Obamacare 2020 Rates and Health Insurance Providers for Rock County , Wisconsin
Obamacare > Rates > Wisconsin > Rock County
Obamacare Rates and Providers for Other Years
Obamacare is also known as the Affordable Care Act. This page gives you an overview of the rates for individual and family health insurance plans available from , the marketplace for Janesville, WI.
The health insurance rates listed below are for calendar year 2020.
Obamacare Providers, Plans and 2020 Rates for Rock County, Wisconsin
Below, you’ll find a summary of the 77 plans for Rock County, Wisconsin 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 take one of the following actions:
The table below shows premiums for the following profiles at various ages:
- Individuals
- Couples
- Couples with 1, 2, or 3 children
- Individuals with 1, 2, or 3 children
- A child alone
Each plan links to the insurance provider's website. You can find the following:
- Summary of plan benefits and costs
- Plan brochure
- Provider Directory where you can find out which doctors and hospitals in the Janesville, WI area accept this insurance coverage as within the plan's network.
Obamacare Rates and Providers for Other Years
2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 |
2020 Obamacare Rates, Providers, and Plans for Rock County
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Quartz Health Benefit Plans CorporationLocal: 1-608-644-3430 | Toll Free: 1-800-362-3310 | TTY: 1-800-877-8973 |
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Silver |
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(HMO) Quartz One Silver I302 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$5,000
| Family:
$10,000 Monthly Premiums: |
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Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
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21 30 40 50 60 |
$420.48 $477.24 $537.37 $750.98 $1,141.18 |
$840.96 $954.48 $1,074.74 $1,501.96 $2,282.36 |
$1,162.63 $1,276.15 $1,396.41 $1,823.63 |
$1,484.30 $1,597.82 $1,718.08 $2,145.30 |
$1,805.97 $1,919.49 $2,039.75 $2,466.97 |
$742.15 $798.91 $859.04 $1,072.65 |
$1,063.82 $1,120.58 $1,180.71 $1,394.32 |
$1,385.49 $1,442.25 $1,502.38 $1,715.99 |
$321.67 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Quartz One Silver I303 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$7,900
| Family:
$15,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$408.83 $464.01 $522.47 $730.16 $1,109.54 |
$817.66 $928.02 $1,044.94 $1,460.32 $2,219.08 |
$1,130.41 $1,240.77 $1,357.69 $1,773.07 |
$1,443.16 $1,553.52 $1,670.44 $2,085.82 |
$1,755.91 $1,866.27 $1,983.19 $2,398.57 |
$721.58 $776.76 $835.22 $1,042.91 |
$1,034.33 $1,089.51 $1,147.97 $1,355.66 |
$1,347.08 $1,402.26 $1,460.72 $1,668.41 |
$312.75 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Beloit One Silver I303 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$7,900
| Family:
$15,800 Monthly Premiums: |
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Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
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21 30 40 50 60 |
$353.23 $400.91 $451.42 $630.86 $958.66 |
$706.46 $801.82 $902.84 $1,261.72 $1,917.32 |
$976.68 $1,072.04 $1,173.06 $1,531.94 |
$1,246.90 $1,342.26 $1,443.28 $1,802.16 |
$1,517.12 $1,612.48 $1,713.50 $2,072.38 |
$623.45 $671.13 $721.64 $901.08 |
$893.67 $941.35 $991.86 $1,171.30 |
$1,163.89 $1,211.57 $1,262.08 $1,441.52 |
$270.22 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Beloit One Silver I302 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$5,000
| Family:
$10,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
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21 30 40 50 60 |
$363.30 $412.34 $464.29 $648.85 $985.99 |
$726.60 $824.68 $928.58 $1,297.70 $1,971.98 |
$1,004.52 $1,102.60 $1,206.50 $1,575.62 |
$1,282.44 $1,380.52 $1,484.42 $1,853.54 |
$1,560.36 $1,658.44 $1,762.34 $2,131.46 |
$641.22 $690.26 $742.21 $926.77 |
$919.14 $968.18 $1,020.13 $1,204.69 |
$1,197.06 $1,246.10 $1,298.05 $1,482.61 |
$277.92 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Quartz One Gold I402 Maintenance with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$1,500
| Family:
$3,000 Monthly Premiums: |
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Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
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21 30 40 50 60 |
$388.78 $441.26 $496.85 $694.35 $1,055.13 |
$777.56 $882.52 $993.70 $1,388.70 $2,110.26 |
$1,074.97 $1,179.93 $1,291.11 $1,686.11 |
$1,372.38 $1,477.34 $1,588.52 $1,983.52 |
$1,669.79 $1,774.75 $1,885.93 $2,280.93 |
$686.19 $738.67 $794.26 $991.76 |
$983.60 $1,036.08 $1,091.67 $1,289.17 |
$1,281.01 $1,333.49 $1,389.08 $1,586.58 |
$297.41 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Beloit One Gold I402 Maintenance with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$1,500
| Family:
$3,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$335.91 $381.25 $429.29 $599.92 $911.64 |
$671.82 $762.50 $858.58 $1,199.84 $1,823.28 |
$928.79 $1,019.47 $1,115.55 $1,456.81 |
$1,185.76 $1,276.44 $1,372.52 $1,713.78 |
$1,442.73 $1,533.41 $1,629.49 $1,970.75 |
$592.88 $638.22 $686.26 $856.89 |
$849.85 $895.19 $943.23 $1,113.86 |
$1,106.82 $1,152.16 $1,200.20 $1,370.83 |
$256.97 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Quartz One Gold I401 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$2,000
| Family:
$4,000 Monthly Premiums: |
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Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
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21 30 40 50 60 |
$383.80 $435.60 $490.48 $685.45 $1,041.61 |
$767.60 $871.20 $980.96 $1,370.90 $2,083.22 |
$1,061.20 $1,164.80 $1,274.56 $1,664.50 |
$1,354.80 $1,458.40 $1,568.16 $1,958.10 |
$1,648.40 $1,752.00 $1,861.76 $2,251.70 |
$677.40 $729.20 $784.08 $979.05 |
$971.00 $1,022.80 $1,077.68 $1,272.65 |
$1,264.60 $1,316.40 $1,371.28 $1,566.25 |
$293.60 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Quartz One Silver I301 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$4,300
| Family:
$8,600 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$422.36 $479.38 $539.78 $754.33 $1,146.28 |
$844.72 $958.76 $1,079.56 $1,508.66 $2,292.56 |
$1,167.82 $1,281.86 $1,402.66 $1,831.76 |
$1,490.92 $1,604.96 $1,725.76 $2,154.86 |
$1,814.02 $1,928.06 $2,048.86 $2,477.96 |
$745.46 $802.48 $862.88 $1,077.43 |
$1,068.56 $1,125.58 $1,185.98 $1,400.53 |
$1,391.66 $1,448.68 $1,509.08 $1,723.63 |
$323.10 | ||||||||||
Expanded Bronze |
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(HMO) Quartz One Bronze I201 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$8,000
| Family:
$16,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$287.00 $325.74 $366.78 $512.57 $778.90 |
$574.00 $651.48 $733.56 $1,025.14 $1,557.80 |
$793.55 $871.03 $953.11 $1,244.69 |
$1,013.10 $1,090.58 $1,172.66 $1,464.24 |
$1,232.65 $1,310.13 $1,392.21 $1,683.79 |
$506.55 $545.29 $586.33 $732.12 |
$726.10 $764.84 $805.88 $951.67 |
$945.65 $984.39 $1,025.43 $1,171.22 |
$219.55 | ||||||||||
Expanded Bronze |
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(HMO) Quartz One Bronze I202 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$7,900
| Family:
$15,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
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21 30 40 50 60 |
$293.74 $333.39 $375.39 $524.61 $797.20 |
$587.48 $666.78 $750.78 $1,049.22 $1,594.40 |
$812.19 $891.49 $975.49 $1,273.93 |
$1,036.90 $1,116.20 $1,200.20 $1,498.64 |
$1,261.61 $1,340.91 $1,424.91 $1,723.35 |
$518.45 $558.10 $600.10 $749.32 |
$743.16 $782.81 $824.81 $974.03 |
$967.87 $1,007.52 $1,049.52 $1,198.74 |
$224.71 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Beloit One Gold I401 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$2,000
| Family:
$4,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$331.60 $376.36 $423.78 $592.23 $899.96 |
$663.20 $752.72 $847.56 $1,184.46 $1,799.92 |
$916.87 $1,006.39 $1,101.23 $1,438.13 |
$1,170.54 $1,260.06 $1,354.90 $1,691.80 |
$1,424.21 $1,513.73 $1,608.57 $1,945.47 |
$585.27 $630.03 $677.45 $845.90 |
$838.94 $883.70 $931.12 $1,099.57 |
$1,092.61 $1,137.37 $1,184.79 $1,353.24 |
$253.67 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Beloit One Silver I301 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$4,300
| Family:
$8,600 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$364.93 $414.19 $466.37 $651.75 $990.40 |
$729.86 $828.38 $932.74 $1,303.50 $1,980.80 |
$1,009.03 $1,107.55 $1,211.91 $1,582.67 |
$1,288.20 $1,386.72 $1,491.08 $1,861.84 |
$1,567.37 $1,665.89 $1,770.25 $2,141.01 |
$644.10 $693.36 $745.54 $930.92 |
$923.27 $972.53 $1,024.71 $1,210.09 |
$1,202.44 $1,251.70 $1,303.88 $1,489.26 |
$279.17 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Beloit One Bronze I201 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$8,000
| Family:
$16,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$247.97 $281.44 $316.90 $442.86 $672.97 |
$495.94 $562.88 $633.80 $885.72 $1,345.94 |
$685.63 $752.57 $823.49 $1,075.41 |
$875.32 $942.26 $1,013.18 $1,265.10 |
$1,065.01 $1,131.95 $1,202.87 $1,454.79 |
$437.66 $471.13 $506.59 $632.55 |
$627.35 $660.82 $696.28 $822.24 |
$817.04 $850.51 $885.97 $1,011.93 |
$189.69 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Beloit One Bronze I202 with Dental
Annual Out of Pocket Expenses
Deductible: Individual:
$7,900
| Family:
$15,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$253.79 $288.05 $324.34 $453.27 $688.79 |
$507.58 $576.10 $648.68 $906.54 $1,377.58 |
$701.73 $770.25 $842.83 $1,100.69 |
$895.88 $964.40 $1,036.98 $1,294.84 |
$1,090.03 $1,158.55 $1,231.13 $1,488.99 |
$447.94 $482.20 $518.49 $647.42 |
$642.09 $676.35 $712.64 $841.57 |
$836.24 $870.50 $906.79 $1,035.72 |
$194.15 | ||||||||||
Silver |
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(HMO) Quartz One Silver I302
Annual Out of Pocket Expenses
Deductible: Individual:
$5,000
| Family:
$10,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$400.91 $455.03 $512.35 $716.01 $1,088.05 |
$801.82 $910.06 $1,024.70 $1,432.02 $2,176.10 |
$1,108.51 $1,216.75 $1,331.39 $1,738.71 |
$1,415.20 $1,523.44 $1,638.08 $2,045.40 |
$1,721.89 $1,830.13 $1,944.77 $2,352.09 |
$707.60 $761.72 $819.04 $1,022.70 |
$1,014.29 $1,068.41 $1,125.73 $1,329.39 |
$1,320.98 $1,375.10 $1,432.42 $1,636.08 |
$306.69 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Quartz One Silver I303
Annual Out of Pocket Expenses
Deductible: Individual:
$7,900
| Family:
$15,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$389.79 $442.41 $498.15 $696.16 $1,057.89 |
$779.58 $884.82 $996.30 $1,392.32 $2,115.78 |
$1,077.77 $1,183.01 $1,294.49 $1,690.51 |
$1,375.96 $1,481.20 $1,592.68 $1,988.70 |
$1,674.15 $1,779.39 $1,890.87 $2,286.89 |
$687.98 $740.60 $796.34 $994.35 |
$986.17 $1,038.79 $1,094.53 $1,292.54 |
$1,284.36 $1,336.98 $1,392.72 $1,590.73 |
$298.19 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Beloit One Silver I303
Annual Out of Pocket Expenses
Deductible: Individual:
$7,900
| Family:
$15,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$336.79 $382.25 $430.41 $601.49 $914.03 |
$673.58 $764.50 $860.82 $1,202.98 $1,828.06 |
$931.22 $1,022.14 $1,118.46 $1,460.62 |
$1,188.86 $1,279.78 $1,376.10 $1,718.26 |
$1,446.50 $1,537.42 $1,633.74 $1,975.90 |
$594.43 $639.89 $688.05 $859.13 |
$852.07 $897.53 $945.69 $1,116.77 |
$1,109.71 $1,155.17 $1,203.33 $1,374.41 |
$257.64 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Beloit One Silver I302
Annual Out of Pocket Expenses
Deductible: Individual:
$5,000
| Family:
$10,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$346.39 $393.15 $442.68 $618.64 $940.09 |
$692.78 $786.30 $885.36 $1,237.28 $1,880.18 |
$957.76 $1,051.28 $1,150.34 $1,502.26 |
$1,222.74 $1,316.26 $1,415.32 $1,767.24 |
$1,487.72 $1,581.24 $1,680.30 $2,032.22 |
$611.37 $658.13 $707.66 $883.62 |
$876.35 $923.11 $972.64 $1,148.60 |
$1,141.33 $1,188.09 $1,237.62 $1,413.58 |
$264.98 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Quartz One Gold I402 Maintenance
Annual Out of Pocket Expenses
Deductible: Individual:
$1,500
| Family:
$3,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$370.68 $420.72 $473.72 $662.02 $1,006.01 |
$741.36 $841.44 $947.44 $1,324.04 $2,012.02 |
$1,024.93 $1,125.01 $1,231.01 $1,607.61 |
$1,308.50 $1,408.58 $1,514.58 $1,891.18 |
$1,592.07 $1,692.15 $1,798.15 $2,174.75 |
$654.25 $704.29 $757.29 $945.59 |
$937.82 $987.86 $1,040.86 $1,229.16 |
$1,221.39 $1,271.43 $1,324.43 $1,512.73 |
$283.57 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Beloit One Gold I402 Maintenance
Annual Out of Pocket Expenses
Deductible: Individual:
$1,500
| Family:
$3,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$320.27 $363.50 $409.30 $572.00 $869.20 |
$640.54 $727.00 $818.60 $1,144.00 $1,738.40 |
$885.54 $972.00 $1,063.60 $1,389.00 |
$1,130.54 $1,217.00 $1,308.60 $1,634.00 |
$1,375.54 $1,462.00 $1,553.60 $1,879.00 |
$565.27 $608.50 $654.30 $817.00 |
$810.27 $853.50 $899.30 $1,062.00 |
$1,055.27 $1,098.50 $1,144.30 $1,307.00 |
$245.00 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Quartz One Gold I401
Annual Out of Pocket Expenses
Deductible: Individual:
$2,000
| Family:
$4,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$365.93 $415.32 $467.65 $653.54 $993.11 |
$731.86 $830.64 $935.30 $1,307.08 $1,986.22 |
$1,011.79 $1,110.57 $1,215.23 $1,587.01 |
$1,291.72 $1,390.50 $1,495.16 $1,866.94 |
$1,571.65 $1,670.43 $1,775.09 $2,146.87 |
$645.86 $695.25 $747.58 $933.47 |
$925.79 $975.18 $1,027.51 $1,213.40 |
$1,205.72 $1,255.11 $1,307.44 $1,493.33 |
$279.93 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Quartz One Silver I301
Annual Out of Pocket Expenses
Deductible: Individual:
$4,300
| Family:
$8,600 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$402.70 $457.06 $514.65 $719.22 $1,092.92 |
$805.40 $914.12 $1,029.30 $1,438.44 $2,185.84 |
$1,113.46 $1,222.18 $1,337.36 $1,746.50 |
$1,421.52 $1,530.24 $1,645.42 $2,054.56 |
$1,729.58 $1,838.30 $1,953.48 $2,362.62 |
$710.76 $765.12 $822.71 $1,027.28 |
$1,018.82 $1,073.18 $1,130.77 $1,335.34 |
$1,326.88 $1,381.24 $1,438.83 $1,643.40 |
$308.06 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Quartz One Bronze I201
Annual Out of Pocket Expenses
Deductible: Individual:
$8,000
| Family:
$16,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$273.64 $310.57 $349.70 $488.71 $742.64 |
$547.28 $621.14 $699.40 $977.42 $1,485.28 |
$756.61 $830.47 $908.73 $1,186.75 |
$965.94 $1,039.80 $1,118.06 $1,396.08 |
$1,175.27 $1,249.13 $1,327.39 $1,605.41 |
$482.97 $519.90 $559.03 $698.04 |
$692.30 $729.23 $768.36 $907.37 |
$901.63 $938.56 $977.69 $1,116.70 |
$209.33 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Quartz One Bronze I202
Annual Out of Pocket Expenses
Deductible: Individual:
$7,900
| Family:
$15,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$280.07 $317.87 $357.92 $500.19 $760.08 |
$560.14 $635.74 $715.84 $1,000.38 $1,520.16 |
$774.39 $849.99 $930.09 $1,214.63 |
$988.64 $1,064.24 $1,144.34 $1,428.88 |
$1,202.89 $1,278.49 $1,358.59 $1,643.13 |
$494.32 $532.12 $572.17 $714.44 |
$708.57 $746.37 $786.42 $928.69 |
$922.82 $960.62 $1,000.67 $1,142.94 |
$214.25 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Beloit One Gold I401
Annual Out of Pocket Expenses
Deductible: Individual:
$2,000
| Family:
$4,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$316.17 $358.84 $404.05 $564.66 $858.06 |
$632.34 $717.68 $808.10 $1,129.32 $1,716.12 |
$874.20 $959.54 $1,049.96 $1,371.18 |
$1,116.06 $1,201.40 $1,291.82 $1,613.04 |
$1,357.92 $1,443.26 $1,533.68 $1,854.90 |
$558.03 $600.70 $645.91 $806.52 |
$799.89 $842.56 $887.77 $1,048.38 |
$1,041.75 $1,084.42 $1,129.63 $1,290.24 |
$241.86 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Beloit One Silver I301
Annual Out of Pocket Expenses
Deductible: Individual:
$4,300
| Family:
$8,600 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$347.94 $394.90 $444.66 $621.41 $944.29 |
$695.88 $789.80 $889.32 $1,242.82 $1,888.58 |
$962.05 $1,055.97 $1,155.49 $1,508.99 |
$1,228.22 $1,322.14 $1,421.66 $1,775.16 |
$1,494.39 $1,588.31 $1,687.83 $2,041.33 |
$614.11 $661.07 $710.83 $887.58 |
$880.28 $927.24 $977.00 $1,153.75 |
$1,146.45 $1,193.41 $1,243.17 $1,419.92 |
$266.17 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Beloit One Bronze I201
Annual Out of Pocket Expenses
Deductible: Individual:
$8,000
| Family:
$16,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$236.43 $268.34 $302.15 $422.25 $641.64 |
$472.86 $536.68 $604.30 $844.50 $1,283.28 |
$653.72 $717.54 $785.16 $1,025.36 |
$834.58 $898.40 $966.02 $1,206.22 |
$1,015.44 $1,079.26 $1,146.88 $1,387.08 |
$417.29 $449.20 $483.01 $603.11 |
$598.15 $630.06 $663.87 $783.97 |
$779.01 $810.92 $844.73 $964.83 |
$180.86 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Beloit One Bronze I202
Annual Out of Pocket Expenses
Deductible: Individual:
$7,900
| Family:
$15,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$241.98 $274.64 $309.24 $432.17 $656.72 |
$483.96 $549.28 $618.48 $864.34 $1,313.44 |
$669.07 $734.39 $803.59 $1,049.45 |
$854.18 $919.50 $988.70 $1,234.56 |
$1,039.29 $1,104.61 $1,173.81 $1,419.67 |
$427.09 $459.75 $494.35 $617.28 |
$612.20 $644.86 $679.46 $802.39 |
$797.31 $829.97 $864.57 $987.50 |
$185.11 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Quartz One Gold I404 HSA
Annual Out of Pocket Expenses
Deductible: Individual:
$2,000
| Family:
$4,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$386.11 $438.23 $493.44 $689.58 $1,047.88 |
$772.22 $876.46 $986.88 $1,379.16 $2,095.76 |
$1,067.59 $1,171.83 $1,282.25 $1,674.53 |
$1,362.96 $1,467.20 $1,577.62 $1,969.90 |
$1,658.33 $1,762.57 $1,872.99 $2,265.27 |
$681.48 $733.60 $788.81 $984.95 |
$976.85 $1,028.97 $1,084.18 $1,280.32 |
$1,272.22 $1,324.34 $1,379.55 $1,575.69 |
$295.37 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Quartz One Bronze I203 HSA
Annual Out of Pocket Expenses
Deductible: Individual:
$6,750
| Family:
$13,500 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$284.03 $322.37 $362.99 $507.28 $770.85 |
$568.06 $644.74 $725.98 $1,014.56 $1,541.70 |
$785.34 $862.02 $943.26 $1,231.84 |
$1,002.62 $1,079.30 $1,160.54 $1,449.12 |
$1,219.90 $1,296.58 $1,377.82 $1,666.40 |
$501.31 $539.65 $580.27 $724.56 |
$718.59 $756.93 $797.55 $941.84 |
$935.87 $974.21 $1,014.83 $1,159.12 |
$217.28 | ||||||||||
Catastrophic |
|||||||||||||||||||
(HMO) Quartz One Catastrophic I101
Annual Out of Pocket Expenses
Deductible: Individual:
$8,150
| Family:
$16,300 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$208.46 $236.59 $266.40 $372.30 $565.74 |
$416.92 $473.18 $532.80 $744.60 $1,131.48 |
$576.39 $632.65 $692.27 $904.07 |
$735.86 $792.12 $851.74 $1,063.54 |
$895.33 $951.59 $1,011.21 $1,223.01 |
$367.93 $396.06 $425.87 $531.77 |
$527.40 $555.53 $585.34 $691.24 |
$686.87 $715.00 $744.81 $850.71 |
$159.47 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Beloit One Bronze I203 HSA
Annual Out of Pocket Expenses
Deductible: Individual:
$6,750
| Family:
$13,500 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$245.41 $278.53 $313.63 $438.29 $666.03 |
$490.82 $557.06 $627.26 $876.58 $1,332.06 |
$678.55 $744.79 $814.99 $1,064.31 |
$866.28 $932.52 $1,002.72 $1,252.04 |
$1,054.01 $1,120.25 $1,190.45 $1,439.77 |
$433.14 $466.26 $501.36 $626.02 |
$620.87 $653.99 $689.09 $813.75 |
$808.60 $841.72 $876.82 $1,001.48 |
$187.73 | ||||||||||
Catastrophic |
|||||||||||||||||||
(HMO) Beloit One Catastrophic I101
Annual Out of Pocket Expenses
Deductible: Individual:
$8,150
| Family:
$16,300 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$180.11 $204.42 $230.17 $321.67 $488.80 |
$360.22 $408.84 $460.34 $643.34 $977.60 |
$498.00 $546.62 $598.12 $781.12 |
$635.78 $684.40 $735.90 $918.90 |
$773.56 $822.18 $873.68 $1,056.68 |
$317.89 $342.20 $367.95 $459.45 |
$455.67 $479.98 $505.73 $597.23 |
$593.45 $617.76 $643.51 $735.01 |
$137.78 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Beloit One Gold I404 HSA
Annual Out of Pocket Expenses
Deductible: Individual:
$2,000
| Family:
$4,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$333.60 $378.63 $426.34 $595.80 $905.38 |
$667.20 $757.26 $852.68 $1,191.60 $1,810.76 |
$922.40 $1,012.46 $1,107.88 $1,446.80 |
$1,177.60 $1,267.66 $1,363.08 $1,702.00 |
$1,432.80 $1,522.86 $1,618.28 $1,957.20 |
$588.80 $633.83 $681.54 $851.00 |
$844.00 $889.03 $936.74 $1,106.20 |
$1,099.20 $1,144.23 $1,191.94 $1,361.40 |
$255.20 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Quartz One Silver I304 HSA
Annual Out of Pocket Expenses
Deductible: Individual:
$5,250
| Family:
$10,500 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$421.99 $478.95 $539.30 $753.67 $1,145.27 |
$843.98 $957.90 $1,078.60 $1,507.34 $2,290.54 |
$1,166.80 $1,280.72 $1,401.42 $1,830.16 |
$1,489.62 $1,603.54 $1,724.24 $2,152.98 |
$1,812.44 $1,926.36 $2,047.06 $2,475.80 |
$744.81 $801.77 $862.12 $1,076.49 |
$1,067.63 $1,124.59 $1,184.94 $1,399.31 |
$1,390.45 $1,447.41 $1,507.76 $1,722.13 |
$322.82 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Beloit One Silver I304 HSA
Annual Out of Pocket Expenses
Deductible: Individual:
$5,250
| Family:
$10,500 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$364.60 $413.82 $465.96 $651.17 $989.52 |
$729.20 $827.64 $931.92 $1,302.34 $1,979.04 |
$1,008.12 $1,106.56 $1,210.84 $1,581.26 |
$1,287.04 $1,385.48 $1,489.76 $1,860.18 |
$1,565.96 $1,664.40 $1,768.68 $2,139.10 |
$643.52 $692.74 $744.88 $930.09 |
$922.44 $971.66 $1,023.80 $1,209.01 |
$1,201.36 $1,250.58 $1,302.72 $1,487.93 |
$278.92 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Quartz One Gold I403 HSA
Annual Out of Pocket Expenses
Deductible: Individual:
$3,000
| Family:
$6,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$389.52 $442.10 $497.80 $695.67 $1,057.14 |
$779.04 $884.20 $995.60 $1,391.34 $2,114.28 |
$1,077.02 $1,182.18 $1,293.58 $1,689.32 |
$1,375.00 $1,480.16 $1,591.56 $1,987.30 |
$1,672.98 $1,778.14 $1,889.54 $2,285.28 |
$687.50 $740.08 $795.78 $993.65 |
$985.48 $1,038.06 $1,093.76 $1,291.63 |
$1,283.46 $1,336.04 $1,391.74 $1,589.61 |
$297.98 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Beloit One Gold I403 HSA
Annual Out of Pocket Expenses
Deductible: Individual:
$3,000
| Family:
$6,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$336.55 $381.98 $430.10 $601.07 $913.38 |
$673.10 $763.96 $860.20 $1,202.14 $1,826.76 |
$930.56 $1,021.42 $1,117.66 $1,459.60 |
$1,188.02 $1,278.88 $1,375.12 $1,717.06 |
$1,445.48 $1,536.34 $1,632.58 $1,974.52 |
$594.01 $639.44 $687.56 $858.53 |
$851.47 $896.90 $945.02 $1,115.99 |
$1,108.93 $1,154.36 $1,202.48 $1,373.45 |
$257.46 | ||||||||||
ADVERTISEMENT
|
|||||||||||||||||||
Dean Health PlanLocal: 1-608-828-1302 | Toll Free: 1-800-279-1302 | TTY: 1-800-947-3529 |
|||||||||||||||||||
Gold |
|||||||||||||||||||
(HMO) Dean Gold Copay Plus 1500X
Annual Out of Pocket Expenses
Deductible: Individual:
$1,500
| Family:
$3,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$377.24 $428.17 $482.12 $673.76 $1,023.84 |
$754.48 $856.34 $964.24 $1,347.52 $2,047.68 |
$1,043.07 $1,144.93 $1,252.83 $1,636.11 |
$1,331.66 $1,433.52 $1,541.42 $1,924.70 |
$1,620.25 $1,722.11 $1,830.01 $2,213.29 |
$665.83 $716.76 $770.71 $962.35 |
$954.42 $1,005.35 $1,059.30 $1,250.94 |
$1,243.01 $1,293.94 $1,347.89 $1,539.53 |
$288.59 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Dean Silver Copay Plus 4400X
Annual Out of Pocket Expenses
Deductible: Individual:
$4,400
| Family:
$8,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$360.58 $409.25 $460.82 $643.99 $978.60 |
$721.16 $818.50 $921.64 $1,287.98 $1,957.20 |
$997.00 $1,094.34 $1,197.48 $1,563.82 |
$1,272.84 $1,370.18 $1,473.32 $1,839.66 |
$1,548.68 $1,646.02 $1,749.16 $2,115.50 |
$636.42 $685.09 $736.66 $919.83 |
$912.26 $960.93 $1,012.50 $1,195.67 |
$1,188.10 $1,236.77 $1,288.34 $1,471.51 |
$275.84 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Dean Bronze Copay Plus 8100X
Annual Out of Pocket Expenses
Deductible: Individual:
$8,100
| Family:
$16,200 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$260.85 $296.07 $333.37 $465.89 $707.96 |
$521.70 $592.14 $666.74 $931.78 $1,415.92 |
$721.25 $791.69 $866.29 $1,131.33 |
$920.80 $991.24 $1,065.84 $1,330.88 |
$1,120.35 $1,190.79 $1,265.39 $1,530.43 |
$460.40 $495.62 $532.92 $665.44 |
$659.95 $695.17 $732.47 $864.99 |
$859.50 $894.72 $932.02 $1,064.54 |
$199.55 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Dean Silver Classic 5000X
Annual Out of Pocket Expenses
Deductible: Individual:
$5,000
| Family:
$10,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$346.26 $393.00 $442.52 $618.42 $939.75 |
$692.52 $786.00 $885.04 $1,236.84 $1,879.50 |
$957.41 $1,050.89 $1,149.93 $1,501.73 |
$1,222.30 $1,315.78 $1,414.82 $1,766.62 |
$1,487.19 $1,580.67 $1,679.71 $2,031.51 |
$611.15 $657.89 $707.41 $883.31 |
$876.04 $922.78 $972.30 $1,148.20 |
$1,140.93 $1,187.67 $1,237.19 $1,413.09 |
$264.89 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Dean Gold Value Copay 3700X
Annual Out of Pocket Expenses
Deductible: Individual:
$3,700
| Family:
$7,400 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$360.51 $409.18 $460.73 $643.87 $978.42 |
$721.02 $818.36 $921.46 $1,287.74 $1,956.84 |
$996.81 $1,094.15 $1,197.25 $1,563.53 |
$1,272.60 $1,369.94 $1,473.04 $1,839.32 |
$1,548.39 $1,645.73 $1,748.83 $2,115.11 |
$636.30 $684.97 $736.52 $919.66 |
$912.09 $960.76 $1,012.31 $1,195.45 |
$1,187.88 $1,236.55 $1,288.10 $1,471.24 |
$275.79 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Dean Silver Value Copay 5000X
Annual Out of Pocket Expenses
Deductible: Individual:
$5,000
| Family:
$10,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$377.34 $428.28 $482.24 $673.93 $1,024.11 |
$754.68 $856.56 $964.48 $1,347.86 $2,048.22 |
$1,043.35 $1,145.23 $1,253.15 $1,636.53 |
$1,332.02 $1,433.90 $1,541.82 $1,925.20 |
$1,620.69 $1,722.57 $1,830.49 $2,213.87 |
$666.01 $716.95 $770.91 $962.60 |
$954.68 $1,005.62 $1,059.58 $1,251.27 |
$1,243.35 $1,294.29 $1,348.25 $1,539.94 |
$288.67 | ||||||||||
Bronze |
|||||||||||||||||||
(HMO) Dean Bronze Value Copay 8100X
Annual Out of Pocket Expenses
Deductible: Individual:
$8,100
| Family:
$16,200 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$254.58 $288.95 $325.35 $454.68 $690.93 |
$509.16 $577.90 $650.70 $909.36 $1,381.86 |
$703.91 $772.65 $845.45 $1,104.11 |
$898.66 $967.40 $1,040.20 $1,298.86 |
$1,093.41 $1,162.15 $1,234.95 $1,493.61 |
$449.33 $483.70 $520.10 $649.43 |
$644.08 $678.45 $714.85 $844.18 |
$838.83 $873.20 $909.60 $1,038.93 |
$194.75 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Dean Silver HSA-E 4000X
Annual Out of Pocket Expenses
Deductible: Individual:
$4,000
| Family:
$8,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$360.22 $408.84 $460.36 $643.35 $977.63 |
$720.44 $817.68 $920.72 $1,286.70 $1,955.26 |
$996.01 $1,093.25 $1,196.29 $1,562.27 |
$1,271.58 $1,368.82 $1,471.86 $1,837.84 |
$1,547.15 $1,644.39 $1,747.43 $2,113.41 |
$635.79 $684.41 $735.93 $918.92 |
$911.36 $959.98 $1,011.50 $1,194.49 |
$1,186.93 $1,235.55 $1,287.07 $1,470.06 |
$275.57 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Dean Bronze HSA-E 6700X
Annual Out of Pocket Expenses
Deductible: Individual:
$6,700
| Family:
$13,400 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$252.55 $286.65 $322.76 $451.06 $685.43 |
$505.10 $573.30 $645.52 $902.12 $1,370.86 |
$698.30 $766.50 $838.72 $1,095.32 |
$891.50 $959.70 $1,031.92 $1,288.52 |
$1,084.70 $1,152.90 $1,225.12 $1,481.72 |
$445.75 $479.85 $515.96 $644.26 |
$638.95 $673.05 $709.16 $837.46 |
$832.15 $866.25 $902.36 $1,030.66 |
$193.20 | ||||||||||
Catastrophic |
|||||||||||||||||||
(HMO) Dean Catastrophic Safety Net
Annual Out of Pocket Expenses
Deductible: Individual:
$8,150
| Family:
$16,300 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$190.84 $216.61 $243.90 $340.85 $517.95 |
$381.68 $433.22 $487.80 $681.70 $1,035.90 |
$527.68 $579.22 $633.80 $827.70 |
$673.68 $725.22 $779.80 $973.70 |
$819.68 $871.22 $925.80 $1,119.70 |
$336.84 $362.61 $389.90 $486.85 |
$482.84 $508.61 $535.90 $632.85 |
$628.84 $654.61 $681.90 $778.85 |
$146.00 | ||||||||||
Silver |
|||||||||||||||||||
(EPO) Dean Focus Network Silver Value Copay 5000X
Annual Out of Pocket Expenses
Deductible: Individual:
$5,000
| Family:
$10,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$353.94 $401.72 $452.34 $632.14 $960.59 |
$707.88 $803.44 $904.68 $1,264.28 $1,921.18 |
$978.64 $1,074.20 $1,175.44 $1,535.04 |
$1,249.40 $1,344.96 $1,446.20 $1,805.80 |
$1,520.16 $1,615.72 $1,716.96 $2,076.56 |
$624.70 $672.48 $723.10 $902.90 |
$895.46 $943.24 $993.86 $1,173.66 |
$1,166.22 $1,214.00 $1,264.62 $1,444.42 |
$270.76 | ||||||||||
Bronze |
|||||||||||||||||||
(EPO) Dean Focus Network Bronze Value Copay 8100X
Annual Out of Pocket Expenses
Deductible: Individual:
$8,100
| Family:
$16,200 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$240.62 $273.11 $307.52 $429.75 $653.05 |
$481.24 $546.22 $615.04 $859.50 $1,306.10 |
$665.32 $730.30 $799.12 $1,043.58 |
$849.40 $914.38 $983.20 $1,227.66 |
$1,033.48 $1,098.46 $1,167.28 $1,411.74 |
$424.70 $457.19 $491.60 $613.83 |
$608.78 $641.27 $675.68 $797.91 |
$792.86 $825.35 $859.76 $981.99 |
$184.08 | ||||||||||
Silver |
|||||||||||||||||||
(EPO) Dean Focus Network Silver HSA-E 4000X
Annual Out of Pocket Expenses
Deductible: Individual:
$4,000
| Family:
$8,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$339.59 $385.44 $434.00 $606.51 $921.65 |
$679.18 $770.88 $868.00 $1,213.02 $1,843.30 |
$938.97 $1,030.67 $1,127.79 $1,472.81 |
$1,198.76 $1,290.46 $1,387.58 $1,732.60 |
$1,458.55 $1,550.25 $1,647.37 $1,992.39 |
$599.38 $645.23 $693.79 $866.30 |
$859.17 $905.02 $953.58 $1,126.09 |
$1,118.96 $1,164.81 $1,213.37 $1,385.88 |
$259.79 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(EPO) Dean Focus Network Bronze HSA-E 6700X
Annual Out of Pocket Expenses
Deductible: Individual:
$6,700
| Family:
$13,400 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$238.73 $270.96 $305.09 $426.37 $647.91 |
$477.46 $541.92 $610.18 $852.74 $1,295.82 |
$660.09 $724.55 $792.81 $1,035.37 |
$842.72 $907.18 $975.44 $1,218.00 |
$1,025.35 $1,089.81 $1,158.07 $1,400.63 |
$421.36 $453.59 $487.72 $609.00 |
$603.99 $636.22 $670.35 $791.63 |
$786.62 $818.85 $852.98 $974.26 |
$182.63 | ||||||||||
Gold |
|||||||||||||||||||
(EPO) Dean Focus Network Gold Value Copay 3700X
Annual Out of Pocket Expenses
Deductible: Individual:
$3,700
| Family:
$7,400 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$340.02 $385.92 $434.54 $607.27 $922.81 |
$680.04 $771.84 $869.08 $1,214.54 $1,845.62 |
$940.15 $1,031.95 $1,129.19 $1,474.65 |
$1,200.26 $1,292.06 $1,389.30 $1,734.76 |
$1,460.37 $1,552.17 $1,649.41 $1,994.87 |
$600.13 $646.03 $694.65 $867.38 |
$860.24 $906.14 $954.76 $1,127.49 |
$1,120.35 $1,166.25 $1,214.87 $1,387.60 |
$260.11 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(EPO) Dean Focus Network Bronze Copay Plus 8100X
Annual Out of Pocket Expenses
Deductible: Individual:
$8,100
| Family:
$16,200 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$246.51 $279.78 $315.04 $440.26 $669.02 |
$493.02 $559.56 $630.08 $880.52 $1,338.04 |
$681.60 $748.14 $818.66 $1,069.10 |
$870.18 $936.72 $1,007.24 $1,257.68 |
$1,058.76 $1,125.30 $1,195.82 $1,446.26 |
$435.09 $468.36 $503.62 $628.84 |
$623.67 $656.94 $692.20 $817.42 |
$812.25 $845.52 $880.78 $1,006.00 |
$188.58 | ||||||||||
ADVERTISEMENT
|
|||||||||||||||||||
MercyCare HMO, Inc.Local: 1-800-895-2421 | Toll Free: 1-800-895-2421 |
|||||||||||||||||||
Gold |
|||||||||||||||||||
(HMO) MercyCare HMO Gold Option A
Annual Out of Pocket Expenses
Deductible: Individual:
$1,500
| Family:
$3,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$303.43 $344.40 $387.79 $541.93 $823.51 |
$606.86 $688.80 $775.58 $1,083.86 $1,647.02 |
$838.99 $920.93 $1,007.71 $1,315.99 |
$1,071.12 $1,153.06 $1,239.84 $1,548.12 |
$1,303.25 $1,385.19 $1,471.97 $1,780.25 |
$535.56 $576.53 $619.92 $774.06 |
$767.69 $808.66 $852.05 $1,006.19 |
$999.82 $1,040.79 $1,084.18 $1,238.32 |
$232.13 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) MercyCare HMO Silver Option A
Annual Out of Pocket Expenses
Deductible: Individual:
$5,750
| Family:
$11,500 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$339.80 $385.68 $434.27 $606.89 $922.22 |
$679.60 $771.36 $868.54 $1,213.78 $1,844.44 |
$939.55 $1,031.31 $1,128.49 $1,473.73 |
$1,199.50 $1,291.26 $1,388.44 $1,733.68 |
$1,459.45 $1,551.21 $1,648.39 $1,993.63 |
$599.75 $645.63 $694.22 $866.84 |
$859.70 $905.58 $954.17 $1,126.79 |
$1,119.65 $1,165.53 $1,214.12 $1,386.74 |
$259.95 | ||||||||||
Bronze |
|||||||||||||||||||
(HMO) MercyCare HMO Bronze Option A
Annual Out of Pocket Expenses
Deductible: Individual:
$5,000
| Family:
$10,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$225.14 $255.53 $287.73 $402.10 $611.02 |
$450.28 $511.06 $575.46 $804.20 $1,222.04 |
$622.51 $683.29 $747.69 $976.43 |
$794.74 $855.52 $919.92 $1,148.66 |
$966.97 $1,027.75 $1,092.15 $1,320.89 |
$397.37 $427.76 $459.96 $574.33 |
$569.60 $599.99 $632.19 $746.56 |
$741.83 $772.22 $804.42 $918.79 |
$172.23 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) MercyCare HMO Gold Option B
Annual Out of Pocket Expenses
Deductible: Individual:
$2,250
| Family:
$4,500 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$273.88 $310.86 $350.02 $489.15 $743.31 |
$547.76 $621.72 $700.04 $978.30 $1,486.62 |
$757.28 $831.24 $909.56 $1,187.82 |
$966.80 $1,040.76 $1,119.08 $1,397.34 |
$1,176.32 $1,250.28 $1,328.60 $1,606.86 |
$483.40 $520.38 $559.54 $698.67 |
$692.92 $729.90 $769.06 $908.19 |
$902.44 $939.42 $978.58 $1,117.71 |
$209.52 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) MercyCare HMO Gold Option C
Annual Out of Pocket Expenses
Deductible: Individual:
$2,700
| Family:
$5,400 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$299.48 $339.91 $382.73 $534.86 $812.78 |
$598.96 $679.82 $765.46 $1,069.72 $1,625.56 |
$828.06 $908.92 $994.56 $1,298.82 |
$1,057.16 $1,138.02 $1,223.66 $1,527.92 |
$1,286.26 $1,367.12 $1,452.76 $1,757.02 |
$528.58 $569.01 $611.83 $763.96 |
$757.68 $798.11 $840.93 $993.06 |
$986.78 $1,027.21 $1,070.03 $1,222.16 |
$229.10 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) MercyCare HMO Silver Option B
Annual Out of Pocket Expenses
Deductible: Individual:
$4,600
| Family:
$9,200 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$322.87 $366.45 $412.62 $576.64 $876.26 |
$645.74 $732.90 $825.24 $1,153.28 $1,752.52 |
$892.74 $979.90 $1,072.24 $1,400.28 |
$1,139.74 $1,226.90 $1,319.24 $1,647.28 |
$1,386.74 $1,473.90 $1,566.24 $1,894.28 |
$569.87 $613.45 $659.62 $823.64 |
$816.87 $860.45 $906.62 $1,070.64 |
$1,063.87 $1,107.45 $1,153.62 $1,317.64 |
$247.00 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) MercyCare HMO Silver Option C
Annual Out of Pocket Expenses
Deductible: Individual:
$5,800
| Family:
$11,600 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$328.65 $373.01 $420.01 $586.96 $891.94 |
$657.30 $746.02 $840.02 $1,173.92 $1,783.88 |
$908.72 $997.44 $1,091.44 $1,425.34 |
$1,160.14 $1,248.86 $1,342.86 $1,676.76 |
$1,411.56 $1,500.28 $1,594.28 $1,928.18 |
$580.07 $624.43 $671.43 $838.38 |
$831.49 $875.85 $922.85 $1,089.80 |
$1,082.91 $1,127.27 $1,174.27 $1,341.22 |
$251.42 | ||||||||||
Bronze |
|||||||||||||||||||
(HMO) MercyCare HMO Bronze Option B
Annual Out of Pocket Expenses
Deductible: Individual:
$7,500
| Family:
$15,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$230.01 $261.06 $293.95 $410.79 $624.23 |
$460.02 $522.12 $587.90 $821.58 $1,248.46 |
$635.98 $698.08 $763.86 $997.54 |
$811.94 $874.04 $939.82 $1,173.50 |
$987.90 $1,050.00 $1,115.78 $1,349.46 |
$405.97 $437.02 $469.91 $586.75 |
$581.93 $612.98 $645.87 $762.71 |
$757.89 $788.94 $821.83 $938.67 |
$175.96 | ||||||||||
Bronze |
|||||||||||||||||||
(HMO) MercyCare HMO Bronze Option C
Annual Out of Pocket Expenses
Deductible: Individual:
$6,950
| Family:
$13,900 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$226.88 $257.51 $289.95 $405.21 $615.75 |
$453.76 $515.02 $579.90 $810.42 $1,231.50 |
$627.33 $688.59 $753.47 $983.99 |
$800.90 $862.16 $927.04 $1,157.56 |
$974.47 $1,035.73 $1,100.61 $1,331.13 |
$400.45 $431.08 $463.52 $578.78 |
$574.02 $604.65 $637.09 $752.35 |
$747.59 $778.22 $810.66 $925.92 |
$173.57 | ||||||||||
Bronze |
|||||||||||||||||||
(HMO) MercyCare HMO Bronze Option D
Annual Out of Pocket Expenses
Deductible: Individual:
$7,900
| Family:
$15,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$216.86 $246.13 $277.14 $387.30 $588.54 |
$433.72 $492.26 $554.28 $774.60 $1,177.08 |
$599.62 $658.16 $720.18 $940.50 |
$765.52 $824.06 $886.08 $1,106.40 |
$931.42 $989.96 $1,051.98 $1,272.30 |
$382.76 $412.03 $443.04 $553.20 |
$548.66 $577.93 $608.94 $719.10 |
$714.56 $743.83 $774.84 $885.00 |
$165.90 | ||||||||||
ADVERTISEMENT
|
|||||||||||||||||||
Group Health Cooperative of South Central WisconsinLocal: 1-608-828-4831 | Toll Free: 1-855-344-2729 | TTY: 1-608-828-4815 |
|||||||||||||||||||
Platinum |
|||||||||||||||||||
(HMO) Platinum 500 Ded/1500 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$500
| Family:
$1,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$462.01 $524.38 $590.44 $825.14 $1,253.87 |
$924.02 $1,048.76 $1,180.88 $1,650.28 $2,507.74 |
$1,277.46 $1,402.20 $1,534.32 $2,003.72 |
$1,630.90 $1,755.64 $1,887.76 $2,357.16 |
$1,984.34 $2,109.08 $2,241.20 $2,710.60 |
$815.45 $877.82 $943.88 $1,178.58 |
$1,168.89 $1,231.26 $1,297.32 $1,532.02 |
$1,522.33 $1,584.70 $1,650.76 $1,885.46 |
$353.44 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Gold 2500 Ded/2500 MOOP HSA
Annual Out of Pocket Expenses
Deductible: Individual:
$2,500
| Family:
$5,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$393.35 $446.46 $502.70 $702.53 $1,067.55 |
$786.70 $892.92 $1,005.40 $1,405.06 $2,135.10 |
$1,087.62 $1,193.84 $1,306.32 $1,705.98 |
$1,388.54 $1,494.76 $1,607.24 $2,006.90 |
$1,689.46 $1,795.68 $1,908.16 $2,307.82 |
$694.27 $747.38 $803.62 $1,003.45 |
$995.19 $1,048.30 $1,104.54 $1,304.37 |
$1,296.11 $1,349.22 $1,405.46 $1,605.29 |
$300.92 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Bronze 4000 Ded/7350 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$4,000
| Family:
$8,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$308.96 $350.67 $394.85 $551.80 $838.51 |
$617.92 $701.34 $789.70 $1,103.60 $1,677.02 |
$854.28 $937.70 $1,026.06 $1,339.96 |
$1,090.64 $1,174.06 $1,262.42 $1,576.32 |
$1,327.00 $1,410.42 $1,498.78 $1,812.68 |
$545.32 $587.03 $631.21 $788.16 |
$781.68 $823.39 $867.57 $1,024.52 |
$1,018.04 $1,059.75 $1,103.93 $1,260.88 |
$236.36 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Bronze 6900 Ded/6900 MOOP HSA
Annual Out of Pocket Expenses
Deductible: Individual:
$6,900
| Family:
$13,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$300.59 $341.16 $384.15 $536.84 $815.78 |
$601.18 $682.32 $768.30 $1,073.68 $1,631.56 |
$831.13 $912.27 $998.25 $1,303.63 |
$1,061.08 $1,142.22 $1,228.20 $1,533.58 |
$1,291.03 $1,372.17 $1,458.15 $1,763.53 |
$530.54 $571.11 $614.10 $766.79 |
$760.49 $801.06 $844.05 $996.74 |
$990.44 $1,031.01 $1,074.00 $1,226.69 |
$229.95 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Gold 2500 Ded/6500 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$2,500
| Family:
$5,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$376.01 $426.77 $480.54 $671.55 $1,020.49 |
$752.02 $853.54 $961.08 $1,343.10 $2,040.98 |
$1,039.67 $1,141.19 $1,248.73 $1,630.75 |
$1,327.32 $1,428.84 $1,536.38 $1,918.40 |
$1,614.97 $1,716.49 $1,824.03 $2,206.05 |
$663.66 $714.42 $768.19 $959.20 |
$951.31 $1,002.07 $1,055.84 $1,246.85 |
$1,238.96 $1,289.72 $1,343.49 $1,534.50 |
$287.65 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Gold Simple Choice 1600 Ded/5200 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$1,600
| Family:
$3,200 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$392.27 $445.23 $501.32 $700.59 $1,064.61 |
$784.54 $890.46 $1,002.64 $1,401.18 $2,129.22 |
$1,084.63 $1,190.55 $1,302.73 $1,701.27 |
$1,384.72 $1,490.64 $1,602.82 $2,001.36 |
$1,684.81 $1,790.73 $1,902.91 $2,301.45 |
$692.36 $745.32 $801.41 $1,000.68 |
$992.45 $1,045.41 $1,101.50 $1,300.77 |
$1,292.54 $1,345.50 $1,401.59 $1,600.86 |
$300.09 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Silver Simple Choice 4550X Ded/7900 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$4,000
| Family:
$8,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$410.48 $465.89 $524.59 $733.11 $1,114.02 |
$820.96 $931.78 $1,049.18 $1,466.22 $2,228.04 |
$1,134.98 $1,245.80 $1,363.20 $1,780.24 |
$1,449.00 $1,559.82 $1,677.22 $2,094.26 |
$1,763.02 $1,873.84 $1,991.24 $2,408.28 |
$724.50 $779.91 $838.61 $1,047.13 |
$1,038.52 $1,093.93 $1,152.63 $1,361.15 |
$1,352.54 $1,407.95 $1,466.65 $1,675.17 |
$314.02 | ||||||||||
Expanded Bronze |
|||||||||||||||||||
(HMO) Bronze Simple Choice 6750 Ded/7650 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$6,750
| Family:
$13,500 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$317.32 $360.15 $405.53 $566.72 $861.18 |
$634.64 $720.30 $811.06 $1,133.44 $1,722.36 |
$877.39 $963.05 $1,053.81 $1,376.19 |
$1,120.14 $1,205.80 $1,296.56 $1,618.94 |
$1,362.89 $1,448.55 $1,539.31 $1,861.69 |
$560.07 $602.90 $648.28 $809.47 |
$802.82 $845.65 $891.03 $1,052.22 |
$1,045.57 $1,088.40 $1,133.78 $1,294.97 |
$242.75 | ||||||||||
Platinum |
|||||||||||||||||||
(HMO) Platinum No Ded/2000 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$0
| Family:
$0 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$466.26 $529.21 $595.88 $832.74 $1,265.43 |
$932.52 $1,058.42 $1,191.76 $1,665.48 $2,530.86 |
$1,289.21 $1,415.11 $1,548.45 $2,022.17 |
$1,645.90 $1,771.80 $1,905.14 $2,378.86 |
$2,002.59 $2,128.49 $2,261.83 $2,735.55 |
$822.95 $885.90 $952.57 $1,189.43 |
$1,179.64 $1,242.59 $1,309.26 $1,546.12 |
$1,536.33 $1,599.28 $1,665.95 $1,902.81 |
$356.69 | ||||||||||
Bronze |
|||||||||||||||||||
(HMO) Bronze 8150 Ded/8150 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$8,150
| Family:
$16,300 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$296.10 $336.08 $378.42 $528.84 $803.62 |
$592.20 $672.16 $756.84 $1,057.68 $1,607.24 |
$818.72 $898.68 $983.36 $1,284.20 |
$1,045.24 $1,125.20 $1,209.88 $1,510.72 |
$1,271.76 $1,351.72 $1,436.40 $1,737.24 |
$522.62 $562.60 $604.94 $755.36 |
$749.14 $789.12 $831.46 $981.88 |
$975.66 $1,015.64 $1,057.98 $1,208.40 |
$226.52 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Silver 4900 Ded/7900 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$4,900
| Family:
$9,800 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$408.56 $463.72 $522.14 $729.68 $1,108.82 |
$817.12 $927.44 $1,044.28 $1,459.36 $2,217.64 |
$1,129.67 $1,239.99 $1,356.83 $1,771.91 |
$1,442.22 $1,552.54 $1,669.38 $2,084.46 |
$1,754.77 $1,865.09 $1,981.93 $2,397.01 |
$721.11 $776.27 $834.69 $1,042.23 |
$1,033.66 $1,088.82 $1,147.24 $1,354.78 |
$1,346.21 $1,401.37 $1,459.79 $1,667.33 |
$312.55 | ||||||||||
Gold |
|||||||||||||||||||
(HMO) Gold 1500 Ded/8150 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$1,500
| Family:
$3,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$365.49 $414.83 $467.10 $652.76 $991.93 |
$730.98 $829.66 $934.20 $1,305.52 $1,983.86 |
$1,010.58 $1,109.26 $1,213.80 $1,585.12 |
$1,290.18 $1,388.86 $1,493.40 $1,864.72 |
$1,569.78 $1,668.46 $1,773.00 $2,144.32 |
$645.09 $694.43 $746.70 $932.36 |
$924.69 $974.03 $1,026.30 $1,211.96 |
$1,204.29 $1,253.63 $1,305.90 $1,491.56 |
$279.60 | ||||||||||
Silver |
|||||||||||||||||||
(HMO) Silver 8100X Ded/8150 MOOP
Annual Out of Pocket Expenses
Deductible: Individual:
$7,500
| Family:
$15,000 Monthly Premiums: |
|||||||||||||||||||
Age | Individual |
Couple |
Couple 1 Child |
Couple 2 Chidren |
Couple 3+ Children |
Individual 1 Child |
Individual 2 Children |
Individual 3+ Children |
Child 0-14 |
||||||||||
21 30 40 50 60 |
$402.85 $457.23 $514.84 $719.48 $1,093.32 |
$805.70 $914.46 $1,029.68 $1,438.96 $2,186.64 |
$1,113.88 $1,222.64 $1,337.86 $1,747.14 |
$1,422.06 $1,530.82 $1,646.04 $2,055.32 |
$1,730.24 $1,839.00 $1,954.22 $2,363.50 |
$711.03 $765.41 $823.02 $1,027.66 |
$1,019.21 $1,073.59 $1,131.20 $1,335.84 |
$1,327.39 $1,381.77 $1,439.38 $1,644.02 |
$308.18 |
‡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 Rock County here.
Rock County is in “Rating Area 14” of Wisconsin.
Currently, there are 77 plans offered in Rating Area 14.
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Obamacare Rates and Providers for Other Years
2014 | 2015 | 2016| 2017 | 2018 | 2019
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Do I Qualify For a Tax Credit to Pay My Premiums?
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How do I sign up in Wisconsin?
-
Using a Broker to Help You Sign Up
Ways to Save Money on Health Insurance in Wisconsin
There are three primary ways to reduce the cost of health plans under the Affordable Care Act in Wisconsin.
- You may be able to lower the cost of monthly premiums when you sign up for a private health insurance plan. Your subsidies will come in the form of a federal tax credit. This article is updated to cover the tax credits available under the American Rescue Plan Act of 2021 and extended under the Inflation Reduction Act through 2025.
- You may be able to reduce your out-of-pocket costs -- including copayments, deductibles, and coinsurance -- with cost-sharing subsidies paid for by insurers.
- You may qualify for free or low-cost coverage through Medicaid in Wisconsin, or your children may be able to obtain coverage through the Children’s Health Insurance Program (CHIP).
Each of these forms of assistance depends on your income and family size.
Many people who apply for coverage at the Wisconsin exchange will be eligible for some form of financial assistance. Read on to learn more about each option.
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