Bronze 60 HDHP HMO - 47579CA0540001 Health Insurance Plan

Chinese Community Health Plan health insurance plan with the Plan ID 47579CA0540001. The plan is called Bronze 60 HDHP HMO.

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 64.17% (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 35.83% 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 47579CA0540001
Health Insurance Plan Year 2023
State California
Health Insurance Issuer Chinese Community Health Plan
Health Insurance Plan Variant 47579CA0540001-01
Provider Network(s) ['CAN001']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 07 May 2024 06:08 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 - 47579CA0540001-01

Open to Indians below 300% FPL - 47579CA0540001-02

Open to Indians above 300% FPL - 47579CA0540001-03

Last Plan Update Date Mon, 17 Apr 2023 00:00 GMT
Last Import Date Tue, 07 May 2024 06:08 GMT

Bronze 60 HDHP HMO Health Insurance Plan Variant 47579CA0540001-01 Attributes

Plan Attribute Value
AV Calculator Output Number 0.641674935
Business Year 2023
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Bronze On Exchange Plan
Dental Only Plan No
Design Type Not Applicable
Disease Management Programs Offered Heart Disease, Diabetes, Pregnancy, High Blood Pressure & High Cholesterol
EHB Percent of Total Premium 100%
First Tier Utilization 100%
Formulary ID CAF008
HIOS Product ID 47579CA054
Import Date 4/17/2023
HSA Eligible Yes
IsItANewPlan Existing
Notice Required for Pregnancy No
Is a Referral Required for Specialist? Yes
Issuer ID 47579
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
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 1/1/2023
Plan ID (Standard Component ID with Variant) 47579CA0540001-01
Plan Marketing Name Bronze 60 HDHP HMO
Plan Type HMO
Plan Variant Marketing Name Bronze 60 HDHP HMO
QHP/Non QHP On the Exchange
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $7,000
SBC Scenario, Having a Baby, Limit $2,700
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $0
SBC Scenario, Having Diabetes, Deductible $5,400
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 $40
Service Area ID CAS002
Source Name SERFF
Specialist Requiring a Referral All
Plan ID 47579CA0540001
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
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family per person not applicable | per group not applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual Not Applicable
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance 0.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family $7000 per person | $14000 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $7,000
TEHBDedOutofNetFamily per person not applicable | per group not applicable
Combined Medical and Drug EHB Deductible, Out of Network, Individual Not Applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family $7000 per person | $14000 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $7,000
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 No
Version Number 1
Wellness Program Offered Yes

Copay & Coinsurance of Bronze 60 HDHP HMO Health Insurance Plan, 47579CA0540001

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

Frequently Asked Questions(FAQ) about Bronze 60 HDHP HMO, 47579CA0540001 Health Insurance Plan, 47579CA0540001

  • Does Bronze 60 HDHP HMO Health Insurance Plan, 47579CA0540001 support Mail Ordering?

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

  • Does (47579CA0540001) Health Insurance Plan, Variant (47579CA0540001-01) offer Disease Management Programs?

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

    Does (47579CA0540001) Health Insurance Plan, Variant (47579CA0540001-01) have Out Of Country Coverage?

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

    Does (47579CA0540001) Health Insurance Plan, Variant (47579CA0540001-01) 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 (47579CA0540001) Health Insurance Plan, Variant (47579CA0540001-01) offer Disease Management Programs?

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

    Does Bronze 60 HDHP HMO Health Insurance Plan, Variant (47579CA0540001-01) offer Disease Management Programs for Heart disease?

    Yes, the Bronze 60 HDHP HMO Health Insurance Plan Variant 47579CA0540001-01 offers Disease Management Program for Heart disease.

    Does Bronze 60 HDHP HMO Health Insurance Plan, Variant (47579CA0540001-01) offer Disease Management Programs for Diabetes?

    Yes, the Bronze 60 HDHP HMO Health Insurance Plan Variant 47579CA0540001-01 offers Disease Management Program for Diabetes.

    Does Bronze 60 HDHP HMO Health Insurance Plan, Variant (47579CA0540001-01) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the Bronze 60 HDHP HMO Health Insurance Plan Variant 47579CA0540001-01 offers Disease Management Program for High blood pressure & high cholesterol.

    Does Bronze 60 HDHP HMO Health Insurance Plan, Variant (47579CA0540001-01) offer Disease Management Programs for Pregnancy?

    Yes, the Bronze 60 HDHP HMO Health Insurance Plan Variant 47579CA0540001-01 offers Disease Management Program for Pregnancy.

 

Disclaimer: This is based on the import(Date: Tue, 07 May 2024 06:08 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