Virginia health plan · 2025

Connect Bronze 0/4900 Indiv Medical/Rx Deductible · 41921VA0020073

Cigna Health and Life Insurance Company offers this marketplace health insurance plan (Plan ID 41921VA0020073) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.

Metal level: Expanded Bronze Plan type: EPO CSR: Limited Cost Sharing Plan Variation Issuer: Cigna Health and Life Insurance Company
Telehealth Data pending HSA eligible No Dental Not listed Vision Not listed
View issuer site

Issuer actuarial value: 64.98%. Expect to pay roughly 35.02% of covered costs out of pocket, based on issuer reporting.

CMS AV Calculator output: 69.93% (30.07% member share on average). Learn about AV methodology.

2025 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 02 Dec 2025 06:13 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.

Monthly premium

See plan search for live pricing

Before subsidies

Estimate after subsidies

Deductible

N/A

N/A

See deductible details

Max out-of-pocket

$9,200

N/A

Review MOOP rules

Office visits

Primary care See benefits
Specialist See benefits
HSA Not eligible

Drug tiers

Generic See drug coverage
Preferred brand See drug coverage

View formulary tiers

Issuer profile See benefits
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Enrollment guidance

Stay on top of 2025 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2025 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Virginia). Submit changes before the deadline to avoid a coverage gap.

  • Enroll by Dec 15 for Jan 1 starts.
  • Finalize plan switches before the window closes.

Special Enrollment Periods

You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).

  • Report the event within 60 days.
  • Keep documentation handy for Healthcare.gov or your state exchange.

CSR & subsidy reminders

Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.

  • Enter accurate income to maximize Advanced Premium Tax Credits.
  • Limited Cost Sharing Plan Variation plans like this one keep deductibles and copays lower if you qualify.

Thinking about switching?

Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.

  • Match provider networks so ongoing care isn’t disrupted.
  • Confirm prescriptions stay on-formulary or budget for tier changes.

Premium snapshot

Plan identifiers & filings

Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.

Plan ID 41921VA0020073
Coverage year 2025
State Virginia
Issuer Cigna Health and Life Insurance Company
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 41921VA0020073-03
Available variants

Standard On Exchange Plan · 41921VA0020073-01

Open to Indians below 300% FPL · 41921VA0020073-02

Open to Indians above 300% FPL · 41921VA0020073-03
Last plan update Fri, 24 Oct 2025 00:00 GMT
Last HealthPorta import Tue, 02 Dec 2025 06:13 GMT

Network stats

Provider access snapshot

Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).

All providers in Virginia N/A
PCPs in Virginia N/A
Telehealth support Data pending
Nationwide providers N/A
N/A doctors statewide N/A PCPs N/A OB/GYN

Provider network(s)

['VIRGINIACONNECTNETWORK']

Providers Virginia 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

Drug coverage overview

4,702 drugs tracked

Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.

Tier Covered drugs
GENERIC 1,901
PREFERRED-BRAND 1,276
SPECIALTY-AND-OTHER-HIGH-COST-DRUGS 534
PREFERRED-GENERIC 532
NON-PREFERRED 459
Prior authorization Drugs
Required 785
Not Required 3,917
Step therapy Drugs
Required 42
Not Required 4,660
Quantity limits Drugs
Has Limit 973
No Limit 3,729

Customer highlights

What stands out for members

  • Issuer: Cigna Health and Life Insurance Company · Plan ID 41921VA0020073 · 2025 filing.
  • Disease management programs available: Pregnancy, High Blood Pressure & High Cholesterol, Diabetes, Heart Disease, Asthma.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 41921VA0020073-03 (Open to Indians above 300% FPL) currently displayed.
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Variant attributes

Connect Bronze 0/4900 Indiv Medical/Rx Deductible · Variant 41921VA0020073-03

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2025

CSR Variation Type

Limited Cost Sharing Plan Variation

HIOS Product ID

41921VA002

Metal Level

Expanded Bronze

Plan ID (Standard Component ID with Variant)

41921VA0020073-03

Plan Marketing Name

Connect Bronze 0/4900 Indiv Medical/Rx Deductible

Plan Variant Marketing Name

Connect Bronze-1 0/4900 Indiv Medical/Rx Deductible

Issuer & service area

Issuer-provided metadata for this variant.

Issuer Actuarial Value

64.98%

Issuer ID

41921

Market Coverage

Individual

Multiple In Network Tiers

No

National Network

No

Network ID

VAN001

Out of Country Coverage

Yes

Out of Country Coverage Description

Emergency Only

Out of Service Area Coverage

Yes

Out of Service Area Coverage Description

Emergency Only

Service Area ID

VAS001

State Code

VA

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

AV Calculator Output Number

0.699326086

Drug EHB Deductible, In Network (Tier 1), Default Coinsurance

50.00%

Inpatient Copayment Maximum Days

3

Medical Drug Deductibles Integrated

No

Medical Drug Maximum Out of Pocket Integrated

Yes

Medical EHB Deductible, In Network (Tier 1), Default Coinsurance

50.00%

SBC Scenario, Having a Baby, Coinsurance

$2,200

SBC Scenario, Having a Baby, Copayment

$5,600

SBC Scenario, Having a Baby, Deductible

$0

SBC Scenario, Having Diabetes, Coinsurance

$400

SBC Scenario, Having Diabetes, Copayment

$1,200

SBC Scenario, Having Diabetes, Deductible

$0

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$900

SBC Scenario, Treatment of a Simple Fracture, Copayment

$700

SBC Scenario, Treatment of a Simple Fracture, Deductible

$0

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

$9200 per person | $18400 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual

$9,200

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

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

VAF010

SBC Scenario, Having a Baby, Limit

$60

SBC Scenario, Having Diabetes, Limit

$20

SBC Scenario, Treatment of a Simple Fracture, Limit

$0

Additional attributes

Issuer-provided metadata for this variant.

Child-Only Offering

Allows Adult and Child-Only

Composite Rating Offered

No

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), Family

$4900 per person | $9800 per group

Drug EHB Deductible, In Network (Tier 1), Individual

$4,900

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, Asthma

EHB Percent of Total Premium

100%

First Tier Utilization

100%

Import Date

1/13/2025

HSA Eligible

No

IsItANewPlan

Existing

Notice Required for Pregnancy

No

Is a Referral Required for Specialist?

No

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), Family

$0 per person | $0 per group

Medical EHB Deductible, In Network (Tier 1), Individual

$0

Medical EHB Deductible, Out of Network, Family

per person not applicable | per group not applicable

Medical EHB Deductible, Out of Network, Individual

Not Applicable

Plan Effective Date

1/1/2025

Plan Expiration Date

12/31/2025

Plan Type

EPO

QHP/Non QHP

Both

Source Name

SERFF

Plan ID

41921VA0020073

Unique Plan Design

Yes

Version Number

1

Wellness Program Offered

No

Copay & coinsurance

Pharmacy cost sharing by tier

Drug tier Pharmacy type Copay amount Copay option Coinsurance rate Coinsurance option Mail order

Questions & answers

Frequently asked questions

How do I choose the right ACA plan in Virginia?

Connect Bronze 0/4900 Indiv Medical/Rx Deductible (41921VA0020073) is a Expanded Bronze EPO from Cigna Health and Life Insurance Company in Virginia for the 2025 coverage year.

Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.

Does Connect Bronze 0/4900 Indiv Medical/Rx Deductible support telehealth or virtual urgent care?

The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.

Is Connect Bronze 0/4900 Indiv Medical/Rx Deductible HSA-eligible and does it include dental or vision coverage?

It is not marked as HSA-eligible, so confirm with the issuer before relying on tax-advantaged savings.

Dental coverage is not listed for this plan.

Vision coverage is not listed for this plan.

Does Connect Bronze 0/4900 Indiv Medical/Rx Deductible support mail-order prescriptions?

Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.

Which disease management programs come with Connect Bronze 0/4900 Indiv Medical/Rx Deductible?

The issuer lists disease management resources for: Pregnancy, High Blood Pressure & High Cholesterol, Diabetes, Heart Disease, Asthma.

Is there out-of-country coverage for Connect Bronze 0/4900 Indiv Medical/Rx Deductible?

Yes, limited out-of-country coverage is available. Review the Summary of Benefits for reimbursement steps. Details: Emergency Only

Does Connect Bronze 0/4900 Indiv Medical/Rx Deductible cover care outside the service area?

Yes, you have limited out-of-area coverage. See the plan documents for referral and prior authorization rules. Details: Emergency Only

Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
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