| Field | Data |
|---|---|
| Health Insurance Plan ID | 38166WI0280005 |
| Health Insurance Plan Year | 2023 |
| State | Wisconsin |
| Health Insurance Issuer | Security Health Plan of Wisconsin, Inc. |
| Plan Formulary Description URL | Formulary URL |
| Plan Marketing Materials URL | Marketing URL |
| Last Plan Update Date | Sun, 19 Mar 2023 00:00 GMT |
| Last Import Date | Tue, 21 Mar 2023 13:10 GMT |
| Health Insurance Plan Variant | 38166WI0280005-02 |
| Available Variants of the Health Plan | |
| 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 | 2023 |
| Child-Only Offering | Allows Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Zero Cost Sharing Plan Variation |
| Dental Only Plan | No |
| Design Type | Not Applicable |
| Disease Management Programs Offered | Asthma, Heart Disease, Depression, Diabetes, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs |
| EHB Percent of Total Premium | 1 |
| First Tier Utilization | 100% |
| Formulary ID | WIF036 |
| Formulary URL | URL |
| HIOS Product ID | 38166WI028 |
| Import Date | 10/11/2022 1:01 |
| 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 | 38166 |
| Issuer Marketplace Marketing Name | Security Health Plan |
| 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 | WIN006 |
| Out of Country Coverage | Yes |
| Out of Country Coverage Description | Urgent and Emergent Care only |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Urgent and Emergent Care only |
| Plan Brochure | URL |
| Plan Effective Date | 1/1/2023 |
| Plan Expiration Date | 12/31/2023 |
| Plan ID (Standard Component ID with Variant) | 38166WI0280005-02 |
| Plan Marketing Name | Enrich $4,100 HDHP |
| Plan Type | HMO |
| Plan Variant Marketing Name | Enrich $4,100 HDHP |
| 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 | $0 |
| SBC Scenario, Having Diabetes, Coinsurance | $0 |
| SBC Scenario, Having Diabetes, Copayment | $0 |
| SBC Scenario, Having Diabetes, Deductible | $0 |
| SBC Scenario, Having Diabetes, Limit | $0 |
| 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 | WIS008 |
| Source Name | HIOS |
| Plan ID | 38166WI0280005 |
| State Code | WI |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group | $0 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person | $0 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual | $0 |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group | $0 per group |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person | $0 per person |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual | $0 |
| 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 |
| TEHBDedOutOfNetFamilyPerGroup | $0 per group |
| TEHBDedOutOfNetFamilyPerPerson | $0 per person |
| Combined Medical and Drug EHB Deductible, Out of Network, Individual | $0 |
| 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 | $0 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person | $0 per person |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual | $0 |
| Unique Plan Design | No |
| URL for Enrollment Payment | URL |
| URL for Summary of Benefits & Coverage | URL |
| Wellness Program Offered | Yes |
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
|---|
Frequently Asked Questions(FAQ) about Enrich $4,100 HDHP, 38166WI0280005 Health Insurance Plan, 38166WI0280005
Does Enrich $4,100 HDHP Health Insurance Plan, 38166WI0280005 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (38166WI0280005) Health Insurance Plan, Variant (38166WI0280005-02) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs
Does (38166WI0280005) Health Insurance Plan, Variant (38166WI0280005-02) have Out Of Country Coverage?
Yes. Details: Urgent and Emergent Care only
Does (38166WI0280005) Health Insurance Plan, Variant (38166WI0280005-02) have Out of Service Area Coverage?
Yes. Details: Urgent and Emergent Care only
Does (38166WI0280005) Health Insurance Plan, Variant (38166WI0280005-02) offer Disease Management Programs?
Yes, and here is the list of available programs: Asthma, Heart Disease, Depression, Diabetes, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs
Does Enrich $4,100 HDHP Health Insurance Plan, Variant (38166WI0280005-02) offer Disease Management Programs for Asthma?
Yes, the Enrich $4,100 HDHP Health Insurance Plan Variant 38166WI0280005-02 offers Disease Management Program for Asthma.
Does Enrich $4,100 HDHP Health Insurance Plan, Variant (38166WI0280005-02) offer Disease Management Programs for Heart disease?
Yes, the Enrich $4,100 HDHP Health Insurance Plan Variant 38166WI0280005-02 offers Disease Management Program for Heart disease.
Does Enrich $4,100 HDHP Health Insurance Plan, Variant (38166WI0280005-02) offer Disease Management Programs for Depression?
Yes, the Enrich $4,100 HDHP Health Insurance Plan Variant 38166WI0280005-02 offers Disease Management Program for Depression.
Does Enrich $4,100 HDHP Health Insurance Plan, Variant (38166WI0280005-02) offer Disease Management Programs for Diabetes?
Yes, the Enrich $4,100 HDHP Health Insurance Plan Variant 38166WI0280005-02 offers Disease Management Program for Diabetes.
Does Enrich $4,100 HDHP Health Insurance Plan, Variant (38166WI0280005-02) offer Disease Management Programs for Low back pain?
Yes, the Enrich $4,100 HDHP Health Insurance Plan Variant 38166WI0280005-02 offers Disease Management Program for Low back pain.
Does Enrich $4,100 HDHP Health Insurance Plan, Variant (38166WI0280005-02) offer Disease Management Programs for Pain management?
Yes, the Enrich $4,100 HDHP Health Insurance Plan Variant 38166WI0280005-02 offers Disease Management Program for Pain management.
Does Enrich $4,100 HDHP Health Insurance Plan, Variant (38166WI0280005-02) offer Disease Management Programs for Pregnancy?
Yes, the Enrich $4,100 HDHP Health Insurance Plan Variant 38166WI0280005-02 offers Disease Management Program for Pregnancy.
Does Enrich $4,100 HDHP Health Insurance Plan, Variant (38166WI0280005-02) offer Disease Management Programs for Weight loss programs?
Yes, the Enrich $4,100 HDHP Health Insurance Plan Variant 38166WI0280005-02 offers Disease Management Program for Weight loss programs.
Disclaimer: This is based on the import(Date: Tue, 21 Mar 2023 13:10 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