Plan documents
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2026 plan year
HMO plans (Available in 21 counties)
Bronze HMO 7450/0/50
| Subscriber Agreement | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
PPO Plans (Available in all Capital counties except Lancaster)
Gold Simple PPO 0/0/25
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Gold QHDHP PPO 1800/0/10
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Gold PPO 1800/10/20
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Gold PPO 2900/10/30
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver QHDHP PPO 3000/10/40
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver PPO 3450/0/40 Rx 250
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver PPO 3500/0/40 Rx 250
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Bronze QHDHP PPO 6400/0/50
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Bronze PPO 7450/0/60
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Bronze PPO 10000/0/60
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Zero/Limited Plans (on Pennie)
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Advance PPO (Available in Lancaster county)
Gold QHDHP Advance PPO 1800/0/10
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Gold Advance PPO 1800/0/25
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Gold Advance PPO 3000/0/30
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver QHDHP Advance PPO 3000/10/35
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver Advance PPO 4450/20/35
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver Advance PPO 4500/20/35
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Bronze QHDHP Advance PPO 6400/0/50
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Bronze Advance PPO 7100/0/50
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Bronze Advance PPO 9000/0/75
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Zero/Limited Plans (on Pennie)
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Capital Advantage PPO (Available in Cumberland, Dauphin, and Perry counties)
Gold Capital Advantage PPO 1800/0/25
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Gold Capital Advantage PPO 3000/0/30
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver Capital Advantage PPO 4450/20/35
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver Capital Advantage PPO 4500/20/35
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Bronze Capital Advantage PPO 7100/0/50
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Bronze Capital Advantage PPO 9000/0/75
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Zero/Limited Plans (on Pennie)
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Convenience PPO (Available in Adams, Franklin, Lebanon, Lehigh, Northampton and York Counties
Gold Convenience PPO 1800/0/25
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Gold Convenience PPO 3000/0/30
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver Convenience PPO 4450/20/35
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver Convenience PPO 4500/20/35
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Bronze Convenience PPO 7100/0/50
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Bronze Convenience PPO 9000/0/75
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Zero/Limited Plans (on Pennie)
| Outline of Coverage (OOC) | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Dental Plans (Available in all 21 counties
Vision Plans (Available in all 21 counties
| Highlight sheet |
|---|
2025 plan year
HMO plans (Available in 21 counties)
Bronze HMO 7450/0/50
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Catastrophic HMO 9200/0/0
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
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 |
|---|---|---|
Gold QHDHP PPO 1700/0/10
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Gold PPO 1800/10/20
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Gold PPO 2300/10/20
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver QHDHP PPO 2900/10/40
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver PPO 3450/0/40 RX 250
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver PPO 3500/0/40 RX 250
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Bronze QHDHP PPO 6400/0/50
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Bronze PPO 7450/0/50
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Catastrophic PPO 9200/0/0
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Zero/Limited Plans (on Pennie)
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
PPO Choice (Available in Lancaster county)
Gold QHDHP PPO Choice 1700/0/10
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Gold PPO Choice 1800/0/25
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Gold PPO Choice 2400/0/25
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver QHDHP PPO Choice 3000/10/35
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver PPO Choice 4450/20/35
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver PPO Choice 4500/20/35
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Bronze QHDHP PPO Choice 6400/0/50
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Bronze PPO Choice 7100/0/50
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Zero/Limited Plans (on Pennie)
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
PPO Choice Select (Available in Cumberland, Dauphin, and Perry counties)
Gold PPO Choice Select 1800/0/25
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Gold PPO Choice Select 2400/0/25
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver PPO Choice Select 4450/20/35
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver PPO Choice Select 4500/20/35
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Bronze PPO Choice Select 7100/0/50
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Zero/Limited Plans (on Pennie)
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Performance PPO (Available in Adams, Franklin, Lebanon, Lehigh, Northampton and York counties)
Gold Performance PPO 1800/0/25
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Gold Performance PPO 2400/0/25
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver Performance PPO 4450/20/35
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Silver Performance PPO 4500/20/35
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Bronze Performance PPO 7100/0/50
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Zero/Limited Plans (on Pennie)
| Benefit contracts | Summary of benefits and coverage (SBCs) | Highlight sheet |
|---|---|---|
Dental Plans (Available in all 21 counties)
Vision Plans (Available in all 21 counties)
| Highlight sheet |
|---|