2015 Oregon Individual and Family Plans

The information on this page is for plans beginning January 1, 2015.  

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PSN Plans


Visit our Oregon Forms and Materials page for more sales materials.

  Plan  

Deductible  

Out-of-pocket Limit  

Co-insurance  

Plan Details  

  Balance Bronze PSN 6600
$6,600 / $13,200
$6,600 / $13,200
0%
Value Bronze PSN 6250  HSA-qualified
$6,250 / $12,500
$6,250 / $12,500
0%
Value Bronze PSN 3000  HSA-qualified
$3,000 / $6,000
$6,450 / $12,900
50%
Standard Bronze PSN
$5,000 / $10,000
$6,350 / $12,700
50%
  Balance Silver PSN 2500 AC
$2,500 / $5,000
$6,450 / $12,900
30%
Balance Silver PSN 1500 AC
$1,500 / $3,000
$6,450 / $12,900
30%
Value Silver PSN 3600  HSA-qualified
$3,600 / $7,200
$3,600 / $7,200
0%
Value Silver PSN 3000  HSA-qualified
$3,000 / $6,000
$3,000 / $6,000
0%
Standard Silver PSN
$2,500 / $5,000
$6,350 / $12,700
30%
  Standard Gold PSN
$1,300/ $2,600
$6,350 / $12,700
10%
  Catastrophic PSN
$6,600 / $13,200
$6,600 / $13,200
0%
  Cost-sharing Plan
Available Only Through HealthCare.gov*

Deductible  

Out-of-pocket Limit  

Co-insurance  

Plan Details  

  Balance Silver PSN 2500 AC (73)
$1,600 / $3,200
$5,000 / $10,000
30%
Balance Silver PSN 2500 AC (87)
$500 / $1,000
$1,750 / $2,500
20%
Balance Silver PSN 2500 AC (94)
$200 / $400
$750 / $1,500
10%
Balance Silver PSN 1500 AC (73)
$1,500 / $3,000
$5,000 / $10,000
30%
Balance Silver PSN 1500 AC (87)
$500 / $1,000
$1,750 / $3,500
20%
Balance Silver PSN 1500 AC (94)
$200 / $400
$750 / $1,500
10%
Value Silver PSN 3600 (73)  HSA-qualified
$2,700 / $5,400
$2,700 / $5,400
0%
Value Silver PSN 3600 (87)  HSA-qualified
$1,000 / $2,000
$1,000 / $2,000
0%
Value Silver PSN 3600 (94)  HSA-qualified
$500 / $1,000
$500 / $1,000
0%
Value Silver PSN 3000 (73)  HSA-qualified
$2,650 / $5,300
$2,650 / $5,300
0%
Value Silver PSN 3000 (87)  HSA-qualified
$1,000 / $2,000
$1,000 / $2,000
0%
Value Silver PSN 3000 (94)  HSA-qualified
$400 / $800
$400 / $800
0%
Standard Silver PSN (73)
$2,500 / $5,000
$4,250 / $8,500
30%
Standard Silver PSN (87)
$750 / $1,500
$1,500 / $3,000
10%
Standard Silver PSN (94)
$100 / $200
$750 / $1,500
10%

 

SmartChoice Plans


Visit our Oregon Forms and Materials page for more sales materials.

 

Plan

Deductible

Out-of-pocket Limit

Co-insurance

Plan Details

  Balance Bronze 6600
$6,600 / $13,200
$6,600 / $13,200
0%
Value Bronze 6250  HSA-qualified
$6,250 / $12,500
$6,250 / $12,500
0%
Value Bronze 3000  HSA-qualified
$3,000 / $6,000
$6,450 / $12,900
50%
Standard Bronze
$5,000 / $10,000
$6,350 / $12,700
50%
  Balance Silver 2500 AC 
$2,500 / $5,000
$6,450 / $12,900
30%
Balance Silver 1500 AC
$1,500 / $3,000
$6,450 / $12,900
30%
Value Silver 3600  HSA-qualified
$3,600 / $7,200
$3,600 / $7,200
0%
Value Silver 3000  HSA-qualified
$3,000 / $6,000
$3,000 / $6,000
0%
Standard Silver
$2,500 / $5,000
$6,350 / $12,700
30%
  Standard Gold
$1,300/ $2,600
$6,350 / $12,700
10%
  Catastrophic
$6,600 / $13,200
$6,600 / $13,200
0%
  Cost-sharing Plan
Available Only Through HealthCare.gov*

Deductible  

Out-of-pocket Limit  

Co-insurance  

Plan Details  

  Balance Silver 2500 AC (73)
$1,600 / $3,200
$5,000 / $10,000
30%
Balance Silver 2500 AC (87)
$500 / $1,000
$1,750 / $2,500
20%
Balance Silver 2500 AC (94)
$200 / $400
$750 / $1,500
10%
Balance Silver 1500 AC (73)
$1,500 / $3,000
$5,000 / $10,000
30%
Balance Silver 1500 AC (87)
$500 / $1,000
$1,750 / $3,500
20%
Balance Silver 1500 AC (94)
$200 / $400
$750 / $1,500
10%
Value Silver 3600 (73)  HSA-qualified
$2,700 / $5,400
$2,700 / $5,400
0%
Value Silver 3600 (87)  HSA-qualified
$1,000 / $2,000
$1,000 / $2,000
0%
Value Silver 3600 (94)  HSA-qualified
$500 / $1,000
$500 / $1,000
0%
Value Silver 3000 (73)  HSA-qualified
$2,650 / $5,300
$2,650 / $5,300
0%
Value Silver 3000 (87)  HSA-qualified
$1,000 / $2,000
$1,000 / $2,000
0%
Value Silver 3000 (94)  HSA-qualified
$400 / $800
$400 / $800
0%
Standard Silver (73)
$2,500 / $5,000
$4,250 / $8,500
30%
Standard Silver (87)
$750 / $1,500
$1,500 / $3,000
10%
Standard Silver (94)
$100 / $200
$750 / $1,500
10%

 

SmartHealth Plans


Visit our Oregon Forms and Materials page for more sales materials.

 

Plan

Deductible

Out-of-pocket Limit

Co-insurance

Plan Details

  Balance Bronze 6600
$6,600 / $13,200
$6,600 / $13,200
0%
Value Bronze 6250  HSA-qualified
$6,250 / $12,500
$6,250 / $12,500
0%
Value Bronze 3000  HSA-qualified
$3,000 / $6,000
$6,450 / $12,900
50%
Standard Bronze
$5,000 / $10,000
$6,350 / $12,700
50%
  Balance Silver 2500 AC 
$2,500 / $5,000
$6,450 / $12,900
30%
Balance Silver 1500 AC
$1,500 / $3,000
$6,450 / $12,900
30%
Value Silver 3600  HSA-qualified
$3,600 / $7,200
$3,600 / $7,200
0%
Value Silver 3000  HSA-qualified
$3,000 / $6,000
$3,000 / $6,000
0%
Standard Silver
$2,500 / $5,000
$6,350 / $12,700
30%
  Standard Gold
$1,300/ $2,600
$6,350 / $12,700
10%
  Catastrophic
$6,600 / $13,200
$6,600 / $13,200
0%
  Cost-sharing Plan
Available Only Through HealthCare.gov*

Deductible  

Out-of-pocket Limit  

Co-insurance  

Plan Details  

  Balance Silver 2500 AC (73)
$1,600 / $3,200
$5,000 / $10,000
30%
Balance Silver 2500 AC (87)
$500 / $1,000
$1,750 / $2,500
20%
Balance Silver 2500 AC (94)
$200 / $400
$800 / $1,600
10%
Balance Silver 1500 AC (73)
$1,500 / $3,000
$5,000 / $10,000
30%
Balance Silver 1500 AC (87)
$500 / $1,000
$1,750 / $3,500
20%
Balance Silver 1500 AC (94)
$200 / $400
$750 / $1,500
10%
Value Silver 3600 (73)  HSA-qualified
$2,700 / $5,400
$2,700 / $5,400
0%
Value Silver 3600 (87)  HSA-qualified
$1,000 / $2,000
$1,000 / $2,000
0%
Value Silver 3600 (94)  HSA-qualified
$500 / $1,000
$500 / $1,000
0%
Value Silver 3000 (73)  HSA-qualified
$2,650 / $5,300
$2,650 / $5,300
0%
Value Silver 3000 (87)  HSA-qualified
$1,000 / $2,000
$1,000 / $2,000
0%
Value Silver 3000 (94)  HSA-qualified
$400 / $800
$400 / $800
0%
Standard Silver (73)
$2,500 / $5,000
$4,250 / $8,500
30%
Standard Silver (87)
$750 / $1,500
$1,500 / $3,000
10%
Standard Silver (94)
$100 / $200
$750 / $1,500
10%

 

American Indian Benefits


Visit our Oregon Forms and Materials page for more sales materials.

  PSN Plan  

Deductible  

Out-of-pocket Limit  

Co-insurance  

Plan Details  

  Balance Bronze PSN 6600 (0)
$0
$0
0%
Balance Bronze PSN 6600 (AI)
$6,600 / $13,200
$6,600 / $13,200
0%
Value Bronze PSN 6250 (0)
$0
$0
0%
Value Bronze PSN 6250 (AI)
$6,250 / $12,500
$6,250 / $12,500
0%
Value Bronze PSN 3000 (0)
$0
$0
0%
Value Bronze PSN 3000 (AI)
$3,000 / $6,000
$6,450 / $12,900
50%
Standard Bronze PSN (0)
$0
$0
0%
Standard Bronze PSN (AI)
$5,000 / $10,000
$6,350 / $12,700
50%
  Balance Silver PSN 2500 AC (0)
$0
$0
0%
Balance Silver PSN 2500 AC (AI)
$2,500 / $5,000
$6,450 / $12,900
30%
Balance Silver PSN 1500 AC (0)
$0
$0
0%
Balance Silver PSN 1500 AC (AI)
$1,500 / $3,000
$6,450 / $12,900
30%
Value Silver PSN 3600 (0)
$0
$0
0%
Value Silver PSN 3600 (AI) 
$3,600 / $7,200
$3,600 / $7,200
0%
Value Silver PSN 3000 (0)
$0
$0
0%
Value Silver PSN 3000 (AI)
$3,000 / $6,000
$3,000 / $6,000
0%
Standard Silver PSN (0)
$0
$0
0%
 SBC
Standard Silver PSN (AI)
$2,500 / $5,000
$6,350 / $12,700
30%
  Standard Gold PSN (0)
$0
$0
0%
Standard Gold PSN (AI)
$1,300/ $2,600
$6,350 / $12,700
10%
  SmartChoice Plan  

Deductible  

Out-of-pocket Limit  

Co-insurance  

Plan Details  

  Balance Bronze 6600 (0)
$0
$0
0%
Balance Bronze 6600 (AI)
$6,600 / $13,200
$6,600 / $13,200
0%
Value Bronze 6250 (0)
$0
$0
0%
Value Bronze 6250 (AI)
$6,250 / $12,500
$6,250 / $12,500
0%
Value Bronze 3000 (0)
$0
$0
0%
Value Bronze 3000 (AI)
$3,000 / $6,000
$6,450 / $12,900
50%
Standard Bronze (0)
$0
$0
0%
Standard Bronze (AI)
$5,000 / $10,000
$6,350 / $12,700
50%
  Balance Silver 2500 AC (0)
$0
$0
0%
Balance Silver 2500 AC (AI)
$2,500 / $5,000
$6,450 / $12,900
30%
Balance Silver 1500 AC (0)
$0
$0
0%
Balance Silver 1500 AC (AI)
$1,500 / $3,000
$6,450 / $12,900
30%
Value Silver 3600 (0)
$0
$0
0%
Value Silver 3600 (AI)
$3,600 / $7,200
$3,600 / $7,200
0%
Value Silver 3000 (0)
$0
$0
0%
Value Silver 3000 (AI)
$3,000 / $6,000
$3,000 / $6,000
0%
Standard Silver (0)
$0
$0
0%
Standard Silver (AI)
$2,500 / $5,000
$6,350 / $12,700
30%
  Standard Gold (0)
$0
$0
0%
Standard Gold (AI)
$1,300/ $2,600
$6,350 / $12,700
10%
  SmartChoice Plan  

Deductible  

Out-of-pocket Limit  

Co-insurance  

Plan Details  

  Balance Bronze 6600 (0)
$0
$0
0%
Balance Bronze 6600 (AI)
$6,600 / $13,200
$6,600 / $13,200
0%
Value Bronze 6250 (0)
$0
$0
0%
Value Bronze 6250 (AI)
$6,250 / $12,500
$6,250 / $12,500
0%
Value Bronze 3000 (0)
$0
$0
0%
Value Bronze 3000 (AI)
$3,000 / $6,000
$6,450 / $12,900
50%
Standard Bronze (0)
$0
$0
0%
Standard Bronze (AI)
$5,000 / $10,000
$6,350 / $12,700
50%
  Balance Silver  2500 AC (0)
$0
$0
0%
Balance Silver  2500 AC (AI)
$2,500 / $5,000
$6,450 / $12,900
30%
Balance Silver 1500 AC (0)
$0
$0
0%
Balance Silver 1500 AC (AI)
$1,500 / $3,000
$6,450 / $12,900
30%
Value Silver 3600 (0)
$0
$0
0%
Value Silver 3600 (AI)
$3,600 / $7,200
$3,600 / $7,200
0%
Value Silver 3000 (0)
$0
$0
0%
Value Silver 3000 (AI)
$3,000 / $6,000
$3,000 / $6,000
0%
Standard Silver (0)
$0
$0
0%
Standard Silver (AI)
$2,500 / $5,000
$6,350 / $12,700
30%
  Standard Gold (0)
$0
$0
0%
Standard Gold (AI)
$1,300/ $2,600
$6,350 / $12,700
10%

 

Dental Plans


Visit our Oregon Forms and Materials page for more sales materials.

  Dental Advanatage Essentials Core*
  Dental Advantage 0/20/50
  Kids Dental Advantage 0/20/50

*Available only through HealthCare.gov.