All Individual and Family Plans

Off-Exchange and Marketplace Plans

† Please be aware that these are sample versions of our member certificates/policies. Please see disclaimer copy below.

• Catastrophic
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Catastrophic On Exchange †
  • Policy - Catastrophic Off Exchange †
• Standard Bronze
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Child Only On Exchange †
  • Policy - Individual Off Exchange †
  • Policy - Child Only Off Exchange †
• Standard Bronze HSA
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Individual Off Exchange †
• Standard Silver
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Child Only On Exchange †
  • Policy - Individual Off Exchange †
  • Policy - Child Only Off Exchange †
• Standard Gold
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Child Only On Exchange †
  • Policy - Individual Off Exchange †
  • Policy - Child Only Off Exchange †
• Standard Platinum
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Child Only On Exchange †
  • Policy - Individual Off Exchange †
  • Policy - Child Only Off Exchange †
• Tradition Platinum 30/30 High Rx
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Individual Off Exchange †
• Tradition Platinum 30/30 Low Rx
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Individual Off Exchange †
• Tradition Gold 30/50 High Rx
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Individual Off Exchange †
• Tradition Gold 30/50 Low Rx
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Individual Off Exchange †
• Tradition Silver 40/60 High Rx
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Individual Off Exchange †
• Tradition Silver 40/60 Low Rx
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Individual Off Exchange †
• Bronze HSA 70%
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Individual Off Exchange †
• Value Platinum 100%
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Individual Off Exchange †
• Value Gold 100%
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Individual Off Exchange †
• Value Silver 100%
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual Off Exchange †
• Value Silver 75%
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Individual Off Exchange †

On-Exchange/Marketplace-Only Plans

• Standard Silver CSR 200-250 *
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Child Only On Exchange †
• Standard Silver CSR 150-200 *
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Child Only On Exchange †
• Standard Silver CSR 100-150 *
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
  • Policy - Child Only On Exchange †
• Tradition Silver 40/60 High Rx CSR 200-250 *
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
• Tradition Silver 40/60 Low Rx CSR 200-250 *
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †
• Value Silver 75% CSR 200-250 *
  • Summary of Benefits and Coverage (SBC)
  • Schedule of Benefits (SOB) †
  • Policy - Individual On Exchange †

* Please note that these plans are only available through the New York State Exchange. Availability is dependent on household income and size.

† Please be aware that these are sample versions of our member certificates/policies. In some cases they reflect, in brackets, the multiple plan design options available for purchase through CareConnect. The certificate or policy you receive in the mail after enrolling with CareConnect will be customized to reflect the exact terms of the plan you have purchased. For example, acupuncture is only included in certain of our plan designs; you may notice that a description of the acupuncture benefit appears in brackets in our sample certificate/policy. If you enroll in a plan that includes acupuncture as a covered benefit CareConnect will send you a certificate or policy that includes a description of the acupuncture benefit. If you enroll in a plan that does not include acupuncture as a covered benefit CareConnect will send you a certificate of policy that omits a description of the acupuncture benefit.