MERCYCARE FOR WISCONSIN INDIVIDUALS 2019

HEALTH INSURANCE PLANS ON THE MARKETPLACE

SUMMARIES OF BENEFITS AND COVERAGE:

• Gold
  • Gold Option A 58326WI0090001 2019
  • Gold Option B- Standard –  58326WI0090012 2019
  • Gold Option C 58326WI0090013 2019
• Silver
  • Silver Option A 58326WI009002 2019
    • Silver Option A 94% 58326WI009002-06 2019– 94% (only available through the marketplace)
    • Silver-Option-A-87-58326WI009002-05-2019– 87% (only available through the marketplace)
    • Silver Option A 73% 58326WI009002-04 2019 (only available through the marketplace)
  • Silver Option B 58326WI0090015 2019
    • Silver Option B 94% 58326WI0090015-06 2019– 94% (only available through the marketplace)
    • Silver Option B 87% 58326WI0090015-05 2019– 87% (only available through the marketplace)
    • Silver Option B 73% 58326WI0090015-04 2019 – 73% (only available through the marketplace)
  • Silver Option C 58326WI0090016 2019
    • Silver Option C 94% 58326WI0090016-06 2019 – 94% (only available through the marketplace)
    • Silver Option C 87% 58326WI0090016-05 2019 – 87% (only available through the marketplace)
    • Silver Option C 73% 58326WI0090016-04 2019– 73% (only available through the marketplace)
• Bronze
  • Bronze Option A 58326WI0090006 2019
  • Bronze Option B Standard 58326WI0090018 2019
  • Bronze Option C 58326WI0090019 2019
  • Bronze Option D 58326WI0090020 2019
• Limited and Zero Cost Sharing Plans

Uniform Glossary