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Home > Members > ME 2017 Individual Market

Schedules of Benefits and SBCs: Maine

Individual Market effective 1/1/17

HMO - ON EXCHANGE without Dental SOB SBC
Gold HMO 1000 MD0000004293
Bronze HMO 6000 MD0000004294
Silver HMO MD0000004295
Maine's ChoiceSM Gold HMO MD0000004299
Maine's ChoiceSM Casco Silver HMO MD0000004300
Maine's ChoiceSM Sebago Silver HMO MD0000004304
Maine's ChoiceSM Pemaquid Silver HMO MD0000004308
Best Buy HSA HMO 5400 MD0000004312

HMO - ON EXCHANGE without Dental - AI/AN - $0 SOB SBC
HMO MD0000004316
HMO MD0000004316
HMO MD0000004316
HMO MD0000004316
Maine's ChoiceSM HMO MD0000004317
Maine's ChoiceSM HMO MD0000004317
Maine's ChoiceSM HMO MD0000004317
Maine's ChoiceSM HMO MD0000004317

HMO - ON EXCHANGE without Dental - AI/AN - LIMITED SOB SBC
Gold HMO 1000 MD0000004293
Bronze HMO 6000 MD0000004294
Silver HMO MD0000004295
Maine's ChoiceSM Gold HMO MD0000004299
Maine's ChoiceSM Casco Silver HMO MD0000004300
Maine's ChoiceSM Sebago Silver HMO MD0000004304
Maine's ChoiceSM Pemaquid Silver HMO MD0000004308
Best Buy HSA HMO 5400 MD0000004312

HMO - ON EXCHANGE without Dental - CSR - 73% SOB SBC
Silver HMO MD0000004298
Maine's ChoiceSM Casco Silver HMO MD0000004303
Maine's ChoiceSM Sebago Silver HMO MD0000004307
Maine's ChoiceSM Pemaquid Silver HMO MD0000004311

HMO - ON EXCHANGE without Dental - CSR - 87% SOB SBC
Silver HMO MD0000004296
Maine's ChoiceSM Casco Silver HMO MD0000004302
Maine's ChoiceSM Sebago Silver HMO MD0000004306
Maine's ChoiceSM Pemaquid Silver HMO MD0000004310

HMO - ON EXCHANGE without Dental - CSR - 94% SOB SBC
Silver HMO MD0000004297
Maine's ChoiceSM Casco Silver HMO MD0000004301
Maine's ChoiceSM Sebago Silver HMO MD0000004305
Maine's ChoiceSM Pemaquid Silver HMO MD0000004309

HMO - OFF EXCHANGE with Dental SOB SBC
Gold HMO 1000 MD0000004293
Bronze HMO 6000 MD0000004294
Silver HMO MD0000004295
Maine's ChoiceSM Gold HMO MD0000004299
Maine's ChoiceSM Casco Silver HMO MD0000004300
Maine's ChoiceSM Sebago Silver HMO MD0000004304
Maine's ChoiceSM Pemaquid Silver HMO MD0000004308
Best Buy HSA HMO 5400 MD0000004312

HMO - OFF EXCHANGE without Dental SOB SBC
Gold HMO 1000 MD0000004293
Bronze HMO 6000 MD0000004294
Silver HMO MD0000004295
Maine's ChoiceSM Gold HMO MD0000004299
Maine's ChoiceSM Casco Silver HMO MD0000004300
Maine's ChoiceSM Sebago Silver HMO MD0000004304
Maine's ChoiceSM Pemaquid Silver HMO MD0000004308
Best Buy HSA HMO 5400 MD0000004312