| Health Plan-ModaModa Select 2016 PlansCompared | ||||||
| COMPANY | Moda | Moda | Moda | Moda | Moda | Moda |
| Plan | BeProtected | BePrepared | StandardSilver | Be SupportedCCN | Standard Bronze |
BeLively |
| MetalTier | Gold | Silver | Silver | Silver | Bronze (HASEligible) |
Bronze |
| Deductible | $1,000 | $1,550 | $2,500 | $2,500 | $5,000 | $5,500 |
| Co-insurance | 15% | 30% | 30% | 35% | 0% | 40% |
| Maximum Out ofPocket (InNetwork) | $5,500 | $6,850 | $6,850 | $6,500 | $6,350 | $6,850 |
| PCP/Spec.copay | $15/$15 | $30/$30 | $35/$70 | $30/$60 | ded | $80 |
| Urgent Carevisit | $15 | $30 | $90 | $30 | ded | $100 |
| AlternativeCare |
$15/$1000max |
$30 visit/$1000max |
na |
na |
na |
40% |
| PrescriptionDrug | $2/$10/40%/50% | $2/$20/40%/50% | $15/$15/$50/50% | $2/$10/40%/50% | ded | $2/$10/ded/ded |
| Mental Healthvisit | $15 | $30 | $35 | $30 | ded | $80 |
| Network | Beacon | Beacon | Beacon | CCN | Beacon | RoseCity |
| Non-Smoker, area 1rates | Monthly | Monthly | Monthly | Monthly | Monthly | Monthly |
| 20 &Under | $183 | $161 | $152 | $143 | $125 | $113 |
| 21 | $289 | $254 | $240 | $226 | $197 | $178 |
| 22 | $289 | $254 | $240 | $226 | $197 | $178 |
| 23 | $289 | $254 | $240 | $226 | $197 | $178 |
| 24 | $289 | $254 | $240 | $226 | $197 | $178 |
| 25 | $290 | $255 | $241 | $227 | $198 | $179 |
| 26 | $296 | $260 | $246 | $231 | $201 | $183 |
| 27 | $302 | $266 | $251 | $237 | $206 | $187 |
| 28 | $314 | $276 | $261 | $245 | $214 | $194 |
| 29 | $323 | $284 | $269 | $253 | $220 | $200 |
| 30 | $328 | $288 | $272 | $256 | $223 | $202 |
| 31 | $334 | $294 | $278 | $262 | $228 | $207 |
| 32 | $341 | $300 | $284 | $267 | $223 | $211 |
| 33 | $346 | $304 | $287 | $270 | $236 | $214 |
| 34 | $350 | $308 | $291 | $274 | $239 | $217 |
| 35 | $353 | $310 | $293 | $276 | $240 | $218 |
| 36 | $355 | $312 | $295 | $278 | $242 | $219 |
| 37 | $357 | $314 | $297 | $279 | $244 | $221 |
| 38 | $360 | $316 | $299 | $281 | $245 | $222 |
| 39 | $364 | $320 | $303 | $285 | $248 | $225 |
| 40 | $369 | $324 | $307 | $288 | $251 | $228 |
| 41 | $376 | $330 | $312 | $294 | $256 | $232 |
| 42 | $382 | $336 | $318 | $299 | $261 | $236 |
| 43 | $392 | $344 | $326 | $306 | $267 | $242 |
| 44 | $403 | $354 | $335 | $315 | $275 | $249 |
| 45 | $417 | $366 | $347 | $326 | $284 | $258 |
| 46 | $433 | $380 | $360 | $339 | $295 | $268 |
| 47 | $451 | $396 | $375 | $353 | $308 | $279 |
| 48 | $472 | $415 | $392 | $369 | $322 | $292 |
| 49 | $492 | $433 | $409 | $385 | $336 | $304 |
| 50 | $515 | $453 | $429 | $403 | $351 | $319 |
| 51 | $538 | $473 | $448 | $421 | $367 | $333 |
| 52 | $563 | $495 | $468 | $441 | $384 | $348 |
| 53 | $589 | $517 | $490 | $460 | $401 | $364 |
| 54 | $616 | $542 | $512 | $482 | $420 | $381 |
| 55 | $644 | $566 | $535 | $503 | $439 | $398 |
| 56 | $673 | $592 | $560 | $527 | $459 | $416 |
| 57 | $703 | $618 | $585 | $550 | $480 | $435 |
| 58 | $735 | $646 | $611 | $575 | $501 | $454 |
| 59 | $751 | $660 | $625 | $588 | $512 | $464 |
| 60 | $783 | $688 | $651 | $613 | $534 | $484 |
| 61 | $811 | $713 | $674 | $634 | $553 | $501 |
| 62 | $829 | $729 | $689 | $648 | $565 | $512 |
| 63 | $852 | $749 | $708 | $666 | $581 | $527 |
| 64 | $866 | $761 | $720 | $677 | $590 | $534 |
