Providers for Zip Code 23030

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Obamacare Providers, Plans and 2017 Rates for Charles City 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 Charles City County, Virginia.

Currently, there are 24 plans offered in Charles City 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)

 

Note: If you are over 65, you qualify for Medicare. Click here to see listings of 2017 Medicare Advantage plans for Charles City County

 

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 Charles City, VA 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 Charles City County here.

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Cigna Health and Life Insurance Company

Local: 1-877-900-1237 | Toll Free: 1-877-900-1237

TTY: 1-800-676-3777

Plan: (EPO) Cigna Connect 6400

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-900-1237 - Provider Directory for This Plan: (Cigna Health and Life Insurance Company)

Deductible: Individual: $6,400 : Family: $12,800
Out of Pocket Maximum per year: 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		 $207.87
$235.94
$265.66
$371.26
$564.17		 $415.74
$471.88
$531.32
$742.52
$1128.34		 $547.74
$603.88
$663.32
$874.52		 $679.74
$735.88
$795.32
$1006.52		 $811.74
$867.88
$927.32
$1138.52		 $339.87
$367.94
$397.66
$503.26		 $471.87
$499.94
$529.66
$635.26		 $603.87
$631.94
$661.66
$767.26		 $132.00

Plan: (EPO) Cigna Connect 1200

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-900-1237 - Provider Directory for This Plan: (Cigna Health and Life Insurance Company)

Deductible: Individual: $1,200 : Family: $2,400
Out of Pocket Maximum per year: 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
Gold 21
30
40
50
60		 $315.58
$358.18
$403.31
$563.62
$856.48		 $631.16
$716.36
$806.62
$1127.24
$1712.96		 $831.55
$916.75
$1007.01
$1327.63		 $1031.94
$1117.14
$1207.40
$1528.02		 $1232.33
$1317.53
$1407.79
$1728.41		 $515.97
$558.57
$603.70
$764.01		 $716.36
$758.96
$804.09
$964.40		 $916.75
$959.35
$1004.48
$1164.79		 $200.39
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HealthKeepers, Inc.

Local: 1-855-748-1810 | Toll Free: 1-855-748-1810

Plan: (HMO) Anthem HealthKeepers Catastrophic X 7150

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)

Deductible: Individual: $7,150 : Family: $14,300
Out of Pocket Maximum per year: 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		 $175.37
$199.04
$224.12
$313.21
$475.95		 $350.74
$398.08
$448.24
$626.42
$951.90		 $462.10
$509.44
$559.60
$737.78		 $573.46
$620.80
$670.96
$849.14		 $684.82
$732.16
$782.32
$960.50		 $286.73
$310.40
$335.48
$424.57		 $398.09
$421.76
$446.84
$535.93		 $509.45
$533.12
$558.20
$647.29		 $111.36

Plan: (HMO) Anthem HealthKeepers Bronze X 6200 for HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)

Deductible: Individual: $6,200 : Family: $12,400
Out of Pocket Maximum per year: Individual: $6,550 : Family: $13,100

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $219.30
$248.91
$280.27
$391.67
$595.18		 $438.60
$497.82
$560.54
$783.34
$1190.36		 $577.86
$637.08
$699.80
$922.60		 $717.12
$776.34
$839.06
$1061.86		 $856.38
$915.60
$978.32
$1201.12		 $358.56
$388.17
$419.53
$530.93		 $497.82
$527.43
$558.79
$670.19		 $637.08
$666.69
$698.05
$809.45		 $139.26

Plan: (HMO) Anthem HealthKeepers Bronze X 5900

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)

Deductible: Individual: $5,900 : Family: $11,800
Out of Pocket Maximum per year: 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		 $214.50
$243.46
$274.13
$383.10
$582.15		 $429.00
$486.92
$548.26
$766.20
$1164.30		 $565.21
$623.13
$684.47
$902.41		 $701.42
$759.34
$820.68
$1038.62		 $837.63
$895.55
$956.89
$1174.83		 $350.71
$379.67
$410.34
$519.31		 $486.92
$515.88
$546.55
$655.52		 $623.13
$652.09
$682.76
$791.73		 $136.21

Plan: (HMO) Anthem HealthKeepers Bronze X 5150

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)

Deductible: Individual: $5,150 : Family: $10,300
Out of Pocket Maximum per year: 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		 $217.76
$247.16
$278.30
$388.92
$591.00		 $435.52
$494.32
$556.60
$777.84
$1182.00		 $573.80
$632.60
$694.88
$916.12		 $712.08
$770.88
$833.16
$1054.40		 $850.36
$909.16
$971.44
$1192.68		 $356.04
$385.44
$416.58
$527.20		 $494.32
$523.72
$554.86
$665.48		 $632.60
$662.00
$693.14
$803.76		 $138.28

Plan: (HMO) Anthem HealthKeepers Bronze X 4500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)

Deductible: Individual: $4,500 : Family: $9,000
Out of Pocket Maximum per year: 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		 $228.04
$258.83
$291.44
$407.28
$618.90		 $456.08
$517.66
$582.88
$814.56
$1237.80		 $600.89
$662.47
$727.69
$959.37		 $745.70
$807.28
$872.50
$1104.18		 $890.51
$952.09
$1017.31
$1248.99		 $372.85
$403.64
$436.25
$552.09		 $517.66
$548.45
$581.06
$696.90		 $662.47
$693.26
$725.87
$841.71		 $144.81

Plan: (HMO) Anthem HealthKeepers Bronze X 4900 for HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)

Deductible: Individual: $4,900 : Family: $9,800
Out of Pocket Maximum per year: Individual: $6,550 : Family: $13,100

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $224.15
$254.41
$286.46
$400.33
$608.34		 $448.30
$508.82
$572.92
$800.66
$1216.68		 $590.64
$651.16
$715.26
$943.00		 $732.98
$793.50
$857.60
$1085.34		 $875.32
$935.84
$999.94
$1227.68		 $366.49
$396.75
$428.80
$542.67		 $508.83
$539.09
$571.14
$685.01		 $651.17
$681.43
$713.48
$827.35		 $142.34

Plan: (HMO) Anthem HealthKeepers Gold X 1300

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)

Deductible: Individual: $1,300 : Family: $3,900
Out of Pocket Maximum per year: Individual: $4,800 : Family: $9,600

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $340.43
$386.39
$435.07
$608.01
$923.93		 $680.86
$772.78
$870.14
$1216.02
$1847.86		 $897.03
$988.95
$1086.31
$1432.19		 $1113.20
$1205.12
$1302.48
$1648.36		 $1329.37
$1421.29
$1518.65
$1864.53		 $556.60
$602.56
$651.24
$824.18		 $772.77
$818.73
$867.41
$1040.35		 $988.94
$1034.90
$1083.58
$1256.52		 $216.17

Plan: (HMO) Anthem HealthKeepers Bronze X 6350

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)

Deductible: Individual: $6,350 : Family: $12,700
Out of Pocket Maximum per year: 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		 $211.88
$240.48
$270.78
$378.42
$575.04		 $423.76
$480.96
$541.56
$756.84
$1150.08		 $558.30
$615.50
$676.10
$891.38		 $692.84
$750.04
$810.64
$1025.92		 $827.38
$884.58
$945.18
$1160.46		 $346.42
$375.02
$405.32
$512.96		 $480.96
$509.56
$539.86
$647.50		 $615.50
$644.10
$674.40
$782.04		 $134.54
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Cigna Health and Life Insurance Company

Local: 1-877-900-1237 | Toll Free: 1-877-900-1237

TTY: 1-800-676-3777

Plan: (EPO) Cigna Connect 5750

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-900-1237 - Provider Directory for This Plan: (Cigna Health and Life Insurance Company)

Deductible: Individual: $5,750 : Family: $11,500
Out of Pocket Maximum per year: 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		 $192.34
$218.31
$245.82
$343.53
$522.02		 $384.68
$436.62
$491.64
$687.06
$1044.04		 $506.82
$558.76
$613.78
$809.20		 $628.96
$680.90
$735.92
$931.34		 $751.10
$803.04
$858.06
$1053.48		 $314.48
$340.45
$367.96
$465.67		 $436.62
$462.59
$490.10
$587.81		 $558.76
$584.73
$612.24
$709.95		 $122.14

Plan: (EPO) Cigna US-VA Connect 6650

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-900-1237 - Provider Directory for This Plan: (Cigna Health and Life Insurance Company)

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: 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		 $195.85
$222.29
$250.30
$349.79
$531.54		 $391.70
$444.58
$500.60
$699.58
$1063.08		 $516.06
$568.94
$624.96
$823.94		 $640.42
$693.30
$749.32
$948.30		 $764.78
$817.66
$873.68
$1072.66		 $320.21
$346.65
$374.66
$474.15		 $444.57
$471.01
$499.02
$598.51		 $568.93
$595.37
$623.38
$722.87		 $124.36

Plan: (EPO) Cigna Connect HSA 5000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-900-1237 - Provider Directory for This Plan: (Cigna Health and Life Insurance Company)

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

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $204.05
$231.60
$260.78
$364.44
$553.80		 $408.10
$463.20
$521.56
$728.88
$1107.60		 $537.67
$592.77
$651.13
$858.45		 $667.24
$722.34
$780.70
$988.02		 $796.81
$851.91
$910.27
$1117.59		 $333.62
$361.17
$390.35
$494.01		 $463.19
$490.74
$519.92
$623.58		 $592.76
$620.31
$649.49
$753.15		 $129.57

Plan: (EPO) Cigna Connect 2500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-900-1237 - Provider Directory for This Plan: (Cigna Health and Life Insurance Company)

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $243.65
$276.55
$311.39
$435.16
$661.27		 $487.30
$553.10
$622.78
$870.32
$1322.54		 $642.02
$707.82
$777.50
$1025.04		 $796.74
$862.54
$932.22
$1179.76		 $951.46
$1017.26
$1086.94
$1334.48		 $398.37
$431.27
$466.11
$589.88		 $553.09
$585.99
$620.83
$744.60		 $707.81
$740.71
$775.55
$899.32		 $154.72

Plan: (EPO) Cigna Connect 4500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-900-1237 - Provider Directory for This Plan: (Cigna Health and Life Insurance Company)

Deductible: Individual: $4,500 : Family: $9,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $231.82
$263.11
$296.26
$414.02
$629.15		 $463.64
$526.22
$592.52
$828.04
$1258.30		 $610.84
$673.42
$739.72
$975.24		 $758.04
$820.62
$886.92
$1122.44		 $905.24
$967.82
$1034.12
$1269.64		 $379.02
$410.31
$443.46
$561.22		 $526.22
$557.51
$590.66
$708.42		 $673.42
$704.71
$737.86
$855.62		 $147.20

Plan: (EPO) Cigna Connect 2000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-900-1237 - Provider Directory for This Plan: (Cigna Health and Life Insurance Company)

Deductible: Individual: $2,000 : Family: $4,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $270.90
$307.47
$346.21
$483.83
$735.22		 $541.80
$614.94
$692.42
$967.66
$1470.44		 $713.82
$786.96
$864.44
$1139.68		 $885.84
$958.98
$1036.46
$1311.70		 $1057.86
$1131.00
$1208.48
$1483.72		 $442.92
$479.49
$518.23
$655.85		 $614.94
$651.51
$690.25
$827.87		 $786.96
$823.53
$862.27
$999.89		 $172.02

Plan: (EPO) Cigna US-VA Connect 3500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-900-1237 - Provider Directory for This Plan: (Cigna Health and Life Insurance Company)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $277.90
$315.41
$355.15
$496.33
$754.22		 $555.80
$630.82
$710.30
$992.66
$1508.44		 $732.27
$807.29
$886.77
$1169.13		 $908.74
$983.76
$1063.24
$1345.60		 $1085.21
$1160.23
$1239.71
$1522.07		 $454.37
$491.88
$531.62
$672.80		 $630.84
$668.35
$708.09
$849.27		 $807.31
$844.82
$884.56
$1025.74		 $176.47
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HealthKeepers, Inc.

Local: 1-855-748-1810 | Toll Free: 1-855-748-1810

Plan: (HMO) Anthem HealthKeepers Silver X 3500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $247.49
$280.90
$316.29
$442.02
$671.69		 $494.98
$561.80
$632.58
$884.04
$1343.38		 $652.14
$718.96
$789.74
$1041.20		 $809.30
$876.12
$946.90
$1198.36		 $966.46
$1033.28
$1104.06
$1355.52		 $404.65
$438.06
$473.45
$599.18		 $561.81
$595.22
$630.61
$756.34		 $718.97
$752.38
$787.77
$913.50		 $157.16

Plan: (HMO) Anthem HealthKeepers Silver X 2800

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)

Deductible: Individual: $2,800 : Family: $5,600
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $254.63
$289.01
$325.42
$454.77
$691.07		 $509.26
$578.02
$650.84
$909.54
$1382.14		 $670.95
$739.71
$812.53
$1071.23		 $832.64
$901.40
$974.22
$1232.92		 $994.33
$1063.09
$1135.91
$1394.61		 $416.32
$450.70
$487.11
$616.46		 $578.01
$612.39
$648.80
$778.15		 $739.70
$774.08
$810.49
$939.84		 $161.69

Plan: (HMO) Anthem HealthKeepers Silver X 2300

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)

Deductible: Individual: $2,300 : Family: $4,600
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $264.81
$300.56
$338.43
$472.95
$718.69		 $529.62
$601.12
$676.86
$945.90
$1437.38		 $697.77
$769.27
$845.01
$1114.05		 $865.92
$937.42
$1013.16
$1282.20		 $1034.07
$1105.57
$1181.31
$1450.35		 $432.96
$468.71
$506.58
$641.10		 $601.11
$636.86
$674.73
$809.25		 $769.26
$805.01
$842.88
$977.40		 $168.15

Plan: (HMO) Anthem HealthKeepers Bronze X 5750 for HSA

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)

Deductible: Individual: $5,750 : Family: $11,500
Out of Pocket Maximum per year: Individual: $6,550 : Family: $13,100

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $226.28
$256.83
$289.19
$404.14
$614.12		 $452.56
$513.66
$578.38
$808.28
$1228.24		 $596.25
$657.35
$722.07
$951.97		 $739.94
$801.04
$865.76
$1095.66		 $883.63
$944.73
$1009.45
$1239.35		 $369.97
$400.52
$432.88
$547.83		 $513.66
$544.21
$576.57
$691.52		 $657.35
$687.90
$720.26
$835.21		 $143.69

Plan: (HMO) Anthem HealthKeepers Silver X 5000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $237.11
$269.12
$303.03
$423.48
$643.52		 $474.22
$538.24
$606.06
$846.96
$1287.04		 $624.78
$688.80
$756.62
$997.52		 $775.34
$839.36
$907.18
$1148.08		 $925.90
$989.92
$1057.74
$1298.64		 $387.67
$419.68
$453.59
$574.04		 $538.23
$570.24
$604.15
$724.60		 $688.79
$720.80
$754.71
$875.16		 $150.56

Plan: (HMO) Anthem HealthKeepers Silver, a Blue Cross and Blue Shield Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)

Deductible: Individual: $1,800 : Family: $3,600
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60		 $266.62
$302.61
$340.74
$476.18
$723.61		 $533.24
$605.22
$681.48
$952.36
$1447.22		 $702.54
$774.52
$850.78
$1121.66		 $871.84
$943.82
$1020.08
$1290.96		 $1041.14
$1113.12
$1189.38
$1460.26		 $435.92
$471.91
$510.04
$645.48		 $605.22
$641.21
$679.34
$814.78		 $774.52
$810.51
$848.64
$984.08		 $169.30

Plan: (HMO) Anthem HealthKeepers Gold, a Blue Cross and Blue Shield Multi-State Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-855-748-1810 - Provider Directory for This Plan: (HealthKeepers, Inc.)

Deductible: Individual: $1,000 : Family: $3,000
Out of Pocket Maximum per year: Individual: $5,000 : Family: $10,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $341.56
$387.67
$436.51
$610.03
$926.99		 $683.12
$775.34
$873.02
$1220.06
$1853.98		 $900.01
$992.23
$1089.91
$1436.95		 $1116.90
$1209.12
$1306.80
$1653.84		 $1333.79
$1426.01
$1523.69
$1870.73		 $558.45
$604.56
$653.40
$826.92		 $775.34
$821.45
$870.29
$1043.81		 $992.23
$1038.34
$1087.18
$1260.70		 $216.89

 

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