View |
View |
Bronze B07E
|
E
|
Yes
|
$5,950 Individual/
$11,900 Family
|
ded/coins |
$0 |
0.5
|
$7,100 Individual/
$14,200 Family
|
ded/coins
|
View |
View |
Bronze B07E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B07E-AI2
|
E
|
Yes
|
$5,950 Individual/
$11,900 Family
|
ded/coins |
$0 |
0.5
|
$7,100 Individual/
$14,200 Family
|
ded/coins
|
View |
View |
Bronze B07L
|
L
|
Yes
|
$5,950 Individual/
$11,900 Family
|
ded/coins |
$0 |
0.5
|
$7,100 Individual/
$14,200 Family
|
ded/coins
|
View |
View |
Bronze B07L-AI1
|
L
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B07L-AI2
|
L
|
Yes
|
$5,950 Individual/
$11,900 Family
|
ded/coins |
$0 |
0.5
|
$7,100 Individual/
$14,200 Family
|
ded/coins
|
View |
View |
Bronze B07S
|
S
|
Yes
|
$5,950 Individual/
$11,900 Family
|
ded/coins |
$0 |
0.5
|
$7,100 Individual/
$14,200 Family
|
ded/coins
|
View |
View |
Bronze B07S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B07S-AI2
|
S
|
Yes
|
$5,950 Individual/
$11,900 Family
|
ded/coins |
$0 |
0.5
|
$7,100 Individual/
$14,200 Family
|
ded/coins
|
View |
View |
Bronze B08S
|
S
|
Yes
|
$8,700 Individual/
$17,400 Family
|
ded/coins |
$0 |
0.0
|
$8,700 Individual/
$17,400 Family
|
ded/coins
|
View |
View |
Bronze B08S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B08S-AI2
|
S
|
Yes
|
$8,700 Individual/
$17,400 Family
|
ded/coins |
$0 |
0.0
|
$8,700 Individual/
$17,400 Family
|
ded/coins
|
View |
View |
Bronze B10E
|
E
|
Yes
|
$7,100 Individual/
$14,200 Family
|
ded/coins |
$0 |
0.5
|
$8,600 Individual/
$17,200 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Bronze B10E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B10E-AI2
|
E
|
Yes
|
$7,100 Individual/
$14,200 Family
|
ded/coins |
$0 |
0.5
|
$8,600 Individual/
$17,200 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Bronze B10L
|
L
|
Yes
|
$7,100 Individual/
$14,200 Family
|
ded/coins |
$0 |
0.5
|
$8,600 Individual/
$17,200 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Bronze B10L-AI1
|
L
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B10L-AI2
|
L
|
Yes
|
$7,100 Individual/
$14,200 Family
|
ded/coins |
$0 |
0.5
|
$8,600 Individual/
$17,200 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Bronze B10S
|
S
|
Yes
|
$7,100 Individual/
$14,200 Family
|
ded/coins |
$0 |
0.5
|
$8,600 Individual/
$17,200 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Bronze B10S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B10S-AI2
|
S
|
Yes
|
$7,100 Individual/
$14,200 Family
|
ded/coins |
$0 |
0.5
|
$8,600 Individual/
$17,200 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Bronze B11E
|
E
|
Yes
|
$6,900 Individual/
$13,800 Family
|
Sanitas PCP: $25
All Others: ded/coins |
$0 |
0.5
|
$9,100 Individual/
$18,200 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Bronze B11E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B11E-AI2
|
E
|
Yes
|
$6,900 Individual/
$13,800 Family
|
Sanitas PCP: $25
All Others: ded/coins |
$0 |
0.5
|
$9,100 Individual/
$18,200 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Bronze B15E
|
E
|
Yes
|
$9,450 Individual/
$18,900 Family
|
ded/coins |
$0 |
0.0
|
$9,450 Individual/
$18,900 Family
|
ded/coins
|
View |
View |
Bronze B15E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B15E-AI2
|
E
|
Yes
|
$9,450 Individual/
$18,900 Family
|
ded/coins |
$0 |
0.0
|
$9,450 Individual/
$18,900 Family
|
ded/coins
|
View |
View |
Bronze B15L
|
L
|
Yes
|
$9,450 Individual/
$18,900 Family
|
ded/coins |
$0 |
0.0
|
$9,450 Individual/
$18,900 Family
|
ded/coins
|
View |
View |
Bronze B15L-AI1
|
L
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B15L-AI2
|
L
|
Yes
|
$9,450 Individual/
$18,900 Family
|
ded/coins |
$0 |
0.0
|
$9,450 Individual/
$18,900 Family
|
ded/coins
|
View |
View |
Bronze B15S
|
S
|
Yes
|
$9,450 Individual/
$18,900 Family
|
ded/coins |
$0 |
0.0
|
$9,450 Individual/
$18,900 Family
|
ded/coins
|
View |
View |
Bronze B15S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B15S-AI2
|
S
|
Yes
|
$9,450 Individual/
$18,900 Family
|
ded/coins |
$0 |
0.0
|
$9,450 Individual/
$18,900 Family
|
ded/coins
|
View |
View |
Bronze B16E
|
E
|
Yes
|
$7,500 Individual/
$15,000 Family
|
PCP: $50
Spec: $100 |
$0 |
0.5
|
$9,400 Individual/
$18,800 Family
|
25/ [50/100 sub to ded]
|
View |
View |
Bronze B16E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B16E-AI2
|
E
|
Yes
|
$7,500 Individual/
$15,000 Family
|
PCP: $50
Spec: $100 |
$0 |
0.5
|
$9,400 Individual/
$18,800 Family
|
25/ [50/100 sub to ded]
|
View |
View |
Bronze B16L
|
L
|
Yes
|
$7,500 Individual/
$15,000 Family
|
PCP: $50
Spec: $100 |
$0 |
0.5
|
$9,400 Individual/
$18,800 Family
|
25/ [50/100 sub to ded]
|
View |
View |
Bronze B16L-AI1
|
L
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B16L-AI2
|
L
|
Yes
|
$7,500 Individual/
$15,000 Family
|
PCP: $50
Spec: $100 |
$0 |
0.5
|
$9,400 Individual/
$18,800 Family
|
25/ [50/100 sub to ded]
|
View |
View |
Bronze B16S
|
S
|
Yes
|
$7,500 Individual/
$15,000 Family
|
PCP: $50
Spec: $100 |
$0 |
0.5
|
$9,400 Individual/
$18,800 Family
|
25/ [50/100 sub to ded]
|
View |
View |
Bronze B16S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Bronze B16S-AI2
|
S
|
Yes
|
$7,500 Individual/
$15,000 Family
|
PCP: $50
Spec: $100 |
$0 |
0.5
|
$9,400 Individual/
$18,800 Family
|
25/ [50/100 sub to ded]
|
View |
View |
Gold G06E
|
E
|
Yes
|
$3,000 Individual/
$6,000 Family
|
PCP: $35
Spec: $50 |
$0 |
0.2
|
$6,600 Individual/
$13,200 Family
|
$8/$35/$60
|
View |
View |
Gold G06E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Gold G06E-AI2
|
E
|
Yes
|
$3,000 Individual/
$6,000 Family
|
PCP: $35
Spec: $50 |
$0 |
0.2
|
$6,600 Individual/
$13,200 Family
|
$8/$35/$60
|
View |
View |
Gold G06L
|
L
|
Yes
|
$3,000 Individual/
$6,000 Family
|
PCP: $35
Spec: $50 |
$0 |
0.2
|
$6,600 Individual/
$13,200 Family
|
$8/$35/$60
|
View |
View |
Gold G06L-AI1
|
L
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Gold G06L-AI2
|
L
|
Yes
|
$3,000 Individual/
$6,000 Family
|
PCP: $35
Spec: $50 |
$0 |
0.2
|
$6,600 Individual/
$13,200 Family
|
$8/$35/$60
|
View |
View |
Gold G06S
|
S
|
Yes
|
$3,000 Individual/
$6,000 Family
|
PCP: $35
Spec: $50 |
$0 |
0.2
|
$6,600 Individual/
$13,200 Family
|
$8/$35/$60
|
View |
View |
Gold G06S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Gold G06S-AI2
|
S
|
Yes
|
$3,000 Individual/
$6,000 Family
|
PCP: $35
Spec: $50 |
$0 |
0.2
|
$6,600 Individual/
$13,200 Family
|
$8/$35/$60
|
View |
View |
Gold G07E
|
E
|
Yes
|
$1,550 Individual/
$3,100 Family
|
Sanitas PCP: $10 Copay
Other PCP: ded/coins
Spec: ded/coins |
$0 |
0.3
|
$6,200 Individual/
$12,400 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Gold G07E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Gold G07E-AI2
|
E
|
Yes
|
$1,550 Individual/
$3,100 Family
|
Sanitas PCP: $10 Copay
Other PCP: ded/coins
Spec: ded/coins |
$0 |
0.3
|
$6,200 Individual/
$12,400 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Gold G07S
|
S
|
Yes
|
$1,000 Individual/
$2,000 Family
|
Sanitas PCP: $10 Copay
Other PCP: ded/coins
Spec: ded/coins |
$0 |
0.3
|
$4,800 Individual/
$9,600 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Gold G07S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Gold G07S-AI2
|
S
|
Yes
|
$1,000 Individual/
$2,000 Family
|
Sanitas PCP: $10 Copay
Other PCP: ded/coins
Spec: ded/coins |
$0 |
0.3
|
$4,800 Individual/
$9,600 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Gold G08E
|
E
|
Yes
|
$1,500 Individual/
$3,000 Family
|
PCP: $30 Copay
Spec: $60 Copay |
$0 |
0.25
|
$8,700 Individual/
$17,400 Family
|
$15/$30/$60
|
View |
View |
Gold G08E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Gold G08E-AI2
|
E
|
Yes
|
$1,500 Individual/
$3,000 Family
|
PCP: $30 Copay
Spec: $60 Copay |
$0 |
0.25
|
$8,700 Individual/
$17,400 Family
|
$15/$30/$60
|
View |
View |
Gold G08L
|
L
|
Yes
|
$1,500 Individual/
$3,000 Family
|
PCP: $30 Copay
Spec: $60 Copay |
$0 |
0.25
|
$8,700 Individual/
$17,400 Family
|
$15/$30/$60
|
View |
View |
Gold G08L-AI1
|
L
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Gold G08L-AI2
|
L
|
Yes
|
$1,500 Individual/
$3,000 Family
|
PCP: $30 Copay
Spec: $60 Copay |
$0 |
0.25
|
$8,700 Individual/
$17,400 Family
|
$15/$30/$60
|
View |
View |
Gold G08S
|
S
|
Yes
|
$1,500 Individual/
$3,000 Family
|
PCP: $30 Copay
Spec: $60 Copay |
$0 |
0.25
|
$8,700 Individual/
$17,400 Family
|
$15/$30/$60
|
View |
View |
Gold G08S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Gold G08S-AI2
|
S
|
Yes
|
$1,500 Individual/
$3,000 Family
|
PCP: $30 Copay
Spec: $60 Copay |
$0 |
0.25
|
$8,700 Individual/
$17,400 Family
|
$15/$30/$60
|
View |
View |
Silver S04E
|
E
|
Yes
|
$3,300 Individual/
$6,600 Family
|
ded/coins |
$0 |
0.5
|
$6,450 Individual/
$12,900 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Silver S04E-A
|
E
|
Yes
|
$2,750 Individual/
$5,500 Family
|
ded/coins |
$0 |
0.5
|
$5,250 Individual/
$10,500 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Silver S04E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S04E-AI2
|
E
|
Yes
|
$3,300 Individual/
$6,600 Family
|
ded/coins |
$0 |
0.5
|
$6,450 Individual/
$12,900 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Silver S04E-B
|
E
|
Yes
|
$950 Individual/
$1,900 Family
|
ded/coins |
$0 |
0.5
|
$1,800 Individual/
$3,600 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Silver S04E-C
|
E
|
Yes
|
$325 Individual/
$650 Family
|
ded/coins |
$0 |
0.5
|
$625 Individual/
$1,250 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Silver S04L
|
L
|
Yes
|
$3,300 Individual/
$6,600 Family
|
ded/coins |
$0 |
0.5
|
$6,450 Individual/
$12,900 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Silver S04L-A
|
L
|
Yes
|
$2,750 Individual/
$5,500 Family
|
ded/coins |
$0 |
0.5
|
$5,250 Individual/
$10,500 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Silver S04L-AI1
|
L
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S04L-AI2
|
L
|
Yes
|
$3,300 Individual/
$6,600 Family
|
ded/coins |
$0 |
0.5
|
$6,450 Individual/
$12,900 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Silver S04L-B
|
L
|
Yes
|
$950 Individual/
$1,900 Family
|
ded/coins |
$0 |
0.5
|
$1,800 Individual/
$3,600 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Silver S04L-C
|
L
|
Yes
|
$325 Individual/
$650 Family
|
ded/coins |
$0 |
0.5
|
$625 Individual/
$1,250 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Silver S04S
|
S
|
Yes
|
$3,300 Individual/
$6,600 Family
|
ded/coins |
$0 |
0.5
|
$6,450 Individual/
$12,900 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Silver S04S-A
|
S
|
Yes
|
$2,750 Individual/
$5,500 Family
|
ded/coins |
$0 |
0.5
|
$5,250 Individual/
$10,500 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Silver S04S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S04S-AI2
|
S
|
Yes
|
$3,300 Individual/
$6,600 Family
|
ded/coins |
$0 |
0.5
|
$6,450 Individual/
$12,900 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Silver S04S-B
|
S
|
Yes
|
$950 Individual/
$1,900 Family
|
ded/coins |
$0 |
0.5
|
$1,800 Individual/
$3,600 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Silver S04S-C
|
S
|
Yes
|
$325 Individual/
$650 Family
|
ded/coins |
$0 |
0.5
|
$625 Individual/
$1,250 Family
|
ded/coins
$20/$50/$100 PRx
|
View |
View |
Silver S24E
|
E
|
Yes
|
$5,450 Individual/
$10,900 Family
|
PCP: $35 Copay
Spec: $75 Copay |
$0 |
0.5
|
$8,900 Individual/
$17,800 Family
|
$60/$100/$250
|
View |
View |
Silver S24E-A
|
E
|
Yes
|
$3,900 Individual/
$7,800 Family
|
PCP: $30 Copay
Spec: $75 Copay |
$0 |
0.5
|
$7,300 Individual/
$14,600 Family
|
40/60/250
|
View |
View |
Silver S24E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S24E-AI2
|
E
|
Yes
|
$5,450 Individual/
$10,900 Family
|
PCP: $35 Copay
Spec: $75 Copay |
$0 |
0.5
|
$8,900 Individual/
$17,800 Family
|
$60/$100/$250
|
View |
View |
Silver S24E-B
|
E
|
Yes
|
$900 Individual/
$1,800 Family
|
PCP: $25 Copay
Spec: $50 Copay |
$0 |
0.5
|
$2,300 Individual/
$4,600 Family
|
20/40/100
|
View |
View |
Silver S24E-C
|
E
|
Yes
|
$250 Individual/
$500 Family
|
PCP: $5 Copay
Spec: $10 Copay |
$0 |
0.5
|
$850 Individual/
$1,700 Family
|
$5/$10/$50
|
View |
View |
Silver S24L
|
L
|
Yes
|
$5,450 Individual/
$10,900 Family
|
PCP: $35 Copay
Spec: $75 Copay |
$0 |
0.5
|
$8,900 Individual/
$17,800 Family
|
$60/$100/$250
|
View |
View |
Silver S24L-A
|
L
|
Yes
|
$3,900 Individual/
$7,800 Family
|
PCP: $30 Copay
Spec: $75 Copay |
$0 |
0.5
|
$7,300 Individual/
$14,600 Family
|
40/60/250
|
View |
View |
Silver S24L-AI1
|
L
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S24L-AI2
|
L
|
Yes
|
$5,450 Individual/
$10,900 Family
|
PCP: $35 Copay
Spec: $75 Copay |
$0 |
0.5
|
$8,900 Individual/
$17,800 Family
|
$60/$100/$250
|
View |
View |
Silver S24L-B
|
L
|
Yes
|
$900 Individual/
$1,800 Family
|
PCP: $25 Copay
Spec: $50 Copay |
$0 |
0.5
|
$2,300 Individual/
$4,600 Family
|
20/40/100
|
View |
View |
Silver S24L-C
|
L
|
Yes
|
$250 Individual/
$500 Family
|
PCP: $5 Copay
Spec: $10 Copay |
$0 |
0.5
|
$850 Individual/
$1,700 Family
|
$5/$10/$50
|
View |
View |
Silver S24S
|
S
|
Yes
|
$5,450 Individual/
$10,900 Family
|
PCP: $35 Copay
Spec: $75 Copay |
$0 |
0.5
|
$8,900 Individual/
$17,800 Family
|
$60/$100/$250
|
View |
View |
Silver S24S-A
|
S
|
Yes
|
$3,900 Individual/
$7,800 Family
|
PCP: $30 Copay
Spec: $75 Copay |
$0 |
0.5
|
$7,300 Individual/
$14,600 Family
|
40/60/250
|
View |
View |
Silver S24S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S24S-AI2
|
S
|
Yes
|
$5,450 Individual/
$10,900 Family
|
PCP: $35 Copay
Spec: $75 Copay |
$0 |
0.5
|
$8,900 Individual/
$17,800 Family
|
$60/$100/$250
|
View |
View |
Silver S24S-B
|
S
|
Yes
|
$900 Individual/
$1,800 Family
|
PCP: $25 Copay
Spec: $50 Copay |
$0 |
0.5
|
$2,300 Individual/
$4,600 Family
|
20/40/100
|
View |
View |
Silver S24S-C
|
S
|
Yes
|
$250 Individual/
$500 Family
|
PCP: $5 Copay
Spec: $10 Copay |
$0 |
0.5
|
$850 Individual/
$1,700 Family
|
$5/$10/$50
|
View |
View |
Silver S25E
|
E
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $55 Copay
Spec: $100 Copay |
$0 |
0.5
|
$9,450 Individual/
$18,900 Family
|
$4500 ded/coins
|
View |
View |
Silver S25E-A
|
E
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $20 Copay
Spec: $80 Copay |
$0 |
0.5
|
$7,550 Individual/
$15,100 Family
|
$4000 ded/coins
|
View |
View |
Silver S25E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S25E-AI2
|
E
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $55 Copay
Spec: $100 Copay |
$0 |
0.5
|
$9,450 Individual/
$18,900 Family
|
$4500 ded/coins
|
View |
View |
Silver S25E-B
|
E
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $10 Copay
Spec: $50 Copay |
$0 |
0.5
|
$2,250 Individual/
$4,500 Family
|
$600 ded/coins
|
View |
View |
Silver S25E-C
|
E
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $0 Copay
Spec: $25 Copay |
$0 |
0.5
|
$650 Individual/
$1,300 Family
|
$300 ded/coins
|
View |
View |
Silver S25L
|
L
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $55 Copay
Spec: $100 Copay |
$0 |
0.5
|
$9,450 Individual/
$18,900 Family
|
$4500 ded/coins
|
View |
View |
Silver S25L-A
|
L
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $20 Copay
Spec: $80 Copay |
$0 |
0.5
|
$7,550 Individual/
$15,100 Family
|
$4000 ded/coins
|
View |
View |
Silver S25L-AI1
|
L
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S25L-AI2
|
L
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $55 Copay
Spec: $100 Copay |
$0 |
0.5
|
$9,450 Individual/
$18,900 Family
|
$4500 ded/coins
|
View |
View |
Silver S25L-B
|
L
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $10 Copay
Spec: $50 Copay |
$0 |
0.5
|
$2,250 Individual/
$4,500 Family
|
$600 ded/coins
|
View |
View |
Silver S25L-C
|
L
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $0 Copay
Spec: $25 Copay |
$0 |
0.5
|
$650 Individual/
$1,300 Family
|
$300 ded/coins
|
View |
View |
Silver S25S
|
S
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $55 Copay
Spec: $100 Copay |
$0 |
0.5
|
$9,450 Individual/
$18,900 Family
|
$4500 ded/coins
|
View |
View |
Silver S25S-A
|
S
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $20 Copay
Spec: $80 Copay |
$0 |
0.5
|
$7,550 Individual/
$15,100 Family
|
$4000 ded/coins
|
View |
View |
Silver S25S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S25S-AI2
|
S
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $55 Copay
Spec: $100 Copay |
$0 |
0.5
|
$9,450 Individual/
$18,900 Family
|
$4500 ded/coins
|
View |
View |
Silver S25S-B
|
S
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $10 Copay
Spec: $50 Copay |
$0 |
0.5
|
$2,250 Individual/
$4,500 Family
|
$600 ded/coins
|
View |
View |
Silver S25S-C
|
S
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $0 Copay
Spec: $25 Copay |
$0 |
0.5
|
$650 Individual/
$1,300 Family
|
$300 ded/coins
|
View |
View |
Silver S26E
|
E
|
Yes
|
$5,900 Individual/
$11,800 Family
|
PCP: $40 Copay
Spec: $80 Copay |
$0 |
0.4
|
$9,100 Individual/
$18,200 Family
|
20/40[80 sub to ded]
|
View |
View |
Silver S26E-A
|
E
|
Yes
|
$5,700 Individual/
$11,400 Family
|
PCP: $40 Copay
Spec: $80 Copay |
$0 |
0.4
|
$7,200 Individual/
$14,400 Family
|
20/40[80 sub to ded]
|
View |
View |
Silver S26E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S26E-AI2
|
E
|
Yes
|
$5,900 Individual/
$11,800 Family
|
PCP: $40 Copay
Spec: $80 Copay |
$0 |
0.4
|
$9,100 Individual/
$18,200 Family
|
20/40[80 sub to ded]
|
View |
View |
Silver S26E-B
|
E
|
Yes
|
$700 Individual/
$1,400 Family
|
PCP: $20 Copay
Spec: $40 Copay |
$0 |
0.3
|
$3,000 Individual/
$6,000 Family
|
10/20[60 sub to ded]
|
View |
View |
Silver S26E-C
|
E
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $0 Copay
Spec: $10 Copay |
$0 |
0.25
|
$1,800 Individual/
$3,600 Family
|
$0/$15/$50
|
View |
View |
Silver S26L
|
L
|
Yes
|
$5,900 Individual/
$11,800 Family
|
PCP: $40 Copay
Spec: $80 Copay |
$0 |
0.4
|
$9,100 Individual/
$18,200 Family
|
20/40[80 sub to ded]
|
View |
View |
Silver S26L-A
|
L
|
Yes
|
$5,700 Individual/
$11,400 Family
|
PCP: $40 Copay
Spec: $80 Copay |
$0 |
0.4
|
$7,200 Individual/
$14,400 Family
|
20/40[80 sub to ded]
|
View |
View |
Silver S26L-AI1
|
L
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S26L-AI2
|
L
|
Yes
|
$5,900 Individual/
$11,800 Family
|
PCP: $40 Copay
Spec: $80 Copay |
$0 |
0.4
|
$9,100 Individual/
$18,200 Family
|
20/40[80 sub to ded]
|
View |
View |
Silver S26L-B
|
L
|
Yes
|
$700 Individual/
$1,400 Family
|
PCP: $20 Copay
Spec: $40 Copay |
$0 |
0.3
|
$3,000 Individual/
$6,000 Family
|
10/20[60 sub to ded]
|
View |
View |
Silver S26L-C
|
L
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $0 Copay
Spec: $10 Copay |
$0 |
0.25
|
$1,800 Individual/
$3,600 Family
|
$0/$15/$50
|
View |
View |
Silver S26S
|
S
|
Yes
|
$5,900 Individual/
$11,800 Family
|
PCP: $40 Copay
Spec: $80 Copay |
$0 |
0.4
|
$9,100 Individual/
$18,200 Family
|
20/40[80 sub to ded]
|
View |
View |
Silver S26S-A
|
S
|
Yes
|
$5,700 Individual/
$11,400 Family
|
PCP: $40 Copay
Spec: $80 Copay |
$0 |
0.4
|
$7,200 Individual/
$14,400 Family
|
20/40[80 sub to ded]
|
View |
View |
Silver S26S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S26S-AI2
|
S
|
Yes
|
$5,900 Individual/
$11,800 Family
|
PCP: $40 Copay
Spec: $80 Copay |
$0 |
0.4
|
$9,100 Individual/
$18,200 Family
|
20/40[80 sub to ded]
|
View |
View |
Silver S26S-B
|
S
|
Yes
|
$700 Individual/
$1,400 Family
|
PCP: $20 Copay
Spec: $40 Copay |
$0 |
0.3
|
$3,000 Individual/
$6,000 Family
|
10/20[60 sub to ded]
|
View |
View |
Silver S26S-C
|
S
|
Yes
|
$0 Individual/
$0 Family
|
PCP: $0 Copay
Spec: $10 Copay |
$0 |
0.25
|
$1,800 Individual/
$3,600 Family
|
$0/$15/$50
|
View |
View |
Silver S27E
|
E
|
Yes
|
$5,700 Individual/
$11,400 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$6,700 Individual/
$13,400 Family
|
ded/coins
|
View |
View |
Silver S27E-A
|
E
|
Yes
|
$4,500 Individual/
$9,000 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$5,500 Individual/
$11,000 Family
|
ded/coins
|
View |
View |
Silver S27E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S27E-AI2
|
E
|
Yes
|
$5,700 Individual/
$11,400 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$6,700 Individual/
$13,400 Family
|
ded/coins
|
View |
View |
Silver S27E-B
|
E
|
Yes
|
$875 Individual/
$1,750 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$1,875 Individual/
$3,750 Family
|
ded/coins
|
View |
View |
Silver S27E-C
|
E
|
Yes
|
$200 Individual/
$400 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$650 Individual/
$1,300 Family
|
ded/coins
|
View |
View |
Silver S27L
|
L
|
Yes
|
$5,700 Individual/
$11,400 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$6,700 Individual/
$13,400 Family
|
ded/coins
|
View |
View |
Silver S27L-A
|
L
|
Yes
|
$4,500 Individual/
$9,000 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$5,500 Individual/
$11,000 Family
|
ded/coins
|
View |
View |
Silver S27L-AI1
|
L
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S27L-AI2
|
L
|
Yes
|
$5,700 Individual/
$11,400 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$6,700 Individual/
$13,400 Family
|
ded/coins
|
View |
View |
Silver S27L-B
|
L
|
Yes
|
$875 Individual/
$1,750 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$1,875 Individual/
$3,750 Family
|
ded/coins
|
View |
View |
Silver S27L-C
|
L
|
Yes
|
$200 Individual/
$400 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$650 Individual/
$1,300 Family
|
ded/coins
|
View |
View |
Silver S27S
|
S
|
Yes
|
$5,700 Individual/
$11,400 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$6,700 Individual/
$13,400 Family
|
ded/coins
|
View |
View |
Silver S27S-A
|
S
|
Yes
|
$4,500 Individual/
$9,000 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$5,500 Individual/
$11,000 Family
|
ded/coins
|
View |
View |
Silver S27S-AI1
|
S
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S27S-AI2
|
S
|
Yes
|
$5,700 Individual/
$11,400 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$6,700 Individual/
$13,400 Family
|
ded/coins
|
View |
View |
Silver S27S-B
|
S
|
Yes
|
$875 Individual/
$1,750 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$1,875 Individual/
$3,750 Family
|
ded/coins
|
View |
View |
Silver S27S-C
|
S
|
Yes
|
$200 Individual/
$400 Family
|
PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$650 Individual/
$1,300 Family
|
ded/coins
|
View |
View |
Silver S28E
|
E
|
Yes
|
$5,850 Individual/
$11,700 Family
|
Sanitas: $30 Copay
Other PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$6,800 Individual/
$13,600 Family
|
ded/coins
|
View |
View |
Silver S28E-A
|
E
|
Yes
|
$4,600 Individual/
$9,200 Family
|
Sanitas: $30 Copay
Other PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$5,550 Individual/
$11,100 Family
|
ded/coins
|
View |
View |
Silver S28E-AI1
|
E
|
Yes
|
$0 Individual/
$0 Family
|
$0 |
$0 |
0.0
|
$0 Individual/
$0 Family
|
$0
|
View |
View |
Silver S28E-AI2
|
E
|
Yes
|
$5,850 Individual/
$11,700 Family
|
Sanitas: $30 Copay
Other PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$6,800 Individual/
$13,600 Family
|
ded/coins
|
View |
View |
Silver S28E-B
|
E
|
Yes
|
$925 Individual/
$1,850 Family
|
Sanitas: $30 Copay
Other PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$1,900 Individual/
$3,800 Family
|
ded/coins
|
View |
View |
Silver S28E-C
|
E
|
Yes
|
$275 Individual/
$550 Family
|
Sanitas: $30 Copay
Other PCP: $60 Copay
Spec: $120 Copay |
$0 |
0.5
|
$650 Individual/
$1,300 Family
|
ded/coins
|