Obamacare 2021 Rates for Waupaca County
Obamacare > Rates > Wisconsin > Waupaca County
Obamacare > Rates > Wisconsin > Waupaca County
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HealthPartnersLocal: 1-952-883-5900 | Toll Free: 1-855-813-3887 | TTY: 1-952-883-6060 |
Toc - Plan #1 HealthPartners | ||||||||||||||||||||
Gold
(PPO) Robin Oak $1,200 w/Copay Gold |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-813-3887
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$406,11 $460,93 $519,01 $725,31 $1 102,18 |
$716,78 $771,60 $829,68 $1 035,98 |
$1 027,45 $1 082,27 $1 140,35 $1 346,65 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$812,22 $921,86 $1 038,02 $1 450,62 $2 204,36 |
$1 122,89 $1 232,53 $1 348,69 $1 761,29 |
$1 433,56 $1 543,20 $1 659,36 $2 071,96 |
Toc - Plan #2 HealthPartners | ||||||||||||||||||||
Silver
(PPO) Robin Oak $4,000 Plus Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-813-3887
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$366,09 $415,51 $467,86 $653,84 $993,57 |
$646,15 $695,57 $747,92 $933,90 |
$926,21 $975,63 $1 027,98 $1 213,96 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$732,18 $831,02 $935,72 $1 307,68 $1 987,14 |
$1 012,24 $1 111,08 $1 215,78 $1 587,74 |
$1 292,30 $1 391,14 $1 495,84 $1 867,80 |
Toc - Plan #3 HealthPartners | ||||||||||||||||||||
Expanded Bronze
(PPO) Robin Oak $6,800 Plus Bronze |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-813-3887
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$290,60 $329,83 $371,39 $519,01 $788,69 |
$512,91 $552,14 $593,70 $741,32 |
$735,22 $774,45 $816,01 $963,63 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$581,20 $659,66 $742,78 $1 038,02 $1 577,38 |
$803,51 $881,97 $965,09 $1 260,33 |
$1 025,82 $1 104,28 $1 187,40 $1 482,64 |
Toc - Plan #4 HealthPartners | ||||||||||||||||||||
Catastrophic
(PPO) Robin Oak $8,550 Catastrophic |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-813-3887
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$222,87 $252,96 $284,83 $398,05 $604,87 |
$393,37 $423,46 $455,33 $568,55 |
$563,87 $593,96 $625,83 $739,05 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$445,74 $505,92 $569,66 $796,10 $1 209,74 |
$616,24 $676,42 $740,16 $966,60 |
$786,74 $846,92 $910,66 $1 137,10 |
Toc - Plan #5 HealthPartners | ||||||||||||||||||||
Silver
(PPO) Robin Oak $3,500 w/Copay P-S Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-813-3887
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$404,17 $458,73 $516,53 $721,85 $1 096,92 |
$713,36 $767,92 $825,72 $1 031,04 |
$1 022,55 $1 077,11 $1 134,91 $1 340,23 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$808,34 $917,46 $1 033,06 $1 443,70 $2 193,84 |
$1 117,53 $1 226,65 $1 342,25 $1 752,89 |
$1 426,72 $1 535,84 $1 651,44 $2 062,08 |
Toc - Plan #6 HealthPartners | ||||||||||||||||||||
Silver
(PPO) Robin Oak $5,000 Plus Silver |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-855-813-3887
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$353,20 $400,88 $451,39 $630,82 $958,58 |
$623,40 $671,08 $721,59 $901,02 |
$893,60 $941,28 $991,79 $1 171,22 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$706,40 $801,76 $902,78 $1 261,64 $1 917,16 |
$976,60 $1 071,96 $1 172,98 $1 531,84 |
$1 246,80 $1 342,16 $1 443,18 $1 802,04 |
ADVERTISEMENT
Security Health PlanLocal: 1-715-221-9258x19258 | Toll Free: 1-844-293-9624 | TTY: 1-877-727-2232 |
Toc - Plan #7 Security Health Plan | ||||||||||||||||||||
Catastrophic
(EPO) Select Protection |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$233,25 $264,72 $298,08 $416,56 $633,01 |
$411,68 $443,15 $476,51 $594,99 |
$590,11 $621,58 $654,94 $773,42 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$466,50 $529,44 $596,16 $833,12 $1 266,02 |
$644,93 $707,87 $774,59 $1 011,55 |
$823,36 $886,30 $953,02 $1 189,98 |
Toc - Plan #8 Security Health Plan | ||||||||||||||||||||
Bronze
(EPO) Select $8,550 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$341,00 $387,02 $435,79 $609,01 $925,45 |
$601,86 $647,88 $696,65 $869,87 |
$862,72 $908,74 $957,51 $1 130,73 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$682,00 $774,04 $871,58 $1 218,02 $1 850,90 |
$942,86 $1 034,90 $1 132,44 $1 478,88 |
$1 203,72 $1 295,76 $1 393,30 $1 739,74 |
Toc - Plan #9 Security Health Plan | ||||||||||||||||||||
Silver
(EPO) Select $6,950 - 30% |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$517,29 $587,11 $661,09 $923,87 $1 403,90 |
$913,01 $982,83 $1 056,81 $1 319,59 |
$1 308,73 $1 378,55 $1 452,53 $1 715,31 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1 034,58 $1 174,22 $1 322,18 $1 847,74 $2 807,80 |
$1 430,30 $1 569,94 $1 717,90 $2 243,46 |
$1 826,02 $1 965,66 $2 113,62 $2 639,18 |
Toc - Plan #10 Security Health Plan | ||||||||||||||||||||
Silver
(EPO) Select $4,500 HDHP |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$541,84 $614,98 $692,46 $967,71 $1 470,54 |
$956,34 $1 029,48 $1 106,96 $1 382,21 |
$1 370,84 $1 443,98 $1 521,46 $1 796,71 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1 083,68 $1 229,96 $1 384,92 $1 935,42 $2 941,08 |
$1 498,18 $1 644,46 $1 799,42 $2 349,92 |
$1 912,68 $2 058,96 $2 213,92 $2 764,42 |
Toc - Plan #11 Security Health Plan | ||||||||||||||||||||
Bronze
(EPO) Select $7,500 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$346,11 $392,83 $442,32 $618,14 $939,33 |
$610,88 $657,60 $707,09 $882,91 |
$875,65 $922,37 $971,86 $1 147,68 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$692,22 $785,66 $884,64 $1 236,28 $1 878,66 |
$956,99 $1 050,43 $1 149,41 $1 501,05 |
$1 221,76 $1 315,20 $1 414,18 $1 765,82 |
Toc - Plan #12 Security Health Plan | ||||||||||||||||||||
Silver
(EPO) Select $4,800 - 30% |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$526,50 $597,56 $672,85 $940,31 $1 428,89 |
$929,26 $1 000,32 $1 075,61 $1 343,07 |
$1 332,02 $1 403,08 $1 478,37 $1 745,83 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$1 053,00 $1 195,12 $1 345,70 $1 880,62 $2 857,78 |
$1 455,76 $1 597,88 $1 748,46 $2 283,38 |
$1 858,52 $2 000,64 $2 151,22 $2 686,14 |
Toc - Plan #13 Security Health Plan | ||||||||||||||||||||
Expanded Bronze
(EPO) Select $6,200 HDHP |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$377,49 $428,44 $482,41 $674,17 $1 024,47 |
$666,26 $717,21 $771,18 $962,94 |
$955,03 $1 005,98 $1 059,95 $1 251,71 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$754,98 $856,88 $964,82 $1 348,34 $2 048,94 |
$1 043,75 $1 145,65 $1 253,59 $1 637,11 |
$1 332,52 $1 434,42 $1 542,36 $1 925,88 |
Toc - Plan #14 Security Health Plan | ||||||||||||||||||||
Gold
(EPO) Select $3,500 - 30% |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-844-293-9624
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$478,76 $543,38 $611,84 $855,05 $1 299,33 |
$845,00 $909,62 $978,08 $1 221,29 |
$1 211,24 $1 275,86 $1 344,32 $1 587,53 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$957,52 $1 086,76 $1 223,68 $1 710,10 $2 598,66 |
$1 323,76 $1 453,00 $1 589,92 $2 076,34 |
$1 690,00 $1 819,24 $1 956,16 $2 442,58 |
ADVERTISEMENT
Molina HealthcareLocal: 1-888-560-2043 | Toll Free: 1-888-560-2043 |
Toc - Plan #15 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Confident Care Gold 1 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2043
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$395,71 $449,13 $505,72 $706,74 $1 073,96 |
$698,43 $751,85 $808,44 $1 009,46 |
$1 001,15 $1 054,57 $1 111,16 $1 312,18 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$791,42 $898,26 $1 011,44 $1 413,48 $2 147,92 |
$1 094,14 $1 200,98 $1 314,16 $1 716,20 |
$1 396,86 $1 503,70 $1 616,88 $2 018,92 |
Toc - Plan #16 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 1 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2043
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$348,80 $395,88 $445,76 $622,95 $946,63 |
$615,63 $662,71 $712,59 $889,78 |
$882,46 $929,54 $979,42 $1 156,61 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$697,60 $791,76 $891,52 $1 245,90 $1 893,26 |
$964,43 $1 058,59 $1 158,35 $1 512,73 |
$1 231,26 $1 325,42 $1 425,18 $1 779,56 |
Toc - Plan #17 Molina Healthcare | ||||||||||||||||||||
Bronze
(HMO) Core Care Bronze 1 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2043
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$276,46 $313,78 $353,31 $493,75 $750,30 |
$487,95 $525,27 $564,80 $705,24 |
$699,44 $736,76 $776,29 $916,73 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$552,92 $627,56 $706,62 $987,50 $1 500,60 |
$764,41 $839,05 $918,11 $1 198,99 |
$975,90 $1 050,54 $1 129,60 $1 410,48 |
Toc - Plan #18 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 4 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2043
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$345,11 $391,70 $441,05 $616,37 $936,63 |
$609,12 $655,71 $705,06 $880,38 |
$873,13 $919,72 $969,07 $1 144,39 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$690,22 $783,40 $882,10 $1 232,74 $1 873,26 |
$954,23 $1 047,41 $1 146,11 $1 496,75 |
$1 218,24 $1 311,42 $1 410,12 $1 760,76 |
Toc - Plan #19 Molina Healthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) Core Care Bronze 4 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2043
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$289,59 $328,68 $370,09 $517,20 $785,94 |
$511,12 $550,21 $591,62 $738,73 |
$732,65 $771,74 $813,15 $960,26 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$579,18 $657,36 $740,18 $1 034,40 $1 571,88 |
$800,71 $878,89 $961,71 $1 255,93 |
$1 022,24 $1 100,42 $1 183,24 $1 477,46 |
Toc - Plan #20 Molina Healthcare | ||||||||||||||||||||
Expanded Bronze
(HMO) Core Care Bronze 5 |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2043
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$281,56 $319,57 $359,83 $502,87 $764,16 |
$496,95 $534,96 $575,22 $718,26 |
$712,34 $750,35 $790,61 $933,65 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$563,12 $639,14 $719,66 $1 005,74 $1 528,32 |
$778,51 $854,53 $935,05 $1 221,13 |
$993,90 $1 069,92 $1 150,44 $1 436,52 |
Toc - Plan #21 Molina Healthcare | ||||||||||||||||||||
Gold
(HMO) Confident Care Gold 1 + Vision |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2043
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$398,84 $452,68 $509,72 $712,33 $1 082,45 |
$703,95 $757,79 $814,83 $1 017,44 |
$1 009,06 $1 062,90 $1 119,94 $1 322,55 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$797,68 $905,36 $1 019,44 $1 424,66 $2 164,90 |
$1 102,79 $1 210,47 $1 324,55 $1 729,77 |
$1 407,90 $1 515,58 $1 629,66 $2 034,88 |
Toc - Plan #22 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 1 + Vision |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2043
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$351,93 $399,44 $449,76 $628,54 $955,13 |
$621,15 $668,66 $718,98 $897,76 |
$890,37 $937,88 $988,20 $1 166,98 |
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Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
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21 30 40 50 60 |
$703,86 $798,88 $899,52 $1 257,08 $1 910,26 |
$973,08 $1 068,10 $1 168,74 $1 526,30 |
$1 242,30 $1 337,32 $1 437,96 $1 795,52 |
Toc - Plan #23 Molina Healthcare | ||||||||||||||||||||
Bronze
(HMO) Core Care Bronze 1 + Vision |
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Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2043
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
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Age | Individual |
Individual 1 Child |
Individual 2 Children |
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21 30 40 50 60 |
$279,59 $317,33 $357,31 $499,34 $758,80 |
$493,47 $531,21 $571,19 $713,22 |
$707,35 $745,09 $785,07 $927,10 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$559,18 $634,66 $714,62 $998,68 $1 517,60 |
$773,06 $848,54 $928,50 $1 212,56 |
$986,94 $1 062,42 $1 142,38 $1 426,44 |
Toc - Plan #24 Molina Healthcare | ||||||||||||||||||||
Silver
(HMO) Constant Care Silver 2 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2043
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$348,42 $395,46 $445,28 $622,28 $945,61 |
$614,96 $662,00 $711,82 $888,82 |
$881,50 $928,54 $978,36 $1 155,36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$696,84 $790,92 $890,56 $1 244,56 $1 891,22 |
$963,38 $1 057,46 $1 157,10 $1 511,10 |
$1 229,92 $1 324,00 $1 423,64 $1 777,64 |
Toc - Plan #25 Molina Healthcare | ||||||||||||||||||||
Bronze
(HMO) Core Care Bronze 2 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-888-560-2043
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$274,01 $311,01 $350,19 $489,39 $743,67 |
$483,63 $520,63 $559,81 $699,01 |
$693,25 $730,25 $769,43 $908,63 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$548,02 $622,02 $700,38 $978,78 $1 487,34 |
$757,64 $831,64 $910,00 $1 188,40 |
$967,26 $1 041,26 $1 119,62 $1 398,02 |
ADVERTISEMENT
Arise Health PlanLocal: 1-920-490-6900 | Toll Free: 1-800-332-6249 | TTY: 1-888-332-0144 |
Toc - Plan #26 Arise Health Plan | ||||||||||||||||||||
Bronze
(HMO) WPS HMO Bronze $8,550 | Select Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-332-6249
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$299,32 $339,73 $382,53 $534,59 $812,35 |
$528,30 $568,71 $611,51 $763,57 |
$757,28 $797,69 $840,49 $992,55 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$598,64 $679,46 $765,06 $1 069,18 $1 624,70 |
$827,62 $908,44 $994,04 $1 298,16 |
$1 056,60 $1 137,42 $1 223,02 $1 527,14 |
Toc - Plan #27 Arise Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) WPS HMO Bronze $6,500 with 3 Free PCP Visits | Select Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-332-6249
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$310,79 $352,75 $397,19 $555,07 $843,48 |
$548,54 $590,50 $634,94 $792,82 |
$786,29 $828,25 $872,69 $1 030,57 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$621,58 $705,50 $794,38 $1 110,14 $1 686,96 |
$859,33 $943,25 $1 032,13 $1 347,89 |
$1 097,08 $1 181,00 $1 269,88 $1 585,64 |
Toc - Plan #28 Arise Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) WPS HMO Bronze $7,200 | Select Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-332-6249
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$304,51 $345,62 $389,16 $543,85 $826,44 |
$537,46 $578,57 $622,11 $776,80 |
$770,41 $811,52 $855,06 $1 009,75 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$609,02 $691,24 $778,32 $1 087,70 $1 652,88 |
$841,97 $924,19 $1 011,27 $1 320,65 |
$1 074,92 $1 157,14 $1 244,22 $1 553,60 |
Toc - Plan #29 Arise Health Plan | ||||||||||||||||||||
Silver
(HMO) WPS HMO Silver $7,500 | Select Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-332-6249
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$402,38 $456,70 $514,24 $718,65 $1 092,06 |
$710,20 $764,52 $822,06 $1 026,47 |
$1 018,02 $1 072,34 $1 129,88 $1 334,29 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$804,76 $913,40 $1 028,48 $1 437,30 $2 184,12 |
$1 112,58 $1 221,22 $1 336,30 $1 745,12 |
$1 420,40 $1 529,04 $1 644,12 $2 052,94 |
Toc - Plan #30 Arise Health Plan | ||||||||||||||||||||
Silver
(HMO) WPS HMO Silver $4,500 | Select Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-332-6249
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$403,34 $457,79 $515,47 $720,37 $1 094,66 |
$711,90 $766,35 $824,03 $1 028,93 |
$1 020,46 $1 074,91 $1 132,59 $1 337,49 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$806,68 $915,58 $1 030,94 $1 440,74 $2 189,32 |
$1 115,24 $1 224,14 $1 339,50 $1 749,30 |
$1 423,80 $1 532,70 $1 648,06 $2 057,86 |
Toc - Plan #31 Arise Health Plan | ||||||||||||||||||||
Silver
(HMO) WPS HMO Silver $5,000 with 3 Free PCP Visits | Select Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-332-6249
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$419,56 $476,20 $536,20 $749,33 $1 138,69 |
$740,52 $797,16 $857,16 $1 070,29 |
$1 061,48 $1 118,12 $1 178,12 $1 391,25 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$839,12 $952,40 $1 072,40 $1 498,66 $2 277,38 |
$1 160,08 $1 273,36 $1 393,36 $1 819,62 |
$1 481,04 $1 594,32 $1 714,32 $2 140,58 |
Toc - Plan #32 Arise Health Plan | ||||||||||||||||||||
Gold
(HMO) WPS HMO Gold $2,500 | Select Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-332-6249
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$555,76 $630,79 $710,26 $992,59 $1 508,33 |
$980,92 $1 055,95 $1 135,42 $1 417,75 |
$1 406,08 $1 481,11 $1 560,58 $1 842,91 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$1 111,52 $1 261,58 $1 420,52 $1 985,18 $3 016,66 |
$1 536,68 $1 686,74 $1 845,68 $2 410,34 |
$1 961,84 $2 111,90 $2 270,84 $2 835,50 |
Toc - Plan #33 Arise Health Plan | ||||||||||||||||||||
Catastrophic
(HMO) WPS HMO Catastrophic $8,550 with 3 Free PCP Visits | Select Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-332-6249
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$260,22 $295,35 $332,56 $464,75 $706,24 |
$459,29 $494,42 $531,63 $663,82 |
$658,36 $693,49 $730,70 $862,89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$520,44 $590,70 $665,12 $929,50 $1 412,48 |
$719,51 $789,77 $864,19 $1 128,57 |
$918,58 $988,84 $1 063,26 $1 327,64 |
Toc - Plan #34 Arise Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) WPS HMO HDHP Bronze $7,000 | Select Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-332-6249
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$311,17 $353,18 $397,68 $555,75 $844,52 |
$549,22 $591,23 $635,73 $793,80 |
$787,27 $829,28 $873,78 $1 031,85 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$622,34 $706,36 $795,36 $1 111,50 $1 689,04 |
$860,39 $944,41 $1 033,41 $1 349,55 |
$1 098,44 $1 182,46 $1 271,46 $1 587,60 |
Toc - Plan #35 Arise Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) WPS HMO HDHP Bronze $6,830 | Select Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-332-6249
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$317,52 $360,39 $405,79 $567,09 $861,75 |
$560,42 $603,29 $648,69 $809,99 |
$803,32 $846,19 $891,59 $1 052,89 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$635,04 $720,78 $811,58 $1 134,18 $1 723,50 |
$877,94 $963,68 $1 054,48 $1 377,08 |
$1 120,84 $1 206,58 $1 297,38 $1 619,98 |
Toc - Plan #36 Arise Health Plan | ||||||||||||||||||||
Expanded Bronze
(HMO) WPS HMO HDHP Bronze $6,000 | Select Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-332-6249
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$311,82 $353,92 $398,51 $556,91 $846,28 |
$550,36 $592,46 $637,05 $795,45 |
$788,90 $831,00 $875,59 $1 033,99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$623,64 $707,84 $797,02 $1 113,82 $1 692,56 |
$862,18 $946,38 $1 035,56 $1 352,36 |
$1 100,72 $1 184,92 $1 274,10 $1 590,90 |
Toc - Plan #37 Arise Health Plan | ||||||||||||||||||||
Silver
(HMO) WPS HMO HDHP Silver $2,800 | Select Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-332-6249
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$413,53 $469,36 $528,49 $738,56 $1 122,32 |
$729,88 $785,71 $844,84 $1 054,91 |
$1 046,23 $1 102,06 $1 161,19 $1 371,26 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$827,06 $938,72 $1 056,98 $1 477,12 $2 244,64 |
$1 143,41 $1 255,07 $1 373,33 $1 793,47 |
$1 459,76 $1 571,42 $1 689,68 $2 109,82 |
Toc - Plan #38 Arise Health Plan | ||||||||||||||||||||
Silver
(HMO) WPS HMO HDHP Silver $4,500 | Select Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-332-6249
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$412,57 $468,27 $527,26 $736,85 $1 119,71 |
$728,19 $783,89 $842,88 $1 052,47 |
$1 043,81 $1 099,51 $1 158,50 $1 368,09 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$825,14 $936,54 $1 054,52 $1 473,70 $2 239,42 |
$1 140,76 $1 252,16 $1 370,14 $1 789,32 |
$1 456,38 $1 567,78 $1 685,76 $2 104,94 |
Toc - Plan #39 Arise Health Plan | ||||||||||||||||||||
Silver
(HMO) WPS HMO HDHP Silver $5,500 | Select Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-332-6249
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$391,74 $444,62 $500,64 $699,65 $1 063,18 |
$691,42 $744,30 $800,32 $999,33 |
$991,10 $1 043,98 $1 100,00 $1 299,01 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$783,48 $889,24 $1 001,28 $1 399,30 $2 126,36 |
$1 083,16 $1 188,92 $1 300,96 $1 698,98 |
$1 382,84 $1 488,60 $1 600,64 $1 998,66 |
Toc - Plan #40 Arise Health Plan | ||||||||||||||||||||
Bronze
(POS) WPS POS Bronze $8,550 | Select Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-332-6249
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$320,15 $363,37 $409,15 $571,79 $868,89 |
$565,06 $608,28 $654,06 $816,70 |
$809,97 $853,19 $898,97 $1 061,61 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$640,30 $726,74 $818,30 $1 143,58 $1 737,78 |
$885,21 $971,65 $1 063,21 $1 388,49 |
$1 130,12 $1 216,56 $1 308,12 $1 633,40 |
Toc - Plan #41 Arise Health Plan | ||||||||||||||||||||
Expanded Bronze
(POS) WPS POS HDHP Bronze $6,000 | Select Network |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-800-332-6249
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$333,48 $378,50 $426,19 $595,60 $905,06 |
$588,59 $633,61 $681,30 $850,71 |
$843,70 $888,72 $936,41 $1 105,82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$666,96 $757,00 $852,38 $1 191,20 $1 810,12 |
$922,07 $1 012,11 $1 107,49 $1 446,31 |
$1 177,18 $1 267,22 $1 362,60 $1 701,42 |
ADVERTISEMENT
Common Ground Healthcare CooperativeLocal: 1-877-514-2442 | Toll Free: 1-877-514-2442 | TTY: 1-844-472-2442 |
Toc - Plan #42 Common Ground Healthcare Cooperative | ||||||||||||||||||||
Gold
(EPO) Envision - Gold 1800/80 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-514-2442
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$405,48 $460,21 $518,20 $724,18 $1 100,46 |
$715,67 $770,40 $828,39 $1 034,37 |
$1 025,86 $1 080,59 $1 138,58 $1 344,56 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$810,96 $920,42 $1 036,40 $1 448,36 $2 200,92 |
$1 121,15 $1 230,61 $1 346,59 $1 758,55 |
$1 431,34 $1 540,80 $1 656,78 $2 068,74 |
Toc - Plan #43 Common Ground Healthcare Cooperative | ||||||||||||||||||||
Gold
(EPO) Envision - Gold 2000/80 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-514-2442
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$381,23 $432,69 $487,20 $680,86 $1 034,64 |
$672,87 $724,33 $778,84 $972,50 |
$964,51 $1 015,97 $1 070,48 $1 264,14 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$762,46 $865,38 $974,40 $1 361,72 $2 069,28 |
$1 054,10 $1 157,02 $1 266,04 $1 653,36 |
$1 345,74 $1 448,66 $1 557,68 $1 945,00 |
Toc - Plan #44 Common Ground Healthcare Cooperative | ||||||||||||||||||||
Silver
(EPO) Envision - Silver 4000/75 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-514-2442
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$372,86 $423,18 $476,50 $665,90 $1 011,91 |
$658,09 $708,41 $761,73 $951,13 |
$943,32 $993,64 $1 046,96 $1 236,36 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$745,72 $846,36 $953,00 $1 331,80 $2 023,82 |
$1 030,95 $1 131,59 $1 238,23 $1 617,03 |
$1 316,18 $1 416,82 $1 523,46 $1 902,26 |
Toc - Plan #45 Common Ground Healthcare Cooperative | ||||||||||||||||||||
Silver
(EPO) Envision - Silver 3000/75/Copay40 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-514-2442
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$389,94 $442,57 $498,33 $696,41 $1 058,26 |
$688,23 $740,86 $796,62 $994,70 |
$986,52 $1 039,15 $1 094,91 $1 292,99 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$779,88 $885,14 $996,66 $1 392,82 $2 116,52 |
$1 078,17 $1 183,43 $1 294,95 $1 691,11 |
$1 376,46 $1 481,72 $1 593,24 $1 989,40 |
Toc - Plan #46 Common Ground Healthcare Cooperative | ||||||||||||||||||||
Catastrophic
(EPO) Envision - Catastrophic 8550/100 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-514-2442
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$184,53 $209,43 $235,81 $329,55 $500,78 |
$325,69 $350,59 $376,97 $470,71 |
$466,85 $491,75 $518,13 $611,87 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$369,06 $418,86 $471,62 $659,10 $1 001,56 |
$510,22 $560,02 $612,78 $800,26 |
$651,38 $701,18 $753,94 $941,42 |
Toc - Plan #47 Common Ground Healthcare Cooperative | ||||||||||||||||||||
Expanded Bronze
(EPO) Envision - Bronze 8550/100 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-514-2442
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$259,60 $294,64 $331,76 $463,64 $704,54 |
$458,19 $493,23 $530,35 $662,23 |
$656,78 $691,82 $728,94 $860,82 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$519,20 $589,28 $663,52 $927,28 $1 409,08 |
$717,79 $787,87 $862,11 $1 125,87 |
$916,38 $986,46 $1 060,70 $1 324,46 |
Toc - Plan #48 Common Ground Healthcare Cooperative | ||||||||||||||||||||
Expanded Bronze
(EPO) Envision - Bronze 8150/ 100 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-514-2442
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$276,53 $313,85 $353,39 $493,87 $750,48 |
$488,07 $525,39 $564,93 $705,41 |
$699,61 $736,93 $776,47 $916,95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$553,06 $627,70 $706,78 $987,74 $1 500,96 |
$764,60 $839,24 $918,32 $1 199,28 |
$976,14 $1 050,78 $1 129,86 $1 410,82 |
Toc - Plan #49 Common Ground Healthcare Cooperative | ||||||||||||||||||||
Expanded Bronze
(EPO) Envision - HSA Bronze 7000/100 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-514-2442
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$274,29 $311,31 $350,53 $489,87 $744,40 |
$484,12 $521,14 $560,36 $699,70 |
$693,95 $730,97 $770,19 $909,53 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$548,58 $622,62 $701,06 $979,74 $1 488,80 |
$758,41 $832,45 $910,89 $1 189,57 |
$968,24 $1 042,28 $1 120,72 $1 399,40 |
Toc - Plan #50 Common Ground Healthcare Cooperative | ||||||||||||||||||||
Silver
(EPO) Envision - Silver 7000/75 |
||||||||||||||||||||
Benefits & Coverage
Plan Brochure
Provider Directory
Customer Service Phone: 1-877-514-2442
Annual Out of Pocket Expenses:
Monthly Premiums:
[show premiums]
|
||||||||||||||||||||
Age | Individual |
Individual 1 Child |
Individual 2 Children |
|||||||||||||||||
21 30 40 50 60 |
$310,01 $351,85 $396,18 $553,65 $841,33 |
$547,16 $589,00 $633,33 $790,80 |
$784,31 $826,15 $870,48 $1 027,95 |
|||||||||||||||||
Age | Couple |
Couple 1 Child |
Couple 2 Chidren |
|||||||||||||||||
21 30 40 50 60 |
$620,02 $703,70 $792,36 $1 107,30 $1 682,66 |
$857,17 $940,85 $1 029,51 $1 344,45 |
$1 094,32 $1 178,00 $1 266,66 $1 581,60 |
‡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 Waupaca County here.
Waupaca County is in “Rating Area 10” of Wisconsin.
Currently, there are 50 plans offered in Rating Area 10.