2021 Non-Marketplace Health Insurance Plans

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

When you click one of the View buttons below, your Summary of Benefits and Coverage or Policy will pull up in PDF Format.
Al hacer clic en uno de los botones de Ver que están a continuación, su Resumen de Beneficios y Cobertura o póliza saldrá a la ver en formato PDF.

SBC SBC en Español Policy Póliza en Español Plan Number Network Maternity In-Network
Deductible Amount		 Primary Care
Practitioner/Specialist
Copay		 PhysicianNow Coinsurance
Percent		 Out-of-Pocket
Maximum		 RX Coverage*
View Ver View Ver Bronze B07L L Yes $5,950 Individual/  $11,900 Family ded/coins $0 50% $6,900 Individual/  $13,800 Family ded/coins
View Ver View Ver Bronze B07S S Yes $5,950 Individual/  $11,900 Family ded/coins $0 50% $6,900 Individual/  $13,800 Family ded/coins
View Ver View Ver Bronze B08L L Yes $8,550 Individual/  $17,100 Family ded/coins $0 0% $8,550 Individual/  $17,100 Family ded/coins
View Ver View Ver Bronze B08S S Yes $8,550 Individual/  $17,100 Family ded/coins $0 0% $8,550 Individual/  $17,100 Family ded/coins
View Ver View Ver Bronze B10S S Yes $6,600 Individual/  $13,200 Family ded/coins $0 50% $8,150 Individual/  $16,300 Family ded/coins $10/$35/$60 PRx
View Ver View Ver Bronze B11S S Yes $6,400 Individual/  $12,800 Family Sanitas PCP: $25 / All Others: ded/coins $0 50% $8,550 Individual/  $17,100 Family ded/coins $10/$35/$60 PRx
View Ver View Ver Gold G06S S Yes $2,750 Individual/  $5,500 Family $35 / $50 $0 20% $6,350 Individual/  $12,700 Family $8/$35/$60
View Ver View Ver Gold G07L L Yes $1,000 Individual/  $2,000 Family Sanitas PCP: $10 / All Others: ded/coins $0 45% $6,000 Individual/  $12,000 Family ded/coins $10/$35/$60 PRx
View Ver View Ver Gold G07S S Yes $1,000 Individual/  $2,000 Family Sanitas PCP: $10 / All Others: ded/coins $0 45% $6,000 Individual/  $12,000 Family ded/coins $10/$35/$60 PRx
View Ver View Ver Silver S01S S Yes $750 Individual/  $1,500 Family ded/coins $0 50% $7,800 Individual/  $15,600 Family ded/coins $10/$35/$60 PRx
View Ver View Ver Silver S04S S Yes $3,500 Individual/  $7,000 Family ded/coins $0 50% $7,900 Individual/  $15,800 Family ded/coins $10/$35/$60 PRx
View Ver View Ver Silver S20S S Yes $5,600 Individual/  $11,200 Family ded/coins $0 50% $7,000 Individual/  $14,000 Family ded/coins $10/$35/$60 PRx
View Ver View Ver Silver S21L L Yes $4,000 Individual/  $8,000 Family Sanitas PCP: $10 / All Others: ded/coins $0 50% $8,000 Individual/  $16,000 Family ded/coins $10/$35/$60 PRx
View Ver View Ver Silver S21S S Yes $3,900 Individual/  $7,800 Family Sanitas PCP: $10 / All Others: ded/coins $0 50% $8,000 Individual/  $16,000 Family ded/coins $10/$35/$60 PRx
View Ver View Ver Silver S22L L Yes $3,500 Individual/  $7,000 Family Sanitas PCP: $25 / All Others: ded/coins $0 50% $8,000 Individual/  $16,000 Family ded/coins $10/$35/$60 PRx
View Ver View Ver Silver S22S S Yes $3,500 Individual/  $7,000 Family Sanitas PCP: $25 / All Others: ded/coins $0 50% $8,000 Individual/  $16,000 Family ded/coins $10/$35/$60 PRx