Ascension_Personalized_Care_ACA_health_plan_Member_Resources_Summary_of_Coverage-Benefits

2022 Summary of Benefits and Coverage

Find specific plan SBC's for Indiana, Kansas and Michigan
  • Indiana

    Bronze

    Balanced Bronze 1 (Off-Exchange) - IN

    Balanced Bronze 1 (On-Exchange) - IN

    Balanced Bronze 1 Zero Cost Sharing Variation - IN

    Balanced Bronze 1 Limited Cost Sharing Variation - IN

    Balanced Bronze 2 (Off-Exchange) - IN

    Balanced Bronze 2 (On-Exchange) - IN

    Balanced Bronze 2 Zero Cost Sharing Variation - IN

    Balanced Bronze 2 Limited Cost Sharing Variation - IN

    HSA Eligible Bronze (Off-Exchange) - IN

    HSA Eligible Bronze (On-Exchange) - IN

    HSA Eligible Bronze Zero Cost Sharing Variation - IN

    HSA Eligible Bronze Limited Cost Sharing Variation - IN

    No Deductible Bronze (Off-Exchange) - IN

    No Deductible Bronze (On-Exchange) - IN

    No Deductible Bronze Zero Cost Sharing Variation - IN

    No Deductible Bronze Limited Cost Sharing Variation - IN

     

    Silver

    Balanced Silver (Off-Exchange) - IN

    Balanced Silver (On-Exchange) - IN

    Balanced Silver Zero Cost Sharing Variation - IN

    Balanced Silver Limited Cost Sharing Variation - IN

    Balanced Silver 73% AV Level Plan - IN

    Balanced Silver 87% AV Level Plan - IN

    Balanced Silver 94% AV Level Plan - IN

    No Deductible Silver (Off-Exchange) - IN

    No Deductible Silver (On-Exchange) - IN

    No Deductible Silver Zero Cost Sharing Variation - IN

    No Deductible Silver Limited Cost Sharing Variation - IN

    No Deductible Silver 73% AV Level Plan - IN

    No Deductible Silver 87% AV Level Plan - IN

    No Deductible Silver 94% AV Level Plan - IN

    Low Premium Silver (Off-Exchange) - IN

    Low Premium Silver (On-Exchange) - IN

    Low Premium Silver Zero Cost Sharing Variation - IN

    Low Premium Silver Limited Cost Sharing Variation - IN

    Low Premium Silver 73% AV Level Plan - IN

    Low Premium Silver 87% AV Level Plan - IN

    Low Premium Silver 94% AV Level Plan - IN

     

    Gold

    Gold (Off-Exchange) - IN

    Gold (On-Exchange) - IN

    Gold Zero Cost Sharing Plan Variation - IN

    Gold Limited Cost Sharing Plan Variation - IN

  • Kansas

    Bronze

    Balanced Bronze 1 (Off-Exchange) - KS

    Balanced Bronze 1 (On-Exchange) - KS

    Balanced Bronze 1 Zero Cost Sharing Variation - KS

    Balanced Bronze 1 Limited Cost Sharing Variation - KS

    Balanced Bronze 2 (Off-Exchange) - KS

    Balanced Bronze 2 (On-Exchange) - KS

    Balanced Bronze 2 Zero Cost Sharing Variation - KS

    Balanced Bronze 2 Limited Cost Sharing Variation - KS

    HSA Eligible Bronze (Off-Exchange) - KS

    HSA Eligible Bronze (On-Exchange) - KS

    HSA Eligible Bronze Zero Cost Sharing Variation - KS

    HSA Eligible Bronze Limited Cost Sharing Variation - KS

    No Deductible Bronze (Off-Exchange) - KS

    No Deductible Bronze (On-Exchange) - KS

    No Deductible Bronze Zero Cost Sharing Variation - KS

    No Deductible Bronze Limited Cost Sharing Variation - KS

     

    Silver

    Balanced Silver (Off-Exchange) - KS

    Balanced Silver (On-Exchange) - KS

    Balanced Silver Zero Cost Sharing Variation - KS

    Balanced Silver Limited Cost Sharing Variation - KS

    Balanced Silver 73% AV Level Plan - KS

    Balanced Silver 87% AV Level Plan - KS

    Balanced Silver 94% AV Level Plan - KS

    No Deductible Silver (Off-Exchange) - KS

    No Deductible Silver (On-Exchange) - KS

    No Deductible Silver Zero Cost Sharing Variation - KS

    No Deductible Silver Limited Cost Sharing Variation - KS

    No Deductible Silver 73% AV Level Plan - KS

    No Deductible Silver 87% AV Level Plan - KS

    No Deductible Silver 94% AV Level Plan - KS

    Low Premium Silver (Off-Exchange) - KS

    Low Premium Silver (On-Exchange) - KS

    Low Premium Silver Zero Cost Sharing Variation - KS

    Low Premium Silver Limited Cost Sharing Variation - KS

    Low Premium Silver 73% AV Level Plan - KS

    Low Premium Silver 87% AV Level Plan - KS

    Low Premium Silver 94% AV Level Plan - KS

     

    Gold

    Gold (Off-Exchange) - KS

    Gold (On-Exchange) - KS

    Gold Zero Cost Sharing Plan Variation - KS

    Gold Limited Cost Sharing Plan Variation - KS

  • Michigan

    Bronze

    Balanced Bronze 1 (Off-Exchange) - MI

    Balanced Bronze 1 (On-Exchange) - MI

    Balanced Bronze 1 Zero Cost Sharing Variation - MI

    Balanced Bronze 1 Limited Cost Sharing Variation - MI

    Balanced Bronze 2 (Off-Exchange) - MI

    Balanced Bronze 2 (On-Exchange) - MI

    Balanced Bronze 2 Zero Cost Sharing Variation - MI

    Balanced Bronze 2 Limited Cost Sharing Variation - MI

    HSA Eligible Bronze (Off-Exchange) - MI

    HSA Eligible Bronze (On-Exchange) - MI

    HSA Eligible Bronze Zero Cost Sharing Variation - MI

    HSA Eligible Bronze Limited Cost Sharing Variation - MI

    No Deductible Bronze (Off-Exchange) - MI

    No Deductible Bronze (On-Exchange) - MI

    No Deductible Bronze Zero Cost Sharing Variation - MI

    No Deductible Bronze Limited Cost Sharing Variation - MI

     

    Silver

    Balanced Silver (Off-Exchange) - MI

    Balanced Silver (On-Exchange) - MI

    Balanced Silver Zero Cost Sharing Variation - MI

    Balanced Silver Limited Cost Sharing Variation - MI

    Balanced Silver 73% AV Level Plan - MI

    Balanced Silver 87% AV Level Plan - MI

    Balanced Silver 94% AV Level Plan - MI

    No Deductible Silver (Off-Exchange) - MI

    No Deductible Silver (On-Exchange) - MI

    No Deductible Silver Zero Cost Sharing Variation - MI

    No Deductible Silver Limited Cost Sharing Variation - MI

    No Deductible Silver 73% AV Level Plan - MI

    No Deductible Silver 87% AV Level Plan - MI

    No Deductible Silver 94% AV Level Plan - MI

    Low Premium Silver (Off-Exchange) - MI

    Low Premium Silver (On-Exchange) - MI

    Low Premium Silver Zero Cost Sharing Variation - MI

    Low Premium Silver Limited Cost Sharing Variation - MI

    Low Premium Silver 73% AV Level Plan - MI

    Low Premium Silver 87% AV Level Plan - MI

    Low Premium Silver 94% AV Level Plan - MI

     

    Gold

    Gold (Off-Exchange) - MI

    Gold (On-Exchange) - MI

    Gold Zero Cost Sharing Plan Variation - MI

    Gold Limited Cost Sharing Plan Variation - MI