Obamacare 2021 Rates for Richmond City

Obamacare > Rates > Virginia > Richmond City

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 Richmond City, VA.

The health insurance rates listed below are for calendar year 2021.

For information on subsidies to make your coverage affordable, you must take one of the following actions:

  • Contact a licensed health insurance agent
  • Complete an application at Healthcare.gov
  • Contact the provider directly

Obamacare Providers, 36 Plans and 2021 Rates for Richmond City, Virginia

Below, you’ll find a summary of the 36 plans for Richmond City, Virginia and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options.

You may also be interested in:

Obamacare Rates and Providers for Other Years

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Optima Health Plan

Local: 1-866-946-6034 | Toll Free: 1-866-946-6034 | TTY: 1-800-828-1140
Toc - Plan #1 Optima Health Plan
Expanded Bronze

(HMO) OptimaFit Bronze 6250 20% HSA Direct M

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-946-6034

Annual Out of Pocket Expenses:

Individual Family
$6,250 $12,500 Annual Deductible
$6,900 $13,800 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$343,21
$389,54
$438,62
$612,97
$931,46 		$605,76
$652,09
$701,17
$875,52 		$868,31
$914,64
$963,72
$1 138,07 		$1 130,86
$1 177,19
$1 226,27
$1 400,62 		$262,55
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$686,42
$779,08
$877,24
$1 225,94
$1 862,92 		$948,97
$1 041,63
$1 139,79
$1 488,49 		$1 211,52
$1 304,18
$1 402,34
$1 751,04 		$1 474,07
$1 566,73
$1 664,89
$2 013,59 		$262,55
Toc - Plan #2 Optima Health Plan
Catastrophic

(HMO) OptimaFit Catastrophic 8550 M

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-946-6034

Annual Out of Pocket Expenses:

Individual Family
$8,550 $17,100 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$260,96
$296,19
$333,50
$466,07
$708,24 		$460,59
$495,82
$533,13
$665,70 		$660,22
$695,45
$732,76
$865,33 		$859,85
$895,08
$932,39
$1 064,96 		$199,63
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$521,92
$592,38
$667,00
$932,14
$1 416,48 		$721,55
$792,01
$866,63
$1 131,77 		$921,18
$991,64
$1 066,26
$1 331,40 		$1 120,81
$1 191,27
$1 265,89
$1 531,03 		$199,63
Toc - Plan #3 Optima Health Plan
Gold

(HMO) OptimaFit Gold 1300 20% Direct M

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-946-6034

Annual Out of Pocket Expenses:

Individual Family
$1,300 $2,600 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$416,59
$472,83
$532,40
$744,02
$1 130,61 		$735,28
$791,52
$851,09
$1 062,71 		$1 053,97
$1 110,21
$1 169,78
$1 381,40 		$1 372,66
$1 428,90
$1 488,47
$1 700,09 		$318,69
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$833,18
$945,66
$1 064,80
$1 488,04
$2 261,22 		$1 151,87
$1 264,35
$1 383,49
$1 806,73 		$1 470,56
$1 583,04
$1 702,18
$2 125,42 		$1 789,25
$1 901,73
$2 020,87
$2 444,11 		$318,69
Toc - Plan #4 Optima Health Plan
Expanded Bronze

(HMO) OptimaFit Bronze 7200 40% Direct M

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-946-6034

Annual Out of Pocket Expenses:

Individual Family
$7,200 $14,400 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$321,75
$365,19
$411,20
$574,65
$873,24 		$567,89
$611,33
$657,34
$820,79 		$814,03
$857,47
$903,48
$1 066,93 		$1 060,17
$1 103,61
$1 149,62
$1 313,07 		$246,14
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$643,50
$730,38
$822,40
$1 149,30
$1 746,48 		$889,64
$976,52
$1 068,54
$1 395,44 		$1 135,78
$1 222,66
$1 314,68
$1 641,58 		$1 381,92
$1 468,80
$1 560,82
$1 887,72 		$246,14
Toc - Plan #5 Optima Health Plan
Silver

(HMO) OptimaFit Silver 3000 25% Direct M

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-946-6034

Annual Out of Pocket Expenses:

Individual Family
$3,000 $6,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$434,81
$493,50
$555,68
$776,56
$1 180,06 		$767,44
$826,13
$888,31
$1 109,19 		$1 100,07
$1 158,76
$1 220,94
$1 441,82 		$1 432,70
$1 491,39
$1 553,57
$1 774,45 		$332,63
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$869,62
$987,00
$1 111,36
$1 553,12
$2 360,12 		$1 202,25
$1 319,63
$1 443,99
$1 885,75 		$1 534,88
$1 652,26
$1 776,62
$2 218,38 		$1 867,51
$1 984,89
$2 109,25
$2 551,01 		$332,63
Toc - Plan #6 Optima Health Plan
Silver

(HMO) OptimaFit Silver 6600 30% Direct M

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-946-6034

Annual Out of Pocket Expenses:

Individual Family
$6,600 $13,200 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$413,35
$469,16
$528,27
$738,25
$1 121,84 		$729,57
$785,38
$844,49
$1 054,47 		$1 045,79
$1 101,60
$1 160,71
$1 370,69 		$1 362,01
$1 417,82
$1 476,93
$1 686,91 		$316,22
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$826,70
$938,32
$1 056,54
$1 476,50
$2 243,68 		$1 142,92
$1 254,54
$1 372,76
$1 792,72 		$1 459,14
$1 570,76
$1 688,98
$2 108,94 		$1 775,36
$1 886,98
$2 005,20
$2 425,16 		$316,22
Toc - Plan #7 Optima Health Plan
Silver

(HMO) OptimaFit Silver 4600 30% Direct M

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-866-946-6034

Annual Out of Pocket Expenses:

Individual Family
$4,600 $9,200 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$420,68
$477,47
$537,63
$751,33
$1 141,72 		$742,50
$799,29
$859,45
$1 073,15 		$1 064,32
$1 121,11
$1 181,27
$1 394,97 		$1 386,14
$1 442,93
$1 503,09
$1 716,79 		$321,82
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$841,36
$954,94
$1 075,26
$1 502,66
$2 283,44 		$1 163,18
$1 276,76
$1 397,08
$1 824,48 		$1 485,00
$1 598,58
$1 718,90
$2 146,30 		$1 806,82
$1 920,40
$2 040,72
$2 468,12 		$321,82

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Oscar Insurance Company

Local: 1-855-672-2755 | Toll Free: 1-855-672-2755

Toc - Plan #8 Oscar Insurance Company
Expanded Bronze

(EPO) Oscar Bronze Classic PCP Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$317,55
$360,41
$405,82
$567,13
$861,81 		$560,47
$603,33
$648,74
$810,05 		$803,39
$846,25
$891,66
$1 052,97 		$1 046,31
$1 089,17
$1 134,58
$1 295,89 		$242,92
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$635,10
$720,82
$811,64
$1 134,26
$1 723,62 		$878,02
$963,74
$1 054,56
$1 377,18 		$1 120,94
$1 206,66
$1 297,48
$1 620,10 		$1 363,86
$1 449,58
$1 540,40
$1 863,02 		$242,92
Toc - Plan #9 Oscar Insurance Company
Expanded Bronze

(EPO) Oscar Bronze Classic

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$310,95
$352,92
$397,38
$555,34
$843,89 		$548,82
$590,79
$635,25
$793,21 		$786,69
$828,66
$873,12
$1 031,08 		$1 024,56
$1 066,53
$1 110,99
$1 268,95 		$237,87
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$621,90
$705,84
$794,76
$1 110,68
$1 687,78 		$859,77
$943,71
$1 032,63
$1 348,55 		$1 097,64
$1 181,58
$1 270,50
$1 586,42 		$1 335,51
$1 419,45
$1 508,37
$1 824,29 		$237,87
Toc - Plan #10 Oscar Insurance Company
Expanded Bronze

(EPO) Oscar Bronze Classic Next

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$364,72
$413,95
$466,10
$651,37
$989,83 		$643,72
$692,95
$745,10
$930,37 		$922,72
$971,95
$1 024,10
$1 209,37 		$1 201,72
$1 250,95
$1 303,10
$1 488,37 		$279,00
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$729,44
$827,90
$932,20
$1 302,74
$1 979,66 		$1 008,44
$1 106,90
$1 211,20
$1 581,74 		$1 287,44
$1 385,90
$1 490,20
$1 860,74 		$1 566,44
$1 664,90
$1 769,20
$2 139,74 		$279,00
Toc - Plan #11 Oscar Insurance Company
Silver

(EPO) Oscar Silver Saver

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$4,200 $8,400 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$418,26
$474,72
$534,53
$747,00
$1 135,14 		$738,22
$794,68
$854,49
$1 066,96 		$1 058,18
$1 114,64
$1 174,45
$1 386,92 		$1 378,14
$1 434,60
$1 494,41
$1 706,88 		$319,96
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$836,52
$949,44
$1 069,06
$1 494,00
$2 270,28 		$1 156,48
$1 269,40
$1 389,02
$1 813,96 		$1 476,44
$1 589,36
$1 708,98
$2 133,92 		$1 796,40
$1 909,32
$2 028,94
$2 453,88 		$319,96
Toc - Plan #12 Oscar Insurance Company
Silver

(EPO) Oscar Silver Classic Next

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$6,000 $12,000 Annual Deductible
$8,000 $16,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$436,01
$494,87
$557,21
$778,70
$1 183,32 		$769,55
$828,41
$890,75
$1 112,24 		$1 103,09
$1 161,95
$1 224,29
$1 445,78 		$1 436,63
$1 495,49
$1 557,83
$1 779,32 		$333,54
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$872,02
$989,74
$1 114,42
$1 557,40
$2 366,64 		$1 205,56
$1 323,28
$1 447,96
$1 890,94 		$1 539,10
$1 656,82
$1 781,50
$2 224,48 		$1 872,64
$1 990,36
$2 115,04
$2 558,02 		$333,54
Toc - Plan #13 Oscar Insurance Company
Catastrophic

(EPO) Oscar Secure

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$8,550 $17,100 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$263,20
$298,72
$336,36
$470,06
$714,30 		$464,54
$500,06
$537,70
$671,40 		$665,88
$701,40
$739,04
$872,74 		$867,22
$902,74
$940,38
$1 074,08 		$201,34
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$526,40
$597,44
$672,72
$940,12
$1 428,60 		$727,74
$798,78
$874,06
$1 141,46 		$929,08
$1 000,12
$1 075,40
$1 342,80 		$1 130,42
$1 201,46
$1 276,74
$1 544,14 		$201,34
Toc - Plan #14 Oscar Insurance Company
Expanded Bronze

(EPO) Oscar Bronze Classic Next 2

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$364,40
$413,59
$465,69
$650,81
$988,96 		$643,16
$692,35
$744,45
$929,57 		$921,92
$971,11
$1 023,21
$1 208,33 		$1 200,68
$1 249,87
$1 301,97
$1 487,09 		$278,76
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$728,80
$827,18
$931,38
$1 301,62
$1 977,92 		$1 007,56
$1 105,94
$1 210,14
$1 580,38 		$1 286,32
$1 384,70
$1 488,90
$1 859,14 		$1 565,08
$1 663,46
$1 767,66
$2 137,90 		$278,76
Toc - Plan #15 Oscar Insurance Company
Gold

(EPO) Oscar Gold Classic

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$2,500 $5,000 Annual Deductible
$6,000 $12,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$397,03
$450,62
$507,39
$709,08
$1 077,52 		$700,75
$754,34
$811,11
$1 012,80 		$1 004,47
$1 058,06
$1 114,83
$1 316,52 		$1 308,19
$1 361,78
$1 418,55
$1 620,24 		$303,72
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$794,06
$901,24
$1 014,78
$1 418,16
$2 155,04 		$1 097,78
$1 204,96
$1 318,50
$1 721,88 		$1 401,50
$1 508,68
$1 622,22
$2 025,60 		$1 705,22
$1 812,40
$1 925,94
$2 329,32 		$303,72
Toc - Plan #16 Oscar Insurance Company
Expanded Bronze

(EPO) Oscar Bronze HDHP

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$5,200 $10,400 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$323,02
$366,61
$412,80
$576,89
$876,64 		$570,12
$613,71
$659,90
$823,99 		$817,22
$860,81
$907,00
$1 071,09 		$1 064,32
$1 107,91
$1 154,10
$1 318,19 		$247,10
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$646,04
$733,22
$825,60
$1 153,78
$1 753,28 		$893,14
$980,32
$1 072,70
$1 400,88 		$1 140,24
$1 227,42
$1 319,80
$1 647,98 		$1 387,34
$1 474,52
$1 566,90
$1 895,08 		$247,10
Toc - Plan #17 Oscar Insurance Company
Silver

(EPO) Oscar Silver Classic Copay

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$7,000 $14,000 Annual Deductible
$8,200 $16,400 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$436,42
$495,32
$557,73
$779,43
$1 184,42 		$770,27
$829,17
$891,58
$1 113,28 		$1 104,12
$1 163,02
$1 225,43
$1 447,13 		$1 437,97
$1 496,87
$1 559,28
$1 780,98 		$333,85
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$872,84
$990,64
$1 115,46
$1 558,86
$2 368,84 		$1 206,69
$1 324,49
$1 449,31
$1 892,71 		$1 540,54
$1 658,34
$1 783,16
$2 226,56 		$1 874,39
$1 992,19
$2 117,01
$2 560,41 		$333,85
Toc - Plan #18 Oscar Insurance Company
Silver

(EPO) Oscar Silver Classic $0 Ded

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-672-2755

Annual Out of Pocket Expenses:

Individual Family
$0 $0 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$474,82
$538,91
$606,80
$848,01
$1 288,63 		$838,05
$902,14
$970,03
$1 211,24 		$1 201,28
$1 265,37
$1 333,26
$1 574,47 		$1 564,51
$1 628,60
$1 696,49
$1 937,70 		$363,23
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$949,64
$1 077,82
$1 213,60
$1 696,02
$2 577,26 		$1 312,87
$1 441,05
$1 576,83
$2 059,25 		$1 676,10
$1 804,28
$1 940,06
$2 422,48 		$2 039,33
$2 167,51
$2 303,29
$2 785,71 		$363,23

ADVERTISEMENT

Cigna Health and Life Insurance Company

Local: 1-877-900-1237 | Toll Free: 1-877-900-1237 | TTY: 1-800-676-3777
Toc - Plan #19 Cigna Health and Life Insurance Company
Bronze

(EPO) Cigna Connect 7000

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$7,000 $14,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$268,15
$304,35
$342,70
$478,92
$727,77 		$473,29
$509,49
$547,84
$684,06 		$678,43
$714,63
$752,98
$889,20 		$883,57
$919,77
$958,12
$1 094,34 		$205,14
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$536,30
$608,70
$685,40
$957,84
$1 455,54 		$741,44
$813,84
$890,54
$1 162,98 		$946,58
$1 018,98
$1 095,68
$1 368,12 		$1 151,72
$1 224,12
$1 300,82
$1 573,26 		$205,14
Toc - Plan #20 Cigna Health and Life Insurance Company
Expanded Bronze

(EPO) Cigna Connect 6750

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$6,750 $13,500 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$279,89
$317,67
$357,69
$499,88
$759,61 		$494,00
$531,78
$571,80
$713,99 		$708,11
$745,89
$785,91
$928,10 		$922,22
$960,00
$1 000,02
$1 142,21 		$214,11
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$559,78
$635,34
$715,38
$999,76
$1 519,22 		$773,89
$849,45
$929,49
$1 213,87 		$988,00
$1 063,56
$1 143,60
$1 427,98 		$1 202,11
$1 277,67
$1 357,71
$1 642,09 		$214,11
Toc - Plan #21 Cigna Health and Life Insurance Company
Silver

(EPO) Cigna Connect 4500 +Acupuncture

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$4,500 $9,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$350,22
$397,50
$447,59
$625,50
$950,51 		$618,14
$665,42
$715,51
$893,42 		$886,06
$933,34
$983,43
$1 161,34 		$1 153,98
$1 201,26
$1 251,35
$1 429,26 		$267,92
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$700,44
$795,00
$895,18
$1 251,00
$1 901,02 		$968,36
$1 062,92
$1 163,10
$1 518,92 		$1 236,28
$1 330,84
$1 431,02
$1 786,84 		$1 504,20
$1 598,76
$1 698,94
$2 054,76 		$267,92
Toc - Plan #22 Cigna Health and Life Insurance Company
Gold

(EPO) Cigna Connect 1500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$1,500 $3,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$341,25
$387,32
$436,12
$609,48
$926,16 		$602,31
$648,38
$697,18
$870,54 		$863,37
$909,44
$958,24
$1 131,60 		$1 124,43
$1 170,50
$1 219,30
$1 392,66 		$261,06
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$682,50
$774,64
$872,24
$1 218,96
$1 852,32 		$943,56
$1 035,70
$1 133,30
$1 480,02 		$1 204,62
$1 296,76
$1 394,36
$1 741,08 		$1 465,68
$1 557,82
$1 655,42
$2 002,14 		$261,06
Toc - Plan #23 Cigna Health and Life Insurance Company
Silver

(EPO) Cigna Connect 6500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$6,500 $13,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$345,42
$392,05
$441,45
$616,92
$937,48 		$609,67
$656,30
$705,70
$881,17 		$873,92
$920,55
$969,95
$1 145,42 		$1 138,17
$1 184,80
$1 234,20
$1 409,67 		$264,25
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$690,84
$784,10
$882,90
$1 233,84
$1 874,96 		$955,09
$1 048,35
$1 147,15
$1 498,09 		$1 219,34
$1 312,60
$1 411,40
$1 762,34 		$1 483,59
$1 576,85
$1 675,65
$2 026,59 		$264,25
Toc - Plan #24 Cigna Health and Life Insurance Company
Expanded Bronze

(EPO) Cigna Connect 5500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$5,500 $11,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$280,09
$317,90
$357,96
$500,24
$760,17 		$494,36
$532,17
$572,23
$714,51 		$708,63
$746,44
$786,50
$928,78 		$922,90
$960,71
$1 000,77
$1 143,05 		$214,27
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$560,18
$635,80
$715,92
$1 000,48
$1 520,34 		$774,45
$850,07
$930,19
$1 214,75 		$988,72
$1 064,34
$1 144,46
$1 429,02 		$1 202,99
$1 278,61
$1 358,73
$1 643,29 		$214,27
Toc - Plan #25 Cigna Health and Life Insurance Company
Silver

(EPO) Cigna Connect 3500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$3,500 $7,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$349,55
$396,74
$446,73
$624,30
$948,68 		$616,96
$664,15
$714,14
$891,71 		$884,37
$931,56
$981,55
$1 159,12 		$1 151,78
$1 198,97
$1 248,96
$1 426,53 		$267,41
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$699,10
$793,48
$893,46
$1 248,60
$1 897,36 		$966,51
$1 060,89
$1 160,87
$1 516,01 		$1 233,92
$1 328,30
$1 428,28
$1 783,42 		$1 501,33
$1 595,71
$1 695,69
$2 050,83 		$267,41
Toc - Plan #26 Cigna Health and Life Insurance Company
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:

Individual Family
$3,500 $7,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$350,37
$397,67
$447,77
$625,76
$950,90 		$618,40
$665,70
$715,80
$893,79 		$886,43
$933,73
$983,83
$1 161,82 		$1 154,46
$1 201,76
$1 251,86
$1 429,85 		$268,03
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$700,74
$795,34
$895,54
$1 251,52
$1 901,80 		$968,77
$1 063,37
$1 163,57
$1 519,55 		$1 236,80
$1 331,40
$1 431,60
$1 787,58 		$1 504,83
$1 599,43
$1 699,63
$2 055,61 		$268,03
Toc - Plan #27 Cigna Health and Life Insurance Company
Gold

(EPO) Cigna Connect 2000

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-877-900-1237

Annual Out of Pocket Expenses:

Individual Family
$2,000 $4,000 Annual Deductible
$8,000 $16,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$344,60
$391,13
$440,40
$615,46
$935,26 		$608,22
$654,75
$704,02
$879,08 		$871,84
$918,37
$967,64
$1 142,70 		$1 135,46
$1 181,99
$1 231,26
$1 406,32 		$263,62
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$689,20
$782,26
$880,80
$1 230,92
$1 870,52 		$952,82
$1 045,88
$1 144,42
$1 494,54 		$1 216,44
$1 309,50
$1 408,04
$1 758,16 		$1 480,06
$1 573,12
$1 671,66
$2 021,78 		$263,62

ADVERTISEMENT

Anthem HealthKeepers

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

Toc - Plan #28 Anthem HealthKeepers
Catastrophic

(HMO) Anthem HealthKeepers Catastrophic X 8550

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1810

Annual Out of Pocket Expenses:

Individual Family
$8,550 $17,100 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$213,04
$241,80
$272,27
$380,49
$578,19 		$376,02
$404,78
$435,25
$543,47 		$539,00
$567,76
$598,23
$706,45 		$701,98
$730,74
$761,21
$869,43 		$162,98
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$426,08
$483,60
$544,54
$760,98
$1 156,38 		$589,06
$646,58
$707,52
$923,96 		$752,04
$809,56
$870,50
$1 086,94 		$915,02
$972,54
$1 033,48
$1 249,92 		$162,98
Toc - Plan #29 Anthem HealthKeepers
Expanded Bronze

(HMO) Anthem HealthKeepers Bronze X 5500

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1810

Annual Out of Pocket Expenses:

Individual Family
$5,500 $11,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$278,97
$316,63
$356,52
$498,24
$757,12 		$492,38
$530,04
$569,93
$711,65 		$705,79
$743,45
$783,34
$925,06 		$919,20
$956,86
$996,75
$1 138,47 		$213,41
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$557,94
$633,26
$713,04
$996,48
$1 514,24 		$771,35
$846,67
$926,45
$1 209,89 		$984,76
$1 060,08
$1 139,86
$1 423,30 		$1 198,17
$1 273,49
$1 353,27
$1 636,71 		$213,41
Toc - Plan #30 Anthem HealthKeepers
Expanded Bronze

(HMO) Anthem HealthKeepers Bronze X 5900 for HSA

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1810

Annual Out of Pocket Expenses:

Individual Family
$5,900 $11,800 Annual Deductible
$7,000 $14,000 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$283,54
$321,82
$362,36
$506,40
$769,53 		$500,45
$538,73
$579,27
$723,31 		$717,36
$755,64
$796,18
$940,22 		$934,27
$972,55
$1 013,09
$1 157,13 		$216,91
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$567,08
$643,64
$724,72
$1 012,80
$1 539,06 		$783,99
$860,55
$941,63
$1 229,71 		$1 000,90
$1 077,46
$1 158,54
$1 446,62 		$1 217,81
$1 294,37
$1 375,45
$1 663,53 		$216,91
Toc - Plan #31 Anthem HealthKeepers
Bronze

(HMO) Anthem HealthKeepers Bronze X 8200

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1810

Annual Out of Pocket Expenses:

Individual Family
$8,200 $16,400 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$267,92
$304,09
$342,40
$478,51
$727,13 		$472,88
$509,05
$547,36
$683,47 		$677,84
$714,01
$752,32
$888,43 		$882,80
$918,97
$957,28
$1 093,39 		$204,96
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$535,84
$608,18
$684,80
$957,02
$1 454,26 		$740,80
$813,14
$889,76
$1 161,98 		$945,76
$1 018,10
$1 094,72
$1 366,94 		$1 150,72
$1 223,06
$1 299,68
$1 571,90 		$204,96
Toc - Plan #32 Anthem HealthKeepers
Gold

(HMO) Anthem HealthKeepers Gold X 2000

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1810

Annual Out of Pocket Expenses:

Individual Family
$2,000 $6,000 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$353,28
$400,97
$451,49
$630,96
$958,80 		$623,54
$671,23
$721,75
$901,22 		$893,80
$941,49
$992,01
$1 171,48 		$1 164,06
$1 211,75
$1 262,27
$1 441,74 		$270,26
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$706,56
$801,94
$902,98
$1 261,92
$1 917,60 		$976,82
$1 072,20
$1 173,24
$1 532,18 		$1 247,08
$1 342,46
$1 443,50
$1 802,44 		$1 517,34
$1 612,72
$1 713,76
$2 072,70 		$270,26
Toc - Plan #33 Anthem HealthKeepers
Silver

(HMO) Anthem HealthKeepers Silver X 2200

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1810

Annual Out of Pocket Expenses:

Individual Family
$2,200 $4,400 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$375,54
$426,24
$479,94
$670,71
$1 019,22 		$662,83
$713,53
$767,23
$958,00 		$950,12
$1 000,82
$1 054,52
$1 245,29 		$1 237,41
$1 288,11
$1 341,81
$1 532,58 		$287,29
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$751,08
$852,48
$959,88
$1 341,42
$2 038,44 		$1 038,37
$1 139,77
$1 247,17
$1 628,71 		$1 325,66
$1 427,06
$1 534,46
$1 916,00 		$1 612,95
$1 714,35
$1 821,75
$2 203,29 		$287,29
Toc - Plan #34 Anthem HealthKeepers
Silver

(HMO) Anthem HealthKeepers Silver X 6250

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1810

Annual Out of Pocket Expenses:

Individual Family
$6,250 $12,500 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$350,21
$397,49
$447,57
$625,48
$950,47 		$618,12
$665,40
$715,48
$893,39 		$886,03
$933,31
$983,39
$1 161,30 		$1 153,94
$1 201,22
$1 251,30
$1 429,21 		$267,91
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$700,42
$794,98
$895,14
$1 250,96
$1 900,94 		$968,33
$1 062,89
$1 163,05
$1 518,87 		$1 236,24
$1 330,80
$1 430,96
$1 786,78 		$1 504,15
$1 598,71
$1 698,87
$2 054,69 		$267,91
Toc - Plan #35 Anthem HealthKeepers
Expanded Bronze

(HMO) Anthem HealthKeepers Bronze X 5800 Online Plus

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1810

Annual Out of Pocket Expenses:

Individual Family
$5,800 $11,600 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$287,31
$326,10
$367,18
$513,14
$779,76 		$507,10
$545,89
$586,97
$732,93 		$726,89
$765,68
$806,76
$952,72 		$946,68
$985,47
$1 026,55
$1 172,51 		$219,79
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$574,62
$652,20
$734,36
$1 026,28
$1 559,52 		$794,41
$871,99
$954,15
$1 246,07 		$1 014,20
$1 091,78
$1 173,94
$1 465,86 		$1 233,99
$1 311,57
$1 393,73
$1 685,65 		$219,79
Toc - Plan #36 Anthem HealthKeepers
Silver

(HMO) Anthem HealthKeepers Silver X 5300 Online Plus

Benefits & Coverage Plan Brochure Provider Directory
Customer Service Phone: 1-855-748-1810

Annual Out of Pocket Expenses:

Individual Family
$5,300 $10,600 Annual Deductible
$8,550 $17,100 Maximum Out of Pocket Per Year

Monthly Premiums:

[show premiums]
Age Individual
 Individual
1 Child
 Individual
2 Children
 Individual
3+ Children
 Child
0-14
21
30
40
50
60 		$355,51
$403,50
$454,34
$634,94
$964,85 		$627,48
$675,47
$726,31
$906,91 		$899,45
$947,44
$998,28
$1 178,88 		$1 171,42
$1 219,41
$1 270,25
$1 450,85 		$271,97
Age Couple
Couple
1 Child
 Couple
2 Chidren
 Couple
3+ Children
 Child
0-14
21
30
40
50
60 		$711,02
$807,00
$908,68
$1 269,88
$1 929,70 		$982,99
$1 078,97
$1 180,65
$1 541,85 		$1 254,96
$1 350,94
$1 452,62
$1 813,82 		$1 526,93
$1 622,91
$1 724,59
$2 085,79 		$271,97

‡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 Richmond City here.

Richmond City is in “Rating Area 7” of Virginia.

Currently, there are 36 plans offered in Rating Area 7.

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