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Home > Members > ME 2018 Individual Market

Schedules of Benefits and SBCs: Maine

Individual Market effective 1/1/18

HMO - ON EXCHANGE without Dental SOB SBC
Gold HMO 1500 MD0000004577
Bronze HMO 6500 MD0000004579
Maine's ChoiceSM HSA HMO 5000 MD0000004580
Silver HMO MD0000004582
Maine's ChoiceSM Casco Silver HMO MD0000004586
Maine's ChoiceSM Sebago Silver HMO MD0000004590
Maine's ChoiceSM Pemaquid Silver HMO MD0000004594
Best Buy HSA HMO 5400 MD0000004666

HMO - ON EXCHANGE without Dental - AI/AN - $0 SOB SBC
HMO MD0000004578
HMO MD0000004578
Maine's ChoiceSM HMO MD0000004581
HMO MD0000004578
Maine's ChoiceSM HMO MD0000004581
Maine's ChoiceSM HMO MD0000004581
Maine's ChoiceSM HMO MD0000004581
HMO MD0000004578

HMO - ON EXCHANGE without Dental - AI/AN - LIMITED SOB SBC
Gold HMO 1500 MD0000004577
Bronze HMO 6500 MD0000004579
Maine's ChoiceSM HSA HMO 5000 MD0000004580
Silver HMO MD0000004582
Maine's ChoiceSM Casco Silver HMO MD0000004586
Maine's ChoiceSM Sebago Silver HMO MD0000004590
Maine's ChoiceSM Pemaquid Silver HMO MD0000004594
Best Buy HSA HMO 5400 MD0000004666

HMO - ON EXCHANGE without Dental - CSR - 73% SOB SBC
Silver HMO MD0000004585
Maine's ChoiceSM Casco Silver HMO MD0000004589
Maine's ChoiceSM Sebago Silver HMO MD0000004593
Maine's ChoiceSM Pemaquid Silver HMO MD0000004597

HMO - ON EXCHANGE without Dental - CSR - 87% SOB SBC
Silver HMO MD0000004584
Maine's ChoiceSM Casco Silver HMO MD0000004588
Maine's ChoiceSM Sebago Silver HMO MD0000004592
Maine's ChoiceSM Pemaquid Silver HMO MD0000004596

HMO - ON EXCHANGE without Dental - CSR - 94% SOB SBC
Silver HMO MD0000004583
Maine's ChoiceSM Casco Silver HMO MD0000004587
Maine's ChoiceSM Sebago Silver HMO MD0000004591
Maine's ChoiceSM Pemaquid Silver HMO MD0000004595

HMO - OFF EXCHANGE with Dental SOB SBC
Gold HMO 1500 MD0000004577
Bronze HMO 6500 MD0000004579
Maine's ChoiceSM HSA HMO 5000 MD0000004580
Silver HMO MD0000004582
Maine's ChoiceSM Casco Silver HMO MD0000004586
Maine's ChoiceSM Sebago Silver HMO MD0000004590
Maine's ChoiceSM Pemaquid Silver HMO MD0000004594
Best Buy HSA HMO 5400 MD0000004666

HMO - OFF EXCHANGE without Dental SOB SBC
Gold HMO 1500 MD0000004577
Bronze HMO 6500 MD0000004579
Maine's ChoiceSM HSA HMO 5000 MD0000004580
Silver HMO MD0000004582
Maine's ChoiceSM Casco Silver HMO MD0000004586
Maine's ChoiceSM Sebago Silver HMO MD0000004590
Maine's ChoiceSM Pemaquid Silver HMO MD0000004594
Best Buy HSA HMO 5400 MD0000004666