $1274.76 $1937.10 |
$940.35 $1036.71 $1138.77 $1501.37 |
$1166.96 $1263.32 $1365.38 $1727.98 |
$1393.57 $1489.93 $1591.99 $1954.59 |
$583.48 $631.66 $682.69 $863.99 |
$810.09 $858.27 $909.30 $1090.60 |
$1036.70 $1084.88 $1135.91 $1317.21 |
$226.61 |
Plan: (POS) Health First GYM ACCESS Catastrophic POS 1331Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
Catastrophic | 21 30 40 50 60 |
$163.30 $185.34 $208.70 $291.65 $443.19 |
$326.60 $370.68 $417.40 $583.30 $886.38 |
$430.29 $474.37 $521.09 $686.99 |
$533.98 $578.06 $624.78 $790.68 |
$637.67 $681.75 $728.47 $894.37 |
$266.99 $289.03 $312.39 $395.34 |
$370.68 $392.72 $416.08 $499.03 |
$474.37 $496.41 $519.77 $602.72 |
$103.69 |
Plan: (POS) Health First Bronze POS 50 1341Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: Individual:
$6,650
: Family:
$13,300 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 |
Bronze | 21 30 40 50 60 |
$232.76 $264.18 $297.47 $415.71 $631.71 |
$465.52 $528.36 $594.94 $831.42 $1263.42 |
$613.32 $676.16 $742.74 $979.22 |
$761.12 $823.96 $890.54 $1127.02 |
$908.92 $971.76 $1038.34 $1274.82 |
$380.56 $411.98 $445.27 $563.51 |
$528.36 $559.78 $593.07 $711.31 |
$676.16 $707.58 $740.87 $859.11 |
$147.80 |
Plan: (POS) Health First Silver POS 80 1346Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, 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 |
$279.46 $317.19 $357.15 $499.12 $758.46 |
$558.92 $634.38 $714.30 $998.24 $1516.92 |
$736.38 $811.84 $891.76 $1175.70 |
$913.84 $989.30 $1069.22 $1353.16 |
$1091.30 $1166.76 $1246.68 $1530.62 |
$456.92 $494.65 $534.61 $676.58 |
$634.38 $672.11 $712.07 $854.04 |
$811.84 $849.57 $889.53 $1031.50 |
$177.46 |
Plan: (POS) Health First Gold POS 80 1351Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: Individual:
$1,250
: Family:
$2,500 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 |
$349.03 $396.15 $446.07 $623.38 $947.28 |
$698.06 $792.30 $892.14 $1246.76 $1894.56 |
$919.70 $1013.94 $1113.78 $1468.40 |
$1141.34 $1235.58 $1335.42 $1690.04 |
$1362.98 $1457.22 $1557.06 $1911.68 |
$570.67 $617.79 $667.71 $845.02 |
$792.31 $839.43 $889.35 $1066.66 |
$1013.95 $1061.07 $1110.99 $1288.30 |
$221.64 |
Plan: (POS) Health First Bronze POS 100 1353Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: Individual:
$7,050
: Family:
$14,100 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 |
$231.72 $263.01 $296.14 $413.86 $628.90 |
$463.44 $526.02 $592.28 $827.72 $1257.80 |
$610.58 $673.16 $739.42 $974.86 |
$757.72 $820.30 $886.56 $1122.00 |
$904.86 $967.44 $1033.70 $1269.14 |
$378.86 $410.15 $443.28 $561.00 |
$526.00 $557.29 $590.42 $708.14 |
$673.14 $704.43 $737.56 $855.28 |
$147.14 |
Plan: (POS) Health First Silver POS 80 1358Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: Individual:
$2,900
: Family:
$5,800 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 |
$279.20 $316.89 $356.82 $498.65 $757.75 |
$558.40 $633.78 $713.64 $997.30 $1515.50 |
$735.69 $811.07 $890.93 $1174.59 |
$912.98 $988.36 $1068.22 $1351.88 |
$1090.27 $1165.65 $1245.51 $1529.17 |
$456.49 $494.18 $534.11 $675.94 |
$633.78 $671.47 $711.40 $853.23 |
$811.07 $848.76 $888.69 $1030.52 |
$177.29 |
Plan: (HMO) Health First GYM ACCESS Bronze HMO 100 HSA 1274Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: Individual:
$6,350
: Family:
$12,700 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$237.53 $269.60 $303.56 $424.23 $644.66 |
$475.06 $539.20 $607.12 $848.46 $1289.32 |
$625.89 $690.03 $757.95 $999.29 |
$776.72 $840.86 $908.78 $1150.12 |
$927.55 $991.69 $1059.61 $1300.95 |
$388.36 $420.43 $454.39 $575.06 |
$539.19 $571.26 $605.22 $725.89 |
$690.02 $722.09 $756.05 $876.72 |
$150.83 |
Plan: (HMO) Health First GYM ACCESS Bronze HMO 70 HSA 1276Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
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 |
Bronze | 21 30 40 50 60 |
$237.73 $269.82 $303.82 $424.59 $645.20 |
$475.46 $539.64 $607.64 $849.18 $1290.40 |
$626.42 $690.60 $758.60 $1000.14 |
$777.38 $841.56 $909.56 $1151.10 |
$928.34 $992.52 $1060.52 $1302.06 |
$388.69 $420.78 $454.78 $575.55 |
$539.65 $571.74 $605.74 $726.51 |
$690.61 $722.70 $756.70 $877.47 |
$150.96 |
Plan: (HMO) Health First GYM ACCESS Silver HMO 100 1277Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: Individual:
$4,400
: Family:
$8,800 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 |
$291.07 $330.36 $371.99 $519.85 $789.96 |
$582.14 $660.72 $743.98 $1039.70 $1579.92 |
$766.97 $845.55 $928.81 $1224.53 |
$951.80 $1030.38 $1113.64 $1409.36 |
$1136.63 $1215.21 $1298.47 $1594.19 |
$475.90 $515.19 $556.82 $704.68 |
$660.73 $700.02 $741.65 $889.51 |
$845.56 $884.85 $926.48 $1074.34 |
$184.83 |
Plan: (HMO) Health First GYM ACCESS Silver HMO 100 1285Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: Individual:
$3,800
: Family:
$7,600 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$292.59 $332.09 $373.93 $522.57 $794.09 |
$585.18 $664.18 $747.86 $1045.14 $1588.18 |
$770.97 $849.97 $933.65 $1230.93 |
$956.76 $1035.76 $1119.44 $1416.72 |
$1142.55 $1221.55 $1305.23 $1602.51 |
$478.38 $517.88 $559.72 $708.36 |
$664.17 $703.67 $745.51 $894.15 |
$849.96 $889.46 $931.30 $1079.94 |
$185.79 |
Plan: (HMO) Health First Bronze HMO 50 1340Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: Individual:
$6,650
: Family:
$13,300 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 |
Bronze | 21 30 40 50 60 |
$225.89 $256.39 $288.69 $403.44 $613.07 |
$451.78 $512.78 $577.38 $806.88 $1226.14 |
$595.22 $656.22 $720.82 $950.32 |
$738.66 $799.66 $864.26 $1093.76 |
$882.10 $943.10 $1007.70 $1237.20 |
$369.33 $399.83 $432.13 $546.88 |
$512.77 $543.27 $575.57 $690.32 |
$656.21 $686.71 $719.01 $833.76 |
$143.44 |
Plan: (HMO) Health First GYM ACCESS Silver HMO 90 1289Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, 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 |
Silver | 21 30 40 50 60 |
$294.29 $334.02 $376.11 $525.61 $798.71 |
$588.58 $668.04 $752.22 $1051.22 $1597.42 |
$775.46 $854.92 $939.10 $1238.10 |
$962.34 $1041.80 $1125.98 $1424.98 |
$1149.22 $1228.68 $1312.86 $1611.86 |
$481.17 $520.90 $562.99 $712.49 |
$668.05 $707.78 $749.87 $899.37 |
$854.93 $894.66 $936.75 $1086.25 |
$186.88 |
Plan: (HMO) Health First GYM ACCESS Silver HMO 80 1293Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: Individual:
$3,100
: Family:
$6,200 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$280.30 $318.14 $358.22 $500.61 $760.73 |
$560.60 $636.28 $716.44 $1001.22 $1521.46 |
$738.59 $814.27 $894.43 $1179.21 |
$916.58 $992.26 $1072.42 $1357.20 |
$1094.57 $1170.25 $1250.41 $1535.19 |
$458.29 $496.13 $536.21 $678.60 |
$636.28 $674.12 $714.20 $856.59 |
$814.27 $852.11 $892.19 $1034.58 |
$177.99 |
Plan: (HMO) Health First GYM ACCESS Silver HMO 70 1307Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, 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 |
$285.28 $323.80 $364.59 $509.52 $774.26 |
$570.56 $647.60 $729.18 $1019.04 $1548.52 |
$751.72 $828.76 $910.34 $1200.20 |
$932.88 $1009.92 $1091.50 $1381.36 |
$1114.04 $1191.08 $1272.66 $1562.52 |
$466.44 $504.96 $545.75 $690.68 |
$647.60 $686.12 $726.91 $871.84 |
$828.76 $867.28 $908.07 $1053.00 |
$181.16 |
Plan: (HMO) Health First GYM ACCESS Silver HMO 70 1315Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, 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 |
$281.90 $319.96 $360.27 $503.48 $765.09 |
$563.80 $639.92 $720.54 $1006.96 $1530.18 |
$742.81 $818.93 $899.55 $1185.97 |
$921.82 $997.94 $1078.56 $1364.98 |
$1100.83 $1176.95 $1257.57 $1543.99 |
$460.91 $498.97 $539.28 $682.49 |
$639.92 $677.98 $718.29 $861.50 |
$818.93 $856.99 $897.30 $1040.51 |
$179.01 |
Plan: (HMO) Health First GYM ACCESS Silver HMO 80 HSA 1319Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, 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 |
$282.39 $320.52 $360.90 $504.36 $766.42 |
$564.78 $641.04 $721.80 $1008.72 $1532.84 |
$744.10 $820.36 $901.12 $1188.04 |
$923.42 $999.68 $1080.44 $1367.36 |
$1102.74 $1179.00 $1259.76 $1546.68 |
$461.71 $499.84 $540.22 $683.68 |
$641.03 $679.16 $719.54 $863.00 |
$820.35 $858.48 $898.86 $1042.32 |
$179.32 |
Plan: (HMO) Health First GYM ACCESS Gold HMO 100 1323Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, 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 |
Gold | 21 30 40 50 60 |
$347.05 $393.90 $443.53 $619.83 $941.90 |
$694.10 $787.80 $887.06 $1239.66 $1883.80 |
$914.48 $1008.18 $1107.44 $1460.04 |
$1134.86 $1228.56 $1327.82 $1680.42 |
$1355.24 $1448.94 $1548.20 $1900.80 |
$567.43 $614.28 $663.91 $840.21 |
$787.81 $834.66 $884.29 $1060.59 |
$1008.19 $1055.04 $1104.67 $1280.97 |
$220.38 |
Plan: (HMO) Health First GYM ACCESS Gold HMO 80 1326Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, 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 |
Gold | 21 30 40 50 60 |
$345.17 $391.77 $441.13 $616.48 $936.80 |
$690.34 $783.54 $882.26 $1232.96 $1873.60 |
$909.53 $1002.73 $1101.45 $1452.15 |
$1128.72 $1221.92 $1320.64 $1671.34 |
$1347.91 $1441.11 $1539.83 $1890.53 |
$564.36 $610.96 $660.32 $835.67 |
$783.55 $830.15 $879.51 $1054.86 |
$1002.74 $1049.34 $1098.70 $1274.05 |
$219.19 |
Plan: (HMO) Health First GYM ACCESS Gold HMO 70 1327Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, 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 |
$353.46 $401.17 $451.72 $631.27 $959.28 |
$706.92 $802.34 $903.44 $1262.54 $1918.56 |
$931.37 $1026.79 $1127.89 $1486.99 |
$1155.82 $1251.24 $1352.34 $1711.44 |
$1380.27 $1475.69 $1576.79 $1935.89 |
$577.91 $625.62 $676.17 $855.72 |
$802.36 $850.07 $900.62 $1080.17 |
$1026.81 $1074.52 $1125.07 $1304.62 |
$224.45 |
Plan: (HMO) Health First GYM ACCESS Gold HMO 90 HSA 1328Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, 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 |
$335.73 $381.05 $429.06 $599.60 $911.16 |
$671.46 $762.10 $858.12 $1199.20 $1822.32 |
$884.65 $975.29 $1071.31 $1412.39 |
$1097.84 $1188.48 $1284.50 $1625.58 |
$1311.03 $1401.67 $1497.69 $1838.77 |
$548.92 $594.24 $642.25 $812.79 |
$762.11 $807.43 $855.44 $1025.98 |
$975.30 $1020.62 $1068.63 $1239.17 |
$213.19 |
Plan: (HMO) Health First GYM ACCESS Catastrophic HMO 1330Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
Catastrophic | 21 30 40 50 60 |
$159.80 $181.37 $204.22 $285.40 $433.69 |
$319.60 $362.74 $408.44 $570.80 $867.38 |
$421.07 $464.21 $509.91 $672.27 |
$522.54 $565.68 $611.38 $773.74 |
$624.01 $667.15 $712.85 $875.21 |
$261.27 $282.84 $305.69 $386.87 |
$362.74 $384.31 $407.16 $488.34 |
$464.21 $485.78 $508.63 $589.81 |
$101.47 |
Plan: (HMO) Health First Silver HMO 80 1342Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, 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 |
$272.06 $308.79 $347.70 $485.90 $738.38 |
$544.12 $617.58 $695.40 $971.80 $1476.76 |
$716.88 $790.34 $868.16 $1144.56 |
$889.64 $963.10 $1040.92 $1317.32 |
$1062.40 $1135.86 $1213.68 $1490.08 |
$444.82 $481.55 $520.46 $658.66 |
$617.58 $654.31 $693.22 $831.42 |
$790.34 $827.07 $865.98 $1004.18 |
$172.76 |
Plan: (HMO) Health First Gold HMO 80 1350Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: Individual:
$1,250
: Family:
$2,500 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 |
$337.63 $383.21 $431.49 $603.01 $916.33 |
$675.26 $766.42 $862.98 $1206.02 $1832.66 |
$889.66 $980.82 $1077.38 $1420.42 |
$1104.06 $1195.22 $1291.78 $1634.82 |
$1318.46 $1409.62 $1506.18 $1849.22 |
$552.03 $597.61 $645.89 $817.41 |
$766.43 $812.01 $860.29 $1031.81 |
$980.83 $1026.41 $1074.69 $1246.21 |
$214.40 |
Plan: (HMO) Health First Bronze HMO 100 1352Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: Individual:
$7,050
: Family:
$14,100 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 |
$224.72 $255.06 $287.19 $401.35 $609.89 |
$449.44 $510.12 $574.38 $802.70 $1219.78 |
$592.14 $652.82 $717.08 $945.40 |
$734.84 $795.52 $859.78 $1088.10 |
$877.54 $938.22 $1002.48 $1230.80 |
$367.42 $397.76 $429.89 $544.05 |
$510.12 $540.46 $572.59 $686.75 |
$652.82 $683.16 $715.29 $829.45 |
$142.70 |
Plan: (HMO) Health First Silver HMO 80 1354Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-443-4735 - Provider Directory for This Plan: (Health First Commercial Plans, Inc.)
Deductible: Individual:
$2,900
: Family:
$5,800 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 |
$270.41 $306.91 $345.58 $482.95 $733.89 |
$540.82 $613.82 $691.16 $965.90 $1467.78 |
$712.53 $785.53 $862.87 $1137.61 |
$884.24 $957.24 $1034.58 $1309.32 |
$1055.95 $1128.95 $1206.29 $1481.03 |
$442.12 $478.62 $517.29 $654.66 |
$613.83 $650.33 $689.00 $826.37 |
$785.54 $822.04 $860.71 $998.08 |
$171.71 |
ADVERTISEMENT
|
||||||||||
Florida Health Care Plan, Inc.Local: 1-386-676-7110 | Toll Free: 1-800-232-0578 TTY: 1-800-955-8771 |
||||||||||
Plan: (HMO) Gym Access IND Essential Plus Catastrophic HMO 36Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
Catastrophic | 21 30 40 50 60 |
$194.21 $220.43 $248.20 $346.86 $527.08 |
$388.42 $440.86 $496.40 $693.72 $1054.16 |
$511.74 $564.18 $619.72 $817.04 |
$635.06 $687.50 $743.04 $940.36 |
$758.38 $810.82 $866.36 $1063.68 |
$317.53 $343.75 $371.52 $470.18 |
$440.85 $467.07 $494.84 $593.50 |
$564.17 $590.39 $618.16 $716.82 |
$123.32 |
Plan: (POS) Gym Access IND Essential Plus Catastrophic POS 37Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$7,150
: Family:
$14,300 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 |
Catastrophic | 21 30 40 50 60 |
$213.64 $242.48 $273.03 $381.55 $579.81 |
$427.28 $484.96 $546.06 $763.10 $1159.62 |
$562.94 $620.62 $681.72 $898.76 |
$698.60 $756.28 $817.38 $1034.42 |
$834.26 $891.94 $953.04 $1170.08 |
$349.30 $378.14 $408.69 $517.21 |
$484.96 $513.80 $544.35 $652.87 |
$620.62 $649.46 $680.01 $788.53 |
$135.66 |
Plan: (HMO) Gym Access IND Essential Plus Silver HMO 53Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$2,500
: 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 |
$276.09 $313.36 $352.85 $493.10 $749.31 |
$552.18 $626.72 $705.70 $986.20 $1498.62 |
$727.50 $802.04 $881.02 $1161.52 |
$902.82 $977.36 $1056.34 $1336.84 |
$1078.14 $1152.68 $1231.66 $1512.16 |
$451.41 $488.68 $528.17 $668.42 |
$626.73 $664.00 $703.49 $843.74 |
$802.05 $839.32 $878.81 $1019.06 |
$175.32 |
Plan: (HMO) IND Essential Plus Bronze HMO 41Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$4,500
: Family:
$9,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$207.83 $235.88 $265.60 $371.18 $564.04 |
$415.66 $471.76 $531.20 $742.36 $1128.08 |
$547.63 $603.73 $663.17 $874.33 |
$679.60 $735.70 $795.14 $1006.30 |
$811.57 $867.67 $927.11 $1138.27 |
$339.80 $367.85 $397.57 $503.15 |
$471.77 $499.82 $529.54 $635.12 |
$603.74 $631.79 $661.51 $767.09 |
$131.97 |
Plan: (HMO) Gym Access IND Essential Plus Gold HMO 63Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$1,250
: Family:
$2,500 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 |
$336.56 $381.99 $430.12 $601.09 $913.42 |
$673.12 $763.98 $860.24 $1202.18 $1826.84 |
$886.83 $977.69 $1073.95 $1415.89 |
$1100.54 $1191.40 $1287.66 $1629.60 |
$1314.25 $1405.11 $1501.37 $1843.31 |
$550.27 $595.70 $643.83 $814.80 |
$763.98 $809.41 $857.54 $1028.51 |
$977.69 $1023.12 $1071.25 $1242.22 |
$213.71 |
Plan: (HMO) Gym Access IND Essential Plus Platinum HMO 65Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$406.21 $461.05 $519.14 $725.49 $1102.46 |
$812.42 $922.10 $1038.28 $1450.98 $2204.92 |
$1070.36 $1180.04 $1296.22 $1708.92 |
$1328.30 $1437.98 $1554.16 $1966.86 |
$1586.24 $1695.92 $1812.10 $2224.80 |
$664.15 $718.99 $777.08 $983.43 |
$922.09 $976.93 $1035.02 $1241.37 |
$1180.03 $1234.87 $1292.96 $1499.31 |
$257.94 |
Plan: (HMO) Gym Access IND Bronze HMO BC 3841Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$6,700
: Family:
$13,400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$223.61 $253.79 $285.77 $399.36 $606.87 |
$447.22 $507.58 $571.54 $798.72 $1213.74 |
$589.21 $649.57 $713.53 $940.71 |
$731.20 $791.56 $855.52 $1082.70 |
$873.19 $933.55 $997.51 $1224.69 |
$365.60 $395.78 $427.76 $541.35 |
$507.59 $537.77 $569.75 $683.34 |
$649.58 $679.76 $711.74 $825.33 |
$141.99 |
Plan: (POS) Gym Access IND Essential Plus Silver POS 54Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$2,500
: 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 |
$303.02 $343.93 $387.26 $541.20 $822.40 |
$606.04 $687.86 $774.52 $1082.40 $1644.80 |
$798.46 $880.28 $966.94 $1274.82 |
$990.88 $1072.70 $1159.36 $1467.24 |
$1183.30 $1265.12 $1351.78 $1659.66 |
$495.44 $536.35 $579.68 $733.62 |
$687.86 $728.77 $772.10 $926.04 |
$880.28 $921.19 $964.52 $1118.46 |
$192.42 |
Plan: (POS) Gym Access IND Essential Plus Bronze POS 42Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$4,500
: Family:
$9,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$234.40 $266.04 $299.56 $418.64 $636.16 |
$468.80 $532.08 $599.12 $837.28 $1272.32 |
$617.64 $680.92 $747.96 $986.12 |
$766.48 $829.76 $896.80 $1134.96 |
$915.32 $978.60 $1045.64 $1283.80 |
$383.24 $414.88 $448.40 $567.48 |
$532.08 $563.72 $597.24 $716.32 |
$680.92 $712.56 $746.08 $865.16 |
$148.84 |
Plan: (HMO) Gym Access IND Platinum HMO 4000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$398.66 $452.48 $509.49 $712.01 $1081.97 |
$797.32 $904.96 $1018.98 $1424.02 $2163.94 |
$1050.47 $1158.11 $1272.13 $1677.17 |
$1303.62 $1411.26 $1525.28 $1930.32 |
$1556.77 $1664.41 $1778.43 $2183.47 |
$651.81 $705.63 $762.64 $965.16 |
$904.96 $958.78 $1015.79 $1218.31 |
$1158.11 $1211.93 $1268.94 $1471.46 |
$253.15 |
Plan: (POS) Gym Access Platinum POS 4000Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$439.96 $499.35 $562.27 $785.77 $1194.05 |
$879.92 $998.70 $1124.54 $1571.54 $2388.10 |
$1159.29 $1278.07 $1403.91 $1850.91 |
$1438.66 $1557.44 $1683.28 $2130.28 |
$1718.03 $1836.81 $1962.65 $2409.65 |
$719.33 $778.72 $841.64 $1065.14 |
$998.70 $1058.09 $1121.01 $1344.51 |
$1278.07 $1337.46 $1400.38 $1623.88 |
$279.37 |
Plan: (HMO) Gym Access IND Gold HMO 5500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$344.28 $390.75 $439.98 $614.88 $934.36 |
$688.56 $781.50 $879.96 $1229.76 $1868.72 |
$907.17 $1000.11 $1098.57 $1448.37 |
$1125.78 $1218.72 $1317.18 $1666.98 |
$1344.39 $1437.33 $1535.79 $1885.59 |
$562.89 $609.36 $658.59 $833.49 |
$781.50 $827.97 $877.20 $1052.10 |
$1000.11 $1046.58 $1095.81 $1270.71 |
$218.61 |
Plan: (POS) Gym Access IND Gold POS 5500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$2,000
: Family:
$4,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$379.12 $430.30 $484.51 $677.11 $1028.93 |
$758.24 $860.60 $969.02 $1354.22 $2057.86 |
$998.98 $1101.34 $1209.76 $1594.96 |
$1239.72 $1342.08 $1450.50 $1835.70 |
$1480.46 $1582.82 $1691.24 $2076.44 |
$619.86 $671.04 $725.25 $917.85 |
$860.60 $911.78 $965.99 $1158.59 |
$1101.34 $1152.52 $1206.73 $1399.33 |
$240.74 |
Plan: (HMO) Gym Access IND Silver HMO 6400Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$5,000
: Family:
$10,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$298.93 $339.29 $382.03 $533.89 $811.30 |
$597.86 $678.58 $764.06 $1067.78 $1622.60 |
$787.68 $868.40 $953.88 $1257.60 |
$977.50 $1058.22 $1143.70 $1447.42 |
$1167.32 $1248.04 $1333.52 $1637.24 |
$488.75 $529.11 $571.85 $723.71 |
$678.57 $718.93 $761.67 $913.53 |
$868.39 $908.75 $951.49 $1103.35 |
$189.82 |
Plan: (HMO) Gym Access IND Silver HMO 6600Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$5,500
: Family:
$11,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$277.29 $314.73 $354.38 $495.25 $752.58 |
$554.58 $629.46 $708.76 $990.50 $1505.16 |
$730.66 $805.54 $884.84 $1166.58 |
$906.74 $981.62 $1060.92 $1342.66 |
$1082.82 $1157.70 $1237.00 $1518.74 |
$453.37 $490.81 $530.46 $671.33 |
$629.45 $666.89 $706.54 $847.41 |
$805.53 $842.97 $882.62 $1023.49 |
$176.08 |
Plan: (HMO) IND Gold HMO 4500Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$1,500
: 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 |
$308.53 $350.18 $394.30 $551.04 $837.35 |
$617.06 $700.36 $788.60 $1102.08 $1674.70 |
$812.98 $896.28 $984.52 $1298.00 |
$1008.90 $1092.20 $1180.44 $1493.92 |
$1204.82 $1288.12 $1376.36 $1689.84 |
$504.45 $546.10 $590.22 $746.96 |
$700.37 $742.02 $786.14 $942.88 |
$896.29 $937.94 $982.06 $1138.80 |
$195.92 |
Plan: (HMO) Gym Access IND Bronze HMO HSA 5500/6550Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$5,500
: Family:
$11,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$216.08 $245.25 $276.15 $385.92 $586.44 |
$432.16 $490.50 $552.30 $771.84 $1172.88 |
$569.37 $627.71 $689.51 $909.05 |
$706.58 $764.92 $826.72 $1046.26 |
$843.79 $902.13 $963.93 $1183.47 |
$353.29 $382.46 $413.36 $523.13 |
$490.50 $519.67 $550.57 $660.34 |
$627.71 $656.88 $687.78 $797.55 |
$137.21 |
Plan: (HMO) Gym Access IND Bronze HMO HSA 6000/6550Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$6,000
: Family:
$12,000 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Bronze | 21 30 40 50 60 |
$216.60 $245.84 $276.81 $386.85 $587.85 |
$433.20 $491.68 $553.62 $773.70 $1175.70 |
$570.74 $629.22 $691.16 $911.24 |
$708.28 $766.76 $828.70 $1048.78 |
$845.82 $904.30 $966.24 $1186.32 |
$354.14 $383.38 $414.35 $524.39 |
$491.68 $520.92 $551.89 $661.93 |
$629.22 $658.46 $689.43 $799.47 |
$137.54 |
Plan: (POS) Gym Access IND Bronze POS BC 3841Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$6,700
: Family:
$13,400 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$245.97 $279.17 $314.35 $439.30 $667.56 |
$491.94 $558.34 $628.70 $878.60 $1335.12 |
$648.13 $714.53 $784.89 $1034.79 |
$804.32 $870.72 $941.08 $1190.98 |
$960.51 $1026.91 $1097.27 $1347.17 |
$402.16 $435.36 $470.54 $595.49 |
$558.35 $591.55 $626.73 $751.68 |
$714.54 $747.74 $782.92 $907.87 |
$156.19 |
Plan: (HMO) Gym Access IND Silver HMO BC 0941Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$5,600
: Family:
$11,200 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$270.35 $306.85 $345.51 $482.84 $733.73 |
$540.70 $613.70 $691.02 $965.68 $1467.46 |
$712.37 $785.37 $862.69 $1137.35 |
$884.04 $957.04 $1034.36 $1309.02 |
$1055.71 $1128.71 $1206.03 $1480.69 |
$442.02 $478.52 $517.18 $654.51 |
$613.69 $650.19 $688.85 $826.18 |
$785.36 $821.86 $860.52 $997.85 |
$171.67 |
Plan: (POS) Gym Access IND Silver POS BC 0941Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$5,600
: Family:
$11,200 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple w 1 Kid |
Couple w 2 Kids |
Couple w3+Kids |
Single w 1 Kid |
Single w 2 Kids |
Single w3+Kids |
Child any age |
Silver | 21 30 40 50 60 |
$292.52 $332.01 $373.84 $522.44 $793.90 |
$585.04 $664.02 $747.68 $1044.88 $1587.80 |
$770.79 $849.77 $933.43 $1230.63 |
$956.54 $1035.52 $1119.18 $1416.38 |
$1142.29 $1221.27 $1304.93 $1602.13 |
$478.27 $517.76 $559.59 $708.19 |
$664.02 $703.51 $745.34 $893.94 |
$849.77 $889.26 $931.09 $1079.69 |
$185.75 |
Plan: (HMO) IND Silver HMO BC 7741Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$6,500
: 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 |
$245.35 $278.47 $313.55 $438.19 $665.87 |
$490.70 $556.94 $627.10 $876.38 $1331.74 |
$646.50 $712.74 $782.90 $1032.18 |
$802.30 $868.54 $938.70 $1187.98 |
$958.10 $1024.34 $1094.50 $1343.78 |
$401.15 $434.27 $469.35 $593.99 |
$556.95 $590.07 $625.15 $749.79 |
$712.75 $745.87 $780.95 $905.59 |
$155.80 |
Plan: (HMO) Gym Access IND Platinum HMO 91Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$250
: Family:
$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 |
Platinum | 21 30 40 50 60 |
$398.32 $452.09 $509.05 $711.39 $1081.03 |
$796.64 $904.18 $1018.10 $1422.78 $2162.06 |
$1049.57 $1157.11 $1271.03 $1675.71 |
$1302.50 $1410.04 $1523.96 $1928.64 |
$1555.43 $1662.97 $1776.89 $2181.57 |
$651.25 $705.02 $761.98 $964.32 |
$904.18 $957.95 $1014.91 $1217.25 |
$1157.11 $1210.88 $1267.84 $1470.18 |
$252.93 |
Plan: (POS) Gym Access IND Silver POS BC 7741Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$6,500
: 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 |
$273.28 $310.17 $349.25 $488.08 $741.68 |
$546.56 $620.34 $698.50 $976.16 $1483.36 |
$720.09 $793.87 $872.03 $1149.69 |
$893.62 $967.40 $1045.56 $1323.22 |
$1067.15 $1140.93 $1219.09 $1496.75 |
$446.81 $483.70 $522.78 $661.61 |
$620.34 $657.23 $696.31 $835.14 |
$793.87 $830.76 $869.84 $1008.67 |
$173.53 |
Plan: (HMO) Gym Access IND Gold HMO BC 5651Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$376.73 $427.58 $481.45 $672.83 $1022.43 |
$753.46 $855.16 $962.90 $1345.66 $2044.86 |
$992.68 $1094.38 $1202.12 $1584.88 |
$1231.90 $1333.60 $1441.34 $1824.10 |
$1471.12 $1572.82 $1680.56 $2063.32 |
$615.95 $666.80 $720.67 $912.05 |
$855.17 $906.02 $959.89 $1151.27 |
$1094.39 $1145.24 $1199.11 $1390.49 |
$239.22 |
Plan: (POS) Gym Access IND Gold POS BC 5651Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$416.94 $473.23 $532.85 $744.66 $1131.58 |
$833.88 $946.46 $1065.70 $1489.32 $2263.16 |
$1098.64 $1211.22 $1330.46 $1754.08 |
$1363.40 $1475.98 $1595.22 $2018.84 |
$1628.16 $1740.74 $1859.98 $2283.60 |
$681.70 $737.99 $797.61 $1009.42 |
$946.46 $1002.75 $1062.37 $1274.18 |
$1211.22 $1267.51 $1327.13 $1538.94 |
$264.76 |
Plan: (HMO) IND Platinum HMO BC 5841Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$800
: Family:
$1,600 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$382.04 $433.61 $488.24 $682.32 $1036.85 |
$764.08 $867.22 $976.48 $1364.64 $2073.70 |
$1006.67 $1109.81 $1219.07 $1607.23 |
$1249.26 $1352.40 $1461.66 $1849.82 |
$1491.85 $1594.99 $1704.25 $2092.41 |
$624.63 $676.20 $730.83 $924.91 |
$867.22 $918.79 $973.42 $1167.50 |
$1109.81 $1161.38 $1216.01 $1410.09 |
$242.59 |
Plan: (POS) Gym Access IND Platinum POS BC 5841Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$800
: Family:
$1,600 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$427.32 $485.01 $546.12 $763.20 $1159.75 |
$854.64 $970.02 $1092.24 $1526.40 $2319.50 |
$1125.99 $1241.37 $1363.59 $1797.75 |
$1397.34 $1512.72 $1634.94 $2069.10 |
$1668.69 $1784.07 $1906.29 $2340.45 |
$698.67 $756.36 $817.47 $1034.55 |
$970.02 $1027.71 $1088.82 $1305.90 |
$1241.37 $1299.06 $1360.17 $1577.25 |
$271.35 |
Plan: (HMO) Gym Access IND Platinum HMO BC 1941Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$406.33 $461.19 $519.30 $725.71 $1102.79 |
$812.66 $922.38 $1038.60 $1451.42 $2205.58 |
$1070.68 $1180.40 $1296.62 $1709.44 |
$1328.70 $1438.42 $1554.64 $1967.46 |
$1586.72 $1696.44 $1812.66 $2225.48 |
$664.35 $719.21 $777.32 $983.73 |
$922.37 $977.23 $1035.34 $1241.75 |
$1180.39 $1235.25 $1293.36 $1499.77 |
$258.02 |
Plan: (POS) Gym Access IND Platinum POS BC 1941Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$0
: Family:
$0 Monthly Premiums: |
||||||||||
Metal level | Age | Individual |
Couple |
Couple 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 |
$449.11 $509.74 $573.97 $802.12 $1218.89 |
$898.22 $1019.48 $1147.94 $1604.24 $2437.78 |
$1183.41 $1304.67 $1433.13 $1889.43 |
$1468.60 $1589.86 $1718.32 $2174.62 |
$1753.79 $1875.05 $2003.51 $2459.81 |
$734.30 $794.93 $859.16 $1087.31 |
$1019.49 $1080.12 $1144.35 $1372.50 |
$1304.68 $1365.31 $1429.54 $1657.69 |
$285.19 |
Plan: (HMO) IND Bronze Standardized HMOSummary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$6,650
: Family:
$13,300 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 |
Bronze | 21 30 40 50 60 |
$208.57 $236.73 $266.55 $372.50 $566.06 |
$417.14 $473.46 $533.10 $745.00 $1132.12 |
$549.58 $605.90 $665.54 $877.44 |
$682.02 $738.34 $797.98 $1009.88 |
$814.46 $870.78 $930.42 $1142.32 |
$341.01 $369.17 $398.99 $504.94 |
$473.45 $501.61 $531.43 $637.38 |
$605.89 $634.05 $663.87 $769.82 |
$132.44 |
Plan: (HMO) IND Silver Standardized HMO 1Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-232-0578 - Provider Directory for This Plan: (Florida Health Care Plan, Inc.)
Deductible: Individual:
$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 |
$273.28 $310.18 $349.26 $488.09 $741.70 |
$546.56 $620.36 $698.52 $976.18 $1483.40 |
$720.10 $793.90 $872.06 $1149.72 |
$893.64 $967.44 $1045.60 $1323.26 |
$1067.18 $1140.98 $1219.14 $1496.80 |
$446.82 $483.72 $522.80 $661.63 |
$620.36 $657.26 $696.34 $835.17 |
$793.90 $830.80 $869.88 $1008.71 |
$173.54 |