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Everything you need for your Maine coverage.

2024 Individual & Family Plans

Summary of Benefits and Coverage (SBC)
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OffEx
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Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx
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Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx ZCS
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Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx LCS
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OffEx
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx ZCS
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx LCS
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 73%
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 87%
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 94%
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Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OffEx
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Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx
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Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx ZCS
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Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx LCS
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Clear Choice Bronze 9450 - OffEx
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Clear Choice Bronze 9450 - OnEx
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Clear Choice Bronze 9450 - OnEx ZCS
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Clear Choice Bronze 9450 - OnEx LCS
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Clear Choice Bronze 7200 HSA - OffEx
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Clear Choice Bronze 7200 HSA - OnEx
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Clear Choice Bronze 7200 HSA - OnEx ZCS
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Clear Choice Bronze 7200 HSA - OnEx LCS
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Clear Choice Silver 4200 - OffEx
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Clear Choice Silver 4200 - OnEx
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Clear Choice Silver 4200 - OnEx ZCS
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Clear Choice Silver 4200 - OnEx LCS
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Clear Choice Silver 4200 - OnEx CSR 73%
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Clear Choice Silver 4200 - OnEx CSR 87%
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Clear Choice Silver 4200 - OnEx CSR 94%
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Clear Choice Silver 4000 HSA - OffEx
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Clear Choice Gold 2500 - OffEx
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Clear Choice Gold 2500 - OnEx
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Clear Choice Gold 2500 - OnEx ZCS
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Clear Choice Gold 2500 - OnEx LCS
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Schedule of Benefits (SOB)
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OffEx
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Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx
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Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx ZCS
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Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx LCS
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OffEx
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx ZCS
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx LCS
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 73%
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 87%
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 94%
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Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OffEx
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Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx
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Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx ZCS
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Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx LCS
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Clear Choice Bronze 9450 - OffEx
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Clear Choice Bronze 9450 - OnEx
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Clear Choice Bronze 9450 - OnEx ZCS
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Clear Choice Bronze 9450 - OnEx LCS
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Clear Choice Bronze 7200 HSA - OffEx
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Clear Choice Bronze 7200 HSA - OnEx
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Clear Choice Bronze 7200 HSA - OnEx ZCS
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Clear Choice Bronze 7200 HSA - OnEx LCS
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Clear Choice Silver 4200 - OffEx
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Clear Choice Silver 4200 - OnEx
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Clear Choice Silver 4200 - OnEx ZCS
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Clear Choice Silver 4200 - OnEx LCS
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Clear Choice Silver 4200 - OnEx CSR 73%
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Clear Choice Silver 4200 - OnEx CSR 87%
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Clear Choice Silver 4200 - OnEx CSR 94%
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Clear Choice Silver 4000 HSA - OffEx
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Clear Choice Gold 2500 - OffEx
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Clear Choice Gold 2500 - OnEx
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Clear Choice Gold 2500 - OnEx ZCS
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Clear Choice Gold 2500 - OnEx LCS
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Evidence of Coverage (EOC)
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OffEx
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Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx
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Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx ZCS
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Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OnEx LCS
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OffEx
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx ZCS
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx LCS
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 73%
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 87%
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OnEx CSR 94%
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Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OffEx
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Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx
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Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx ZCS
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Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OnEx LCS
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Clear Choice Bronze 9450 - OffEx
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Clear Choice Bronze 9450 - OnEx
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Clear Choice Bronze 9450 - OnEx ZCS
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Clear Choice Bronze 9450 - OnEx LCS
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Clear Choice Bronze 7200 HSA - OffEx
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Clear Choice Bronze 7200 HSA - OnEx
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Clear Choice Bronze 7200 HSA - OnEx ZCS
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Clear Choice Bronze 7200 HSA - OnEx LCS
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Clear Choice Silver 4200 - OffEx
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Clear Choice Silver 4200 - OnEx
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Clear Choice Silver 4200 - OnEx ZCS
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Clear Choice Silver 4200 - OnEx LCS
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Clear Choice Silver 4200 - OnEx CSR 73%
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Clear Choice Silver 4200 - OnEx CSR 87%
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Clear Choice Silver 4200 - OnEx CSR 94%
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Clear Choice Silver 4000 HSA - OffEx
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Clear Choice Gold 2500 - OffEx
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Clear Choice Gold 2500 - OnEx
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Clear Choice Gold 2500 - OnEx ZCS
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Clear Choice Gold 2500 - OnEx LCS
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2024 Small Group Plans

Summary of Benefits and Coverage (SBC)
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OffEx
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OffEx
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Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OffEx
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Clear Choice Bronze 9450 - OffEx
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Clear Choice Bronze 7200 HSA - OffEx
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Clear Choice Silver 4200 - OffEx
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Clear Choice Silver 4000 HSA - OffEx
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Clear Choice Gold 2500 - OffEx
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Schedule of Benefits (SOB)
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OffEx
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OffEx
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Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OffEx
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Clear Choice Bronze 9450 - OffEx
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Clear Choice Bronze 7200 HSA - OffEx
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Clear Choice Silver 4200 - OffEx
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Clear Choice Silver 4000 HSA - OffEx
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Clear Choice Gold 2500 - OffEx
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Evidence of Coverage (EOC)
Direct Primary Care Bronze ($0 PCP, Mental Health + $15 Labs) - OffEx
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Direct Primary Care Silver ($0 PCP, Mental Health, Labs, Generics) - OffEx
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Direct Primary Care Gold ($0 PCP, Mental Health, Labs, Generics, $0 Deduct) - OffEx
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Clear Choice Bronze 9450 - OffEx
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Clear Choice Bronze 7200 HSA - OffEx
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Clear Choice Silver 4200 - OffEx
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Clear Choice Silver 4000 HSA - OffEx
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Clear Choice Gold 2500 - OffEx
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2023 Individual & Family Plans

Summary of Benefits and Coverage (SBC)
Bronze Specialist Saver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health) - OffEx
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Bronze Specialist Saver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health) - OnEx
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Bronze Specialist Saver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health) - OnEx ZCS
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Bronze Specialist Saver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health) - OnEx LCS
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OffEx
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx ZCS
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx LCS
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx CSR 73%
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx CSR 87%
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx CSR 94%
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Gold 0000 $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs & X-Rays) 50% Coinsurance - OffEx
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Gold 0000 $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs & X-Rays) 50% Coinsurance - OnEx
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Gold 0000 $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs & X-Rays) 50% Coinsurance - OnEx ZCS
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Gold 0000 $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs & X-Rays) 50% Coinsurance - OnEx LCS
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Clear Choice Enhanced Bronze 9100 - OffEx
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Clear Choice Enhanced Bronze 9100 - OnEx
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Clear Choice Enhanced Bronze 9100 - OnEx ZCS
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Clear Choice Enhanced Bronze 9100 - OnEx LCS
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Clear Choice Silver 3000 - OffEx
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Clear Choice Silver 3000 - OnEx
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Clear Choice Silver 3000 - OnEx ZCS
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Clear Choice Silver 3000 - OnEx LCS
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Clear Choice Silver 3000 - OnEx CSR 73%
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Clear Choice Silver 3000 - OnEx CSR 87%
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Clear Choice Silver 3000 - OnEx CSR 94%
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Clear Choice Gold 1500 - OffEx
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Clear Choice Gold 1500 - OnEx
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Clear Choice Gold 1500 - OnEx ZCS
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Clear Choice Gold 1500 - OnEx LCS
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Schedule of Benefits (SOB)
Bronze Specialist Saver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health) - OffEx
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Bronze Specialist Saver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health) - OnEx
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Bronze Specialist Saver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health) - OnEx ZCS
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Bronze Specialist Saver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health) - OnEx LCS
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OffEx
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx ZCS
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx LCS
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx CSR 73%
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx CSR 87%
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx CSR 94%
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Gold 0000 $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs & X-Rays) 50% Coinsurance - OffEx
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Gold 0000 $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs & X-Rays) 50% Coinsurance - OnEx
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Gold 0000 $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs & X-Rays) 50% Coinsurance - OnEx ZCS
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Gold 0000 $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs & X-Rays) 50% Coinsurance - OnEx LCS
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Clear Choice Enhanced Bronze 9100 - OffEx
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Clear Choice Enhanced Bronze 9100 - OnEx
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Clear Choice Enhanced Bronze 9100 - OnEx ZCS
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Clear Choice Enhanced Bronze 9100 - OnEx LCS
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Clear Choice Silver 3000 - OffEx
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Clear Choice Silver 3000 - OnEx
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Clear Choice Silver 3000 - OnEx ZCS
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Clear Choice Silver 3000 - OnEx LCS
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Clear Choice Silver 3000 - OnEx CSR 73%
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Clear Choice Silver 3000 - OnEx CSR 87%
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Clear Choice Silver 3000 - OnEx CSR 94%
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Clear Choice Gold 1500 - OffEx
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Clear Choice Gold 1500 - OnEx
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Clear Choice Gold 1500 - OnEx ZCS
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Clear Choice Gold 1500 - OnEx LCS
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Evidence of Coverage (EOC)
Bronze Specialist Saver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health) - OffEx
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Bronze Specialist Saver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health) - OnEx
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Bronze Specialist Saver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health) - OnEx ZCS
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Bronze Specialist Saver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health) - OnEx LCS
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OffEx
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx ZCS
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx LCS
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx CSR 73%
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx CSR 87%
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OnEx CSR 94%
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Gold 0000 $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs & X-Rays) 50% Coinsurance - OffEx
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Gold 0000 $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs & X-Rays) 50% Coinsurance - OnEx
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Gold 0000 $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs & X-Rays) 50% Coinsurance - OnEx ZCS
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Gold 0000 $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs & X-Rays) 50% Coinsurance - OnEx LCS
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Clear Choice Enhanced Bronze 9100 - OffEx
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Clear Choice Enhanced Bronze 9100 - OnEx
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Clear Choice Enhanced Bronze 9100 - OnEx ZCS
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Clear Choice Enhanced Bronze 9100 - OnEx LCS
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Clear Choice Silver 3000 - OffEx
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Clear Choice Silver 3000 - OnEx
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Clear Choice Silver 3000 - OnEx ZCS
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Clear Choice Silver 3000 - OnEx LCS
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Clear Choice Silver 3000 - OnEx CSR 73%
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Clear Choice Silver 3000 - OnEx CSR 87%
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Clear Choice Silver 3000 - OnEx CSR 94%
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Clear Choice Gold 1500 - OffEx
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Clear Choice Gold 1500 - OnEx
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Clear Choice Gold 1500 - OnEx ZCS
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Clear Choice Gold 1500 - OnEx LCS
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2023 Small Group Plans

Summary of Benefits and Coverage (SBC)
Bronze Specialist Saver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health) - OffEx
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OffEx
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Gold 0000 $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs & X-Rays) 50% Coinsurance - OffEx
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Clear Choice Enhanced Bronze 9100 - OffEx
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Clear Choice Silver 3000 - OffEx
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Clear Choice Gold 1500 - OffEx
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Schedule of Benefits (SOB)
Bronze Specialist Saver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health) - OffEx
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OffEx
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Gold 0000 $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs & X-Rays) 50% Coinsurance - OffEx
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Clear Choice Enhanced Bronze 9100 - OffEx
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Clear Choice Silver 3000 - OffEx
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Clear Choice Gold 1500 - OffEx
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Evidence of Coverage (EOC)
Bronze Specialist Saver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health) - OffEx
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Silver $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs) - OffEx
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Gold 0000 $0 Direct Primary Care + $0 Copays (Telehealth + Mental Health + Generic Drugs + Labs & X-Rays) 50% Coinsurance - OffEx
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Clear Choice Enhanced Bronze 9100 - OffEx
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Clear Choice Silver 3000 - OffEx
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Clear Choice Gold 1500 - OffEx
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