Non-Marketplace Health Insurance Plans

Select Plan to Review

*RX Coverage: Generic/Preferred Brand/Non-Preferred Brand Copay.

When you click on one of the View buttons below your Summary of Benefits and Coverage (SBC) will pull up in PDF format.

  Plan Number Network Maternity In-Network Deductible Amount Primary Care Practitioner/Specialist Copay Coinsurance Percent Out-of-Pocket Maximum RX Coverage*
View Bronze B01P P Yes $2500 Individual/$5000 Family ded/coins 50% $6350 Individual/$12700 Family ded/coins
View Bronze B01S S Yes $2500 Individual/$5000 Family ded/coins 50% $6350 Individual/$12700 Family ded/coins
View Bronze B02P P Yes $4000 Individual/$8000 Family ded/coins 50% $6350 Individual/$12700 Family ded/coins
View Bronze B02S S Yes $4000 Individual/$8000 Family ded/coins 50% $6350 Individual/$12700 Family ded/coins
View Bronze B03P P Yes $4000 Individual/$8000 Family ded/coins 20% $6350 Individual/$12700 Family ded/coins
View Bronze B03S S Yes $4000 Individual/$8000 Family ded/coins 20% $6350 Individual/$12700 Family ded/coins
View Bronze B04P P Yes $5300 Individual/$10600 Family ded/coins 0% $5300 Individual/$10600 Family ded/coins
View Bronze B04S S Yes $5300 Individual/$10600 Family ded/coins 0% $5300 Individual/$10600 Family ded/coins
View Bronze B05P P Yes $6250 Individual/$12500 Family ded/coins 0% $6250 Individual/$12500 Family ded/coins
View Bronze B05S S Yes $6250 Individual/$12500 Family ded/coins 0% $6250 Individual/$12500 Family ded/coins
View Bronze B06P P Yes $6350 Individual/$12700 Family ded/coins 0% $6350 Individual/$12700 Family $3/$75/$250
View Bronze B06S S Yes $6350 Individual/$12700 Family ded/coins 0% $6350 Individual/$12700 Family $3/$75/$250
View Bronze B07P P Yes $5200 Individual/$10400 Family ded/coins 50% $6400 Individual/$12800 Family ded/coins
View Bronze B07S S Yes $5200 Individual/$10400 Family ded/coins 50% $6400 Individual/$12800 Family ded/coins
View Gold G01P P Yes $0 Individual/$0 Family ded/coins 35% $5250 Individual/$10500 Family ded/coins
View Gold G01S S Yes $0 Individual/$0 Family ded/coins 35% $5250 Individual/$10500 Family ded/coins
View Gold G02P P Yes $0 Individual/$0 Family ded/coins 25% $6350 Individual/$12700 Family ded/coins
View Gold G02S S Yes $0 Individual/$0 Family ded/coins 25% $6350 Individual/$12700 Family ded/coins
View Gold G03P P Yes $1000 Individual/$2000 Family $35 20% $4000 Individual/$8000 Family $8/$35/$60
View Gold G03S S Yes $1000 Individual/$2000 Family $35 20% $4000 Individual/$8000 Family $8/$35/$60
View Gold G04P P Yes $1000 Individual/$2000 Family $35 20% $4000 Individual/$8000 Family $8/$35/$60
View Gold G04S S Yes $1000 Individual/$2000 Family $35 20% $4000 Individual/$8000 Family $8/$35/$60
View Gold G05P P Yes $1500 Individual/$3000 Family $35 20% $4500 Individual/$9000 Family $8/$35/$60
View Gold G05S S Yes $1500 Individual/$3000 Family $35 20% $4500 Individual/$9000 Family $8/$35/$60
View Gold G06P P Yes $1500 Individual/$3000 Family $35 20% $4500 Individual/$9000 Family $8/$35/$60
View Gold G06S S Yes $1500 Individual/$3000 Family $35 20% $4500 Individual/$9000 Family $8/$35/$60
View Gold G07P P Yes $2000 Individual/$4000 Family $10 20% $6350 Individual/$12700 Family $3/$25/$50
View Gold G07S S Yes $2000 Individual/$4000 Family $10 20% $6350 Individual/$12700 Family $3/$25/$50
View Gold G08P P Yes $2100 Individual/$4200 Family ded/coins 0% $2100 Individual/$4200 Family ded/coins
View Gold G08S S Yes $2100 Individual/$4200 Family ded/coins 0% $2100 Individual/$4200 Family ded/coins
View Gold G10P P Yes $3500 Individual/$7000 Family $35 0% $3500 Individual/$7000 Family 50%
View Gold G10S S Yes $3500 Individual/$7000 Family $35 0% $3500 Individual/$7000 Family 50%
View Gold G11P P Yes $3500 Individual/$7000 Family $35 0% $3500 Individual/$7000 Family $8/$35/$60
View Gold G11S S Yes $3500 Individual/$7000 Family $35 0% $3500 Individual/$7000 Family $8/$35/$60
View Platinum P01P P Yes $0 Individual/$0 Family $20 50% $1800 Individual/$3600 Family $3/$25/$50
View Platinum P01S S Yes $0 Individual/$0 Family $20 50% $1800 Individual/$3600 Family $3/$25/$50
View Platinum P02P P Yes $0 Individual/$0 Family ded/coins 25% $1500 Individual/$3000 Family ded/coins
View Platinum P02S S Yes $0 Individual/$0 Family ded/coins 25% $1500 Individual/$3000 Family ded/coins
View Platinum P03P P Yes $0 Individual/$0 Family $10 25% $3000 Individual/$6000 Family $3/$25/$50
View Platinum P03S S Yes $0 Individual/$0 Family $10 25% $3000 Individual/$6000 Family $3/$25/$50
View Platinum P04P P Yes $1500 Individual/$3000 Family $10 0% $1500 Individual/$3000 Family $3/$25/$50
View Platinum P04S S Yes $1500 Individual/$3000 Family $10 0% $1500 Individual/$3000 Family $3/$25/$50
View Silver S01P P Yes $0 Individual/$0 Family ded/coins 50% $6350 Individual/$12700 Family ded/coins
View Silver S01S S Yes $0 Individual/$0 Family ded/coins 50% $6350 Individual/$12700 Family ded/coins
View Silver S02P P Yes $1000 Individual/$2000 Family ded/coins 50% $6250 Individual/$12500 Family $3/50%
View Silver S02S S Yes $1000 Individual/$2000 Family ded/coins 50% $6250 Individual/$12500 Family $3/50%
View Silver S03P P Yes $1000 Individual/$2000 Family $60 50% $6350 Individual/$12700 Family $3/50%
View Silver S03S S Yes $1000 Individual/$2000 Family $60 50% $6350 Individual/$12700 Family $3/50%
View Silver S04P P Yes $2000 Individual/$4000 Family ded/coins 50% $4000 Individual/$8000 Family ded/coins
View Silver S04S S Yes $2000 Individual/$4000 Family ded/coins 50% $4000 Individual/$8000 Family ded/coins
View Silver S05P P Yes $2000 Individual/$4000 Family $40 50% $6350 Individual/$12700 Family $3/50%
View Silver S05S S Yes $2000 Individual/$4000 Family $40 50% $6350 Individual/$12700 Family $3/50%
View Silver S06P P Yes $2000 Individual/$4000 Family $55 50% $6350 Individual/$12700 Family $3/$50/$100
View Silver S06S S Yes $2000 Individual/$4000 Family $55 50% $6350 Individual/$12700 Family $3/$50/$100
View Silver S07P P Yes $1500 Individual/$3000 Family ded/coins 30% $6350 Individual/$12700 Family ded/coins
View Silver S07S S Yes $1500 Individual/$3000 Family ded/coins 30% $6350 Individual/$12700 Family ded/coins
View Silver S08P P Yes $2000 Individual/$4000 Family ded/coins 20% $5000 Individual/$10000 Family ded/coins
View Silver S08S S Yes $2000 Individual/$4000 Family ded/coins 20% $5000 Individual/$10000 Family ded/coins
View Silver S09P P Yes $2500 Individual/$5000 Family ded/coins 20% $4500 Individual/$9000 Family ded/coins
View Silver S09S S Yes $2500 Individual/$5000 Family ded/coins 20% $4500 Individual/$9000 Family ded/coins
View Silver S10P P Yes $2500 Individual/$5000 Family ded/coins 20% $5500 Individual/$11000 Family $8/$35/$60
View Silver S10S S Yes $2500 Individual/$5000 Family ded/coins 20% $5500 Individual/$11000 Family $8/$35/$60
View Silver S11P P Yes $2500 Individual/$5000 Family ded/coins 20% $5500 Individual/$11000 Family $8/$35/$60
View Silver S11S S Yes $2500 Individual/$5000 Family ded/coins 20% $5500 Individual/$11000 Family $8/$35/$60
View Silver S12P P Yes $4000 Individual/$8000 Family $10 20% $5500 Individual/$11000 Family ded/coins
View Silver S12S S Yes $4000 Individual/$8000 Family $10 20% $5500 Individual/$11000 Family ded/coins
View Silver S13P P Yes $4000 Individual/$8000 Family $10 20% $5500 Individual/$11000 Family $3/$100/$250
View Silver S13S S Yes $4000 Individual/$8000 Family $10 20% $5500 Individual/$11000 Family $3/$100/$250
View Silver S14P P Yes $5500 Individual/$11000 Family $10 20% $6350 Individual/$12700 Family $3/$50/$100
View Silver S14S S Yes $5500 Individual/$11000 Family $10 20% $6350 Individual/$12700 Family $3/$50/$100
View Silver S15P P Yes $5500 Individual/$11000 Family $35 20% $6350 Individual/$12700 Family $3/$35/$75
View Silver S15S S Yes $5500 Individual/$11000 Family $35 20% $6350 Individual/$12700 Family $3/$35/$75
View Silver S16P P Yes $3500 Individual/$7000 Family ded/coins 0% $3500 Individual/$7000 Family ded/coins
View Silver S16S S Yes $3500 Individual/$7000 Family ded/coins 0% $3500 Individual/$7000 Family ded/coins
View Silver S18P P Yes $6350 Individual/$12700 Family $35 0% $6350 Individual/$12700 Family $3/$50/$100
View Silver S18S S Yes $6350 Individual/$12700 Family $35 0% $6350 Individual/$12700 Family $3/$50/$100
View Silver S19P P Yes $3000 Individual/$6000 Family ded/coins 10% $4250 Individual/$8500 Family ded/coins
View Silver S19S S Yes $3000 Individual/$6000 Family ded/coins 10% $4250 Individual/$8500 Family ded/coins