| 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 | 73836AK0710003-01 | Endeavor Providence Silver 3000 | Standard Silver On 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 |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0710004 | Endeavor Providence Silver 4000 | 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 | 73836AK0710004-00 | Endeavor Providence Silver 4000 | Standard Silver Off Exchange Plan | | 0.700335103 | Yes | Yes | No | 100 | | 4000.00 | 40.00 | 2900.00 | 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 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 4000.00 | $4000 per person | $8000 per group | 35 | | | | | $12,000 | $12000 per person | $24000 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_Silver4000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Providence_Silver4000_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0710004 | Endeavor Providence Silver 4000 | 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 | 73836AK0710004-01 | Endeavor Providence Silver 4000 | Standard Silver On Exchange Plan | | 0.700335103 | Yes | Yes | No | 100 | | 4000.00 | 40.00 | 2900.00 | 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 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 4000.00 | $4000 per person | $8000 per group | 35 | | | | | $12,000 | $12000 per person | $24000 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_Silver4000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Providence_Silver4000_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0710006 | Endeavor Select Silver 2000 | 73836AK071 | | AKN001 | 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 | 73836AK0710006-00 | Endeavor Select 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_Select_Silver2000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Silver2000_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0710006 | Endeavor Select Silver 2000 | 73836AK071 | | AKN001 | 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 | 73836AK0710006-01 | Endeavor Select 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_Select_Silver2000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Silver2000_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0700009 | Endeavor Select Silver 2500 | 73836AK070 | | AKN001 | 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 | 73836AK0700009-00 | Endeavor Select 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_Select_Silver2500_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Silver2500_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0700009 | Endeavor Select Silver 2500 | 73836AK070 | | AKN001 | 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 | 73836AK0700009-01 | Endeavor Select 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_Select_Silver2500_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Silver2500_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0710007 | Endeavor Select Silver 3000 | 73836AK071 | | AKN001 | 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 | 73836AK0710007-00 | Endeavor Select 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_Select_Silver3000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Silver3000_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0710007 | Endeavor Select Silver 3000 | 73836AK071 | | AKN001 | 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 | 73836AK0710007-01 | Endeavor Select Silver 3000 | Standard Silver On 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_Select_Silver3000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Silver3000_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0710008 | Endeavor Select Silver 4000 | 73836AK071 | | AKN001 | 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 | 73836AK0710008-00 | Endeavor Select Silver 4000 | Standard Silver Off Exchange Plan | | 0.700335103 | Yes | Yes | No | 100 | | 4000.00 | 40.00 | 2900.00 | 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 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 4000.00 | $4000 per person | $8000 per group | 35 | | | | | $12,000 | $12000 per person | $24000 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_Silver4000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Silver4000_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0710008 | Endeavor Select Silver 4000 | 73836AK071 | | AKN001 | 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 | 73836AK0710008-01 | Endeavor Select Silver 4000 | Standard Silver On Exchange Plan | | 0.700335103 | Yes | Yes | No | 100 | | 4000.00 | 40.00 | 2900.00 | 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 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 4000.00 | $4000 per person | $8000 per group | 35 | | | | | $12,000 | $12000 per person | $24000 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_Silver4000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Silver4000_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0810001 | Endeavor Select Bronze 7350 | 73836AK081 | | AKN001 | AKS001 | AKF004 | Existing | PPO | Bronze | 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 | 73836AK0810001-00 | Endeavor Select Bronze 7350 | Standard Bronze Off Exchange Plan | | 0.605988703 | Yes | Yes | No | 100 | | 7350.00 | 0.00 | 0.00 | 300.00 | 5310.00 | 800.00 | 0.00 | 60.00 | 1460.00 | 400.00 | 0.00 | 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 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 7350.00 | $7350 per person | $14700 per group | 0 | | | | | $22,050 | $22050 per person | $44100 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_Bronze7350_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Bronze7350_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0810001 | Endeavor Select Bronze 7350 | 73836AK081 | | AKN001 | AKS001 | AKF004 | Existing | PPO | Bronze | 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 | 73836AK0810001-01 | Endeavor Select Bronze 7350 | Standard Bronze On Exchange Plan | | 0.605988703 | Yes | Yes | No | 100 | | 7350.00 | 0.00 | 0.00 | 300.00 | 5310.00 | 800.00 | 0.00 | 60.00 | 1460.00 | 400.00 | 0.00 | 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 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 7350.00 | $7350 per person | $14700 per group | 0 | | | | | $22,050 | $22050 per person | $44100 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_Bronze7350_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Bronze7350_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0820001 | Endeavor Select Bronze 4000 | 73836AK082 | | AKN001 | AKS001 | AKF003 | Existing | PPO | Bronze | 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 | 73836AK0820001-00 | Endeavor Select Bronze 4000 | Standard Bronze Off Exchange Plan | | 0.605994165 | Yes | Yes | No | 100 | | 4000.00 | 0.00 | 3400.00 | 300.00 | 4000.00 | 0.00 | 1300.00 | 60.00 | 1930.00 | 0.00 | 0.00 | 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 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 4000.00 | $4000 per person | $8000 per group | 50 | | | | | $12,000 | $12000 per person | $24000 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_Bronze4000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Bronze4000_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0820001 | Endeavor Select Bronze 4000 | 73836AK082 | | AKN001 | AKS001 | AKF003 | Existing | PPO | Bronze | 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 | 73836AK0820001-01 | Endeavor Select Bronze 4000 | Standard Bronze On Exchange Plan | | 0.605994165 | Yes | Yes | No | 100 | | 4000.00 | 0.00 | 3400.00 | 300.00 | 4000.00 | 0.00 | 1300.00 | 60.00 | 1930.00 | 0.00 | 0.00 | 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 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 4000.00 | $4000 per person | $8000 per group | 50 | | | | | $12,000 | $12000 per person | $24000 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_Bronze4000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Bronze4000_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0820002 | Endeavor Select Bronze 5000 | 73836AK082 | | AKN001 | AKS001 | AKF003 | Existing | PPO | Bronze | 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 | 73836AK0820002-00 | Endeavor Select Bronze 5000 | Standard Bronze Off Exchange Plan | | 0.59409672 | Yes | Yes | No | 100 | | 5000.00 | 0.00 | 2400.00 | 300.00 | 5000.00 | 0.00 | 900.00 | 60.00 | 1930.00 | 0.00 | 0.00 | 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 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 5000.00 | $5000 per person | $10000 per group | 50 | | | | | $15,000 | $15000 per person | $30000 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_Bronze5000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Bronze5000_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0820002 | Endeavor Select Bronze 5000 | 73836AK082 | | AKN001 | AKS001 | AKF003 | Existing | PPO | Bronze | 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 | 73836AK0820002-01 | Endeavor Select Bronze 5000 | Standard Bronze On Exchange Plan | | 0.59409672 | Yes | Yes | No | 100 | | 5000.00 | 0.00 | 2400.00 | 300.00 | 5000.00 | 0.00 | 900.00 | 60.00 | 1930.00 | 0.00 | 0.00 | 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 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 5000.00 | $5000 per person | $10000 per group | 50 | | | | | $15,000 | $15000 per person | $30000 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_Bronze5000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Select_Bronze5000_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0820003 | Endeavor Providence Bronze 4000 | 73836AK082 | | AKN002 | AKS001 | AKF003 | Existing | PPO | Bronze | 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 | 73836AK0820003-00 | Endeavor Providence Bronze 4000 | Standard Bronze Off Exchange Plan | | 0.605994165 | Yes | Yes | No | 100 | | 4000.00 | 0.00 | 3400.00 | 300.00 | 4000.00 | 0.00 | 1300.00 | 60.00 | 1930.00 | 0.00 | 0.00 | 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 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 4000.00 | $4000 per person | $8000 per group | 50 | | | | | $12,000 | $12000 per person | $24000 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_Bronze4000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Providence_Bronze4000_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0820003 | Endeavor Providence Bronze 4000 | 73836AK082 | | AKN002 | AKS001 | AKF003 | Existing | PPO | Bronze | 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 | 73836AK0820003-01 | Endeavor Providence Bronze 4000 | Standard Bronze On Exchange Plan | | 0.605994165 | Yes | Yes | No | 100 | | 4000.00 | 0.00 | 3400.00 | 300.00 | 4000.00 | 0.00 | 1300.00 | 60.00 | 1930.00 | 0.00 | 0.00 | 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 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 4000.00 | $4000 per person | $8000 per group | 50 | | | | | $12,000 | $12000 per person | $24000 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_Bronze4000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Providence_Bronze4000_SG_2018_AK.pdf |
| 2018 | AK | 73836 | HIOS | 09/02/2017 02:21:00 AM | SHOP (Small Group) | No | 93-0989307 | 73836AK0820004 | Endeavor Providence Bronze 5000 | 73836AK082 | | AKN002 | AKS001 | AKF003 | Existing | PPO | Bronze | 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 | 73836AK0820004-00 | Endeavor Providence Bronze 5000 | Standard Bronze Off Exchange Plan | | 0.59409672 | Yes | Yes | No | 100 | | 5000.00 | 0.00 | 2400.00 | 300.00 | 5000.00 | 0.00 | 900.00 | 60.00 | 1930.00 | 0.00 | 0.00 | 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 | | | | | | | | | | | | | | | | | | | | | | | | | | | | | 5000.00 | $5000 per person | $10000 per group | 50 | | | | | $15,000 | $15000 per person | $30000 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_Bronze5000_SBC_SG_2018_AK.pdf | https://www.modahealth.com/pdfs/ben_sum/AK/170101/Moda_Endeavor_Providence_Bronze5000_SG_2018_AK.pdf |
