{ "plans": [ { "planName": "Gold Simple PPO 0/0/25", "PlanDetails": { "metalLevel": "Gold", "plantype": "medical", "productType": "PPO", "dataCatProductType":"PPO", "deductible": [ "No deductible" ], "OOPmax": [ "$8,550 individual", "$17,100 family" ], "Exchange": [ "On Pennie", "Off Pennie" ], "hsaeligible": "No", "county": "All counties except Lancaster", "Coinsurance": [ "None" ], "PrimaryCare": [ "$25 copay" ], "specialist": [ "$50 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/a9d21fca-894d-4ce3-abc2-00555919b1ac/images%252Fgold-plan.jpg?MOD=AJPERES" } }, { "planName": "Gold QHDHP PPO 1700/0/10", "PlanDetails": { "metalLevel": "Gold", "plantype": "medical", "productType": "PPO", "dataCatProductType":"PPO", "deductible": [ "$1,700/$3,400", "Non-embedded" ], "OOPmax": [ "$6,900 individual", "$13,800 family" ], "Exchange": [ "Off Pennie" ], "hsaeligible": "Yes- HSA account set up included with purchase of plan", "county": "All counties except Lancaster", 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"Choice 1 - $10 copay after deductible", "Choice 2 - $20 copay after deductible" ], "specialist": [ "Choice 1 - $20 copay after deductible", "Choice 2 - $40 copay after deductible" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/a9d21fca-894d-4ce3-abc2-00555919b1ac/images%252Fgold-plan.jpg?MOD=AJPERES" } }, { "planName": "Gold PPO Choice 1800/0/25", "PlanDetails": { "metalLevel": "Gold", "plantype": "medical", "productType": "PPO Choice", "dataCatProductType":"Choice", "deductible": [ "Choice 1 - $1,800/$3,600", "Choice 2 - $4,000/$8,000" ], "OOPmax": [ "$8,550 individual", "$17,100 family" ], "Exchange": [ "On Pennie", "Off Pennie" ], "hsaeligible": "No", "county": "Available in Lancaster", "Coinsurance": [ "Choice 1 - None", "Choice 2 - 30%" ], "PrimaryCare": [ "Choice 1 - $25 copay", "Choice 2 - $50 copay" ], "specialist": [ "Choice 1 - $50 copay", "Choice 2 - $75 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/a9d21fca-894d-4ce3-abc2-00555919b1ac/images%252Fgold-plan.jpg?MOD=AJPERES" } }, { "planName": "Gold PPO Choice 2400/0/25", "PlanDetails": { "metalLevel": "Gold", "plantype": "medical", "productType": "PPO Choice", "dataCatProductType":"Choice", "deductible": [ "Choice 1 - $2,400/$4,800", "Choice 2 - $4,800/$9,600" ], "OOPmax": [ "$8,550 individual", "$17,100 family" ], "Exchange": [ "On Pennie", "Off Pennie" ], "hsaeligible": "No", "county": "Available in Lancaster", "Coinsurance": [ "Choice 1 - None", "Choice 2 - 30%" ], "PrimaryCare": [ "Choice 1 - $25 copay", "Choice 2 - $50 copay" ], "specialist": [ "Choice 1 - $50 copay", "Choice 2 - $75 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/a9d21fca-894d-4ce3-abc2-00555919b1ac/images%252Fgold-plan.jpg?MOD=AJPERES" } }, { "planName": "Gold PPO Choice Select 1800/0/25", "PlanDetails": { "metalLevel": "Gold", "plantype": "medical", "productType": "PPO Choice Select", 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"Available in Cumberland, Dauphin and Perry Counties", "Coinsurance": [ "Choice 1 - None", "Choice 2 - 30%" ], "PrimaryCare": [ "Choice 1 - $25 copay", "Choice 2 - $50 copay" ], "specialist": [ "Choice 1 - $50 copay", "Choice 2 - $75 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/a9d21fca-894d-4ce3-abc2-00555919b1ac/images%252Fgold-plan.jpg?MOD=AJPERES" } }, { "planName": "Gold Performance PPO 1800/0/25", "PlanDetails": { "metalLevel": "Gold", "plantype": "medical", "productType": "Performance PPO", "dataCatProductType":"Performance", "deductible": [ "Performance Plus - $1,800/$3,600", "Performance Select - $4,000/$8,000" ], "OOPmax": [ "$8,550 individual", "$17,100 family" ], "Exchange": [ "On Pennie", "Off Pennie" ], "hsaeligible": "No", "county": "Available in Adams, Franklin, Lebanon, Lehigh, Northampton, and York Counties", "Coinsurance": [ "Performance Plus - None", "Performance Select - 30%" ], "PrimaryCare": [ "Performance Plus - $25 copay", "Performance 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"/wps/wcm/connect/prod_nws.capblue.com29556/a9d21fca-894d-4ce3-abc2-00555919b1ac/images%252Fgold-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver QHDHP PPO 2900/10/40", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO", "dataCatProductType":"PPO", "deductible": [ "$2,900 individual", "$5,800 family", "Non-embedded" ], "OOPmax": [ "$7,450 individual", "$14,900 family" ], "Exchange": [ "Off Pennie" ], "hsaeligible": "Yes - HSA account set up included with purchase of plan", "county": "Available in all counties except Lancaster", "Coinsurance": [ "10%" ], "PrimaryCare": [ "$40 copay after deductible" ], "specialist": [ "$85 copay after deductible" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver PPO 3450/0/40 Rx 250", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO", "dataCatProductType":"PPO", "deductible": [ "Medical -$3,450 Individual/$6,900 Family", "Prescription - $250 individual/$500 family" ], "OOPmax": [ "$8,700 individual", "$17,400 Family" ], "Exchange": [ "Off Pennie" ], "hsaeligible": "No", "county": "Available in all counties except Lancaster", "Coinsurance": [ "None" ], "PrimaryCare": [ "$40 copay" ], "specialist": [ "$75 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver PPO 3500/0/40 Rx 250", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO", "dataCatProductType":"PPO", "deductible": [ "Medical -$3,500 Individual/$7,000 Family", "Prescription - $250 individual/$500 family" ], "OOPmax": [ "$8,700 individual", "$17,400 Family" ], "Exchange": [ "On Pennie", "Off Pennie" ], "hsaeligible": "No", "county": "Available in all counties except Lancaster", "Coinsurance": [ "None" ], "PrimaryCare": [ "$40 copay" ], "specialist": [ "$75 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver PPO 3400/0/30 Rx 200 CSR73", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO", "dataCatProductType":"PPO", "deductible": [ "Medical -$3,400 Individual/$6,800 Family", "Prescription - $200 individual/$400 family" ], "OOPmax": [ "$7,350 individual", "$14,700 family" ], "Exchange": [ "On Pennie" ], "hsaeligible": "No", "county": "Available in all counties except Lancaster", "Coinsurance": [ "None" ], "PrimaryCare": [ "$30 copay" ], "specialist": [ "$60 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver PPO 1400/0/5 Rx 150 CSR87", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO", "dataCatProductType":"PPO", "deductible": [ "Medical -$1,400 Individual/$2,800 Family", "Prescription - $150 individual/$300 family" ], "OOPmax": [ "$3,050 individual", "$6,100 family" ], "Exchange": [ "On Pennie" ], "hsaeligible": "No", "county": "Available in all counties except Lancaster", "Coinsurance": [ "None" ], "PrimaryCare": [ "$5 copay" ], "specialist": [ "$10 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver PPO 450/0/3 Rx 100 CSR94", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO", "dataCatProductType":"PPO", "deductible": [ "Medical -$450 Individual/$900 Family", "Prescription - $100 individual/$200 family" ], "OOPmax": [ "$1,000 individual", "$2,000 family" ], "Exchange": [ "On Pennie" ], "hsaeligible": "No", "county": "Available in all counties except Lancaster", "Coinsurance": [ "None" ], "PrimaryCare": [ "$3 copay" ], "specialist": [ "$5 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver QHDHP PPO Choice 3000/10/35", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO Choice", "dataCatProductType":"Choice", "deductible": [ "Choice 1 - $3,000/$6,000", "Choice 2 - $6,000/$12,000", "Non-embedded" ], "OOPmax": [ "$7,450 individual", "$14,900 family" ], "Exchange": [ "Off Pennie" ], "hsaeligible": "Yes", "county": "Available in Lancaster", "Coinsurance": [ "Choice 1 - 10%", "Choice 2 - 30%" ], "PrimaryCare": [ "Choice 1 - $35 copay after deductible", "Choice 2 - $60 copay after deductible" ], "specialist": [ "Choice 1 - $65 copay after deductible", "Choice 2 - $85 copay after deductible" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver PPO Choice 4450/20/35", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO Choice", "dataCatProductType":"Choice", "deductible": [ "Choice 1 - $4,450/$8,900", "Choice 2 - $8,550/$17,100" ], "OOPmax": [ "$8,550 individual", "$17,100 family" ], "Exchange": [ "Off Pennie" ], "hsaeligible": "No", "county": "Available in Lancaster", "Coinsurance": [ "Choice 1 - 20%", "Choice 2 - None" ], "PrimaryCare": [ "Choice 1 - $35 copay", "Choice 2 - $60 copay" ], "specialist": [ "Choice 1 - $65 copay", "Choice 2 - $85 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver PPO Choice 4500/20/35", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO Choice", "dataCatProductType":"Choice", "deductible": [ "Choice 1 - $4,500/$9,000", "Choice 2 - $8,550/$17,100" ], "OOPmax": [ "$8,550 individual", "$17,100 family" ], "Exchange": [ "On Pennie", "Off Pennie" ], "hsaeligible": "No", "county": "Available in Lancaster", "Coinsurance": [ "Choice 1 - 20%", "Choice 2 - None" ], "PrimaryCare": [ "Choice 1 - $35 copay", "Choice 2 - $60 copay" ], "specialist": [ "Choice 1 - $65 copay", "Choice 2 - $85 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver PPO Choice 4000/15/25 CSR73", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO Choice", "dataCatProductType":"Choice", "deductible": [ "Choice 1 - $4,000/$8,000", "Choice 2 - $7,350/$14,700" ], "OOPmax": [ "$7,350 individual", "$14,700 family" ], "Exchange": [ "On Pennie" ], "hsaeligible": "No", "county": "Available in Lancaster", "Coinsurance": [ "Choice 1 - 15%", "Choice 2 - None" ], "PrimaryCare": [ "Choice 1 - $25 copay", "Choice 2 - $50 copay" ], "specialist": [ "Choice 1 - $55 copay", "Choice 2 - $75 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver PPO Choice 1200/0/15 CSR87", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO Choice", "dataCatProductType":"Choice", "deductible": [ "Choice 1 - $1,200/$2,400", "Choice 2 - $3,050/$6,100" ], "OOPmax": [ "$3,050 individual", "$6,100 family" ], "Exchange": [ "On Pennie" ], "hsaeligible": "No", "county": "Available in Lancaster", "Coinsurance": [ "Choice 1 - None", "Choice 2 - None" ], "PrimaryCare": [ "Choice 1 - $15 copay", "Choice 2 - $30 copay" ], "specialist": [ "Choice 1 - $30 copay", "Choice 2 - $60 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver PPO Choice 475/0/5 CSR94", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO Choice", "dataCatProductType":"Choice", "deductible": [ "Choice 1 - $475/$950", "Choice 2 - $1,000/$2,000" ], "OOPmax": [ "$1,000 individual", "$2,000 family" ], "Exchange": [ "On Pennie" ], "hsaeligible": "No", "county": "Available in Lancaster", "Coinsurance": [ "Choice 1 - None", "Choice 2 - None" ], "PrimaryCare": [ "Choice 1 - $5 copay", "Choice 2 - $20 copay" ], "specialist": [ "Choice 1 - $10 copay", "Choice 2 - $30 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver PPO Choice Select 4450/20/35", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO Choice Select", "dataCatProductType":"Select", "deductible": [ "Choice 1 - $4,450/$8,900", "Choice 2 - $8,550/$17,100" ], "OOPmax": [ "$8,550 individual", "$17,100 family" ], "Exchange": [ "Off Pennie" ], "hsaeligible": "No", "county": "Available in Cumberland, Dauphin and Perry Counties", "Coinsurance": [ "Choice 1 - 20%", "Choice 2 - None" ], "PrimaryCare": [ "Choice 1 - $35 copay", "Choice 2 - $60 copay" ], "specialist": [ "Choice 1 - $65 copay", "Choice 2 - $85 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver PPO Choice Select 4500/20/35", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO Choice Select", "dataCatProductType":"Select", "deductible": [ "Choice 1 - $4,500/$9,000", "Choice 2 - $8,550/$17,100" ], "OOPmax": [ "$8,550 individual", "$17,100 family" ], "Exchange": [ "On Pennie", "Off Pennie" ], "hsaeligible": "No", "county": "Available in Cumberland, Dauphin and Perry Counties", "Coinsurance": [ "Choice 1 - 20%", "Choice 2 - None" ], "PrimaryCare": [ "Choice 1 - $35 copay", "Choice 2 - $60 copay" ], "specialist": [ "Choice 1 - $65 copay", "Choice 2 - $85 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver PPO Choice Select 4000/15/25 CSR73", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO Choice Select", "dataCatProductType":"Select", "deductible": [ "Choice 1 - $4,000/$8,000", "Choice 2 - $7,350/$14,700" ], "OOPmax": [ "$7,350 individual", "$14,700 family" ], "Exchange": [ "On Pennie" ], "hsaeligible": "No", "county": "Available in Cumberland, Dauphin and Perry Counties", "Coinsurance": [ "Choice 1 - 15%", "Choice 2 - None" ], "PrimaryCare": [ "Choice 1 - $25 copay", "Choice 2 - $50 copay" ], "specialist": [ "Choice 1 - $55 copay", "Choice 2 - $75 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver PPO Choice Select 1200/0/15 CSR87", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO Choice Select", "dataCatProductType":"Select", "deductible": [ "Choice 1 - $1,200/$2,400", "Choice 2 - $3,050/$6,100" ], "OOPmax": [ "$3,050 individual", "$6,100 family" ], "Exchange": [ "On Pennie" ], "hsaeligible": "No", "county": "Available in Cumberland, Dauphin and Perry Counties", "Coinsurance": [ "Choice 1 - None", "Choice 2 - None" ], "PrimaryCare": [ "Choice 1 - $15 copay", "Choice 2 - $30 copay" ], "specialist": [ "Choice 1 - $30 copay", "Choice 2 - $60 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver PPO Choice Select 475/0/5 CSR94", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "PPO Choice Select", "dataCatProductType":"Select", "deductible": [ "Choice 1 - $475/$950", "Choice 2 - $1,000/$2,000" ], "OOPmax": [ "$1,000 individual", "$2,000 family" ], "Exchange": [ "On Pennie" ], "hsaeligible": "No", "county": "Available in Cumberland, Dauphin and Perry Counties", "Coinsurance": [ "Choice 1 - None", "Choice 2 - None" ], "PrimaryCare": [ "Choice 1 - $5 copay", "Choice 2 - $20 copay" ], "specialist": [ "Choice 1 - $10 copay", "Choice 2 - $30 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver Performance PPO 4450/20/35", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "Performance PPO", "dataCatProductType":"Performance", "deductible": [ "Performance Plus - $4,450/$8,900", "Performance Select - $8,550/$17,100" ], "OOPmax": [ "$8,550 individual", "$17,100 family" ], "Exchange": [ "Off Pennie" ], "hsaeligible": "No", "county": "Available in Adams, Franklin, Lebanon, Lehigh, Northampton, and York Counties", "Coinsurance": [ "Performance Plus - 20%", "Performance Select - None" ], "PrimaryCare": [ "Performance Plus - $35 copay", "Performance Select - $60 copay" ], "specialist": [ "Performance Plus - $65 copay", "Performance Select - $85 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver Performance PPO 4500/20/35", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "Performance PPO", "dataCatProductType":"Performance", "deductible": [ "Performance Plus - $4,450/$8,900", "Performance Select - $8,550/$17,100" ], "OOPmax": [ "$8,550 individual", "$17,100 family" ], "Exchange": [ "On Pennie", "Off Pennie" ], "hsaeligible": "No", "county": "Available in Adams, Franklin, Lebanon, Lehigh, Northampton, and York Counties", "Coinsurance": [ "Performance Plus - 20%", "Performance Select - None" ], "PrimaryCare": [ "Performance Plus - $35 copay", "Performance Select - $60 copay" ], "specialist": [ "Performance Plus - $65 copay", "Performance Select - $85 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver Performance PPO 4000/15/25 CSR73", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "Performance PPO", "dataCatProductType":"Performance", "deductible": [ "Performance Plus - $4,000/$8,000", "Performance Select - $7,350/$14,700" ], "OOPmax": [ "$7,350 individual", "$14,700 family" ], "Exchange": [ "On Pennie" ], "hsaeligible": "No", "county": "Available in Adams, Franklin, Lebanon, Lehigh, Northampton, and York Counties", "Coinsurance": [ "Performance Plus - 15%", "Performance Select - None" ], "PrimaryCare": [ "Performance Plus - $25 copay", "Performance Select - $50 copay" ], "specialist": [ "Performance Plus - $55 copay", "Performance Select - $75 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver Performance PPO 1200/0/15 CSR87", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "Performance PPO", "dataCatProductType":"Performance", "deductible": [ "Performance Plus - $1,200/$2,400", "Performance Select - $3,050/$6,100" ], "OOPmax": [ "$3,050 individual", "$6,100 family" ], "Exchange": [ "On Pennie" ], "hsaeligible": "No", "county": "Available in Adams, Franklin, Lebanon, Lehigh, Northampton, and York Counties", "Coinsurance": [ "Performance Plus - None", "Performance Select - None" ], "PrimaryCare": [ "Performance Plus - $15 copay", "Performance Select - $30 copay" ], "specialist": [ "Performance Plus - $30 copay", "Performance Select - $60 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Silver Performance PPO 475/0/5 CSR94", "PlanDetails": { "metalLevel": "Silver", "plantype": "medical", "productType": "Performance PPO", "dataCatProductType":"Performance", "deductible": [ "Performance Plus - $475/$950", "Performance Select - $1,000/$2,000" ], "OOPmax": [ "$1,000 individual", "$2,000 family" ], "Exchange": [ "On Pennie" ], "hsaeligible": "No", "county": "Available in Adams, Franklin, Lebanon, Lehigh, Northampton, and York Counties", "Coinsurance": [ "Performance Plus - None", "Performance Select - None" ], "PrimaryCare": [ "Performance Plus - $5 copay", "Performance Select - $20 copay" ], "specialist": [ "Performance Plus - $10 copay", "Performance Select - $30 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/58e247c4-1137-4b2c-a09c-b43bc1ae4089/images%252Fsilver-plan.jpg?MOD=AJPERES" } }, { "planName": "Bronze QHDHP PPO 6400/0/50", "PlanDetails": { "metalLevel": "Bronze", "plantype": "medical", "productType": "PPO", "dataCatProductType":"PPO", "deductible": [ "$6,400 individual", "$12,800 family", "Non-embedded" ], "OOPmax": [ "$7,450 individual", "$14,900 family" ], "Exchange": [ "On Pennie", "Off Pennie" ], "hsaeligible": "Yes", "county": "Available in all counties except Lancaster", "Coinsurance": [ "None" ], "PrimaryCare": [ "$50 copay after deductible" ], "specialist": [ "$85 copay after deductible" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/b2d110c7-15e4-411d-bfe2-109c70083ea0/images%252Fbronze-plan.jpg?MOD=AJPERES" } }, { "planName": "Bronze PPO 7450/0/50", "PlanDetails": { "metalLevel": "Bronze", "plantype": "medical", "productType": "PPO", "dataCatProductType":"PPO", "deductible": [ "$7,450 individual", "$14,900 family" ], "OOPmax": [ "$9,100 individual", "$18,200 family" ], "Exchange": [ "On Pennie", "Off Pennie" ], "hsaeligible": "No", "county": "Available in all counties except Lancaster", "Coinsurance": [ "None" ], "PrimaryCare": [ "$50 copay" ], "specialist": [ "$85 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/b2d110c7-15e4-411d-bfe2-109c70083ea0/images%252Fbronze-plan.jpg?MOD=AJPERES" } }, { "planName": "Bronze QHDHP PPO Choice 6400/0/50", "PlanDetails": { "metalLevel": "Bronze", "plantype": "medical", "productType": "PPO Choice", "dataCatProductType":"Choice", "deductible": [ "Choice 1 - $6,400/$12,800", "Choice 2 - $7,450/$14,900", "Non-embedded" ], "OOPmax": [ "$7,450 individual", "$14,900 family" ], "Exchange": [ "On Pennie", "Off Pennie" ], "hsaeligible": "Yes - HSA account set up included with purchase of plan", "county": "Available in Lancaster", "Coinsurance": [ "Choice 1- None", "Choice 2- None" ], "PrimaryCare": [ "Choice 1 - $50 copay after deductible", "Choice 2 - Paid in full after deductible" ], "specialist": [ "Choice 1 - $85 copay after deductible", "Choice 2 - Paid in full after deductible" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/b2d110c7-15e4-411d-bfe2-109c70083ea0/images%252Fbronze-plan.jpg?MOD=AJPERES" } }, { "planName": "Bronze PPO Choice 7100/0/50", "PlanDetails": { "metalLevel": "Bronze", "plantype": "medical", "productType": "PPO Choice", "dataCatProductType":"Choice", "deductible": [ "Choice 1 - $7,100/$14,200", "Choice 2 - $9,100/$18,200" ], "OOPmax": [ "$9,100 individual", "$18,200 family" ], "Exchange": [ "On Pennie", "Off Pennie" ], "hsaeligible": "No", "county": "Available in Lancaster", "Coinsurance": [ "Choice 1-None", "Choice 2 -None" ], "PrimaryCare": [ "Choice 1 - $50 copay", "Choice 2 - Paid in full after deductible" ], "specialist": [ "Choice 1 - $85 copay", "Choice 2 - Paid in full after deductible" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/b2d110c7-15e4-411d-bfe2-109c70083ea0/images%252Fbronze-plan.jpg?MOD=AJPERES" } }, { "planName": "Bronze PPO Choice Select 7100/0/50", "PlanDetails": { "metalLevel": "Bronze", "plantype": "medical", "productType": "PPO Choice Select", "dataCatProductType":"Select", "deductible": [ "Choice 1 - $7,100/$14,200", "Choice 2 - $9,100/$18,200" ], "OOPmax": [ "$9,100 individual", "$18,200 family" ], "Exchange": [ "On Pennie", "Off Pennie" ], "hsaeligible": "No", "county": "Available in Cumberland, Dauphin and Perry Counties", "Coinsurance": [ "Choice 1-None", "Choice 2 -None" ], "PrimaryCare": [ "Choice 1 - $50 copay", "Choice 2 - Paid in full after deductible" ], "specialist": [ "Choice 1 - $85 copay", "Choice 2 - Paid in full after deductible" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/b2d110c7-15e4-411d-bfe2-109c70083ea0/images%252Fbronze-plan.jpg?MOD=AJPERES" } }, { "planName": "Bronze Performance PPO 7100/0/50", "PlanDetails": { "metalLevel": "Bronze", "plantype": "medical", "productType": "Performance PPO", "dataCatProductType":"Performance", "deductible": [ "Performance Plus - $7,100/$14,200", "Performance Select - $9,100/$18,200" ], "OOPmax": [ "$9,100 individual", "$18,200 family" ], "Exchange": [ "On Pennie", "Off Pennie" ], "hsaeligible": "No", "county": "Available in Adams, Franklin, Lebanon, Lehigh, Northampton, and York Counties", "Coinsurance": [ "Performance Plus - None", "Performance Select - None" ], "PrimaryCare": [ "Performance Plus - $50 copay", "Performance Select - Paid in full after deductible" ], "specialist": [ "Performance Plus - $85 copay", "Performance Select - Paid in full after deductible" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/b2d110c7-15e4-411d-bfe2-109c70083ea0/images%252Fbronze-plan.jpg?MOD=AJPERES" } }, { "planName": "Bronze HMO 7450/0/50", "PlanDetails": { "metalLevel": "Bronze", "plantype": "medical", "productType": "HMO", "dataCatProductType":"HMO", "deductible": [ "$7,450 individual", "$14,900 family" ], "OOPmax": [ "$9,100 individual", "$18,200 family" ], "Exchange": [ "Off Pennie" ], "hsaeligible": "No", "county": "Available in all Capital counties", "Coinsurance": [ "None" ], "PrimaryCare": [ "$50 copay" ], "specialist": [ "$85 copay" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/b2d110c7-15e4-411d-bfe2-109c70083ea0/images%252Fbronze-plan.jpg?MOD=AJPERES" } }, { "planName": "Catastrophic PPO 9200/0/0", "PlanDetails": { "metalLevel": "Catastrophic", "plantype": "medical", "productType": "PPO", "dataCatProductType":"PPO", "age": "Available if you are under age 30^", "deductible": [ "$9,200 individual", "$18,400 family" ], "OOPmax": [ "$9,200 individual", "$18,400 family" ], "Exchange": [ "On Pennie", "Off Pennie" ], "hsaeligible": "No", "county": "Available in all Capital counties", "Coinsurance": [ "None" ], "PrimaryCare": [ "$0 copay", "Deductible applies after fourth nonpreventive visit" ], "specialist": [ "Paid in full after deductible" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/b2d110c7-15e4-411d-bfe2-109c70083ea0/images%252Fbronze-plan.jpg?MOD=AJPERES" } }, { "planName": "Catastrophic HMO 9200/0/0", "PlanDetails": { "metalLevel": "Catastrophic", "plantype": "medical", "productType": "HMO", "dataCatProductType":"HMO", "age": "Available if you are under age 30^", "deductible": [ "$9,200 individual", "$18,400 family" ], "OOPmax": [ "$9,200 individual", "$18,400 family" ], "Exchange": [ "Off Pennie" ], "hsaeligible": "No", "county": "Available in all Capital counties", "Coinsurance": [ "None" ], "PrimaryCare": [ "$0 copay", "Deductible applies after fourth nonpreventive visit" ], "specialist": [ "Paid in full after deductible" ], "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/b2d110c7-15e4-411d-bfe2-109c70083ea0/images%252Fbronze-plan.jpg?MOD=AJPERES" } }, { "planName": "Dental PPO Loyalty Plan", "PlanDetails": { "metalLevel": "", "plantype": "dental", "productType": "Dental", "dataCatProductType":"Dental", "deductible": { "Children": "$75", "Adults": "$50" }, "OOPmax": { "Children": "$425", "Adults": "None" }, "routinecheckup": { "Children": "$10 copay", "Adults": "$0" }, "Exchange": [ "On Pennie", "Off Pennie" ], "county": "Available in all Capital counties ", "Coinsurance": " N/A ", "PrimaryCare": "N/A ", "specialist": " N/A", "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/22bf62d3-9d35-4817-a87c-23c8a074f568/images%252Fdental-alt-one.png?MOD=AJPERES" } }, { "planName": "Dental PPO Care Plan", "PlanDetails": { "metalLevel": "", "plantype": "dental", "productType": "Dental", "dataCatProductType":"Dental", "deductible": { "Children": "$75", "Adults": "$50" }, "OOPmax": { "Children": "$425", "Adults": "None" }, "routinecheckup": { "Children": "$10 copay", "Adults": "$0" }, "Exchange": [ "On Pennie", "Off Pennie" ], "county": "Available in all Capital counties ", "Coinsurance": " N/A ", "PrimaryCare": "N/A ", "specialist": " N/A", "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/22bf62d3-9d35-4817-a87c-23c8a074f568/images%252Fdental-alt-one.png?MOD=AJPERES" } }, { "planName": "Dental PPO Standard Plan", "PlanDetails": { "metalLevel": "", "plantype": "dental", "productType": "Dental", "dataCatProductType":"Dental", "deductible": { "Children": "$75", "Adults": "$50" }, "OOPmax": { "Children": "$425", "Adults": "None" }, "routinecheckup": { "Children": "$10 copay", "Adults": "$0" }, "Exchange": [ "Off Pennie" ], "county": "Available in all Capital counties ", "Coinsurance": " N/A ", "PrimaryCare": "N/A ", "specialist": " N/A", "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/22bf62d3-9d35-4817-a87c-23c8a074f568/images%252Fdental-alt-one.png?MOD=AJPERES" } }, { "planName": "Dental PPO Premium Plan", "PlanDetails": { "metalLevel": "", "plantype": "dental", "productType": "Dental", "dataCatProductType":"Dental", "deductible": { "Children": "$75", "Adults": "$50" }, "OOPmax": { "Children": "$425", "Adults": "None" }, "routinecheckup": { "Children": "$10 copay", "Adults": "$0" }, "Exchange": [ "Off Pennie" ], "county": "Available in all Capital counties ", "Coinsurance": " N/A ", "PrimaryCare": "N/A ", "specialist": " N/A", "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/22bf62d3-9d35-4817-a87c-23c8a074f568/images%252Fdental-alt-one.png?MOD=AJPERES" } }, { "planName": "Dental PPO Preventive Plan", "PlanDetails": { "metalLevel": "", "plantype": "dental", "productType": "Dental", "dataCatProductType":"Dental", "deductible": { "Children": "$75", "Adults": "$50" }, "OOPmax": { "Children": "$425", "Adults": "None" }, "routinecheckup": { "Children": "$10 copay", "Adults": "$0" }, "Exchange": [ "On Pennie", "Off Pennie" ], "county": "Available in all Capital counties ", "Coinsurance": " N/A ", "PrimaryCare": "N/A ", "specialist": " N/A", "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/22bf62d3-9d35-4817-a87c-23c8a074f568/images%252Fdental-alt-one.png?MOD=AJPERES" } }, { "planName": "Dental Select Basic", "PlanDetails": { "metalLevel": "", "plantype": "dental", "productType": "Dental", "dataCatProductType":"Dental", "deductible": { "Children": "No Deductible", "Adults": "No Deductible" }, "OOPmax": { "Children": "$425", "Adults": "None" }, "routinecheckup": { "Children": "$10 copay", "Adults": "$10 copay" }, "Exchange": [ "On Pennie", "Off Pennie" ], "county": "Available in all Capital counties ", "Coinsurance": " N/A ", "PrimaryCare": "N/A ", "specialist": " N/A", "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/22bf62d3-9d35-4817-a87c-23c8a074f568/images%252Fdental-alt-one.png?MOD=AJPERES" } }, { "planName": "Vision Essential Plan", "PlanDetails": { "metalLevel": "", "plantype": "vision", "productType": "Vision", "dataCatProductType":"Vision", "deductible": "N/A ", "OOPmax": "none ", "Exchange": [ "Off Pennie" ], "county": "Available in all 21 counties ", "Coinsurance": " N/A ", "PrimaryCare": "N/A ", "specialist": "N/A ", "Exam": "$10 copay", "Lenses": "$10 copay", "planimgurl": "/wps/wcm/connect/prod_nws.capblue.com29556/6b9686ce-4424-4ca7-b751-c869be200eef/images%252Fvison-alt-one.png?MOD=AJPERES" } } ] }