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HEALTH INSURANCE PLANS ON THE MARKETPLACE

SUMMARIES OF BENEFITS AND COVERAGE:

• Gold
  • Gold Option A
    • HMO Gold Opt A Zero Cost Share
    • HMO Gold Opt A Limited Cost Share
  • Gold Option B – Standard Plan
    • HMO Gold Opt B Zero Cost Share
    • HMO Gold Opt B Limited Cost Share
  • Gold Option C
    • HMO Gold Opt C Zero Cost Share
    • HMO Gold Opt C Limited Cost Share
• Silver
  • Silver Option A
    • Silver Option A – 94% to 100-150% FPL (only available through the marketplace)
    • Silver Option A – 87% to 151-200% FPL (only available through the marketplace)
    • Silver Option A – 73% to 201-250% FPL (only available through the marketplace)
    • HMO Silver Opt A Zero Cost Share
    • HMO Silver Opt A Limited Cost Share
  • Silver Option B– Standard Plan
    • Silver Option B – 94% to 100-150% FPL (only available through the marketplace)
    • Silver Option B – 87% to 151-200% FPL (only available through the marketplace)
    • Silver Option B – 73% to 201-250% FPL (only available through the marketplace)
    • HMO Silver Opt B Zero Cost Share
    • HMO Silver Opt B Limited Cost Share
  • Silver Option C
    • Silver Option C – 94% to 100-150% FPL (only available through the marketplace)
    • Silver Option C – 87% to 151-200% FPL (only available through the marketplace)
    • Silver Option C – 73% to 201-250% FPL (only available through the marketplace)
    • HMO Silver Opt C Zero Cost Share
    • HMO Silver Opt C Limited Cost Share
• Bronze
  • Bronze Option A
    • HMO Bronze Opt A Zero Cost Share
    • HMO Bronze Opt A Limited Cost Share
  • Bronze Option B – Standard Plan
    • HMO Bronze Opt B Zero Cost Share
    • HMO Bronze Opt B Limited Cost Share
  • Bronze Option C
    • HMO Bronze Opt C Zero Cost Share
    • HMO Bronze Opt C Limited Cost Share