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Providers for Zip Code 44646

Obamacare 2018 Marketplace Rates For Stark County, Ohio

Wednesday, April 24th, 2024


The health insurance rates listed below are for calendar year 2018.

2018 Rates and Providers

(click here for 2014)

(click here for 2015)

(click here for 2016)

(click here for 2017)

This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for Stark County, Ohio.

Obamacare Providers, Plans and 2018 Rates for Stark County

Stark County is in “Rating Area 15” of Ohio.

Currently, there are 85 plans offered in Rating Area 15.

Below, you’ll find a summary of plans and rates for each of these providers. This chart is designed to give you a preview of your health insurance options. For detailed information on available subsidies to make your coverage affordable, you must complete an application at HealthCare.gov or contact the provider directly.

The table below shows premiums for the following scenarios for:

  • Individual
  • Couple
  • Couple with 1 2 or 3 children
  • Individual with 1 2 or 3 children
  • A child alone

Each scenario is covered for age

  • Age 21, 30, 40, 50
  • Age 60 (Individual and Couple only)

For each plan, there are links that go to the insurance provider's website in a new window. You can find links to:

  • a summary of plan benefits and costs,
  • a plan brochure, and
  • a "Provider Directory" -- where you can find out which doctors and hospitals in the Massillon, OH area accept this insurance coverage as within the plan's "network".
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AultCare Insurance Company

Local: 1-330-363-6360 | Toll Free: 1-800-344-8858

TTY: 1-330-363-2393

Plan: (PPO) AultCare Bronze 5000 No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare 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
$317.43
$360.28
$405.68
$566.93
$861.51
$634.86
$720.56
$811.36
$1,133.86
$1,723.02
$877.69
$963.39
$1,054.19
$1,376.69
$1,120.52
$1,206.22
$1,297.02
$1,619.52
$1,363.35
$1,449.05
$1,539.85
$1,862.35
$560.26
$603.11
$648.51
$809.76
$803.09
$845.94
$891.34
$1,052.59
$1,045.92
$1,088.77
$1,134.17
$1,295.42
$242.83

Plan: (PPO) AultCare Gold 750 No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $750 : Family: $1,500
Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$518.55
$588.55
$662.70
$926.12
$1,407.34
$1,037.10
$1,177.10
$1,325.40
$1,852.24
$2,814.68
$1,433.79
$1,573.79
$1,722.09
$2,248.93
$1,830.48
$1,970.48
$2,118.78
$2,645.62
$2,227.17
$2,367.17
$2,515.47
$3,042.31
$915.24
$985.24
$1,059.39
$1,322.81
$1,311.93
$1,381.93
$1,456.08
$1,719.50
$1,708.62
$1,778.62
$1,852.77
$2,116.19
$396.69

Plan: (PPO) AultCare Gold 350 No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $350 : Family: $700
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$536.66
$609.11
$685.85
$958.47
$1,456.49
$1,073.32
$1,218.22
$1,371.70
$1,916.94
$2,912.98
$1,483.86
$1,628.76
$1,782.24
$2,327.48
$1,894.40
$2,039.30
$2,192.78
$2,738.02
$2,304.94
$2,449.84
$2,603.32
$3,148.56
$947.20
$1,019.65
$1,096.39
$1,369.01
$1,357.74
$1,430.19
$1,506.93
$1,779.55
$1,768.28
$1,840.73
$1,917.47
$2,190.09
$410.54

Plan: (PPO) AultCare Catastrophic Select

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $7,350 : Family: $14,700
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Catastrophic 21
30
40
50
60
$185.52
$210.57
$237.10
$331.34
$503.51
$371.04
$421.14
$474.20
$662.68
$1,007.02
$512.96
$563.06
$616.12
$804.60
$654.88
$704.98
$758.04
$946.52
$796.80
$846.90
$899.96
$1,088.44
$327.44
$352.49
$379.02
$473.26
$469.36
$494.41
$520.94
$615.18
$611.28
$636.33
$662.86
$757.10
$141.92

Plan: (PPO) AultCare Bronze 6000 Select

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $6,000 : Family: $12,000
Out of Pocket Maximum per year: Individual: $6,400 : Family: $12,800

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$251.90
$285.91
$321.93
$449.89
$683.66
$503.80
$571.82
$643.86
$899.78
$1,367.32
$696.50
$764.52
$836.56
$1,092.48
$889.20
$957.22
$1,029.26
$1,285.18
$1,081.90
$1,149.92
$1,221.96
$1,477.88
$444.60
$478.61
$514.63
$642.59
$637.30
$671.31
$707.33
$835.29
$830.00
$864.01
$900.03
$1,027.99
$192.70

Plan: (PPO) AultCare Bronze 5000 Select

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare 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
$259.40
$294.42
$331.51
$463.29
$704.01
$518.80
$588.84
$663.02
$926.58
$1,408.02
$717.24
$787.28
$861.46
$1,125.02
$915.68
$985.72
$1,059.90
$1,323.46
$1,114.12
$1,184.16
$1,258.34
$1,521.90
$457.84
$492.86
$529.95
$661.73
$656.28
$691.30
$728.39
$860.17
$854.72
$889.74
$926.83
$1,058.61
$198.44

Plan: (PPO) AultCare Gold 750 Select

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $750 : Family: $1,500
Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$423.47
$480.64
$541.20
$756.32
$1,149.30
$846.94
$961.28
$1,082.40
$1,512.64
$2,298.60
$1,170.89
$1,285.23
$1,406.35
$1,836.59
$1,494.84
$1,609.18
$1,730.30
$2,160.54
$1,818.79
$1,933.13
$2,054.25
$2,484.49
$747.42
$804.59
$865.15
$1,080.27
$1,071.37
$1,128.54
$1,189.10
$1,404.22
$1,395.32
$1,452.49
$1,513.05
$1,728.17
$323.95

Plan: (PPO) AultCare Gold 350 Select

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $350 : Family: $700
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$438.33
$497.51
$560.19
$782.86
$1,189.63
$876.66
$995.02
$1,120.38
$1,565.72
$2,379.26
$1,211.98
$1,330.34
$1,455.70
$1,901.04
$1,547.30
$1,665.66
$1,791.02
$2,236.36
$1,882.62
$2,000.98
$2,126.34
$2,571.68
$773.65
$832.83
$895.51
$1,118.18
$1,108.97
$1,168.15
$1,230.83
$1,453.50
$1,444.29
$1,503.47
$1,566.15
$1,788.82
$335.32

Plan: (PPO) AultCare Catastrophic

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $7,350 : Family: $14,700
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Catastrophic 21
30
40
50
60
$228.19
$259.00
$291.63
$407.55
$619.31
$456.38
$518.00
$583.26
$815.10
$1,238.62
$630.95
$692.57
$757.83
$989.67
$805.52
$867.14
$932.40
$1,164.24
$980.09
$1,041.71
$1,106.97
$1,338.81
$402.76
$433.57
$466.20
$582.12
$577.33
$608.14
$640.77
$756.69
$751.90
$782.71
$815.34
$931.26
$174.57

Plan: (PPO) AultCare Bronze 6000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $6,000 : Family: $12,000
Out of Pocket Maximum per year: Individual: $6,400 : Family: $12,800

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$309.84
$351.66
$395.97
$553.37
$840.90
$619.68
$703.32
$791.94
$1,106.74
$1,681.80
$856.70
$940.34
$1,028.96
$1,343.76
$1,093.72
$1,177.36
$1,265.98
$1,580.78
$1,330.74
$1,414.38
$1,503.00
$1,817.80
$546.86
$588.68
$632.99
$790.39
$783.88
$825.70
$870.01
$1,027.41
$1,020.90
$1,062.72
$1,107.03
$1,264.43
$237.02

Plan: (PPO) AultCare Bronze 5000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare 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
$319.06
$362.13
$407.76
$569.84
$865.93
$638.12
$724.26
$815.52
$1,139.68
$1,731.86
$882.20
$968.34
$1,059.60
$1,383.76
$1,126.28
$1,212.42
$1,303.68
$1,627.84
$1,370.36
$1,456.50
$1,547.76
$1,871.92
$563.14
$606.21
$651.84
$813.92
$807.22
$850.29
$895.92
$1,058.00
$1,051.30
$1,094.37
$1,140.00
$1,302.08
$244.08

Plan: (PPO) AultCare Gold 350

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $350 : Family: $700
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$539.15
$611.93
$689.03
$962.92
$1,463.25
$1,078.30
$1,223.86
$1,378.06
$1,925.84
$2,926.50
$1,490.75
$1,636.31
$1,790.51
$2,338.29
$1,903.20
$2,048.76
$2,202.96
$2,750.74
$2,315.65
$2,461.21
$2,615.41
$3,163.19
$951.60
$1,024.38
$1,101.48
$1,375.37
$1,364.05
$1,436.83
$1,513.93
$1,787.82
$1,776.50
$1,849.28
$1,926.38
$2,200.27
$412.45

Plan: (PPO) AultCare Catastrophic No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $7,350 : Family: $14,700
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Catastrophic 21
30
40
50
60
$227.12
$257.78
$290.25
$405.63
$616.39
$454.24
$515.56
$580.50
$811.26
$1,232.78
$627.98
$689.30
$754.24
$985.00
$801.72
$863.04
$927.98
$1,158.74
$975.46
$1,036.78
$1,101.72
$1,332.48
$400.86
$431.52
$463.99
$579.37
$574.60
$605.26
$637.73
$753.11
$748.34
$779.00
$811.47
$926.85
$173.74

Plan: (PPO) AultCare Gold 350 Select No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $350 : Family: $700
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$436.31
$495.21
$557.60
$779.24
$1,184.14
$872.62
$990.42
$1,115.20
$1,558.48
$2,368.28
$1,206.39
$1,324.19
$1,448.97
$1,892.25
$1,540.16
$1,657.96
$1,782.74
$2,226.02
$1,873.93
$1,991.73
$2,116.51
$2,559.79
$770.08
$828.98
$891.37
$1,113.01
$1,103.85
$1,162.75
$1,225.14
$1,446.78
$1,437.62
$1,496.52
$1,558.91
$1,780.55
$333.77

Plan: (PPO) AultCare Gold 750 Select No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $750 : Family: $1,500
Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$421.58
$478.50
$538.78
$752.95
$1,144.18
$843.16
$957.00
$1,077.56
$1,505.90
$2,288.36
$1,165.67
$1,279.51
$1,400.07
$1,828.41
$1,488.18
$1,602.02
$1,722.58
$2,150.92
$1,810.69
$1,924.53
$2,045.09
$2,473.43
$744.09
$801.01
$861.29
$1,075.46
$1,066.60
$1,123.52
$1,183.80
$1,397.97
$1,389.11
$1,446.03
$1,506.31
$1,720.48
$322.51

Plan: (PPO) AultCare Gold 1200 Select No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $1,200 : Family: $2,400
Out of Pocket Maximum per year: Individual: $5,700 : Family: $11,400

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
Gold 21
30
40
50
60
$422.88
$479.96
$540.43
$755.26
$1,147.68
$845.76
$959.92
$1,080.86
$1,510.52
$2,295.36
$1,169.26
$1,283.42
$1,404.36
$1,834.02
$1,492.76
$1,606.92
$1,727.86
$2,157.52
$1,816.26
$1,930.42
$2,051.36
$2,481.02
$746.38
$803.46
$863.93
$1,078.76
$1,069.88
$1,126.96
$1,187.43
$1,402.26
$1,393.38
$1,450.46
$1,510.93
$1,725.76
$323.50

Plan: (PPO) AultCare Bronze 6000 Select No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $6,000 : Family: $12,000
Out of Pocket Maximum per year: Individual: $6,400 : Family: $12,800

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$250.66
$284.50
$320.35
$447.68
$680.30
$501.32
$569.00
$640.70
$895.36
$1,360.60
$693.08
$760.76
$832.46
$1,087.12
$884.84
$952.52
$1,024.22
$1,278.88
$1,076.60
$1,144.28
$1,215.98
$1,470.64
$442.42
$476.26
$512.11
$639.44
$634.18
$668.02
$703.87
$831.20
$825.94
$859.78
$895.63
$1,022.96
$191.76

Plan: (PPO) AultCare Catastrophic Select No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $7,350 : Family: $14,700
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Catastrophic 21
30
40
50
60
$184.65
$209.57
$235.98
$329.78
$501.13
$369.30
$419.14
$471.96
$659.56
$1,002.26
$510.55
$560.39
$613.21
$800.81
$651.80
$701.64
$754.46
$942.06
$793.05
$842.89
$895.71
$1,083.31
$325.90
$350.82
$377.23
$471.03
$467.15
$492.07
$518.48
$612.28
$608.40
$633.32
$659.73
$753.53
$141.25

Plan: (PPO) AultCare Bronze 6550

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $6,550 : Family: $13,100
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
$304.66
$345.79
$389.35
$544.12
$826.85
$609.32
$691.58
$778.70
$1,088.24
$1,653.70
$842.38
$924.64
$1,011.76
$1,321.30
$1,075.44
$1,157.70
$1,244.82
$1,554.36
$1,308.50
$1,390.76
$1,477.88
$1,787.42
$537.72
$578.85
$622.41
$777.18
$770.78
$811.91
$855.47
$1,010.24
$1,003.84
$1,044.97
$1,088.53
$1,243.30
$233.06

Plan: (PPO) AultCare Bronze 6550 Select

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $6,550 : Family: $13,100
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
$247.69
$281.13
$316.55
$442.38
$672.23
$495.38
$562.26
$633.10
$884.76
$1,344.46
$684.86
$751.74
$822.58
$1,074.24
$874.34
$941.22
$1,012.06
$1,263.72
$1,063.82
$1,130.70
$1,201.54
$1,453.20
$437.17
$470.61
$506.03
$631.86
$626.65
$660.09
$695.51
$821.34
$816.13
$849.57
$884.99
$1,010.82
$189.48

Plan: (PPO) AultCare Bronze 6550 No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $6,550 : Family: $13,100
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
$303.19
$344.12
$387.48
$541.50
$822.85
$606.38
$688.24
$774.96
$1,083.00
$1,645.70
$838.32
$920.18
$1,006.90
$1,314.94
$1,070.26
$1,152.12
$1,238.84
$1,546.88
$1,302.20
$1,384.06
$1,470.78
$1,778.82
$535.13
$576.06
$619.42
$773.44
$767.07
$808.00
$851.36
$1,005.38
$999.01
$1,039.94
$1,083.30
$1,237.32
$231.94

Plan: (PPO) AultCare Bronze 6550 Select No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $6,550 : Family: $13,100
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
$246.49
$279.77
$315.02
$440.24
$668.99
$492.98
$559.54
$630.04
$880.48
$1,337.98
$681.55
$748.11
$818.61
$1,069.05
$870.12
$936.68
$1,007.18
$1,257.62
$1,058.69
$1,125.25
$1,195.75
$1,446.19
$435.06
$468.34
$503.59
$628.81
$623.63
$656.91
$692.16
$817.38
$812.20
$845.48
$880.73
$1,005.95
$188.57

Plan: (PPO) AultCare Bronze Standard Select No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

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
Expanded Bronze 21
30
40
50
60
$269.29
$305.64
$344.15
$480.95
$730.85
$538.58
$611.28
$688.30
$961.90
$1,461.70
$744.59
$817.29
$894.31
$1,167.91
$950.60
$1,023.30
$1,100.32
$1,373.92
$1,156.61
$1,229.31
$1,306.33
$1,579.93
$475.30
$511.65
$550.16
$686.96
$681.31
$717.66
$756.17
$892.97
$887.32
$923.67
$962.18
$1,098.98
$206.01

Plan: (PPO) AultCare Bronze 7350

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $7,350 : Family: $14,700
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

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
$286.98
$325.72
$366.76
$512.54
$778.86
$573.96
$651.44
$733.52
$1,025.08
$1,557.72
$793.50
$870.98
$953.06
$1,244.62
$1,013.04
$1,090.52
$1,172.60
$1,464.16
$1,232.58
$1,310.06
$1,392.14
$1,683.70
$506.52
$545.26
$586.30
$732.08
$726.06
$764.80
$805.84
$951.62
$945.60
$984.34
$1,025.38
$1,171.16
$219.54

Plan: (PPO) AultCare Bronze 7350 Select

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $7,350 : Family: $14,700
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

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
$233.32
$264.81
$298.18
$416.70
$633.22
$466.64
$529.62
$596.36
$833.40
$1,266.44
$645.13
$708.11
$774.85
$1,011.89
$823.62
$886.60
$953.34
$1,190.38
$1,002.11
$1,065.09
$1,131.83
$1,368.87
$411.81
$443.30
$476.67
$595.19
$590.30
$621.79
$655.16
$773.68
$768.79
$800.28
$833.65
$952.17
$178.49

Plan: (PPO) AultCare Bronze 7350 No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $7,350 : Family: $14,700
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

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
$285.60
$324.16
$365.00
$510.09
$775.13
$571.20
$648.32
$730.00
$1,020.18
$1,550.26
$789.69
$866.81
$948.49
$1,238.67
$1,008.18
$1,085.30
$1,166.98
$1,457.16
$1,226.67
$1,303.79
$1,385.47
$1,675.65
$504.09
$542.65
$583.49
$728.58
$722.58
$761.14
$801.98
$947.07
$941.07
$979.63
$1,020.47
$1,165.56
$218.49

Plan: (PPO) AultCare Bronze 7350 Select No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $7,350 : Family: $14,700
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

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
$232.20
$263.54
$296.75
$414.71
$630.19
$464.40
$527.08
$593.50
$829.42
$1,260.38
$642.03
$704.71
$771.13
$1,007.05
$819.66
$882.34
$948.76
$1,184.68
$997.29
$1,059.97
$1,126.39
$1,362.31
$409.83
$441.17
$474.38
$592.34
$587.46
$618.80
$652.01
$769.97
$765.09
$796.43
$829.64
$947.60
$177.63
ADVERTISEMENT

Buckeye Community Health Plan

Local: 1-877-687-1189 | Toll Free: 1-877-687-1189

TTY: 1-877-941-9236

Plan: (HMO) Ambetter Secure Care 1 (2018) with 3 Free PCP Visits

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$295.84
$335.77
$378.07
$528.35
$802.89
$591.68
$671.54
$756.14
$1,056.70
$1,605.78
$817.99
$897.85
$982.45
$1,283.01
$1,044.30
$1,124.16
$1,208.76
$1,509.32
$1,270.61
$1,350.47
$1,435.07
$1,735.63
$522.15
$562.08
$604.38
$754.66
$748.46
$788.39
$830.69
$980.97
$974.77
$1,014.70
$1,057.00
$1,207.28
$226.31
ADVERTISEMENT

Summa Insurance Company, Inc.

Local: 1-330-996-8675 | Toll Free: 1-888-996-8675

TTY: 1-800-750-0750

Plan: (PPO) SummaCare Bronze 5000 HSA with SCConnect Network

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-996-8675 - Provider Directory for This Plan: (Summa Insurance Company, Inc.)

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

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$272.16
$308.89
$347.80
$486.05
$738.60
$544.32
$617.78
$695.60
$972.10
$1,477.20
$752.51
$825.97
$903.79
$1,180.29
$960.70
$1,034.16
$1,111.98
$1,388.48
$1,168.89
$1,242.35
$1,320.17
$1,596.67
$480.35
$517.08
$555.99
$694.24
$688.54
$725.27
$764.18
$902.43
$896.73
$933.46
$972.37
$1,110.62
$208.19
ADVERTISEMENT

Molina Healthcare of Ohio, Inc.

Local: 1-888-296-7677 | Toll Free: 1-888-296-7677

Plan: (HMO) Molina Marketplace Gold Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-296-7677 - Provider Directory for This Plan: (Molina Healthcare of Ohio, Inc.)

Deductible: Individual: $3,800 : Family: $7,600
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$310.18
$352.06
$396.41
$553.98
$841.83
$620.36
$704.12
$792.82
$1,107.96
$1,683.66
$857.65
$941.41
$1,030.11
$1,345.25
$1,094.94
$1,178.70
$1,267.40
$1,582.54
$1,332.23
$1,415.99
$1,504.69
$1,819.83
$547.47
$589.35
$633.70
$791.27
$784.76
$826.64
$870.99
$1,028.56
$1,022.05
$1,063.93
$1,108.28
$1,265.85
$237.29
ADVERTISEMENT

AultCare Insurance Company

Local: 1-330-363-6360 | Toll Free: 1-800-344-8858

TTY: 1-330-363-2393

Plan: (PPO) AultCare Bronze 6000 No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $6,000 : Family: $12,000
Out of Pocket Maximum per year: Individual: $6,400 : Family: $12,800

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Bronze 21
30
40
50
60
$308.31
$349.94
$394.03
$550.65
$836.77
$616.62
$699.88
$788.06
$1,101.30
$1,673.54
$852.48
$935.74
$1,023.92
$1,337.16
$1,088.34
$1,171.60
$1,259.78
$1,573.02
$1,324.20
$1,407.46
$1,495.64
$1,808.88
$544.17
$585.80
$629.89
$786.51
$780.03
$821.66
$865.75
$1,022.37
$1,015.89
$1,057.52
$1,101.61
$1,258.23
$235.86

Plan: (PPO) AultCare Silver 5000 No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$458.98
$520.94
$586.58
$819.74
$1,245.67
$917.96
$1,041.88
$1,173.16
$1,639.48
$2,491.34
$1,269.08
$1,393.00
$1,524.28
$1,990.60
$1,620.20
$1,744.12
$1,875.40
$2,341.72
$1,971.32
$2,095.24
$2,226.52
$2,692.84
$810.10
$872.06
$937.70
$1,170.86
$1,161.22
$1,223.18
$1,288.82
$1,521.98
$1,512.34
$1,574.30
$1,639.94
$1,873.10
$351.12

Plan: (PPO) AultCare Silver 3000 No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $3,000 : Family: $6,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$495.49
$562.38
$633.23
$884.94
$1,344.76
$990.98
$1,124.76
$1,266.46
$1,769.88
$2,689.52
$1,370.03
$1,503.81
$1,645.51
$2,148.93
$1,749.08
$1,882.86
$2,024.56
$2,527.98
$2,128.13
$2,261.91
$2,403.61
$2,907.03
$874.54
$941.43
$1,012.28
$1,263.99
$1,253.59
$1,320.48
$1,391.33
$1,643.04
$1,632.64
$1,699.53
$1,770.38
$2,022.09
$379.05

Plan: (PPO) AultCare Silver 2500 No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$505.53
$573.78
$646.07
$902.88
$1,372.02
$1,011.06
$1,147.56
$1,292.14
$1,805.76
$2,744.04
$1,397.79
$1,534.29
$1,678.87
$2,192.49
$1,784.52
$1,921.02
$2,065.60
$2,579.22
$2,171.25
$2,307.75
$2,452.33
$2,965.95
$892.26
$960.51
$1,032.80
$1,289.61
$1,278.99
$1,347.24
$1,419.53
$1,676.34
$1,665.72
$1,733.97
$1,806.26
$2,063.07
$386.73

Plan: (PPO) AultCare Gold 1200 No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $1,200 : Family: $2,400
Out of Pocket Maximum per year: Individual: $5,700 : Family: $11,400

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
Gold 21
30
40
50
60
$520.14
$590.36
$664.73
$928.96
$1,411.65
$1,040.28
$1,180.72
$1,329.46
$1,857.92
$2,823.30
$1,438.18
$1,578.62
$1,727.36
$2,255.82
$1,836.08
$1,976.52
$2,125.26
$2,653.72
$2,233.98
$2,374.42
$2,523.16
$3,051.62
$918.04
$988.26
$1,062.63
$1,326.86
$1,315.94
$1,386.16
$1,460.53
$1,724.76
$1,713.84
$1,784.06
$1,858.43
$2,122.66
$397.90

Plan: (PPO) AultCare Silver 5000 Select

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$375.00
$425.62
$479.25
$669.75
$1,017.75
$750.00
$851.24
$958.50
$1,339.50
$2,035.50
$1,036.87
$1,138.11
$1,245.37
$1,626.37
$1,323.74
$1,424.98
$1,532.24
$1,913.24
$1,610.61
$1,711.85
$1,819.11
$2,200.11
$661.87
$712.49
$766.12
$956.62
$948.74
$999.36
$1,052.99
$1,243.49
$1,235.61
$1,286.23
$1,339.86
$1,530.36
$286.87

Plan: (PPO) AultCare Silver 3000 Select

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $3,000 : Family: $6,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$404.82
$459.47
$517.36
$723.01
$1,098.68
$809.64
$918.94
$1,034.72
$1,446.02
$2,197.36
$1,119.33
$1,228.63
$1,344.41
$1,755.71
$1,429.02
$1,538.32
$1,654.10
$2,065.40
$1,738.71
$1,848.01
$1,963.79
$2,375.09
$714.51
$769.16
$827.05
$1,032.70
$1,024.20
$1,078.85
$1,136.74
$1,342.39
$1,333.89
$1,388.54
$1,446.43
$1,652.08
$309.69

Plan: (PPO) AultCare Silver 2500 Select

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$412.96
$468.71
$527.76
$737.54
$1,120.77
$825.92
$937.42
$1,055.52
$1,475.08
$2,241.54
$1,141.83
$1,253.33
$1,371.43
$1,790.99
$1,457.74
$1,569.24
$1,687.34
$2,106.90
$1,773.65
$1,885.15
$2,003.25
$2,422.81
$728.87
$784.62
$843.67
$1,053.45
$1,044.78
$1,100.53
$1,159.58
$1,369.36
$1,360.69
$1,416.44
$1,475.49
$1,685.27
$315.91

Plan: (PPO) AultCare Gold 1200 Select

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $1,200 : Family: $2,400
Out of Pocket Maximum per year: Individual: $5,700 : Family: $11,400

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
Gold 21
30
40
50
60
$424.71
$482.05
$542.79
$758.54
$1,152.68
$849.42
$964.10
$1,085.58
$1,517.08
$2,305.36
$1,174.33
$1,289.01
$1,410.49
$1,841.99
$1,499.24
$1,613.92
$1,735.40
$2,166.90
$1,824.15
$1,938.83
$2,060.31
$2,491.81
$749.62
$806.96
$867.70
$1,083.45
$1,074.53
$1,131.87
$1,192.61
$1,408.36
$1,399.44
$1,456.78
$1,517.52
$1,733.27
$324.91

Plan: (PPO) AultCare Silver 5000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$461.25
$523.52
$589.48
$823.79
$1,251.83
$922.50
$1,047.04
$1,178.96
$1,647.58
$2,503.66
$1,275.36
$1,399.90
$1,531.82
$2,000.44
$1,628.22
$1,752.76
$1,884.68
$2,353.30
$1,981.08
$2,105.62
$2,237.54
$2,706.16
$814.11
$876.38
$942.34
$1,176.65
$1,166.97
$1,229.24
$1,295.20
$1,529.51
$1,519.83
$1,582.10
$1,648.06
$1,882.37
$352.86

Plan: (PPO) AultCare Silver 3000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $3,000 : Family: $6,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$497.93
$565.15
$636.35
$889.30
$1,351.38
$995.86
$1,130.30
$1,272.70
$1,778.60
$2,702.76
$1,376.78
$1,511.22
$1,653.62
$2,159.52
$1,757.70
$1,892.14
$2,034.54
$2,540.44
$2,138.62
$2,273.06
$2,415.46
$2,921.36
$878.85
$946.07
$1,017.27
$1,270.22
$1,259.77
$1,326.99
$1,398.19
$1,651.14
$1,640.69
$1,707.91
$1,779.11
$2,032.06
$380.92

Plan: (PPO) AultCare Silver 2500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$507.94
$576.51
$649.14
$907.18
$1,378.54
$1,015.88
$1,153.02
$1,298.28
$1,814.36
$2,757.08
$1,404.45
$1,541.59
$1,686.85
$2,202.93
$1,793.02
$1,930.16
$2,075.42
$2,591.50
$2,181.59
$2,318.73
$2,463.99
$2,980.07
$896.51
$965.08
$1,037.71
$1,295.75
$1,285.08
$1,353.65
$1,426.28
$1,684.32
$1,673.65
$1,742.22
$1,814.85
$2,072.89
$388.57

Plan: (PPO) AultCare Gold 1200

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $1,200 : Family: $2,400
Out of Pocket Maximum per year: Individual: $5,700 : Family: $11,400

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
Gold 21
30
40
50
60
$522.40
$592.92
$667.63
$933.00
$1,417.79
$1,044.80
$1,185.84
$1,335.26
$1,866.00
$2,835.58
$1,444.44
$1,585.48
$1,734.90
$2,265.64
$1,844.08
$1,985.12
$2,134.54
$2,665.28
$2,243.72
$2,384.76
$2,534.18
$3,064.92
$922.04
$992.56
$1,067.27
$1,332.64
$1,321.68
$1,392.20
$1,466.91
$1,732.28
$1,721.32
$1,791.84
$1,866.55
$2,131.92
$399.64

Plan: (PPO) AultCare Gold 750

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $750 : Family: $1,500
Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$520.87
$591.19
$665.67
$930.27
$1,413.64
$1,041.74
$1,182.38
$1,331.34
$1,860.54
$2,827.28
$1,440.20
$1,580.84
$1,729.80
$2,259.00
$1,838.66
$1,979.30
$2,128.26
$2,657.46
$2,237.12
$2,377.76
$2,526.72
$3,055.92
$919.33
$989.65
$1,064.13
$1,328.73
$1,317.79
$1,388.11
$1,462.59
$1,727.19
$1,716.25
$1,786.57
$1,861.05
$2,125.65
$398.46

Plan: (PPO) AultCare Silver 2500 Select No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$411.00
$466.49
$525.26
$734.05
$1,115.46
$822.00
$932.98
$1,050.52
$1,468.10
$2,230.92
$1,136.42
$1,247.40
$1,364.94
$1,782.52
$1,450.84
$1,561.82
$1,679.36
$2,096.94
$1,765.26
$1,876.24
$1,993.78
$2,411.36
$725.42
$780.91
$839.68
$1,048.47
$1,039.84
$1,095.33
$1,154.10
$1,362.89
$1,354.26
$1,409.75
$1,468.52
$1,677.31
$314.42

Plan: (PPO) AultCare Silver 3000 Select No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $3,000 : Family: $6,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$402.84
$457.22
$514.83
$719.47
$1,093.30
$805.68
$914.44
$1,029.66
$1,438.94
$2,186.60
$1,113.85
$1,222.61
$1,337.83
$1,747.11
$1,422.02
$1,530.78
$1,646.00
$2,055.28
$1,730.19
$1,838.95
$1,954.17
$2,363.45
$711.01
$765.39
$823.00
$1,027.64
$1,019.18
$1,073.56
$1,131.17
$1,335.81
$1,327.35
$1,381.73
$1,439.34
$1,643.98
$308.17

Plan: (PPO) AultCare Silver 5000 Select No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $6,000 : Family: $12,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$373.15
$423.53
$476.89
$666.45
$1,012.74
$746.30
$847.06
$953.78
$1,332.90
$2,025.48
$1,031.76
$1,132.52
$1,239.24
$1,618.36
$1,317.22
$1,417.98
$1,524.70
$1,903.82
$1,602.68
$1,703.44
$1,810.16
$2,189.28
$658.61
$708.99
$762.35
$951.91
$944.07
$994.45
$1,047.81
$1,237.37
$1,229.53
$1,279.91
$1,333.27
$1,522.83
$285.46

Plan: (PPO) AultCare Bronze 5000 Select No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare 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
$258.07
$292.91
$329.82
$460.92
$700.41
$516.14
$585.82
$659.64
$921.84
$1,400.82
$713.57
$783.25
$857.07
$1,119.27
$911.00
$980.68
$1,054.50
$1,316.70
$1,108.43
$1,178.11
$1,251.93
$1,514.13
$455.50
$490.34
$527.25
$658.35
$652.93
$687.77
$724.68
$855.78
$850.36
$885.20
$922.11
$1,053.21
$197.43

Plan: (PPO) AultCare Silver 6850

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $6,850 : Family: $13,700
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$401.87
$456.12
$513.59
$717.74
$1,090.67
$803.74
$912.24
$1,027.18
$1,435.48
$2,181.34
$1,111.17
$1,219.67
$1,334.61
$1,742.91
$1,418.60
$1,527.10
$1,642.04
$2,050.34
$1,726.03
$1,834.53
$1,949.47
$2,357.77
$709.30
$763.55
$821.02
$1,025.17
$1,016.73
$1,070.98
$1,128.45
$1,332.60
$1,324.16
$1,378.41
$1,435.88
$1,640.03
$307.43

Plan: (PPO) AultCare Silver 6850 Select

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $6,850 : Family: $13,700
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$326.72
$370.83
$417.55
$583.53
$886.72
$653.44
$741.66
$835.10
$1,167.06
$1,773.44
$903.38
$991.60
$1,085.04
$1,417.00
$1,153.32
$1,241.54
$1,334.98
$1,666.94
$1,403.26
$1,491.48
$1,584.92
$1,916.88
$576.66
$620.77
$667.49
$833.47
$826.60
$870.71
$917.43
$1,083.41
$1,076.54
$1,120.65
$1,167.37
$1,333.35
$249.94

Plan: (PPO) AultCare Silver 6850 No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $6,850 : Family: $13,700
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$399.83
$453.80
$510.98
$714.09
$1,085.13
$799.66
$907.60
$1,021.96
$1,428.18
$2,170.26
$1,105.53
$1,213.47
$1,327.83
$1,734.05
$1,411.40
$1,519.34
$1,633.70
$2,039.92
$1,717.27
$1,825.21
$1,939.57
$2,345.79
$705.70
$759.67
$816.85
$1,019.96
$1,011.57
$1,065.54
$1,122.72
$1,325.83
$1,317.44
$1,371.41
$1,428.59
$1,631.70
$305.87

Plan: (PPO) AultCare Silver 6850 Select No Pediatric Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-344-8858 - Provider Directory for This Plan: (AultCare Insurance Company)

Deductible: Individual: $6,850 : Family: $13,700
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$325.06
$368.94
$415.43
$580.56
$882.22
$650.12
$737.88
$830.86
$1,161.12
$1,764.44
$898.79
$986.55
$1,079.53
$1,409.79
$1,147.46
$1,235.22
$1,328.20
$1,658.46
$1,396.13
$1,483.89
$1,576.87
$1,907.13
$573.73
$617.61
$664.10
$829.23
$822.40
$866.28
$912.77
$1,077.90
$1,071.07
$1,114.95
$1,161.44
$1,326.57
$248.67
ADVERTISEMENT

Buckeye Community Health Plan

Local: 1-877-687-1189 | Toll Free: 1-877-687-1189

TTY: 1-877-941-9236

Plan: (HMO) Ambetter Balanced Care 1 (2018)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$253.15
$287.32
$323.52
$452.12
$687.03
$506.30
$574.64
$647.04
$904.24
$1,374.06
$699.96
$768.30
$840.70
$1,097.90
$893.62
$961.96
$1,034.36
$1,291.56
$1,087.28
$1,155.62
$1,228.02
$1,485.22
$446.81
$480.98
$517.18
$645.78
$640.47
$674.64
$710.84
$839.44
$834.13
$868.30
$904.50
$1,033.10
$193.66

Plan: (HMO) Ambetter Balanced Care 2 (2018)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $6,500 : Family: $13,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$248.19
$281.68
$317.17
$443.25
$673.56
$496.38
$563.36
$634.34
$886.50
$1,347.12
$686.24
$753.22
$824.20
$1,076.36
$876.10
$943.08
$1,014.06
$1,266.22
$1,065.96
$1,132.94
$1,203.92
$1,456.08
$438.05
$471.54
$507.03
$633.11
$627.91
$661.40
$696.89
$822.97
$817.77
$851.26
$886.75
$1,012.83
$189.86

Plan: (HMO) Ambetter Balanced Care 10 (2018)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60
$266.06
$301.97
$340.01
$475.16
$722.06
$532.12
$603.94
$680.02
$950.32
$1,444.12
$735.65
$807.47
$883.55
$1,153.85
$939.18
$1,011.00
$1,087.08
$1,357.38
$1,142.71
$1,214.53
$1,290.61
$1,560.91
$469.59
$505.50
$543.54
$678.69
$673.12
$709.03
$747.07
$882.22
$876.65
$912.56
$950.60
$1,085.75
$203.53

Plan: (HMO) Ambetter Balanced Care 12 (2018)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$272.02
$308.73
$347.62
$485.80
$738.22
$544.04
$617.46
$695.24
$971.60
$1,476.44
$752.12
$825.54
$903.32
$1,179.68
$960.20
$1,033.62
$1,111.40
$1,387.76
$1,168.28
$1,241.70
$1,319.48
$1,595.84
$480.10
$516.81
$555.70
$693.88
$688.18
$724.89
$763.78
$901.96
$896.26
$932.97
$971.86
$1,110.04
$208.08

Plan: (HMO) Ambetter Balanced Care 5 (2018)

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $7,350 : Family: $14,700
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$232.31
$263.66
$296.88
$414.88
$630.45
$464.62
$527.32
$593.76
$829.76
$1,260.90
$642.33
$705.03
$771.47
$1,007.47
$820.04
$882.74
$949.18
$1,185.18
$997.75
$1,060.45
$1,126.89
$1,362.89
$410.02
$441.37
$474.59
$592.59
$587.73
$619.08
$652.30
$770.30
$765.44
$796.79
$830.01
$948.01
$177.71

Plan: (HMO) Ambetter Balanced Care 1 (2018) + Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$256.40
$291.00
$327.66
$457.91
$695.84
$512.80
$582.00
$655.32
$915.82
$1,391.68
$708.94
$778.14
$851.46
$1,111.96
$905.08
$974.28
$1,047.60
$1,308.10
$1,101.22
$1,170.42
$1,243.74
$1,504.24
$452.54
$487.14
$523.80
$654.05
$648.68
$683.28
$719.94
$850.19
$844.82
$879.42
$916.08
$1,046.33
$196.14

Plan: (HMO) Ambetter Balanced Care 2 (2018) + Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $6,500 : Family: $13,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$251.37
$285.29
$321.24
$448.93
$682.19
$502.74
$570.58
$642.48
$897.86
$1,364.38
$695.03
$762.87
$834.77
$1,090.15
$887.32
$955.16
$1,027.06
$1,282.44
$1,079.61
$1,147.45
$1,219.35
$1,474.73
$443.66
$477.58
$513.53
$641.22
$635.95
$669.87
$705.82
$833.51
$828.24
$862.16
$898.11
$1,025.80
$192.29

Plan: (HMO) Ambetter Balanced Care 10 (2018) + Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60
$269.47
$305.84
$344.37
$481.25
$731.31
$538.94
$611.68
$688.74
$962.50
$1,462.62
$745.08
$817.82
$894.88
$1,168.64
$951.22
$1,023.96
$1,101.02
$1,374.78
$1,157.36
$1,230.10
$1,307.16
$1,580.92
$475.61
$511.98
$550.51
$687.39
$681.75
$718.12
$756.65
$893.53
$887.89
$924.26
$962.79
$1,099.67
$206.14

Plan: (HMO) Ambetter Balanced Care 1 (2018) + Vision + Adult Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$265.88
$301.77
$339.79
$474.85
$721.58
$531.76
$603.54
$679.58
$949.70
$1,443.16
$735.15
$806.93
$882.97
$1,153.09
$938.54
$1,010.32
$1,086.36
$1,356.48
$1,141.93
$1,213.71
$1,289.75
$1,559.87
$469.27
$505.16
$543.18
$678.24
$672.66
$708.55
$746.57
$881.63
$876.05
$911.94
$949.96
$1,085.02
$203.39

Plan: (HMO) Ambetter Balanced Care 2 (2018) + Vision + Adult Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $6,500 : Family: $13,000
Out of Pocket Maximum per year: Individual: $6,500 : Family: $13,000

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$260.67
$295.85
$333.12
$465.54
$707.43
$521.34
$591.70
$666.24
$931.08
$1,414.86
$720.74
$791.10
$865.64
$1,130.48
$920.14
$990.50
$1,065.04
$1,329.88
$1,119.54
$1,189.90
$1,264.44
$1,529.28
$460.07
$495.25
$532.52
$664.94
$659.47
$694.65
$731.92
$864.34
$858.87
$894.05
$931.32
$1,063.74
$199.40

Plan: (HMO) Ambetter Balanced Care 10 (2018) + Vision + Adult Dental

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-877-687-1189 - Provider Directory for This Plan: (Buckeye Community Health Plan)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: 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
Silver 21
30
40
50
60
$279.44
$317.15
$357.11
$499.06
$758.36
$558.88
$634.30
$714.22
$998.12
$1,516.72
$772.64
$848.06
$927.98
$1,211.88
$986.40
$1,061.82
$1,141.74
$1,425.64
$1,200.16
$1,275.58
$1,355.50
$1,639.40
$493.20
$530.91
$570.87
$712.82
$706.96
$744.67
$784.63
$926.58
$920.72
$958.43
$998.39
$1,140.34
$213.76
ADVERTISEMENT

Summa Insurance Company, Inc.

Local: 1-330-996-8675 | Toll Free: 1-888-996-8675

TTY: 1-800-750-0750

Plan: (PPO) SummaCare Silver 3500 with SCConnect Network and 3 Free PCP Visits

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-996-8675 - Provider Directory for This Plan: (Summa Insurance Company, Inc.)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$338.83
$384.56
$433.01
$605.14
$919.56
$677.66
$769.12
$866.02
$1,210.28
$1,839.12
$936.86
$1,028.32
$1,125.22
$1,469.48
$1,196.06
$1,287.52
$1,384.42
$1,728.68
$1,455.26
$1,546.72
$1,643.62
$1,987.88
$598.03
$643.76
$692.21
$864.34
$857.23
$902.96
$951.41
$1,123.54
$1,116.43
$1,162.16
$1,210.61
$1,382.74
$259.20

Plan: (PPO) SummaCare Silver 5000 with SCConnect Network and 3 Free PCP Visits

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-996-8675 - Provider Directory for This Plan: (Summa Insurance Company, Inc.)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$324.14
$367.88
$414.23
$578.89
$879.68
$648.28
$735.76
$828.46
$1,157.78
$1,759.36
$896.24
$983.72
$1,076.42
$1,405.74
$1,144.20
$1,231.68
$1,324.38
$1,653.70
$1,392.16
$1,479.64
$1,572.34
$1,901.66
$572.10
$615.84
$662.19
$826.85
$820.06
$863.80
$910.15
$1,074.81
$1,068.02
$1,111.76
$1,158.11
$1,322.77
$247.96

Plan: (PPO) SummaCare Gold 750 with SCConnect Network and 3 Free PCP Visits

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-996-8675 - Provider Directory for This Plan: (Summa Insurance Company, Inc.)

Deductible: Individual: $750 : Family: $1,500
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Gold 21
30
40
50
60
$368.22
$417.92
$470.58
$657.63
$999.33
$736.44
$835.84
$941.16
$1,315.26
$1,998.66
$1,018.12
$1,117.52
$1,222.84
$1,596.94
$1,299.80
$1,399.20
$1,504.52
$1,878.62
$1,581.48
$1,680.88
$1,786.20
$2,160.30
$649.90
$699.60
$752.26
$939.31
$931.58
$981.28
$1,033.94
$1,220.99
$1,213.26
$1,262.96
$1,315.62
$1,502.67
$281.68

Plan: (PPO) SummaCare Silver 5000 40 with SCConnect Network

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-996-8675 - Provider Directory for This Plan: (Summa Insurance Company, Inc.)

Deductible: Individual: $5,000 : Family: $10,000
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$296.65
$336.69
$379.10
$529.80
$805.08
$593.30
$673.38
$758.20
$1,059.60
$1,610.16
$820.23
$900.31
$985.13
$1,286.53
$1,047.16
$1,127.24
$1,212.06
$1,513.46
$1,274.09
$1,354.17
$1,438.99
$1,740.39
$523.58
$563.62
$606.03
$756.73
$750.51
$790.55
$832.96
$983.66
$977.44
$1,017.48
$1,059.89
$1,210.59
$226.93

Plan: (PPO) SummaCare Value with SCConnect Network and 3 Free PCP Visits

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-996-8675 - Provider Directory for This Plan: (Summa Insurance Company, Inc.)

Deductible: Individual: $7,350 : Family: $14,700
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Catastrophic 21
30
40
50
60
$206.02
$233.83
$263.29
$367.94
$559.12
$412.04
$467.66
$526.58
$735.88
$1,118.24
$569.64
$625.26
$684.18
$893.48
$727.24
$782.86
$841.78
$1,051.08
$884.84
$940.46
$999.38
$1,208.68
$363.62
$391.43
$420.89
$525.54
$521.22
$549.03
$578.49
$683.14
$678.82
$706.63
$736.09
$840.74
$157.60
ADVERTISEMENT

Molina Healthcare of Ohio, Inc.

Local: 1-888-296-7677 | Toll Free: 1-888-296-7677

Plan: (HMO) Molina Marketplace Silver Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-296-7677 - Provider Directory for This Plan: (Molina Healthcare of Ohio, Inc.)

Deductible: Individual: $4,950 : Family: $9,900
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$285.86
$324.45
$365.33
$510.55
$775.83
$571.72
$648.90
$730.66
$1,021.10
$1,551.66
$790.40
$867.58
$949.34
$1,239.78
$1,009.08
$1,086.26
$1,168.02
$1,458.46
$1,227.76
$1,304.94
$1,386.70
$1,677.14
$504.54
$543.13
$584.01
$729.23
$723.22
$761.81
$802.69
$947.91
$941.90
$980.49
$1,021.37
$1,166.59
$218.68

Plan: (HMO) Molina Marketplace Bronze Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-296-7677 - Provider Directory for This Plan: (Molina Healthcare of Ohio, Inc.)

Deductible: Individual: $6,400 : Family: $12,800
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

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
Expanded Bronze 21
30
40
50
60
$208.77
$236.95
$266.80
$372.86
$566.59
$417.54
$473.90
$533.60
$745.72
$1,133.18
$577.25
$633.61
$693.31
$905.43
$736.96
$793.32
$853.02
$1,065.14
$896.67
$953.03
$1,012.73
$1,224.85
$368.48
$396.66
$426.51
$532.57
$528.19
$556.37
$586.22
$692.28
$687.90
$716.08
$745.93
$851.99
$159.71

Plan: (HMO) Molina Marketplace Options Silver Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-296-7677 - Provider Directory for This Plan: (Molina Healthcare of Ohio, Inc.)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$297.38
$337.52
$380.05
$531.11
$807.08
$594.76
$675.04
$760.10
$1,062.22
$1,614.16
$822.25
$902.53
$987.59
$1,289.71
$1,049.74
$1,130.02
$1,215.08
$1,517.20
$1,277.23
$1,357.51
$1,442.57
$1,744.69
$524.87
$565.01
$607.54
$758.60
$752.36
$792.50
$835.03
$986.09
$979.85
$1,019.99
$1,062.52
$1,213.58
$227.49

Plan: (HMO) Molina Marketplace Options Bronze Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-888-296-7677 - Provider Directory for This Plan: (Molina Healthcare of Ohio, Inc.)

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

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
Expanded Bronze 21
30
40
50
60
$219.28
$248.88
$280.24
$391.64
$595.13
$438.56
$497.76
$560.48
$783.28
$1,190.26
$606.31
$665.51
$728.23
$951.03
$774.06
$833.26
$895.98
$1,118.78
$941.81
$1,001.01
$1,063.73
$1,286.53
$387.03
$416.63
$447.99
$559.39
$554.78
$584.38
$615.74
$727.14
$722.53
$752.13
$783.49
$894.89
$167.75
ADVERTISEMENT

CareSource

Local: 1-800-479-9502 | Toll Free: 1-800-479-9502

TTY: 1-800-750-0750

Plan: (HMO) CareSource HSA Bronze

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $4,000 : Family: $8,000
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
$226.41
$256.97
$289.35
$404.36
$614.47
$452.82
$513.94
$578.70
$808.72
$1,228.94
$626.02
$687.14
$751.90
$981.92
$799.22
$860.34
$925.10
$1,155.12
$972.42
$1,033.54
$1,098.30
$1,328.32
$399.61
$430.17
$462.55
$577.56
$572.81
$603.37
$635.75
$750.76
$746.01
$776.57
$808.95
$923.96
$173.20

Plan: (HMO) CareSource Low Premium Silver

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $6,150 : Family: $12,300
Out of Pocket Maximum per year: Individual: $7,300 : Family: $14,600

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
$272.09
$308.82
$347.73
$485.95
$738.45
$544.18
$617.64
$695.46
$971.90
$1,476.90
$752.33
$825.79
$903.61
$1,180.05
$960.48
$1,033.94
$1,111.76
$1,388.20
$1,168.63
$1,242.09
$1,319.91
$1,596.35
$480.24
$516.97
$555.88
$694.10
$688.39
$725.12
$764.03
$902.25
$896.54
$933.27
$972.18
$1,110.40
$208.15

Plan: (HMO) CareSource Gold

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $1,500 : 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
$328.13
$372.42
$419.35
$586.03
$890.53
$656.26
$744.84
$838.70
$1,172.06
$1,781.06
$907.28
$995.86
$1,089.72
$1,423.08
$1,158.30
$1,246.88
$1,340.74
$1,674.10
$1,409.32
$1,497.90
$1,591.76
$1,925.12
$579.15
$623.44
$670.37
$837.05
$830.17
$874.46
$921.39
$1,088.07
$1,081.19
$1,125.48
$1,172.41
$1,339.09
$251.02

Plan: (HMO) CareSource Silver

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $3,900 : Family: $7,800
Out of Pocket Maximum per year: Individual: $7,300 : Family: $14,600

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
$285.34
$323.85
$364.65
$509.60
$774.39
$570.68
$647.70
$729.30
$1,019.20
$1,548.78
$788.96
$865.98
$947.58
$1,237.48
$1,007.24
$1,084.26
$1,165.86
$1,455.76
$1,225.52
$1,302.54
$1,384.14
$1,674.04
$503.62
$542.13
$582.93
$727.88
$721.90
$760.41
$801.21
$946.16
$940.18
$978.69
$1,019.49
$1,164.44
$218.28

Plan: (HMO) CareSource Bronze

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $7,250 : Family: $14,500
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

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
$208.06
$236.14
$265.89
$371.58
$564.66
$416.12
$472.28
$531.78
$743.16
$1,129.32
$575.28
$631.44
$690.94
$902.32
$734.44
$790.60
$850.10
$1,061.48
$893.60
$949.76
$1,009.26
$1,220.64
$367.22
$395.30
$425.05
$530.74
$526.38
$554.46
$584.21
$689.90
$685.54
$713.62
$743.37
$849.06
$159.16

Plan: (HMO) CareSource Low Premium Silver Dental and Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $6,150 : Family: $12,300
Out of Pocket Maximum per year: Individual: $7,300 : Family: $14,600

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
$285.45
$323.99
$364.81
$509.82
$774.71
$570.90
$647.98
$729.62
$1,019.64
$1,549.42
$789.27
$866.35
$947.99
$1,238.01
$1,007.64
$1,084.72
$1,166.36
$1,456.38
$1,226.01
$1,303.09
$1,384.73
$1,674.75
$503.82
$542.36
$583.18
$728.19
$722.19
$760.73
$801.55
$946.56
$940.56
$979.10
$1,019.92
$1,164.93
$218.37

Plan: (HMO) CareSource Gold Dental and Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $1,500 : 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
$341.49
$387.59
$436.42
$609.90
$926.80
$682.98
$775.18
$872.84
$1,219.80
$1,853.60
$944.22
$1,036.42
$1,134.08
$1,481.04
$1,205.46
$1,297.66
$1,395.32
$1,742.28
$1,466.70
$1,558.90
$1,656.56
$2,003.52
$602.73
$648.83
$697.66
$871.14
$863.97
$910.07
$958.90
$1,132.38
$1,125.21
$1,171.31
$1,220.14
$1,393.62
$261.24

Plan: (HMO) CareSource Silver Dental and Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $3,900 : Family: $7,800
Out of Pocket Maximum per year: Individual: $7,300 : Family: $14,600

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
$298.70
$339.02
$381.73
$533.47
$810.66
$597.40
$678.04
$763.46
$1,066.94
$1,621.32
$825.90
$906.54
$991.96
$1,295.44
$1,054.40
$1,135.04
$1,220.46
$1,523.94
$1,282.90
$1,363.54
$1,448.96
$1,752.44
$527.20
$567.52
$610.23
$761.97
$755.70
$796.02
$838.73
$990.47
$984.20
$1,024.52
$1,067.23
$1,218.97
$228.50

Plan: (HMO) CareSource Bronze Dental and Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $7,250 : Family: $14,500
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

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
$221.42
$251.31
$282.97
$395.45
$600.92
$442.84
$502.62
$565.94
$790.90
$1,201.84
$612.22
$672.00
$735.32
$960.28
$781.60
$841.38
$904.70
$1,129.66
$950.98
$1,010.76
$1,074.08
$1,299.04
$390.80
$420.69
$452.35
$564.83
$560.18
$590.07
$621.73
$734.21
$729.56
$759.45
$791.11
$903.59
$169.38

Plan: (HMO) CareSource Federal Simple Choice Silver

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$296.35
$336.35
$378.73
$529.27
$804.28
$592.70
$672.70
$757.46
$1,058.54
$1,608.56
$819.40
$899.40
$984.16
$1,285.24
$1,046.10
$1,126.10
$1,210.86
$1,511.94
$1,272.80
$1,352.80
$1,437.56
$1,738.64
$523.05
$563.05
$605.43
$755.97
$749.75
$789.75
$832.13
$982.67
$976.45
$1,016.45
$1,058.83
$1,209.37
$226.70

Plan: (HMO) CareSource Federal Simple Choice Bronze

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

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
Expanded Bronze 21
30
40
50
60
$236.30
$268.20
$301.99
$422.03
$641.31
$472.60
$536.40
$603.98
$844.06
$1,282.62
$653.37
$717.17
$784.75
$1,024.83
$834.14
$897.94
$965.52
$1,205.60
$1,014.91
$1,078.71
$1,146.29
$1,386.37
$417.07
$448.97
$482.76
$602.80
$597.84
$629.74
$663.53
$783.57
$778.61
$810.51
$844.30
$964.34
$180.77

Plan: (HMO) CareSource Federal Simple Choice Silver Dental and Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

Monthly Premiums:

Metal level Age Individual
Couple
Couple
w 1 Kid
Couple
w 2 Kids
Couple
w3+Kids
Single
w 1 Kid
Single
w 2 Kids
Single
w3+Kids
Child
any age
Silver 21
30
40
50
60
$309.71
$351.52
$395.81
$553.14
$840.55
$619.42
$703.04
$791.62
$1,106.28
$1,681.10
$856.35
$939.97
$1,028.55
$1,343.21
$1,093.28
$1,176.90
$1,265.48
$1,580.14
$1,330.21
$1,413.83
$1,502.41
$1,817.07
$546.64
$588.45
$632.74
$790.07
$783.57
$825.38
$869.67
$1,027.00
$1,020.50
$1,062.31
$1,106.60
$1,263.93
$236.93

Plan: (HMO) CareSource Federal Simple Choice Bronze Dental and Vision

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-479-9502 - Provider Directory for This Plan: (CareSource)

Deductible: Individual: $6,650 : Family: $13,300
Out of Pocket Maximum per year: Individual: $7,350 : Family: $14,700

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
Expanded Bronze 21
30
40
50
60
$249.67
$283.37
$319.08
$445.91
$677.60
$499.34
$566.74
$638.16
$891.82
$1,355.20
$690.34
$757.74
$829.16
$1,082.82
$881.34
$948.74
$1,020.16
$1,273.82
$1,072.34
$1,139.74
$1,211.16
$1,464.82
$440.67
$474.37
$510.08
$636.91
$631.67
$665.37
$701.08
$827.91
$822.67
$856.37
$892.08
$1,018.91
$191.00

‡Source: HealthCare.gov has released sample rates for all counties in the 36 states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Stark County here.

 

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