Bronze 60 HMO - 47579CA0330001 Health Insurance Plan

Chinese Community Health Plan health insurance plan with the Plan ID 47579CA0330001. The plan is called Bronze 60 HMO.

Based on the data of Health Plan Issuer, this plan has an actuarial value of 64.40% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 35.60% of the costs of all covered benefits (according to the Issuer).

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 65.03% (we converted the output of AV Calculator to percentage to compare with data provided by Issuer, it shows the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 34.97% of the costs of all covered benefits (according to the AV Calculator by CMS.gov). More information about AV Calculator methodology.

Health Insurance Plan ID 47579CA0330001
Health Insurance Plan Year 2024
State California
Health Insurance Issuer Chinese Community Health Plan
Health Insurance Plan Variant 47579CA0330001-01
Provider Network(s) ['CAN001']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Thu, 21 Nov 2024 00:44 GMT).

Providers California All US States
All N/A N/A
PCP N/A N/A
Allergy N/A N/A
OB/GYN N/A N/A
Dentists N/A N/A
Available Variants of the Health Plan

Standard On Exchange Plan - 47579CA0330001-01

Open to Indians below 300% FPL - 47579CA0330001-02

Open to Indians above 300% FPL - 47579CA0330001-03

Last Plan Update Date Mon, 12 Feb 2024 00:00 GMT
Last Import Date Thu, 21 Nov 2024 00:44 GMT

Bronze 60 HMO Health Insurance Plan Variant 47579CA0330001-01 Attributes

Plan Attribute Value
AV Calculator Output Number 0.65034833
Begin Primary Care Deductible Coinsurance After Number Of Copays 3
Business Year 2024
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Bronze On Exchange Plan
Drug EHB Deductible, Combined In/Out of Network, Family per person not applicable | per group not applicable
Drug EHB Deductible, Combined In/Out of Network, Individual Not Applicable
Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 40.00%
Drug EHB Deductible, In Network (Tier 1), Family $500 per person | $1000 per group
Drug EHB Deductible, In Network (Tier 1), Individual $500
Drug EHB Deductible, Out of Network, Family per person not applicable | per group not applicable
Drug EHB Deductible, Out of Network, Individual Not Applicable
Dental Only Plan No
Design Type Not Applicable
Disease Management Programs Offered Pregnancy, High Blood Pressure & High Cholesterol, Diabetes, Heart Disease
EHB Percent of Total Premium 99%
First Tier Utilization 100%
Formulary ID CAF007
HIOS Product ID 47579CA033
Import Date 2/12/2024
HSA Eligible No
IsItANewPlan Existing
Notice Required for Pregnancy No
Is a Referral Required for Specialist? Yes
Issuer Actuarial Value 64.40%
Issuer ID 47579
Market Coverage Individual
Medical Drug Deductibles Integrated No
Medical Drug Maximum Out of Pocket Integrated Yes
Medical EHB Deductible, Combined In/Out of Network, Family per person not applicable | per group not applicable
Medical EHB Deductible, Combined In/Out of Network, Individual Not Applicable
Medical EHB Deductible, In Network (Tier 1), Default Coinsurance 40.00%
Medical EHB Deductible, In Network (Tier 1), Family $6300 per person | $12600 per group
Medical EHB Deductible, In Network (Tier 1), Individual $6,300
Medical EHB Deductible, Out of Network, Family per person not applicable | per group not applicable
Medical EHB Deductible, Out of Network, Individual Not Applicable
Metal Level Expanded Bronze
Multiple In Network Tiers No
National Network No
Network ID CAN001
Out of Country Coverage No
Out of Service Area Coverage No
Plan Effective Date 1/1/2024
Plan ID (Standard Component ID with Variant) 47579CA0330001-01
Plan Marketing Name Bronze 60 HMO
Plan Type HMO
Plan Variant Marketing Name Bronze 60 HMO
QHP/Non QHP On the Exchange
SBC Scenario, Having a Baby, Coinsurance $1,000
SBC Scenario, Having a Baby, Copayment $500
SBC Scenario, Having a Baby, Deductible $6,300
SBC Scenario, Having a Baby, Limit $2,700
SBC Scenario, Having Diabetes, Coinsurance $1,200
SBC Scenario, Having Diabetes, Copayment $200
SBC Scenario, Having Diabetes, Deductible $2,300
SBC Scenario, Having Diabetes, Limit $20
SBC Scenario, Treatment of a Simple Fracture, Coinsurance $0
SBC Scenario, Treatment of a Simple Fracture, Copayment $0
SBC Scenario, Treatment of a Simple Fracture, Deductible $2,400
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID CAS002
Source Name SERFF
Specialist Requiring a Referral All
Specialty Drug Maximum Coinsurance $500
Plan ID 47579CA0330001
State Code CA
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual Not Applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family $9100 per person | $18200 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $9,100
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family per person not applicable | per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual Not Applicable
Unique Plan Design Yes
Version Number 1
Wellness Program Offered Yes

Copay & Coinsurance of Bronze 60 HMO Health Insurance Plan, 47579CA0330001

Drug Tier Pharmacy Type Copay amount Copay option Coinsurance rate Coinsurance option Mail Order

Frequently Asked Questions(FAQ) about Bronze 60 HMO, 47579CA0330001 Health Insurance Plan, 47579CA0330001

  • Does Bronze 60 HMO Health Insurance Plan, 47579CA0330001 support Mail Ordering?

    Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.

  • Does (47579CA0330001) Health Insurance Plan, Variant (47579CA0330001-01) offer Disease Management Programs?

    Yes, and here is the list of available programs: Pregnancy, High Blood Pressure & High Cholesterol, Diabetes, Heart Disease

    Does (47579CA0330001) Health Insurance Plan, Variant (47579CA0330001-01) have Out Of Country Coverage?

    No, unfortunately there is no Out Of Country Coverage for this Health Insurance Plan (variant of plan).

    Does (47579CA0330001) Health Insurance Plan, Variant (47579CA0330001-01) have Out of Service Area Coverage?

    No, unfortunately there is no Out of Service Area Coverage for this Health Insurance Plan (variant of plan).

    Does (47579CA0330001) Health Insurance Plan, Variant (47579CA0330001-01) offer Disease Management Programs?

    Yes, and here is the list of available programs: Pregnancy, High Blood Pressure & High Cholesterol, Diabetes, Heart Disease

    Does Bronze 60 HMO Health Insurance Plan, Variant (47579CA0330001-01) offer Disease Management Programs for Heart disease?

    Yes, the Bronze 60 HMO Health Insurance Plan Variant 47579CA0330001-01 offers Disease Management Program for Heart disease.

    Does Bronze 60 HMO Health Insurance Plan, Variant (47579CA0330001-01) offer Disease Management Programs for Diabetes?

    Yes, the Bronze 60 HMO Health Insurance Plan Variant 47579CA0330001-01 offers Disease Management Program for Diabetes.

    Does Bronze 60 HMO Health Insurance Plan, Variant (47579CA0330001-01) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the Bronze 60 HMO Health Insurance Plan Variant 47579CA0330001-01 offers Disease Management Program for High blood pressure & high cholesterol.

    Does Bronze 60 HMO Health Insurance Plan, Variant (47579CA0330001-01) offer Disease Management Programs for Pregnancy?

    Yes, the Bronze 60 HMO Health Insurance Plan Variant 47579CA0330001-01 offers Disease Management Program for Pregnancy.

 

Disclaimer: This is based on the import(Date: Thu, 21 Nov 2024 00:44 GMT) of the data from Healthcare Issuers listed by CMS. While we make every effort to ensure that data is accurate, you should assume all results are unvalidated. Source: CMS.gov, HealthPorta HEALTHCARE MRF API