Obamacare 2021 Rates for Weber County
Obamacare > Rates > Utah > Weber County
Obamacare > Rates > Utah > Weber County
ADVERTISEMENT
ADVERTISEMENT
Molina HealthcareLocal: 1-801-858-0400 | Toll Free: 1-888-858-3973 |
Toc - Plan #1 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Confident Care Gold 1 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$321,41 $446,76 $475,37 $683,64 $964,23 |
$576,29 $701,64 $730,25 $938,52 |
$831,17 $956,52 $985,13 $1 193,40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$642,82 $893,52 $950,74 $1 367,28 $1 928,46 |
$897,70 $1 148,40 $1 205,62 $1 622,16 |
$1 152,58 $1 403,28 $1 460,50 $1 877,04 |
Toc - Plan #2 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 1 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$331,38 $460,62 $490,11 $704,84 $994,14 |
$594,16 $723,40 $752,89 $967,62 |
$856,94 $986,18 $1 015,67 $1 230,40 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$662,76 $921,24 $980,22 $1 409,68 $1 988,28 |
$925,54 $1 184,02 $1 243,00 $1 672,46 |
$1 188,32 $1 446,80 $1 505,78 $1 935,24 |
Toc - Plan #3 Molina Healthcare | ||||||||||||||||||||
Bronze
(HMO) Core Care Bronze 1 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$227,67 $316,47 $336,73 $484,26 $683,01 |
$408,22 $497,02 $517,28 $664,81 |
$588,77 $677,57 $697,83 $845,36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$455,34 $632,94 $673,46 $968,52 $1 366,02 |
$635,89 $813,49 $854,01 $1 149,07 |
$816,44 $994,04 $1 034,56 $1 329,62 |
Toc - Plan #4 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 4 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$318,59 $442,85 $471,20 $677,65 $955,77 |
$571,24 $695,50 $723,85 $930,30 |
$823,89 $948,15 $976,50 $1 182,95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$637,18 $885,70 $942,40 $1 355,30 $1 911,54 |
$889,83 $1 138,35 $1 195,05 $1 607,95 |
$1 142,48 $1 391,00 $1 447,70 $1 860,60 |
Toc - Plan #5 Molina Healthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) Core Care Bronze 4 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$238,18 $331,07 $352,26 $506,60 $714,53 |
$427,05 $519,94 $541,13 $695,47 |
$615,92 $708,81 $730,00 $884,34 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$476,36 $662,14 $704,52 $1 013,20 $1 429,06 |
$665,23 $851,01 $893,39 $1 202,07 |
$854,10 $1 039,88 $1 082,26 $1 390,94 |
Toc - Plan #6 Molina Healthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) Core Care Bronze 5 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$231,76 $322,14 $342,77 $492,95 $695,27 |
$415,54 $505,92 $526,55 $676,73 |
$599,32 $689,70 $710,33 $860,51 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$463,52 $644,28 $685,54 $985,90 $1 390,54 |
$647,30 $828,06 $869,32 $1 169,68 |
$831,08 $1 011,84 $1 053,10 $1 353,46 |
Toc - Plan #7 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Confident Care Gold 1 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$325,25 $452,10 $481,04 $691,80 $975,75 |
$583,17 $710,02 $738,96 $949,72 |
$841,09 $967,94 $996,88 $1 207,64 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$650,50 $904,20 $962,08 $1 383,60 $1 951,50 |
$908,42 $1 162,12 $1 220,00 $1 641,52 |
$1 166,34 $1 420,04 $1 477,92 $1 899,44 |
Toc - Plan #8 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 1 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$335,22 $465,95 $495,78 $713,00 $1 005,65 |
$601,05 $731,78 $761,61 $978,83 |
$866,88 $997,61 $1 027,44 $1 244,66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$670,44 $931,90 $991,56 $1 426,00 $2 011,30 |
$936,27 $1 197,73 $1 257,39 $1 691,83 |
$1 202,10 $1 463,56 $1 523,22 $1 957,66 |
Toc - Plan #9 Molina Healthcare | ||||||||||||||||||||
Bronze
(HMO) Core Care Bronze 1 + Vision |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$231,51 $321,80 $342,40 $492,42 $694,53 |
$415,10 $505,39 $525,99 $676,01 |
$598,69 $688,98 $709,58 $859,60 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$463,02 $643,60 $684,80 $984,84 $1 389,06 |
$646,61 $827,19 $868,39 $1 168,43 |
$830,20 $1 010,78 $1 051,98 $1 352,02 |
Toc - Plan #10 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 2 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$327,96 $455,86 $485,05 $697,57 $983,88 |
$588,03 $715,93 $745,12 $957,64 |
$848,10 $976,00 $1 005,19 $1 217,71 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$655,92 $911,72 $970,10 $1 395,14 $1 967,76 |
$915,99 $1 171,79 $1 230,17 $1 655,21 |
$1 176,06 $1 431,86 $1 490,24 $1 915,28 |
Toc - Plan #11 Molina Healthcare | ||||||||||||||||||||
Bronze
(HMO) Core Care Bronze 2 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-858-3973
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$225,72 $313,75 $333,84 $480,11 $677,16 |
$404,72 $492,75 $512,84 $659,11 |
$583,72 $671,75 $691,84 $838,11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$451,44 $627,50 $667,68 $960,22 $1 354,32 |
$630,44 $806,50 $846,68 $1 139,22 |
$809,44 $985,50 $1 025,68 $1 318,22 |
ADVERTISEMENT
Regence BlueCross BlueShield of UtahLocal: 1-888-231-8424 | Toll Free: 1-888-231-8424 |
Toc - Plan #12 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Silver
(EPO) Silver 3500 EPO |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$321,67 $447,12 $475,75 $684,19 $965,01 |
$576,76 $702,21 $730,84 $939,28 |
$831,85 $957,30 $985,93 $1 194,37 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$643,34 $894,24 $951,50 $1 368,38 $1 930,02 |
$898,43 $1 149,33 $1 206,59 $1 623,47 |
$1 153,52 $1 404,42 $1 461,68 $1 878,56 |
Toc - Plan #13 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze HDHP 5700 EPO |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$235,83 $327,80 $348,79 $501,61 $707,49 |
$422,84 $514,81 $535,80 $688,62 |
$609,85 $701,82 $722,81 $875,63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$471,66 $655,60 $697,58 $1 003,22 $1 414,98 |
$658,67 $842,61 $884,59 $1 190,23 |
$845,68 $1 029,62 $1 071,60 $1 377,24 |
Toc - Plan #14 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Essential 7500 EPO |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$234,83 $326,41 $347,31 $499,48 $704,49 |
$421,05 $512,63 $533,53 $685,70 |
$607,27 $698,85 $719,75 $871,92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$469,66 $652,82 $694,62 $998,96 $1 408,98 |
$655,88 $839,04 $880,84 $1 185,18 |
$842,10 $1 025,26 $1 067,06 $1 371,40 |
Toc - Plan #15 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Expanded Bronze
(EPO) Bronze Care on Demand 8000 EPO |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$224,06 $311,45 $331,39 $476,58 $672,18 |
$401,74 $489,13 $509,07 $654,26 |
$579,42 $666,81 $686,75 $831,94 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$448,12 $622,90 $662,78 $953,16 $1 344,36 |
$625,80 $800,58 $840,46 $1 130,84 |
$803,48 $978,26 $1 018,14 $1 308,52 |
Toc - Plan #16 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Gold
(EPO) Gold 1200 EPO |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$383,42 $532,95 $567,08 $815,53 $1 150,25 |
$687,47 $837,00 $871,13 $1 119,58 |
$991,52 $1 141,05 $1 175,18 $1 423,63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$766,84 $1 065,90 $1 134,16 $1 631,06 $2 300,50 |
$1 070,89 $1 369,95 $1 438,21 $1 935,11 |
$1 374,94 $1 674,00 $1 742,26 $2 239,16 |
Toc - Plan #17 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Silver
(EPO) Silver Care on Demand 4000 EPO |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$314,31 $436,89 $464,87 $668,54 $942,93 |
$563,56 $686,14 $714,12 $917,79 |
$812,81 $935,39 $963,37 $1 167,04 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$628,62 $873,78 $929,74 $1 337,08 $1 885,86 |
$877,87 $1 123,03 $1 178,99 $1 586,33 |
$1 127,12 $1 372,28 $1 428,24 $1 835,58 |
Toc - Plan #18 Regence BlueCross BlueShield of Utah | ||||||||||||||||||||
Silver
(EPO) Silver 5000 EPO |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-231-8424
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$306,99 $426,72 $454,04 $652,97 $920,97 |
$550,43 $670,16 $697,48 $896,41 |
$793,87 $913,60 $940,92 $1 139,85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$613,98 $853,44 $908,08 $1 305,94 $1 841,94 |
$857,42 $1 096,88 $1 151,52 $1 549,38 |
$1 100,86 $1 340,32 $1 394,96 $1 792,82 |
ADVERTISEMENT
BridgeSpan Health CompanyLocal: 1-855-857-9945 | Toll Free: 1-855-857-9945 | TTY: 1-800-735-2900 |
Toc - Plan #19 BridgeSpan Health Company | ||||||||||||||||||||
Silver
(HMO) BridgeSpan Silver Essential 4000 HMO |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-857-9945
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$340,54 $473,35 $503,66 $724,33 $1 021,62 |
$610,59 $743,40 $773,71 $994,38 |
$880,64 $1 013,45 $1 043,76 $1 264,43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$681,08 $946,70 $1 007,32 $1 448,66 $2 043,24 |
$951,13 $1 216,75 $1 277,37 $1 718,71 |
$1 221,18 $1 486,80 $1 547,42 $1 988,76 |
Toc - Plan #20 BridgeSpan Health Company | ||||||||||||||||||||
Gold
(HMO) Gold Essential 1200 HMO |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-857-9945
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$383,22 $532,67 $566,78 $815,10 $1 149,65 |
$687,11 $836,56 $870,67 $1 118,99 |
$991,00 $1 140,45 $1 174,56 $1 422,88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$766,44 $1 065,34 $1 133,56 $1 630,20 $2 299,30 |
$1 070,33 $1 369,23 $1 437,45 $1 934,09 |
$1 374,22 $1 673,12 $1 741,34 $2 237,98 |
Toc - Plan #21 BridgeSpan Health Company | ||||||||||||||||||||
Expanded Bronze
(HMO) Bronze Care on Demand 8000 HMO |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-857-9945
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$228,94 $318,22 $338,60 $486,95 $686,81 |
$410,49 $499,77 $520,15 $668,50 |
$592,04 $681,32 $701,70 $850,05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$457,88 $636,44 $677,20 $973,90 $1 373,62 |
$639,43 $817,99 $858,75 $1 155,45 |
$820,98 $999,54 $1 040,30 $1 337,00 |
ADVERTISEMENT
University of Utah Health PlansLocal: 1-801-587-6480x1 | Toll Free: 1-888-271-5870 | TTY: 1-800-346-4128 |
Toc - Plan #22 University of Utah Health Plans | ||||||||||||||||||||
Gold
(EPO) Healthy Premier Gold Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-271-5870
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$550,30 $764,92 $813,90 $1 170,50 $1 650,90 |
$986,69 $1 201,31 $1 250,29 $1 606,89 |
$1 423,08 $1 637,70 $1 686,68 $2 043,28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1 100,60 $1 529,84 $1 627,80 $2 341,00 $3 301,80 |
$1 536,99 $1 966,23 $2 064,19 $2 777,39 |
$1 973,38 $2 402,62 $2 500,58 $3 213,78 |
Toc - Plan #23 University of Utah Health Plans | ||||||||||||||||||||
Silver
(EPO) Healthy Premier Silver Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-271-5870
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$422,44 $587,19 $624,78 $898,52 $1 267,31 |
$757,43 $922,18 $959,77 $1 233,51 |
$1 092,42 $1 257,17 $1 294,76 $1 568,50 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$844,88 $1 174,38 $1 249,56 $1 797,04 $2 534,62 |
$1 179,87 $1 509,37 $1 584,55 $2 132,03 |
$1 514,86 $1 844,36 $1 919,54 $2 467,02 |
Toc - Plan #24 University of Utah Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Healthy Premier Bronze HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-271-5870
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$261,54 $363,55 $386,82 $556,31 $784,62 |
$468,94 $570,95 $594,22 $763,71 |
$676,34 $778,35 $801,62 $971,11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$523,08 $727,10 $773,64 $1 112,62 $1 569,24 |
$730,48 $934,50 $981,04 $1 320,02 |
$937,88 $1 141,90 $1 188,44 $1 527,42 |
Toc - Plan #25 University of Utah Health Plans | ||||||||||||||||||||
Gold
(EPO) Healthy Preferred Gold Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-271-5870
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$487,00 $676,92 $720,27 $1 035,84 $1 460,99 |
$873,19 $1 063,11 $1 106,46 $1 422,03 |
$1 259,38 $1 449,30 $1 492,65 $1 808,22 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$974,00 $1 353,84 $1 440,54 $2 071,68 $2 921,98 |
$1 360,19 $1 740,03 $1 826,73 $2 457,87 |
$1 746,38 $2 126,22 $2 212,92 $2 844,06 |
Toc - Plan #26 University of Utah Health Plans | ||||||||||||||||||||
Silver
(EPO) Healthy Preferred Silver Copay |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-271-5870
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$373,84 $519,63 $552,90 $795,15 $1 121,51 |
$670,29 $816,08 $849,35 $1 091,60 |
$966,74 $1 112,53 $1 145,80 $1 388,05 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$747,68 $1 039,26 $1 105,80 $1 590,30 $2 243,02 |
$1 044,13 $1 335,71 $1 402,25 $1 886,75 |
$1 340,58 $1 632,16 $1 698,70 $2 183,20 |
Toc - Plan #27 University of Utah Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Healthy Preferred Bronze HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-271-5870
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$231,46 $321,72 $342,32 $492,31 $694,37 |
$415,00 $505,26 $525,86 $675,85 |
$598,54 $688,80 $709,40 $859,39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$462,92 $643,44 $684,64 $984,62 $1 388,74 |
$646,46 $826,98 $868,18 $1 168,16 |
$830,00 $1 010,52 $1 051,72 $1 351,70 |
Toc - Plan #28 University of Utah Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Healthy Premier Expanded Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-271-5870
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$314,39 $437,00 $464,98 $668,70 $943,16 |
$563,70 $686,31 $714,29 $918,01 |
$813,01 $935,62 $963,60 $1 167,32 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$628,78 $874,00 $929,96 $1 337,40 $1 886,32 |
$878,09 $1 123,31 $1 179,27 $1 586,71 |
$1 127,40 $1 372,62 $1 428,58 $1 836,02 |
Toc - Plan #29 University of Utah Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Healthy Preferred Expanded Bronze |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-271-5870
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$278,22 $386,72 $411,49 $591,77 $834,66 |
$498,85 $607,35 $632,12 $812,40 |
$719,48 $827,98 $852,75 $1 033,03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$556,44 $773,44 $822,98 $1 183,54 $1 669,32 |
$777,07 $994,07 $1 043,61 $1 404,17 |
$997,70 $1 214,70 $1 264,24 $1 624,80 |
Toc - Plan #30 University of Utah Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Healthy Premier Expanded Bronze HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-271-5870
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$314,39 $437,00 $464,98 $668,70 $943,16 |
$563,70 $686,31 $714,29 $918,01 |
$813,01 $935,62 $963,60 $1 167,32 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$628,78 $874,00 $929,96 $1 337,40 $1 886,32 |
$878,09 $1 123,31 $1 179,27 $1 586,71 |
$1 127,40 $1 372,62 $1 428,58 $1 836,02 |
Toc - Plan #31 University of Utah Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Healthy Preferred Expanded Bronze HSA |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-271-5870
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$278,22 $386,72 $411,49 $591,77 $834,66 |
$498,85 $607,35 $632,12 $812,40 |
$719,48 $827,98 $852,75 $1 033,03 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$556,44 $773,44 $822,98 $1 183,54 $1 669,32 |
$777,07 $994,07 $1 043,61 $1 404,17 |
$997,70 $1 214,70 $1 264,24 $1 624,80 |
Toc - Plan #32 University of Utah Health Plans | ||||||||||||||||||||
Silver
(EPO) Healthy Premier Silver 2300 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-271-5870
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$423,02 $587,99 $625,64 $899,76 $1 269,05 |
$758,47 $923,44 $961,09 $1 235,21 |
$1 093,92 $1 258,89 $1 296,54 $1 570,66 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$846,04 $1 175,98 $1 251,28 $1 799,52 $2 538,10 |
$1 181,49 $1 511,43 $1 586,73 $2 134,97 |
$1 516,94 $1 846,88 $1 922,18 $2 470,42 |
Toc - Plan #33 University of Utah Health Plans | ||||||||||||||||||||
Silver
(EPO) Healthy Preferred Silver 2300 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-271-5870
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$374,35 $520,35 $553,66 $796,24 $1 123,05 |
$671,21 $817,21 $850,52 $1 093,10 |
$968,07 $1 114,07 $1 147,38 $1 389,96 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$748,70 $1 040,70 $1 107,32 $1 592,48 $2 246,10 |
$1 045,56 $1 337,56 $1 404,18 $1 889,34 |
$1 342,42 $1 634,42 $1 701,04 $2 186,20 |
Toc - Plan #34 University of Utah Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Healthy Premier Bronze w.3 Copays Before Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-271-5870
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$263,29 $365,97 $389,40 $560,01 $789,86 |
$472,08 $574,76 $598,19 $768,80 |
$680,87 $783,55 $806,98 $977,59 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$526,58 $731,94 $778,80 $1 120,02 $1 579,72 |
$735,37 $940,73 $987,59 $1 328,81 |
$944,16 $1 149,52 $1 196,38 $1 537,60 |
Toc - Plan #35 University of Utah Health Plans | ||||||||||||||||||||
Expanded Bronze
(EPO) Healthy Preferred Bronze w.3 Copays Before Deductible |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-271-5870
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$233,00 $323,87 $344,60 $495,59 $698,99 |
$417,77 $508,64 $529,37 $680,36 |
$602,54 $693,41 $714,14 $865,13 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$466,00 $647,74 $689,20 $991,18 $1 397,98 |
$650,77 $832,51 $873,97 $1 175,95 |
$835,54 $1 017,28 $1 058,74 $1 360,72 |
ADVERTISEMENT
SelectHealthLocal: 1-801-442-5038 | Toll Free: 1-800-538-5038 |
Toc - Plan #36 SelectHealth | ||||||||||||||||||||
Silver
(HMO) Med Silver 2500 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$374,78 $520,94 $554,29 $797,15 $1 124,33 |
$671,98 $818,14 $851,49 $1 094,35 |
$969,18 $1 115,34 $1 148,69 $1 391,55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$749,56 $1 041,88 $1 108,58 $1 594,30 $2 248,66 |
$1 046,76 $1 339,08 $1 405,78 $1 891,50 |
$1 343,96 $1 636,28 $1 702,98 $2 188,70 |
Toc - Plan #37 SelectHealth | ||||||||||||||||||||
Gold
(HMO) Med Gold 1500 - no deductible for office visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$462,16 $642,41 $683,54 $983,02 $1 386,48 |
$828,65 $1 008,90 $1 050,03 $1 349,51 |
$1 195,14 $1 375,39 $1 416,52 $1 716,00 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$924,32 $1 284,82 $1 367,08 $1 966,04 $2 772,96 |
$1 290,81 $1 651,31 $1 733,57 $2 332,53 |
$1 657,30 $2 017,80 $2 100,06 $2 699,02 |
Toc - Plan #38 SelectHealth | ||||||||||||||||||||
Expanded Bronze
(HMO) Med Expanded Bronze 7800 - no deductible for one urgent care and all PCP visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$235,52 $327,37 $348,33 $500,95 $706,56 |
$422,29 $514,14 $535,10 $687,72 |
$609,06 $700,91 $721,87 $874,49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$471,04 $654,74 $696,66 $1 001,90 $1 413,12 |
$657,81 $841,51 $883,43 $1 188,67 |
$844,58 $1 028,28 $1 070,20 $1 375,44 |
Toc - Plan #39 SelectHealth | ||||||||||||||||||||
Expanded Bronze
(HMO) Med Expanded Bronze 6900 HSA Qualified |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$237,39 $329,97 $351,10 $504,93 $712,17 |
$425,64 $518,22 $539,35 $693,18 |
$613,89 $706,47 $727,60 $881,43 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$474,78 $659,94 $702,20 $1 009,86 $1 424,34 |
$663,03 $848,19 $890,45 $1 198,11 |
$851,28 $1 036,44 $1 078,70 $1 386,36 |
Toc - Plan #40 SelectHealth | ||||||||||||||||||||
Catastrophic
(HMO) Med Catastrophic 8550 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$196,73 $273,46 $290,97 $418,45 $590,19 |
$352,74 $429,47 $446,98 $574,46 |
$508,75 $585,48 $602,99 $730,47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$393,46 $546,92 $581,94 $836,90 $1 180,38 |
$549,47 $702,93 $737,95 $992,91 |
$705,48 $858,94 $893,96 $1 148,92 |
Toc - Plan #41 SelectHealth | ||||||||||||||||||||
Gold
(HMO) Value Gold 1500 - no deductible for office visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$409,02 $568,54 $604,95 $870,00 $1 227,06 |
$733,38 $892,90 $929,31 $1 194,36 |
$1 057,74 $1 217,26 $1 253,67 $1 518,72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$818,04 $1 137,08 $1 209,90 $1 740,00 $2 454,12 |
$1 142,40 $1 461,44 $1 534,26 $2 064,36 |
$1 466,76 $1 785,80 $1 858,62 $2 388,72 |
Toc - Plan #42 SelectHealth | ||||||||||||||||||||
Silver
(HMO) Value Silver 2500 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$331,69 $461,04 $490,56 $705,50 $995,06 |
$594,72 $724,07 $753,59 $968,53 |
$857,75 $987,10 $1 016,62 $1 231,56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$663,38 $922,08 $981,12 $1 411,00 $1 990,12 |
$926,41 $1 185,11 $1 244,15 $1 674,03 |
$1 189,44 $1 448,14 $1 507,18 $1 937,06 |
Toc - Plan #43 SelectHealth | ||||||||||||||||||||
Expanded Bronze
(HMO) Value Expanded Bronze 7800 - no deductible for one urgent care and all PCP visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$208,44 $289,73 $308,28 $443,35 $625,32 |
$373,73 $455,02 $473,57 $608,64 |
$539,02 $620,31 $638,86 $773,93 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$416,88 $579,46 $616,56 $886,70 $1 250,64 |
$582,17 $744,75 $781,85 $1 051,99 |
$747,46 $910,04 $947,14 $1 217,28 |
Toc - Plan #44 SelectHealth | ||||||||||||||||||||
Expanded Bronze
(HMO) Value Expanded Bronze 6900 HSA Qualified |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$210,10 $292,03 $310,73 $446,87 $630,29 |
$376,71 $458,64 $477,34 $613,48 |
$543,32 $625,25 $643,95 $780,09 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$420,20 $584,06 $621,46 $893,74 $1 260,58 |
$586,81 $750,67 $788,07 $1 060,35 |
$753,42 $917,28 $954,68 $1 226,96 |
Toc - Plan #45 SelectHealth | ||||||||||||||||||||
Catastrophic
(HMO) Value Catastrophic 8550 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$174,11 $242,02 $257,52 $370,34 $522,33 |
$312,18 $380,09 $395,59 $508,41 |
$450,25 $518,16 $533,66 $646,48 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$348,22 $484,04 $515,04 $740,68 $1 044,66 |
$486,29 $622,11 $653,11 $878,75 |
$624,36 $760,18 $791,18 $1 016,82 |
Toc - Plan #46 SelectHealth | ||||||||||||||||||||
Silver
(HMO) Value Silver 3000 - no deductible for office visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$357,33 $496,69 $528,49 $760,04 $1 071,98 |
$640,69 $780,05 $811,85 $1 043,40 |
$924,05 $1 063,41 $1 095,21 $1 326,76 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$714,66 $993,38 $1 056,98 $1 520,08 $2 143,96 |
$998,02 $1 276,74 $1 340,34 $1 803,44 |
$1 281,38 $1 560,10 $1 623,70 $2 086,80 |
Toc - Plan #47 SelectHealth | ||||||||||||||||||||
Silver
(HMO) Med Silver 3000 - no deductible for office visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$403,75 $561,21 $597,15 $858,77 $1 211,25 |
$723,92 $881,38 $917,32 $1 178,94 |
$1 044,09 $1 201,55 $1 237,49 $1 499,11 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$807,50 $1 122,42 $1 194,30 $1 717,54 $2 422,50 |
$1 127,67 $1 442,59 $1 514,47 $2 037,71 |
$1 447,84 $1 762,76 $1 834,64 $2 357,88 |
Toc - Plan #48 SelectHealth | ||||||||||||||||||||
Expanded Bronze
(HMO) Value Expanded Bronze 5900 HSA Qualified |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$264,27 $367,34 $390,86 $562,11 $792,81 |
$473,84 $576,91 $600,43 $771,68 |
$683,41 $786,48 $810,00 $981,25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$528,54 $734,68 $781,72 $1 124,22 $1 585,62 |
$738,11 $944,25 $991,29 $1 333,79 |
$947,68 $1 153,82 $1 200,86 $1 543,36 |
Toc - Plan #49 SelectHealth | ||||||||||||||||||||
Expanded Bronze
(HMO) Med Expanded Bronze 5900 HSA Qualified |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$298,61 $415,06 $441,64 $635,14 $895,82 |
$535,40 $651,85 $678,43 $871,93 |
$772,19 $888,64 $915,22 $1 108,72 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$597,22 $830,12 $883,28 $1 270,28 $1 791,64 |
$834,01 $1 066,91 $1 120,07 $1 507,07 |
$1 070,80 $1 303,70 $1 356,86 $1 743,86 |
Toc - Plan #50 SelectHealth | ||||||||||||||||||||
Expanded Bronze
(HMO) Value Expanded Bronze 5300 Copay Plan - no deductible for one urgent care and all PCP visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$257,66 $358,14 $381,07 $548,04 $772,97 |
$461,98 $562,46 $585,39 $752,36 |
$666,30 $766,78 $789,71 $956,68 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$515,32 $716,28 $762,14 $1 096,08 $1 545,94 |
$719,64 $920,60 $966,46 $1 300,40 |
$923,96 $1 124,92 $1 170,78 $1 504,72 |
Toc - Plan #51 SelectHealth | ||||||||||||||||||||
Expanded Bronze
(HMO) Med Expanded Bronze 5300 Copay Plan - no deductible for one urgent care and all PCP visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$291,13 $404,67 $430,58 $619,23 $873,39 |
$522,00 $635,54 $661,45 $850,10 |
$752,87 $866,41 $892,32 $1 080,97 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$582,26 $809,34 $861,16 $1 238,46 $1 746,78 |
$813,13 $1 040,21 $1 092,03 $1 469,33 |
$1 044,00 $1 271,08 $1 322,90 $1 700,20 |
Toc - Plan #52 SelectHealth | ||||||||||||||||||||
Expanded Bronze
(HMO) Value Expanded Bronze 8550 - no deductible for office visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$256,00 $355,84 $378,63 $544,52 $768,00 |
$459,01 $558,85 $581,64 $747,53 |
$662,02 $761,86 $784,65 $950,54 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$512,00 $711,68 $757,26 $1 089,04 $1 536,00 |
$715,01 $914,69 $960,27 $1 292,05 |
$918,02 $1 117,70 $1 163,28 $1 495,06 |
Toc - Plan #53 SelectHealth | ||||||||||||||||||||
Expanded Bronze
(HMO) Med Expanded Bronze 8550 - no deductible for office visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$289,26 $402,07 $427,82 $615,26 $867,78 |
$518,64 $631,45 $657,20 $844,64 |
$748,02 $860,83 $886,58 $1 074,02 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$578,52 $804,14 $855,64 $1 230,52 $1 735,56 |
$807,90 $1 033,52 $1 085,02 $1 459,90 |
$1 037,28 $1 262,90 $1 314,40 $1 689,28 |
Toc - Plan #54 SelectHealth | ||||||||||||||||||||
Expanded Bronze
(HMO) Med Benchmark Expanded Bronze 6800 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$225,75 $313,79 $333,88 $480,16 $677,24 |
$404,77 $492,81 $512,90 $659,18 |
$583,79 $671,83 $691,92 $838,20 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$451,50 $627,58 $667,76 $960,32 $1 354,48 |
$630,52 $806,60 $846,78 $1 139,34 |
$809,54 $985,62 $1 025,80 $1 318,36 |
Toc - Plan #55 SelectHealth | ||||||||||||||||||||
Expanded Bronze
(HMO) Value Benchmark Expanded Bronze 6800 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$199,79 $277,71 $295,49 $424,95 $599,37 |
$358,22 $436,14 $453,92 $583,38 |
$516,65 $594,57 $612,35 $741,81 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$399,58 $555,42 $590,98 $849,90 $1 198,74 |
$558,01 $713,85 $749,41 $1 008,33 |
$716,44 $872,28 $907,84 $1 166,76 |
Toc - Plan #56 SelectHealth | ||||||||||||||||||||
Expanded Bronze
(HMO) Value Benchmark Expanded Bronze 3800 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$236,16 $328,27 $349,29 $502,32 $708,48 |
$423,44 $515,55 $536,57 $689,60 |
$610,72 $702,83 $723,85 $876,88 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$472,32 $656,54 $698,58 $1 004,64 $1 416,96 |
$659,60 $843,82 $885,86 $1 191,92 |
$846,88 $1 031,10 $1 073,14 $1 379,20 |
Toc - Plan #57 SelectHealth | ||||||||||||||||||||
Expanded Bronze
(HMO) Med Benchmark Expanded Bronze 3800 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$266,85 $370,91 $394,66 $567,58 $800,54 |
$478,46 $582,52 $606,27 $779,19 |
$690,07 $794,13 $817,88 $990,80 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$533,70 $741,82 $789,32 $1 135,16 $1 601,08 |
$745,31 $953,43 $1 000,93 $1 346,77 |
$956,92 $1 165,04 $1 212,54 $1 558,38 |
Toc - Plan #58 SelectHealth | ||||||||||||||||||||
Bronze
(HMO) Value Benchmark Bronze 8550 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$193,16 $268,50 $285,69 $410,86 $579,48 |
$346,34 $421,68 $438,87 $564,04 |
$499,52 $574,86 $592,05 $717,22 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$386,32 $537,00 $571,38 $821,72 $1 158,96 |
$539,50 $690,18 $724,56 $974,90 |
$692,68 $843,36 $877,74 $1 128,08 |
Toc - Plan #59 SelectHealth | ||||||||||||||||||||
Bronze
(HMO) Med Benchmark Bronze 8550 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$218,26 $303,38 $322,80 $464,23 $654,77 |
$391,34 $476,46 $495,88 $637,31 |
$564,42 $649,54 $668,96 $810,39 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$436,52 $606,76 $645,60 $928,46 $1 309,54 |
$609,60 $779,84 $818,68 $1 101,54 |
$782,68 $952,92 $991,76 $1 274,62 |
Toc - Plan #60 SelectHealth | ||||||||||||||||||||
Silver
(HMO) Value Benchmark Silver 6500 - no deductible for office visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$320,57 $445,60 $474,13 $681,86 $961,71 |
$574,78 $699,81 $728,34 $936,07 |
$828,99 $954,02 $982,55 $1 190,28 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$641,14 $891,20 $948,26 $1 363,72 $1 923,42 |
$895,35 $1 145,41 $1 202,47 $1 617,93 |
$1 149,56 $1 399,62 $1 456,68 $1 872,14 |
Toc - Plan #61 SelectHealth | ||||||||||||||||||||
Silver
(HMO) Med Benchmark Silver 6500 - no deductible for office visits |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-538-5038
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$362,22 $503,49 $535,72 $770,44 $1 086,66 |
$649,46 $790,73 $822,96 $1 057,68 |
$936,70 $1 077,97 $1 110,20 $1 344,92 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$724,44 $1 006,98 $1 071,44 $1 540,88 $2 173,32 |
$1 011,68 $1 294,22 $1 358,68 $1 828,12 |
$1 298,92 $1 581,46 $1 645,92 $2 115,36 |
ADVERTISEMENT
Cigna HealthcareLocal: 1-877-900-1237 | Toll Free: 1-877-900-1237 | TTY: 1-800-676-3777 |
Toc - Plan #62 Cigna Healthcare | ||||||||||||||||||||
Bronze
(EPO) Cigna Connect 7000 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$259,55 $360,78 $383,88 $552,07 $778,65 |
$465,38 $566,61 $589,71 $757,90 |
$671,21 $772,44 $795,54 $963,73 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$519,10 $721,56 $767,76 $1 104,14 $1 557,30 |
$724,93 $927,39 $973,59 $1 309,97 |
$930,76 $1 133,22 $1 179,42 $1 515,80 |
Toc - Plan #63 Cigna Healthcare | ||||||||||||||||||||
Bronze
(EPO) Cigna Connect 8550 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$266,69 $370,71 $394,44 $567,26 $800,07 |
$478,18 $582,20 $605,93 $778,75 |
$689,67 $793,69 $817,42 $990,24 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$533,38 $741,42 $788,88 $1 134,52 $1 600,14 |
$744,87 $952,91 $1 000,37 $1 346,01 |
$956,36 $1 164,40 $1 211,86 $1 557,50 |
Toc - Plan #64 Cigna Healthcare | ||||||||||||||||||||
Expanded Bronze
(EPO) Cigna Connect 6900 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$276,90 $384,89 $409,53 $588,96 $830,69 |
$496,48 $604,47 $629,11 $808,54 |
$716,06 $824,05 $848,69 $1 028,12 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$553,80 $769,78 $819,06 $1 177,92 $1 661,38 |
$773,38 $989,36 $1 038,64 $1 397,50 |
$992,96 $1 208,94 $1 258,22 $1 617,08 |
Toc - Plan #65 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 1750 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$330,86 $459,89 $489,34 $703,73 $992,57 |
$593,23 $722,26 $751,71 $966,10 |
$855,60 $984,63 $1 014,08 $1 228,47 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$661,72 $919,78 $978,68 $1 407,46 $1 985,14 |
$924,09 $1 182,15 $1 241,05 $1 669,83 |
$1 186,46 $1 444,52 $1 503,42 $1 932,20 |
Toc - Plan #66 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 2000 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$334,33 $464,72 $494,48 $711,12 $1 002,99 |
$599,46 $729,85 $759,61 $976,25 |
$864,59 $994,98 $1 024,74 $1 241,38 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$668,66 $929,44 $988,96 $1 422,24 $2 005,98 |
$933,79 $1 194,57 $1 254,09 $1 687,37 |
$1 198,92 $1 459,70 $1 519,22 $1 952,50 |
Toc - Plan #67 Cigna Healthcare | ||||||||||||||||||||
Gold
(EPO) Cigna Connect 1800 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$398,87 $554,43 $589,93 $848,40 $1 196,61 |
$715,17 $870,73 $906,23 $1 164,70 |
$1 031,47 $1 187,03 $1 222,53 $1 481,00 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$797,74 $1 108,86 $1 179,86 $1 696,80 $2 393,22 |
$1 114,04 $1 425,16 $1 496,16 $2 013,10 |
$1 430,34 $1 741,46 $1 812,46 $2 329,40 |
Toc - Plan #68 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 3500 Diabetes Care |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$335,31 $466,09 $495,93 $713,21 $1 005,93 |
$601,21 $731,99 $761,83 $979,11 |
$867,11 $997,89 $1 027,73 $1 245,01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$670,62 $932,18 $991,86 $1 426,42 $2 011,86 |
$936,52 $1 198,08 $1 257,76 $1 692,32 |
$1 202,42 $1 463,98 $1 523,66 $1 958,22 |
Toc - Plan #69 Cigna Healthcare | ||||||||||||||||||||
Silver
(EPO) Cigna Connect 5000 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-900-1237
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$328,66 $456,84 $486,09 $699,07 $985,98 |
$589,29 $717,47 $746,72 $959,70 |
$849,92 $978,10 $1 007,35 $1 220,33 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$657,32 $913,68 $972,18 $1 398,14 $1 971,96 |
$917,95 $1 174,31 $1 232,81 $1 658,77 |
$1 178,58 $1 434,94 $1 493,44 $1 919,40 |
‡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 Weber County here.
Weber County is in “Rating Area 2” of Utah.
Currently, there are 69 plans offered in Rating Area 2.