2027 Schedules of Benefits and SBCs: Maine

Individual Market effective 1/1/27

HMO - OFF EXCHANGE with dental SOBSBC
Clear Choice HMO Gold 2000 MD0000201883
Clear Choice Maine's Choice Plus HMO Gold 2000 MD0000201885
Clear Choice HMO Gold 3000 MD0000201886
Clear Choice Maine's Choice Plus HMO Gold 3000 MD0000201888
Clear Choice HMO Silver 4500 MD0000201896
Clear Choice Maine's Choice Plus HMO Silver 4500 MD0000201901
Clear Choice HMO Silver 6000 MD0000201916
Clear Choice Maine's Choice Plus HMO Silver 6000 MD0000201920
Maine's Choice Plus HMO HSA Bronze 7200 MD0000201926
HMO HSA Bronze 7200 MD0000201933
Clear Choice HMO HSA Bronze 7500 MD0000201934
Clear Choice Maine's Choice Plus HMO HSA Bronze 7500 MD0000201935
HMO - OFF EXCHANGE without dental SOBSBC
Clear Choice HMO Gold 2000 MD0000201883
Clear Choice HMO Gold 3000 MD0000201886
Clear Choice Maine's Choice Plus HMO Gold 3000 MD0000201888
Clear Choice HMO Silver 4500 MD0000201896
Clear Choice Maine's Choice Plus HMO Silver 4500 MD0000201901
Clear Choice HMO Silver 6000 MD0000201916
Clear Choice Maine's Choice Plus HMO Silver 6000 MD0000201920
Clear Choice HMO HSA Bronze 7500 MD0000201934
Clear Choice Maine's Choice Plus HMO HSA Bronze 7500 MD0000201935
HMO - ON EXCHANGE without dental SOBSBC
Clear Choice HMO Gold 2000 MD0000201883
Clear Choice HMO Gold 3000 MD0000201886
Clear Choice Maine's Choice Plus HMO Gold 3000 MD0000201888
Clear Choice HMO Silver 4500 MD0000201900
Clear Choice Maine's Choice Plus HMO Silver 4500 MD0000201906
Clear Choice HMO Silver 6000 MD0000201940
Clear Choice Maine's Choice Plus HMO Silver 6000 MD0000201931
Clear Choice HMO HSA Bronze 7500 MD0000201934
Clear Choice Maine's Choice Plus HMO HSA Bronze 7500 MD0000201935
HMO - ON EXCHANGE without dental - AI/AN - LimitedSOBSBC
Clear Choice HMO Gold 2000 MD0000201883
Clear Choice HMO Gold 3000 MD0000201886
Clear Choice Maine's Choice Plus HMO Gold 3000 MD0000201888
Clear Choice HMO Silver 4500 MD0000201896
Clear Choice Maine's Choice Plus HMO Silver 4500 MD0000201901
Clear Choice HMO Silver 6000 MD0000201916
Clear Choice Maine's Choice Plus HMO Silver 6000 MD0000201920
Clear Choice HMO HSA Bronze 7500 MD0000201934
Clear Choice Maine's Choice Plus HMO HSA Bronze 7500 MD0000201935
HMO - ON EXCHANGE without dental - AI/AN - $0SOBSBC
HMO CSR 100 MD0000201884
HMO CSR 100 MD0000201884
Maine's Choice Plus HMO CSR 100 MD0000201890
HMO CSR 100 MD0000201884
Maine's Choice Plus HMO CSR 100 MD0000201890
HMO CSR 100 MD0000201884
Maine's Choice Plus HMO CSR 100 MD0000201890
HMO CSR 100 MD0000201884
Maine's Choice Plus HMO CSR 100 MD0000201890
EPO - OFF EXCHANGE with dental SOBSBC
Clear Choice National Access Gold 3000 MD0000201889
Clear Choice National Access Silver 4500 MD0000201907
Clear Choice National Access HSA Bronze 7500 MD0000201938
EPO - OFF EXCHANGE without dental SOBSBC
Clear Choice National Access Gold 3000 MD0000201889
Clear Choice National Access Silver 4500 MD0000201907
Clear Choice National Access HSA Bronze 7500 MD0000201938
EPO - ON EXCHANGE without dental SOBSBC
Clear Choice National Access Gold 3000 MD0000201889
Clear Choice National Access Silver 4500 MD0000201930
Clear Choice National Access HSA Bronze 7500 MD0000201938
EPO - ON EXCHANGE without dental - AI/AN - LimitedSOBSBC
Clear Choice National Access Gold 3000 MD0000201889
Clear Choice National Access Silver 4500 MD0000201907
Clear Choice National Access HSA Bronze 7500 MD0000201938
EPO - ON EXCHANGE without dental - AI/AN - $0SOBSBC
National Access CSR 100 MD0000201891
National Access CSR 100 MD0000201891
National Access CSR 100 MD0000201891
HMO - ON EXCHANGE without dental - CSR - 73%SOBSBC
Clear Choice HMO Silver 3600 CSR 73 MD0000201897
Clear Choice Maine's Choice Plus HMO Silver 3600 CSR 73 MD0000201903
Clear Choice HMO Silver 4500 CSR 73 MD0000201917
Clear Choice Maine's Choice Plus HMO Silver 4500 CSR 73 MD0000201921
HMO - ON EXCHANGE without dental - CSR - 87%SOBSBC
Clear Choice HMO Silver 800 CSR 87 MD0000201898
Clear Choice Maine's Choice Plus HMO Silver 800 CSR 87 MD0000201904
Clear Choice HMO Silver 1000 CSR 87 MD0000201918
Clear Choice Maine's Choice Plus HMO Silver 1000 CSR 87 MD0000201922
HMO - ON EXCHANGE without dental - CSR - 94%SOBSBC
Clear Choice HMO Silver 400 CSR 94 MD0000201899
Clear Choice Maine's Choice Plus HMO Silver 400 CSR 94 MD0000201905
Clear Choice HMO Silver 500 CSR 94 MD0000201919
Clear Choice Maine's Choice Plus HMO Silver 500 CSR 94 MD0000201923
EPO - ON EXCHANGE without dental - CSR - 73%SOBSBC
Clear Choice National Access Silver 3600 CSR 73 MD0000201927
EPO - ON EXCHANGE without dental - CSR - 87%SOBSBC
Clear Choice National Access Silver 800 CSR 87 MD0000201928
EPO - ON EXCHANGE without dental - CSR - 94%SOBSBC
Clear Choice National Access Silver 400 CSR 94 MD0000201929