2025 Non-Marketplace Health Insurance Plans

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*RX Coverage: Generic/Preferred Brand/Non-Preferred Brand Copay.

When you click one of the View buttons below, your Summary of Benefits and Coverage or Policy will pull up in PDF Format.
Al hacer clic en uno de los botones de Ver que están a continuación, su Resumen de Beneficios y Cobertura o póliza saldrá a la ver en formato PDF.

SBC Policy Plan Number Network Maternity In-Network
Deductible Amount		 Primary Care
Practitioner/Specialist
Copay		 Teladoc Coinsurance
Percent		 Out-of-Pocket
Maximum		 RX Coverage*
View View Bronze B07E E Yes $5,950 Individual/  $11,900 Family ded/coins ded/coins 0.5 $7,100 Individual/  $14,200 Family ded/coins
View View Bronze B07S S Yes $5,950 Individual/  $11,900 Family ded/coins ded/coins 0.5 $7,100 Individual/  $14,200 Family ded/coins
View View Bronze B15E E Yes $9,200 Individual/  $18,400 Family ded/coins $0 0.0 $9,200 Individual/  $18,400 Family ded/coins
View View Bronze B15S S Yes $9,200 Individual/  $18,400 Family ded/coins $0 0.0 $9,200 Individual/  $18,400 Family ded/coins
View View Bronze B16E E Yes $7,500 Individual/  $15,000 Family PCP: $50 Spec: $100 $0 0.5 $9,200 Individual/  $18,400 Family 25/ [50/100 sub to ded]
View View Bronze B16S S Yes $7,500 Individual/  $15,000 Family PCP: $50 Spec: $100 $0 0.5 $9,200 Individual/  $18,400 Family 25/ [50/100 sub to ded]
View View Bronze B17E E Yes $9,200 Individual/  $18,400 Family ded/coins $0 0.0 $9,200 Individual/  $18,400 Family ded/coins
View View Bronze B17S S Yes $9,200 Individual/  $18,400 Family ded/coins $0 0.0 $9,200 Individual/  $18,400 Family ded/coins
View View Gold G06E E Yes $3,000 Individual/  $6,000 Family PCP: $35 Spec: $50 $0 0.2 $6,600 Individual/  $13,200 Family $8/$35/$60
View View Gold G06S S Yes $3,000 Individual/  $6,000 Family PCP: $35 Spec: $50 $0 0.2 $6,600 Individual/  $13,200 Family $8/$35/$60
View View Gold G08E E Yes $1,500 Individual/  $3,000 Family PCP: $30 Copay Spec: $60 Copay $0 0.25 $7,800 Individual/  $15,600 Family $15/$30/$60
View View Gold G08S S Yes $1,500 Individual/  $3,000 Family PCP: $30 Copay Spec: $60 Copay $0 0.25 $7,800 Individual/  $15,600 Family $15/$30/$60
View View Silver S20E E Yes $3,200 Individual/  $6,400 Family ded/coins $0 0.5 $7,300 Individual/  $14,600 Family ded/coins $20/$50/$100 PRx
View View Silver S20S S Yes $3,200 Individual/  $6,400 Family ded/coins $0 0.5 $7,300 Individual/  $14,600 Family ded/coins $20/$50/$100 PRx
View View Silver S25E E Yes $0 Individual/  $0 Family PCP: $55 Copay Spec: $100 Copay $0 0.5 $8,900 Individual/  $17,800 Family $4500 ded/coins
View View Silver S25S S Yes $0 Individual/  $0 Family PCP: $55 Copay Spec: $100 Copay $0 0.5 $8,900 Individual/  $17,800 Family $4500 ded/coins
View View Silver S26E E Yes $5,000 Individual/  $10,000 Family PCP: $40 Copay Spec: $80 Copay $0 0.4 $8,000 Individual/  $16,000 Family 20/40[80 sub to ded]
View View Silver S26S S Yes $5,000 Individual/  $10,000 Family PCP: $40 Copay Spec: $80 Copay $0 0.4 $8,000 Individual/  $16,000 Family 20/40[80 sub to ded]
View View Silver S27E E Yes $5,300 Individual/  $10,600 Family PCP: $60 Copay Spec: $120 Copay $0 0.5 $6,300 Individual/  $12,600 Family ded/coins
View View Silver S27S S Yes $5,300 Individual/  $10,600 Family PCP: $60 Copay Spec: $120 Copay $0 0.5 $6,300 Individual/  $12,600 Family ded/coins
View View Silver S29E E Yes $5,300 Individual/  $10,600 Family PCP: $60 Copay Spec: $120 Copay $0 0.5 $6,300 Individual/  $12,600 Family ded/coins
View View Silver S29S S Yes $5,300 Individual/  $10,600 Family PCP: $60 Copay Spec: $120 Copay $0 0.5 $6,300 Individual/  $12,600 Family ded/coins