Paramount Silver 4 HRA - 74313OH0210012 Health Insurance Plan

Paramount Insurance Company health insurance plan with the Plan ID 74313OH0210012. The plan is called Paramount Silver 4 HRA.

Based on the AV Calculator by CMS.gov, the plan has an actuarial value of 100.00% (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 0.00% 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 74313OH0210012
Health Insurance Plan Year 2022
State Ohio
Health Insurance Issuer Paramount Insurance Company
Plan Formulary Description URL Formulary URL
Plan Marketing Materials URL Marketing URL
Health Insurance Plan Variant 74313OH0210012-02
Provider Network(s) ['OHN001']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 22 Oct 2024 06:47 GMT).

Providers Ohio 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 Off Exchange Plan - 74313OH0210012-00

Standard On Exchange Plan - 74313OH0210012-01

Open to Indians below 300% FPL - 74313OH0210012-02

Open to Indians above 300% FPL - 74313OH0210012-03

73% AV Silver Plan - 74313OH0210012-04

87% AV Silver Plan - 74313OH0210012-05

94% AV Silver Plan - 74313OH0210012-06

Last Plan Update Date Wed, 18 Aug 2021 00:00 GMT
Last Import Date Tue, 22 Oct 2024 06:47 GMT

Paramount Silver 4 HRA Health Insurance Plan Variant 74313OH0210012-02 Attributes

Plan Attribute Value
AV Calculator Output Number 1
Begin Primary Care Cost-Sharing After Number Of Visits 0
Begin Primary Care Deductible Coinsurance After Number Of Copays 0
Business Year 2022
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Zero Cost Sharing Plan Variation
Dental Only Plan No
Disease Management Programs Offered Asthma,Heart Disease,Depression,Diabetes,Pregnancy
EHB Percent of Total Premium 0.9974
First Tier Utilization 100%
Formulary ID OHF004
Formulary URL URL
HIOS Product ID 74313OH021
Import Date 8/18/2021 20:00
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 74313
Issuer Marketplace Marketing Name Paramount
Market Coverage Individual
Medical Drug Deductibles Integrated Yes
Medical Drug Maximum Out of Pocket Integrated Yes
Metal Level Silver
Multiple In Network Tiers No
National Network No
Network ID OHN001
Out of Country Coverage Yes
Out of Country Coverage Description Emergency Services which are required as the result of an Emergency Medical Condition are covered at any medical facility, anytime, anywhere without prior authorization. The service will be subject to an emergency room, urgent care facility or office visit Copay/Coinsurance, depending on where you receive treatment.
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Limited. Out of service area coverage is available for emergency services or if the services have been prior-authorized.
Plan Brochure URL
Plan Effective Date 1/1/2022
Plan Expiration Date 12/31/2022
Plan ID (Standard Component ID with Variant) 74313OH0210012-02
Plan Marketing Name Paramount Silver 4 HRA
Plan Type HMO
Plan Variant Marketing Name Paramount Silver 4 HRA
QHP/Non QHP Both
SBC Scenario, Having a Baby, Coinsurance $0
SBC Scenario, Having a Baby, Copayment $0
SBC Scenario, Having a Baby, Deductible $0
SBC Scenario, Having a Baby, Limit $60
SBC Scenario, Having Diabetes, Coinsurance $0
SBC Scenario, Having Diabetes, Copayment $0
SBC Scenario, Having Diabetes, Deductible $0
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 $0
SBC Scenario, Treatment of a Simple Fracture, Limit $0
Service Area ID OHS001
Source Name SERFF
Plan ID 74313OH0210012
State Code OH
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 0.00%
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group $0 per group
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person $0 per person
Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual $0
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group per group not applicable
Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person per person 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 Per Group $0 per group
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person $0 per person
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual $0
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person per person not applicable
Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual Not Applicable
Unique Plan Design No
URL for Enrollment Payment URL
URL for Summary of Benefits & Coverage URL
Wellness Program Offered No

Copay & Coinsurance of Paramount Silver 4 HRA Health Insurance Plan, 74313OH0210012

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

Frequently Asked Questions(FAQ) about Paramount Silver 4 HRA, 74313OH0210012 Health Insurance Plan, 74313OH0210012

  • Does Paramount Silver 4 HRA Health Insurance Plan, 74313OH0210012 support Mail Ordering?

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

  • Does (74313OH0210012) Health Insurance Plan, Variant (74313OH0210012-02) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma,Heart Disease,Depression,Diabetes,Pregnancy

    Does (74313OH0210012) Health Insurance Plan, Variant (74313OH0210012-02) have Out Of Country Coverage?

    Yes. Details: Emergency Services which are required as the result of an Emergency Medical Condition are covered at any medical facility, anytime, anywhere without prior authorization. The service will be subject to an emergency room, urgent care facility or office visit Copay/Coinsurance, depending on where you receive treatment.

    Does (74313OH0210012) Health Insurance Plan, Variant (74313OH0210012-02) have Out of Service Area Coverage?

    Yes. Details: Limited. Out of service area coverage is available for emergency services or if the services have been prior-authorized.

    Does (74313OH0210012) Health Insurance Plan, Variant (74313OH0210012-02) offer Disease Management Programs?

    Yes, and here is the list of available programs: Asthma,Heart Disease,Depression,Diabetes,Pregnancy

    Does Paramount Silver 4 HRA Health Insurance Plan, Variant (74313OH0210012-02) offer Disease Management Programs for Asthma?

    Yes, the Paramount Silver 4 HRA Health Insurance Plan Variant 74313OH0210012-02 offers Disease Management Program for Asthma.

    Does Paramount Silver 4 HRA Health Insurance Plan, Variant (74313OH0210012-02) offer Disease Management Programs for Heart disease?

    Yes, the Paramount Silver 4 HRA Health Insurance Plan Variant 74313OH0210012-02 offers Disease Management Program for Heart disease.

    Does Paramount Silver 4 HRA Health Insurance Plan, Variant (74313OH0210012-02) offer Disease Management Programs for Depression?

    Yes, the Paramount Silver 4 HRA Health Insurance Plan Variant 74313OH0210012-02 offers Disease Management Program for Depression.

    Does Paramount Silver 4 HRA Health Insurance Plan, Variant (74313OH0210012-02) offer Disease Management Programs for Diabetes?

    Yes, the Paramount Silver 4 HRA Health Insurance Plan Variant 74313OH0210012-02 offers Disease Management Program for Diabetes.

    Does Paramount Silver 4 HRA Health Insurance Plan, Variant (74313OH0210012-02) offer Disease Management Programs for Pregnancy?

    Yes, the Paramount Silver 4 HRA Health Insurance Plan Variant 74313OH0210012-02 offers Disease Management Program for Pregnancy.

 

Disclaimer: This is based on the import(Date: Tue, 22 Oct 2024 06:47 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