HA Bronze Exp Standardized - 13262AR0230007 Health Insurance Plan

HMO Partners, Inc. health insurance plan with the Plan ID 13262AR0230007. The plan is called HA Bronze Exp Standardized.

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 63.81% (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 36.19% 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 13262AR0230007
Health Insurance Plan Year 2025
State Arkansas
Health Insurance Issuer HMO Partners, Inc.
Plan Formulary Description URL Formulary URL
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 13262AR0230007-00
Provider Network(s) PREFERRED TRUE-BLUE-PPO
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 17 Jun 2025 12:51 GMT).

Providers Arkansas All US States
All 22077 35465
PCP 2213 2847
Allergy 4 6
OB/GYN 71 109
Dentists 632 721
Available Variants of the Health Plan

Standard Off Exchange Plan - 13262AR0230007-00

Standard On Exchange Plan - 13262AR0230007-01

Open to Indians below 300% FPL - 13262AR0230007-02

Open to Indians above 300% FPL - 13262AR0230007-03

Last Plan Update Date Thu, 10 Oct 2024 00:00 GMT
Last Import Date Tue, 17 Jun 2025 12:51 GMT

HA Bronze Exp Standardized Health Insurance Plan Variant 13262AR0230007-00 Attributes

Plan Attribute Value
AV Calculator Output Number 0.638091065338329
Begin Primary Care Cost-Sharing After Number Of Visits 0
Begin Primary Care Deductible Coinsurance After Number Of Copays 0
Business Year 2025
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard Bronze Off Exchange Plan
Dental Only Plan No
Design Type Design 1
Disease Management Programs Offered Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs
EHB Percent of Total Premium 0.9996
First Tier Utilization 100%
Formulary ID ARF006
Formulary URL URL
HIOS Product ID 13262AR023
Import Date 2024-10-10 20:01:47
Limited Cost Sharing Plan Variation - Estimated Advanced Payment $0.00
Inpatient Copayment Maximum Days 0
HSA Eligible No
New/Existing Plan Existing
Notice Required for Pregnancy Yes
Is a Referral Required for Specialist? No
Issuer ID 13262
Issuer Marketplace Marketing Name Health Advantage
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 ARN001
Out of Country Coverage Yes
Out of Country Coverage Description Emergency Care
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Benefit Reduction
Plan Brochure URL
Plan Effective Date 2025-01-01
Plan Expiration Date 2025-12-31
Plan ID (Standard Component ID with Variant) 13262AR0230007-00
Plan Level Exclusions No
Plan Marketing Name HA Bronze Exp Standardized
Plan Type POS
Plan Variant Marketing Name HA Bronze Exp Standardized
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $2,600
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $7,500
SBC Scenario, Having a Baby, Limit $40
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $0
SBC Scenario, Having Diabetes, Deductible $7,300
SBC Scenario, Having Diabetes, Limit $60
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 $1,900
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID ARS001
Source Name SERFF
Plan ID 13262AR0230007
State Code AR
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person per person 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 Group per group not applicable
Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person per person 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 50.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group $15000 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person $7500 per person
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $7,500
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group $27000 per group
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person $13500 per person
Combined Medical and Drug EHB Deductible, Out of Network, Individual $13,500
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group $18400 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $9200 per person
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 Group $30400 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person $15200 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual $15,200
Unique Plan Design No
URL for Enrollment Payment URL
URL for Summary of Benefits & Coverage URL
Wellness Program Offered Yes

Copay & Coinsurance of HA Bronze Exp Standardized Health Insurance Plan, 13262AR0230007

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

Frequently Asked Questions(FAQ) about HA Bronze Exp Standardized, 13262AR0230007 Health Insurance Plan, 13262AR0230007

  • Does HA Bronze Exp Standardized Health Insurance Plan, 13262AR0230007 support Mail Ordering?

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

  • Does (13262AR0230007) Health Insurance Plan, Variant (13262AR0230007-00) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs

    Does (13262AR0230007) Health Insurance Plan, Variant (13262AR0230007-00) have Out Of Country Coverage?

    Yes. Details: Emergency Care

    Does (13262AR0230007) Health Insurance Plan, Variant (13262AR0230007-00) have Out of Service Area Coverage?

    Yes. Details: Benefit Reduction

    Does (13262AR0230007) Health Insurance Plan, Variant (13262AR0230007-00) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs

    Does HA Bronze Exp Standardized Health Insurance Plan, Variant (13262AR0230007-00) offer Disease Management Programs for Asthma?

    Yes, the HA Bronze Exp Standardized Health Insurance Plan Variant 13262AR0230007-00 offers Disease Management Program for Asthma.

    Does HA Bronze Exp Standardized Health Insurance Plan, Variant (13262AR0230007-00) offer Disease Management Programs for Heart disease?

    Yes, the HA Bronze Exp Standardized Health Insurance Plan Variant 13262AR0230007-00 offers Disease Management Program for Heart disease.

    Does HA Bronze Exp Standardized Health Insurance Plan, Variant (13262AR0230007-00) offer Disease Management Programs for Depression?

    Yes, the HA Bronze Exp Standardized Health Insurance Plan Variant 13262AR0230007-00 offers Disease Management Program for Depression.

    Does HA Bronze Exp Standardized Health Insurance Plan, Variant (13262AR0230007-00) offer Disease Management Programs for Diabetes?

    Yes, the HA Bronze Exp Standardized Health Insurance Plan Variant 13262AR0230007-00 offers Disease Management Program for Diabetes.

    Does HA Bronze Exp Standardized Health Insurance Plan, Variant (13262AR0230007-00) offer Disease Management Programs for High blood pressure & high cholesterol?

    Yes, the HA Bronze Exp Standardized Health Insurance Plan Variant 13262AR0230007-00 offers Disease Management Program for High blood pressure & high cholesterol.

    Does HA Bronze Exp Standardized Health Insurance Plan, Variant (13262AR0230007-00) offer Disease Management Programs for Low back pain?

    Yes, the HA Bronze Exp Standardized Health Insurance Plan Variant 13262AR0230007-00 offers Disease Management Program for Low back pain.

    Does HA Bronze Exp Standardized Health Insurance Plan, Variant (13262AR0230007-00) offer Disease Management Programs for Pregnancy?

    Yes, the HA Bronze Exp Standardized Health Insurance Plan Variant 13262AR0230007-00 offers Disease Management Program for Pregnancy.

    Does HA Bronze Exp Standardized Health Insurance Plan, Variant (13262AR0230007-00) offer Disease Management Programs for Weight loss programs?

    Yes, the HA Bronze Exp Standardized Health Insurance Plan Variant 13262AR0230007-00 offers Disease Management Program for Weight loss programs.

 

Disclaimer: This is based on the import(Date: Tue, 17 Jun 2025 12:51 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