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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

Off Pennie

Off Pennie

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Off Pennie- Spanish


Catastrophic HMO 9450/0/0

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie- Spanish

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

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

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Off Pennie


Gold PPO 1800/10/20

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie


Gold PPO 2400/10/20

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie


Silver QHDHP PPO 2900/10/40

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie- Spanish


Silver PPO 5950/20/30

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie- Spanish


Silver PPO 6000/20/30

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

On Pennie- 5900/15/20 73% CSR

On Pennie- 5900/15/20 73% CSR

On Pennie- 5900/15/20 73% CSR

On Pennie- 5900/15/20 73% CSR Spanish

On Pennie- 1750/5/5 87% CSR

On Pennie- 1750/5/5 87% CSR

On Pennie- 1750/5/5 87% CSR

On Pennie- 1750/5/5 87% CSR Spanish

On Pennie- 450/0/3 94% CSR

On Pennie- 450/0/3 94% CSR

On Pennie- 450/0/3 94% CSR

On Pennie- 450/0/3 94% CSR Spanish

Off Pennie

Off Pennie

Off Pennie

Bronze QHDHP PPO 6400/0/50

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie

Bronze PPO 7450/0/50

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie

Catastrophic PPO 9450/0/0

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie

Zero/Limited Plans (on Pennie)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Gold Simple PPO Zero CSR

Gold Simple PPO Zero CSR

Gold Simple PPO Zero CSR

Gold Simple PPO Limited CSR

Gold Simple PPO Limited CSR

Gold Simple PPO Limited CSR

Gold PPO Zero CSR 1

Gold PPO Zero CSR 1

Gold PPO Zero CSR 1

Gold PPO Limited CSR 1

Gold PPO Limited CSR 1

Gold PPO Limited CSR 1

Gold PPO Zero CSR 2

Gold PPO Zero CSR 2

Gold PPO Zero CSR 2

Gold PPO Limited CSR 2

Gold PPO Limited CSR 2

Gold PPO Limited CSR 2

Silver PPO Zero CSR

Silver PPO Zero CSR

Silver PPO Zero CSR

Silver PPO Limited CSR

Silver PPO Limited CSR

Silver PPO Limited CSR

Bronze PPO Zero CSR 1

Bronze PPO Zero CSR 1

Bronze PPO Zero CSR 1

Bronze PPO Limited CSR 1

Bronze PPO Limited CSR 1

Bronze PPO Limited CSR 1

Bronze PPO Zero CSR 2

Bronze PPO Zero CSR 2

Bronze PPO Zero CSR 2

Bronze PPO Limited CSR 2

Bronze PPO Limited CSR 2

Bronze PPO Limited CSR 2

PPO Choice (Available in Lancaster County)

Gold PPO Choice 2000/0/30

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie


Gold PPO Choice 2650/0/25

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie

Silver QHDHP PPO Choice 3000/10/35

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie- Spanish

Silver PPO Choice 4450/20/35

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie- Spanish

Silver PPO Choice 4500/20/35

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

On Pennie- 4400/15/30 73% CSR

On Pennie- 4400/15/30 73% CSR

On Pennie- 4400/15/30 73% CSR

On Pennie- 4400/15/30 73% CSR Spanish

On Pennie- 1400/0/15 87% CSR

On Pennie- 1400/0/15 87% CSR

On Pennie- 1400/0/15 87% CSR

On Pennie- 1400/0/15 87% CSR Spanish

On Pennie- 475/0/5 94% CSR

On Pennie- 475/0/5 94% CSR

On Pennie- 475/0/5 94% CSR

On Pennie- 475/0/5 94% CSR Spanish

Off Pennie

Off Pennie

Off Pennie

Bronze QHDHP PPO Choice 6400/0/50

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie

Bronze PPO Choice 7100/0/50

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie

Zero/Limited Plans (on Pennie)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Gold PPO Choice Zero CSR 1

Gold PPO Choice Zero CSR 1

Gold PPO Choice Zero CSR 1

Gold PPO Choice Limited CSR 1

Gold PPO Choice Limited CSR 1

Gold PPO Choice Limited CSR 1

Gold PPO Choice Zero CSR 2

Gold PPO Choice Zero CSR 2

Gold PPO Choice Zero CSR 2

Gold PPO Choice Limited CSR 2

Gold PPO Choice Limited CSR 2

Gold PPO Choice Limited CSR 2

Silver PPO Choice Zero CSR

Silver PPO Choice Zero CSR

Silver PPO Choice Zero CSR

Silver PPO Choice Limited CSR

Silver PPO Choice Limited CSR

Silver PPO Choice Limited CSR

Bronze PPO Choice Zero CSR 1

Bronze PPO Choice Zero CSR 1

Bronze PPO Choice Zero CSR 1

Bronze PPO Choice Limited CSR 1

Bronze PPO Choice Limited CSR 1

Bronze PPO Choice Limited CSR 1

Bronze PPO Choice Zero CSR 2

Bronze PPO Choice Zero CSR 2

Bronze PPO Choice Zero CSR 2

Bronze PPO Choice Limited CSR 2

Bronze PPO Choice Limited CSR 2

Bronze PPO Choice Limited CSR 2

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

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie


Gold PPO Choice Select 2650/0/25

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie


Silver PPO Choice Select 4450/20/35

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie- Spanish


Silver PPO Choice Select 4500/20/35

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

On Pennie- 4400/15/30 73% CSR

On Pennie- 4400/15/30 73% CSR

On Pennie- 4400/15/30 73% CSR

On Pennie- 4400/15/30 73% CSR Spanish

On Pennie- 1400/0/15 87% CSR

On Pennie- 1400/0/15 87% CSR

On Pennie- 1400/0/15 87% CSR

On Pennie- 1400/0/15 87% CSR Spanish

On Pennie- 475/0/5 94% CSR

On Pennie- 475/0/5 94% CSR

On Pennie- 475/0/5 94% CSR

On Pennie- 475/0/5 94% CSR Spanish

Off Pennie

Off Pennie

Off Pennie


Bronze PPO Choice Select 7100/0/50

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie


Zero/Limited Plans (on Pennie)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Gold PPO Choice Select Zero CSR 1

Gold PPO Choice Select Zero CSR 1

Gold PPO Choice Select Zero CSR 1

Gold PPO Choice Select Limited CSR 1

Gold PPO Choice Select Limited CSR 1

Gold PPO Choice Select Limited CSR 1

Gold PPO Choice Select Zero CSR 2

Gold PPO Choice Select Zero CSR 2

Gold PPO Choice Select Zero CSR 2

Gold PPO Choice Select Limited CSR 2

Gold PPO Choice Select Limited CSR 2

Gold PPO Choice Select Limited CSR 2

Silver PPO Choice Select Zero CSR

Silver PPO Choice Select Zero CSR

Silver PPO Choice Select Zero CSR

Silver PPO Choice Select Limited CSR

Silver PPO Choice Select Limited CSR

Silver PPO Choice Select Limited CSR

Bronze PPO Choice Select Zero CSR

Bronze PPO Choice Select Zero CSR

Bronze PPO Choice Select Zero CSR

Bronze PPO Choice Select Limited CSR

Bronze PPO Choice Select Limited CSR

Bronze PPO Choice Select Limited CSR

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

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie


Gold Performance PPO 2650/0/25

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie


Silver Performance PPO 4450/20/35

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie- Spanish


Silver Performance PPO 4500/20/35

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

On Pennie- 4400/15/30 73% CSR

On Pennie- 4400/15/30 73% CSR

On Pennie- 4400/15/30 73% CSR

On Pennie- 4400/15/30 73% CSR Spanish

On Pennie- 1400/0/15 87% CSR

On Pennie- 1400/0/15 87% CSR

On Pennie- 1400/0/15 87% CSR

On Pennie- 1400/0/15 87% CSR Spanish

On Pennie- 475/0/5 94% CSR

On Pennie- 475/0/5 94% CSR

On Pennie- 475/0/5 94% CSR

On Pennie- 475/0/5 94% CSR Spanish

Off Pennie

Off Pennie

Off Pennie


Bronze Performance PPO 7100/0/50

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie


Zero/Limited Plans (on Pennie)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Gold Performance PPO Zero CSR 1

Gold Performance PPO Zero CSR 1

Gold Performance PPO Zero CSR 1

Gold Performance PPO Limited CSR 1

Gold Performance PPO Limited CSR 1

Gold Performance PPO Limited CSR 1

Gold Performance PPO Zero CSR 2

Gold Performance PPO Zero CSR 2

Gold Performance PPO Zero CSR 2

Gold Performance PPO Limited CSR 2

Gold Performance PPO Limited CSR 2

Gold Performance PPO Limited CSR 2

Silver Performance PPO Zero CSR

Silver Performance PPO Zero CSR

Silver Performance PPO Zero CSR

Silver Performance PPO Limited CSR

Silver Performance PPO Limited CSR

Silver Performance PPO Limited CSR

Bronze Performance PPO Zero CSR

Bronze Performance PPO Zero CSR

Bronze Performance PPO Zero CSR

Bronze Performance PPO Limited CSR

Bronze Performance PPO Limited CSR

Bronze Performance PPO Limited CSR

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

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie


Gold Valley Advantage EPO 2400/10/20

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie


Silver Valley Advantage EPO 5950/20/30

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie


Off Pennie

Off Pennie

Off Pennie- Spanish


Silver Valley Advantage EPO 6000/20/30

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie


On Pennie

On Pennie

On Pennie- Spanish

On Pennie- 5900/15/20 73% CSR

On Pennie- 5900/15/20 73% CSR

On Pennie- 5900/15/20 73% CSR

On Pennie- 5900/15/20 73% CSR Spanish

On Pennie- 1750/5/5 87% CSR

On Pennie- 1750/5/5 87% CSR

On Pennie- 1750/5/5 87% CSR

On Pennie- 1750/5/5 87% CSR Spanish

On Pennie- 450/0/3 94% CSR

On Pennie- 450/0/3 94% CSR

On Pennie- 450/0/3 94% CSR

On Pennie- 450/0/3 94% CSR Spanish

Off Pennie

Off Pennie

Off Pennie


Bronze Valley Advantage EPO 7450/0/50

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie- Spanish

Off Pennie

Off Pennie

Off Pennie


Zero/Limited Plans (on Pennie)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Gold Valley Advantage EPO Zero CSR 1

Gold Valley Advantage EPO Zero CSR 1

Gold Valley Advantage EPO Zero CSR 1

Gold Valley Advantage EPO Limited CSR 1

Gold Valley Advantage EPO Limited CSR 1

Gold Valley Advantage EPO Limited CSR 1

Gold Valley Advantage EPO Zero CSR 2

Gold Valley Advantage EPO Zero CSR 2

Gold Valley Advantage EPO Zero CSR 2

Gold Valley Advantage EPO Limited CSR 2

Gold Valley Advantage EPO Limited CSR 2

Gold Valley Advantage EPO Limited CSR 2

Silver Valley Advantage EPO Zero CSR

Silver Valley Advantage EPO Zero CSR

Silver Valley Advantage EPO Zero CSR

Silver Valley Advantage EPO Limited CSR

Silver Valley Advantage EPO Limited CSR

Silver Valley Advantage EPO Limited CSR

Bronze Valley Advantage EPO Zero CSR

Bronze Valley Advantage EPO Zero CSR

Bronze Valley Advantage EPO Zero CSR

Bronze Valley Advantage EPO Limited CSR

Bronze Valley Advantage EPO Limited CSR

Bronze Valley Advantage EPO Limited CSR

Vision Plans (Available in all 21 counties)

Highlight sheet

Vision Essential Plan

2023 plan year

Gold Capital Advantage EPO 1800/10/20 (Available in Cumberland, Dauphin and Perry Counties)

Gold Valley Advantage EPO 1800/10/20 (Available in Lehigh and Northampton Counties)

Gold Capital Advantage EPO 2650/10/20 (Available in Cumberland, Dauphin and Perry Counties)

Gold Valley Advantage EPO 2650/10/20 (Available in Lehigh and Northampton Counties)

Silver QHDHP PPO 2500/10/40 (Available in all counties except Lancaster)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Silver QHDHP PPO Choice 2700/10/35 (Available in Lancaster County)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Silver PPO Choice 4450/20/35 (Available in Lancaster County)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Silver PPO 5950/20/30 (Available in all counties except Lancaster)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish


Silver Capital Advantage EPO 5950/20/30 (Available in Cumberland, Dauphin and Perry Counties)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Silver Valley Advantage EPO 5950/20/30 (Available in Lehigh and Northampton Counties)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Bronze Capital Advantage EPO 7450/0/50 (Available in Cumberland, Dauphin and Perry Counties)

Bronze Valley Advantage EPO 7450/0/50 (Available in Lehigh and Northampton Counties)

Bronze HMO 7450/0/50 (Available in all 21 counties)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Catastrophic PPO 9100/0/0 (Available in all 21 counties)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie - Spanish

Off Pennie

Off Pennie

Off Pennie

Catastrophic HMO 9100/0/0 (Available in all 21 counties)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Vision Plans (Available in all 21 counties)

Highlight sheet

Vision Essential Plan

Silver QHDHP PPO 2200/10/40 (Available in all counties except Lancaster)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Silver QHDHP PPO Choice 2200/10/35 (Available in Lancaster County)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Silver PPO Choice 3950/20/35 (Available in Lancaster County)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Silver Valley Advantage EPO 5950/20/40 (Available in Lehigh and Northampton Counties)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish


Silver Capital Advantage EPO 5950/20/40 (Available in Cumberland, Dauphin and Perry Counties)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Silver PPO 5950/20/40 (Available in all counties except Lancaster)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Bronze Valley Advantage EPO 7450/0/50 (Available in Lehigh and Northampton Counties)

Bronze Capital Advantage EPO 7450/0/50 (Available in Cumberland, Dauphin and Perry Counties)

Bronze HMO 7450/0/50 (Available in all 21 counties)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Catastrophic PPO 8700/0/0 (Available in all 21 counties)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

On Pennie

On Pennie

On Pennie

On Pennie - Spanish

Off Pennie

Off Pennie

Off Pennie

Catastrophic HMO 8700/0/0 (Available in all 21 counties)

Benefit contracts Summary of benefits and coverage (SBCs) Highlight sheet

Off Pennie

Off Pennie

Off Pennie

Off Pennie - Spanish

Vision Plans (Available in all counties)

Highlight sheet

Vision Essential Plan