2018 | AK | 74819 | HIOS | 08/08/2017 02:20:00 AM | SHOP (Small Group) | Yes | 95-6042390 | 74819AK0010011 | BESTDental Choice - L | 74819AK001 | | AKN001 | AKS001 | | Existing | PPO | Low | Not Applicable | | Both | | | | | | No | Allows Adult and Child-Only | | | | | 1 | Guaranteed Rate | 01/01/2018 12:00:00 AM | | No | | Yes | Full | Yes | http://www.bestlife.com/exchange/payment_option.html | | 74819AK0010011-00 | BESTDental Choice - L | Standard Low Off Exchange Plan | 70.8 | | | | No | 100 | | | | | | | | | | | | | | | 0 | 0 | 0 | $350 | $350 per person | $700 per group | | | | $700 | $700 per person | $1400 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | $75 | $75 per person | per group not applicable | | | | | | $100 | $100 per person | per group not applicable | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
2018 | AK | 38344 | HIOS | 11/01/2017 02:20:00 AM | Individual | No | 91-0499247 | 38344AK0540010 | Premera Blue Cross Preferred Plus Silver 3000 HSA | 38344AK054 | | AKN001 | AKS001 | AKF003 | New | PPO | Silver | Not Applicable | No | Both | No | No | | | 0.00 | No | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Diabetes | 0.998 | | | 01/01/2018 12:00:00 AM | | Yes | Benefits for covered services received from providers located outside the United States, Puerto Rico and the U.S. Virgin Islands are provided at the highest level of benefits available under the plan. | Yes | If you're outside Alaska and Washington, you may receive covered services from any provider licensed to provide the service. | Yes | https://premera.softheon.com/Marketplace.AK/PaymentCenter/Payment.aspx | https://www.premera.com/ak/visitor/pharmacy/drug-search/M2/ | 38344AK0540010-06 | Premera Blue Cross Preferred Plus Silver 3000 HSA | 94% AV Level Silver Plan | | 0.94159631 | Yes | Yes | No | 100 | | 250.00 | 0.00 | 300.00 | 60.00 | 250.00 | 0.00 | 300.00 | 20.00 | 250.00 | 0.00 | 300.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 500.00 | $500 per person | $1000 per group | | | | Not Applicable | per person not applicable | per group not applicable | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 250.00 | $250 per person | $500 per group | 30 | | | | | $500 | $500 per person | $1000 per group | Not Applicable | per person not applicable | per group not applicable | No | | | https://www.premera.com/documents/042186_2018.pdf | https://www.premera.com/documents/007528_2018.pdf |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0700001 | Endeavor Providence Gold 500 | 73836AK070 | | AKN002 | AKS001 | AKF001 | Existing | PPO | Gold | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0700001-00 | Endeavor Providence Gold 500 | Standard Gold Off Exchange Plan | | 0.813083276 | Yes | Yes | No | 100 | | 500.00 | 40.00 | 2400.00 | 300.00 | 500.00 | 1100.00 | 300.00 | 60.00 | 500.00 | 400.00 | 200.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7000.00 | $7000 per person | $14000 per group | | | | $21,000 | $21000 per person | $42000 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 500.00 | $500 per person | $1000 per group | 20 | | | | | $1,500 | $1500 per person | $3000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Providence_Gold500_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Providence_Gold500_SG_2018_AK.pdf |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0700001 | Endeavor Providence Gold 500 | 73836AK070 | | AKN002 | AKS001 | AKF001 | Existing | PPO | Gold | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0700001-01 | Endeavor Providence Gold 500 | Standard Gold On Exchange Plan | | 0.813083276 | Yes | Yes | No | 100 | | 500.00 | 40.00 | 2400.00 | 300.00 | 500.00 | 1100.00 | 300.00 | 60.00 | 500.00 | 400.00 | 200.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7000.00 | $7000 per person | $14000 per group | | | | $21,000 | $21000 per person | $42000 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 500.00 | $500 per person | $1000 per group | 20 | | | | | $1,500 | $1500 per person | $3000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Providence_Gold500_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Providence_Gold500_SG_2018_AK.pdf |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0700002 | Endeavor Providence Gold 1000 | 73836AK070 | | AKN002 | AKS001 | AKF001 | Existing | PPO | Gold | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0700002-00 | Endeavor Providence Gold 1000 | Standard Gold Off Exchange Plan | | 0.802456118 | Yes | Yes | No | 100 | | 1000.00 | 40.00 | 2300.00 | 300.00 | 1000.00 | 1100.00 | 200.00 | 60.00 | 1000.00 | 400.00 | 50.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7000.00 | $7000 per person | $14000 per group | | | | $21,000 | $21000 per person | $42000 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 1000.00 | $1000 per person | $2000 per group | 20 | | | | | $3,000 | $3000 per person | $6000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Providence_Gold1000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Providence_Gold1000_SG_2018_AK.pdf |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0700002 | Endeavor Providence Gold 1000 | 73836AK070 | | AKN002 | AKS001 | AKF001 | Existing | PPO | Gold | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0700002-01 | Endeavor Providence Gold 1000 | Standard Gold On Exchange Plan | | 0.802456118 | Yes | Yes | No | 100 | | 1000.00 | 40.00 | 2300.00 | 300.00 | 1000.00 | 1100.00 | 200.00 | 60.00 | 1000.00 | 400.00 | 50.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7000.00 | $7000 per person | $14000 per group | | | | $21,000 | $21000 per person | $42000 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 1000.00 | $1000 per person | $2000 per group | 20 | | | | | $3,000 | $3000 per person | $6000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Providence_Gold1000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Providence_Gold1000_SG_2018_AK.pdf |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0700003 | Endeavor Providence Gold 1500 | 73836AK070 | | AKN002 | AKS001 | AKF001 | Existing | PPO | Gold | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0700003-00 | Endeavor Providence Gold 1500 | Standard Gold Off Exchange Plan | | 0.794060591 | Yes | Yes | No | 100 | | 1500.00 | 40.00 | 2200.00 | 300.00 | 1500.00 | 1100.00 | 70.00 | 60.00 | 1190.00 | 400.00 | 10.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7000.00 | $7000 per person | $14000 per group | | | | $21,000 | $21000 per person | $42000 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 1500.00 | $1500 per person | $3000 per group | 20 | | | | | $4,500 | $4500 per person | $9000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Providence_Gold1500_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Providence_Gold1500_SG_2018_AK.pdf |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0700003 | Endeavor Providence Gold 1500 | 73836AK070 | | AKN002 | AKS001 | AKF001 | Existing | PPO | Gold | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0700003-01 | Endeavor Providence Gold 1500 | Standard Gold On Exchange Plan | | 0.794060591 | Yes | Yes | No | 100 | | 1500.00 | 40.00 | 2200.00 | 300.00 | 1500.00 | 1100.00 | 70.00 | 60.00 | 1190.00 | 400.00 | 10.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7000.00 | $7000 per person | $14000 per group | | | | $21,000 | $21000 per person | $42000 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 1500.00 | $1500 per person | $3000 per group | 20 | | | | | $4,500 | $4500 per person | $9000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Providence_Gold1500_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Providence_Gold1500_SG_2018_AK.pdf |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0700006 | Endeavor Select Gold 500 | 73836AK070 | | AKN001 | AKS001 | AKF001 | Existing | PPO | Gold | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0700006-00 | Endeavor Select Gold 500 | Standard Gold Off Exchange Plan | | 0.813083276 | Yes | Yes | No | 100 | | 500.00 | 40.00 | 2400.00 | 300.00 | 500.00 | 1100.00 | 300.00 | 60.00 | 500.00 | 400.00 | 200.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7000.00 | $7000 per person | $14000 per group | | | | $21,000 | $21000 per person | $42000 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 500.00 | $500 per person | $1000 per group | 20 | | | | | $1,500 | $1500 per person | $3000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Select_Gold500_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Gold500_SG_2018_AK.pdf |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0700006 | Endeavor Select Gold 500 | 73836AK070 | | AKN001 | AKS001 | AKF001 | Existing | PPO | Gold | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0700006-01 | Endeavor Select Gold 500 | Standard Gold On Exchange Plan | | 0.813083276 | Yes | Yes | No | 100 | | 500.00 | 40.00 | 2400.00 | 300.00 | 500.00 | 1100.00 | 300.00 | 60.00 | 500.00 | 400.00 | 200.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7000.00 | $7000 per person | $14000 per group | | | | $21,000 | $21000 per person | $42000 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 500.00 | $500 per person | $1000 per group | 20 | | | | | $1,500 | $1500 per person | $3000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Select_Gold500_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Gold500_SG_2018_AK.pdf |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0700007 | Endeavor Select Gold 1000 | 73836AK070 | | AKN001 | AKS001 | AKF001 | Existing | PPO | Gold | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0700007-00 | Endeavor Select Gold 1000 | Standard Gold Off Exchange Plan | | 0.802456118 | Yes | Yes | No | 100 | | 1000.00 | 40.00 | 2300.00 | 300.00 | 1000.00 | 1100.00 | 200.00 | 60.00 | 1000.00 | 400.00 | 50.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7000.00 | $7000 per person | $14000 per group | | | | $21,000 | $21000 per person | $42000 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 1000.00 | $1000 per person | $2000 per group | 20 | | | | | $3,000 | $3000 per person | $6000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Select_Gold1000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Gold1000_SG_2018_AK.pdf |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0700007 | Endeavor Select Gold 1000 | 73836AK070 | | AKN001 | AKS001 | AKF001 | Existing | PPO | Gold | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0700007-01 | Endeavor Select Gold 1000 | Standard Gold On Exchange Plan | | 0.802456118 | Yes | Yes | No | 100 | | 1000.00 | 40.00 | 2300.00 | 300.00 | 1000.00 | 1100.00 | 200.00 | 60.00 | 1000.00 | 400.00 | 50.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7000.00 | $7000 per person | $14000 per group | | | | $21,000 | $21000 per person | $42000 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 1000.00 | $1000 per person | $2000 per group | 20 | | | | | $3,000 | $3000 per person | $6000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Select_Gold1000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Gold1000_SG_2018_AK.pdf |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0700008 | Endeavor Select Gold 1500 | 73836AK070 | | AKN001 | AKS001 | AKF001 | Existing | PPO | Gold | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0700008-00 | Endeavor Select Gold 1500 | Standard Gold Off Exchange Plan | | 0.794060591 | Yes | Yes | No | 100 | | 1500.00 | 40.00 | 2200.00 | 300.00 | 1500.00 | 1100.00 | 70.00 | 60.00 | 1190.00 | 400.00 | 10.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7000.00 | $7000 per person | $14000 per group | | | | $21,000 | $21000 per person | $42000 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 1500.00 | $1500 per person | $3000 per group | 20 | | | | | $4,500 | $4500 per person | $9000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Select_Gold1500_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Gold1500_SG_2018_AK.pdf |
2018 | FL | 17121 | HIOS | 08/17/2017 02:20:00 AM | Individual | Yes | 95-6042390 | 17121FL0020006 | BEST Dental Basic - Silver | 17121FL002 | | FLN001 | FLS001 | | New | PPO | Low | Not Applicable | | Both | | | | | | No | Allows Adult and Child-Only | | | | | 1 | Guaranteed Rate | 01/01/2018 12:00:00 AM | 12/31/2018 12:00:00 AM | No | | Yes | Full | Yes | http://www.bestlife.com/exchange/payment_option.html | | 17121FL0020006-01 | BEST Dental Basic - Silver | Standard Low On Exchange Plan | 70 | | | | No | 100 | | | | | | | | | | | | | | | 0 | 0 | 0 | $350 | $350 per person | $700 per group | | | | $700 | $700 per person | $1400 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | $75 | $75 per person | per group not applicable | | | | | | $100 | $100 per person | per group not applicable | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0700008 | Endeavor Select Gold 1500 | 73836AK070 | | AKN001 | AKS001 | AKF001 | Existing | PPO | Gold | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0700008-01 | Endeavor Select Gold 1500 | Standard Gold On Exchange Plan | | 0.794060591 | Yes | Yes | No | 100 | | 1500.00 | 40.00 | 2200.00 | 300.00 | 1500.00 | 1100.00 | 70.00 | 60.00 | 1190.00 | 400.00 | 10.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7000.00 | $7000 per person | $14000 per group | | | | $21,000 | $21000 per person | $42000 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 1500.00 | $1500 per person | $3000 per group | 20 | | | | | $4,500 | $4500 per person | $9000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Select_Gold1500_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Gold1500_SG_2018_AK.pdf |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0710002 | Endeavor Providence Silver 2000 | 73836AK071 | | AKN002 | AKS001 | AKF002 | Existing | PPO | Silver | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0710002-00 | Endeavor Providence Silver 2000 | Standard Silver Off Exchange Plan | | 0.719996654 | Yes | Yes | No | 100 | | 2000.00 | 40.00 | 3600.00 | 300.00 | 1730.00 | 1900.00 | 50.00 | 60.00 | 1460.00 | 200.00 | 20.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7350.00 | $7350 per person | $14700 per group | | | | $22,050 | $22050 per person | $44100 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 2000.00 | $2000 per person | $4000 per group | 35 | | | | | $6,000 | $6000 per person | $12000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Providence_Silver2000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Providence_Silver2000_SG_2018_AK.pdf |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0710002 | Endeavor Providence Silver 2000 | 73836AK071 | | AKN002 | AKS001 | AKF002 | Existing | PPO | Silver | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0710002-01 | Endeavor Providence Silver 2000 | Standard Silver On Exchange Plan | | 0.719996654 | Yes | Yes | No | 100 | | 2000.00 | 40.00 | 3600.00 | 300.00 | 1730.00 | 1900.00 | 50.00 | 60.00 | 1460.00 | 200.00 | 20.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7350.00 | $7350 per person | $14700 per group | | | | $22,050 | $22050 per person | $44100 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 2000.00 | $2000 per person | $4000 per group | 35 | | | | | $6,000 | $6000 per person | $12000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Providence_Silver2000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Providence_Silver2000_SG_2018_AK.pdf |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0700004 | Endeavor Providence Silver 2500 | 73836AK070 | | AKN002 | AKS001 | AKF002 | Existing | PPO | Silver | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0700004-00 | Endeavor Providence Silver 2500 | Standard Silver Off Exchange Plan | | 0.714196731 | Yes | Yes | No | 100 | | 2500.00 | 40.00 | 3500.00 | 300.00 | 1730.00 | 1900.00 | 50.00 | 60.00 | 1460.00 | 200.00 | 20.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7350.00 | $7350 per person | $14700 per group | | | | $22,050 | $22050 per person | $44100 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 2500.00 | $2500 per person | $5000 per group | 35 | | | | | $7,500 | $7500 per person | $15000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Providence_Silver2500_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Providence_Silver2500_SG_2018_AK.pdf |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0700004 | Endeavor Providence Silver 2500 | 73836AK070 | | AKN002 | AKS001 | AKF002 | Existing | PPO | Silver | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0700004-01 | Endeavor Providence Silver 2500 | Standard Silver On Exchange Plan | | 0.714196731 | Yes | Yes | No | 100 | | 2500.00 | 40.00 | 3500.00 | 300.00 | 1730.00 | 1900.00 | 50.00 | 60.00 | 1460.00 | 200.00 | 20.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7350.00 | $7350 per person | $14700 per group | | | | $22,050 | $22050 per person | $44100 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 2500.00 | $2500 per person | $5000 per group | 35 | | | | | $7,500 | $7500 per person | $15000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Providence_Silver2500_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Providence_Silver2500_SG_2018_AK.pdf |
2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0710003 | Endeavor Providence Silver 3000 | 73836AK071 | | AKN002 | AKS001 | AKF002 | Existing | PPO | Silver | Not Applicable | No | Both | No | No | | | | Yes | Allows Adult and Child-Only | | No | Asthma, Heart Disease, Depression, Diabetes, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs | | | | 01/01/2018 12:00:00 AM | | No | | Yes | Travel Network | No | | http://www.modahealth.com/pdl?type=SG&state=AK | 73836AK0710003-00 | Endeavor Providence Silver 3000 | Standard Silver Off Exchange Plan | | 0.709104254 | Yes | Yes | No | 100 | | 3000.00 | 40.00 | 3300.00 | 300.00 | 1730.00 | 1900.00 | 50.00 | 60.00 | 1460.00 | 200.00 | 20.00 | 0.00 | | 0 | 0 | 0 | | | | | | | | | | | | | | | | | | | | | | | | | 7350.00 | $7350 per person | $14700 per group | | | | $22,050 | $22050 per person | $44100 per group | Not Applicable | per person not applicable | per group not applicable | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 3000.00 | $3000 per person | $6000 per group | 35 | | | | | $9,000 | $9000 per person | $18000 per group | Not Applicable | per person not applicable | per group not applicable | No | No | | https://www.modahealth.com/pdfs/sbcs/ak/170101/Moda_Endeavor_Providence_Silver3000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Providence_Silver3000_SG_2018_AK.pdf |