Plan documents
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2024 plan year
HMO plans (Available in 21 counties)
Bronze HMO 7450/0/50
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Catastrophic HMO 9450/0/0
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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PPO Plans (Available in all Capital counties except Lancaster)
Gold Simple PPO 0/0/25
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Gold PPO 1800/10/20
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Gold PPO 2400/10/20
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver QHDHP PPO 2900/10/40
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver PPO 5950/20/30
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver PPO 6000/20/30
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze QHDHP PPO 6400/0/50
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze PPO 7450/0/50
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Catastrophic PPO 9450/0/0
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Zero/Limited Plans (on Pennie)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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PPO Choice (Available in Lancaster County)
Gold PPO Choice 2000/0/30
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Gold PPO Choice 2650/0/25
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver QHDHP PPO Choice 3000/10/35
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver PPO Choice 4450/20/35
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver PPO Choice 4500/20/35
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze QHDHP PPO Choice 6400/0/50
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze PPO Choice 7100/0/50
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Zero/Limited Plans (on Pennie)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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PPO Choice Select (Available in Cumberland, Dauphin, and Perry Counties)
Gold PPO Choice Select 1800/0/30
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Gold PPO Choice Select 2650/0/25
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver PPO Choice Select 4450/20/35
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver PPO Choice Select 4500/20/35
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze PPO Choice Select 7100/0/50
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Zero/Limited Plans (on Pennie)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Performance PPO (Available in Adams, Franklin, Lebanon, and York Counties)
Gold Performance PPO 1800/0/30
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Gold Performance PPO 2650/0/25
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver Performance PPO 4450/20/35
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver Performance PPO 4500/20/35
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze Performance PPO 7100/0/50
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Zero/Limited Plans (on Pennie)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Valley Advantage EPO (Available in Lehigh and Northampton Counties)
Gold Valley Advantage EPO 1800/10/20
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Gold Valley Advantage EPO 2400/10/20
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver Valley Advantage EPO 5950/20/30
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver Valley Advantage EPO 6000/20/30
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze Valley Advantage EPO 7450/0/50
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Zero/Limited Plans (on Pennie)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Dental Plans (Available in all 21 counties)
Vision Plans (Available in all 21 counties)
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2023 plan year
Gold Simple PPO 0/0/25 (Available in all counties except Lancaster)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Gold PPO 1800/10/20 (Available in all counties except Lancaster)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Gold Capital Advantage EPO 1800/10/20 (Available in Cumberland, Dauphin and Perry Counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Gold Valley Advantage EPO 1800/10/20 (Available in Lehigh and Northampton Counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Gold PPO Choice 2000/0/30 (Available in Lancaster County)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Gold PPO 2650/10/20 (Available in all counties except Lancaster)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Gold Capital Advantage EPO 2650/10/20 (Available in Cumberland, Dauphin and Perry Counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Gold Valley Advantage EPO 2650/10/20 (Available in Lehigh and Northampton Counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Gold PPO Choice 3000/0/25 (Available in Lancaster County)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver QHDHP PPO 2500/10/40 (Available in all counties except Lancaster)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver QHDHP PPO Choice 2700/10/35 (Available in Lancaster County)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver PPO Choice 4450/20/35 (Available in Lancaster County)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver PPO Choice 4500/20/35 (Available in Lancaster County)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver PPO 5950/20/30 (Available in all counties except Lancaster)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver Capital Advantage EPO 5950/20/30 (Available in Cumberland, Dauphin and Perry Counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver Valley Advantage EPO 5950/20/30 (Available in Lehigh and Northampton Counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver PPO 6000/20/30 (Available in all counties except Lancaster)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver Capital Advantage EPO 6000/20/30 (Available in Cumberland, Dauphin and Perry Counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver Valley Advantage EPO 6000/20/40 (Available in Lehigh and Northampton Counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze QHDHP PPO 6300/0/50 (Available in all counties except Lancaster)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze QHDHP PPO Choice 6300/0/50 (Available in Lancaster County)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze PPO Choice 7100/0/50 (Available in Lancaster County)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze PPO 7450/0/50 (Available in all counties except Lancaster)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze Capital Advantage EPO 7450/0/50 (Available in Cumberland, Dauphin and Perry Counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze Valley Advantage EPO 7450/0/50 (Available in Lehigh and Northampton Counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze HMO 7450/0/50 (Available in all 21 counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Catastrophic PPO 9100/0/0 (Available in all 21 counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Catastrophic HMO 9100/0/0 (Available in all 21 counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Dental Plans (Available in all 21 counties)
Vision Plans (Available in all 21 counties)
Highlight sheet |
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Gold PPO 3250/10/25 (Available in all counties expect Lancaster)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver QHDHP PPO 2200/10/40 (Available in all counties except Lancaster)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver QHDHP PPO Choice 2200/10/35 (Available in Lancaster County)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver PPO Choice 3950/20/35 (Available in Lancaster County)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver PPO Choice 4000/20/35 (Available in Lancaster County)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver Valley Advantage EPO 5950/20/40 (Available in Lehigh and Northampton Counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver Capital Advantage EPO 5950/20/40 (Available in Cumberland, Dauphin and Perry Counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver PPO 5950/20/40 (Available in all counties except Lancaster)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver Valley Advantage EPO 6000/20/40 (Available in Lehigh and Northampton Counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver Capital Advantage EPO 6000/20/40 (Available in Cumberland, Dauphin and Perry Counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Silver PPO 6000/20/40 (Available in all counties except Lancaster)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze QHDHP PPO 6300/0/50 (Available in all counties except Lancaster)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze QHDHP PPO Choice 6300/0/50 (Available in Lancaster County)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze PPO Choice 7100/0/50 (Available in Lancaster County)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze Valley Advantage EPO 7450/0/50 (Available in Lehigh and Northampton Counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze Capital Advantage EPO 7450/0/50 (Available in Cumberland, Dauphin and Perry Counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze PPO 7450/0/50 (Available in all counties except Lancaster)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Bronze HMO 7450/0/50 (Available in all 21 counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Catastrophic PPO 8700/0/0 (Available in all 21 counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Catastrophic HMO 8700/0/0 (Available in all 21 counties)
Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
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Dental Plans (Available in all counties)
Vision Plans (Available in all counties)
Highlight sheet |
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