2015 QHP Landscape NV SHOP Market Medical

State Want total control? Request access to start using the data.	County Want total control? Request access to start using the data.	Metal Level Want total control? Request access to start using the data.	Issuer Name Want total control? Request access to start using the data.	Plan Id (Standard Component) Want total control? Request access to start using the data.	Plan Marketing Name Want total control? Request access to start using the data.	Plan Type Want total control? Request access to start using the data.	Rating Area Want total control? Request access to start using the data.	Child Only Offering Want total control? Request access to start using the data.	Source Want total control? Request access to start using the data.	Customer Service Phone Number Local Want total control? Request access to start using the data.	Customer Service Phone Number Toll Free Want total control? Request access to start using the data.	Customer Service Phone Number Tty Want total control? Request access to start using the data.	Network Url Want total control? Request access to start using the data.	Plan Brochure Url Want total control? Request access to start using the data.	Summary Of Benefits Url Want total control? Request access to start using the data.	Drug Formulary Url Want total control? Request access to start using the data.	Premium Child Want total control? Request access to start using the data.	Premium Adult Individual Age 21 Want total control? Request access to start using the data.	Premium Adult Individual Age 27 Want total control? Request access to start using the data.	Premium Adult Individual Age 30 Want total control? Request access to start using the data.	Premium Adult Individual Age 40 Want total control? Request access to start using the data.	Premium Adult Individual Age 50 Want total control? Request access to start using the data.	Premium Adult Individual Age 60 Want total control? Request access to start using the data.	Premium Couple 21 Want total control? Request access to start using the data.	Premium Couple 30 Want total control? Request access to start using the data.	Premium Couple 40 Want total control? Request access to start using the data.	Premium Couple 50 Want total control? Request access to start using the data.	Premium Couple 60 Want total control? Request access to start using the data.	Couple+1 Child, Age 21 Want total control? Request access to start using the data.	Couple+1 Child, Age 30 Want total control? Request access to start using the data.	Couple+1 Child, Age 40 Want total control? Request access to start using the data.	Couple+1 Child, Age 50 Want total control? Request access to start using the data.	Couple+2 Children, Age 21 Want total control? Request access to start using the data.	Couple+2 Children, Age 30 Want total control? Request access to start using the data.	Couple+2 Children, Age 40 Want total control? Request access to start using the data.	Couple+2 Children, Age 50 Want total control? Request access to start using the data.	Couple+3 Or More Children, Age 21 Want total control? Request access to start using the data.	Couple+3 Or More Children, Age 30 Want total control? Request access to start using the data.	Couple+3 Or More Children, Age 40 Want total control? Request access to start using the data.	Couple+3 Or More Children, Age 50 Want total control? Request access to start using the data.	Individual+1 Child, Age 21 Want total control? Request access to start using the data.	Individual+1 Child, Age 30 Want total control? Request access to start using the data.	Individual+1 Child, Age 40 Want total control? Request access to start using the data.	Individual+1 Child, Age 50 Want total control? Request access to start using the data.	Individual+2 Children, Age 21 Want total control? Request access to start using the data.	Individual+2 Children, Age 30 Want total control? Request access to start using the data.	Individual+2 Children, Age 40 Want total control? Request access to start using the data.	Individual+2 Children, Age 50 Want total control? Request access to start using the data.	Individual+3 Or More Children, Age 21 Want total control? Request access to start using the data.	Individual+3 Or More Children, Age 30 Want total control? Request access to start using the data.	Individual+3 Or More Children, Age 40 Want total control? Request access to start using the data.	Individual+3 Or More Children, Age 50 Want total control? Request access to start using the data.	Medical Deductible-Individual-Standard Want total control? Request access to start using the data.	Drug Deductible-Individual-Standard Want total control? Request access to start using the data.	Medical Deductible-Family-Standard Want total control? Request access to start using the data.	Drug Deductible - Family - Standard Want total control? Request access to start using the data.	Medical Maximum Out Of Pocket - Individual - Standard Want total control? Request access to start using the data.	Drug Maximum Out Of Pocket - Individual - Standard Want total control? Request access to start using the data.	Medical Maximum Out Of Pocket - Family - Standard Want total control? Request access to start using the data.	Drug Maximum Out Of Pocket - Family - Standard Want total control? Request access to start using the data.	Primary Care Physician - Standard Want total control? Request access to start using the data.	Specialist - Standard Want total control? Request access to start using the data.	Emergency Room - Standard Want total control? Request access to start using the data.	Inpatient Facility - Standard Want total control? Request access to start using the data.	Inpatient Physician - Standard Want total control? Request access to start using the data.	Generic Drugs - Standard Want total control? Request access to start using the data.	Preferred Brand Drugs - Standard Want total control? Request access to start using the data.	Non-Preferred Brand Drugs - Standard Want total control? Request access to start using the data.	Specialty Drugs - Standard Want total control? Request access to start using the data.
NV	Carson City	Bronze	Nevada Health CO-OP	34996NV0060003	Northern Simple/Fácil Bronze HSA	POS	Rating Area 3	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Northern-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Northern-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Northern-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	126.63	199.42	208.99	226.34	254.86	356.17	541.23	398.84	452.68	509.72	712.34	1082.46	525.47	579.31	636.35	838.97	652.1	705.94	762.98	965.6	778.73	832.57	889.61	1092.23	326.05	352.97	381.49	482.8	452.68	479.6	508.12	609.43	579.31	606.23	634.75	736.06	6250	Included in Medical	12500	Included in Medical	6250	Included in Medical	12500	Included in Medical	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible
NV	Carson City	Gold	Nevada Health CO-OP	34996NV0060001	Northern Simple/Fácil Gold	POS	Rating Area 3	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Northern-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Northern-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Northern-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	188.63	297.05	311.31	337.15	379.63	530.53	806.19	594.1	674.3	759.26	1061.06	1612.38	782.73	862.93	947.89	1249.69	971.36	1051.56	1136.52	1438.32	1159.99	1240.19	1325.15	1626.95	485.68	525.78	568.26	719.16	674.31	714.41	756.89	907.79	862.94	903.04	945.52	1096.42	650	Included in Medical	1300	Included in Medical	6350	Included in Medical	12700	Included in Medical	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	No Charge	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible
NV	Carson City	Platinum	Nevada Health CO-OP	34996NV0060004	Northern Simple/Fácil Platinum	POS	Rating Area 3	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Northern-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Northern-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Northern-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	216.97	341.68	358.08	387.81	436.67	610.24	927.32	683.36	775.62	873.34	1220.48	1854.64	900.33	992.59	1090.31	1437.45	1117.3	1209.56	1307.28	1654.42	1334.27	1426.53	1524.25	1871.39	558.65	604.78	653.64	827.21	775.62	821.75	870.61	1044.18	992.59	1038.72	1087.58	1261.15	250	Included in Medical	500	Included in Medical	6350	Included in Medical	12700	Included in Medical	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	No Charge	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible
NV	Carson City	Silver	Nevada Health CO-OP	34996NV0060002	Northern Simple/Fácil Silver	POS	Rating Area 3	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Northern-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Northern-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Northern-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	161.57	254.44	266.65	288.79	325.18	454.43	690.55	508.88	577.58	650.36	908.86	1381.1	670.45	739.15	811.93	1070.43	832.02	900.72	973.5	1232	993.59	1062.29	1135.07	1393.57	416.01	450.36	486.75	616	577.58	611.93	648.32	777.57	739.15	773.5	809.89	939.14	1500	Included in Medical	3000	Included in Medical	6350	Included in Medical	12700	Included in Medical	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	No Charge	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible
NV	Churchill	Bronze	Nevada Health CO-OP	34996NV0060007	Frontier Simple/Fácil Bronze HSA	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	177.44	279.43	292.85	317.16	357.12	499.07	758.38	558.86	634.32	714.24	998.14	1516.76	736.3	811.76	891.68	1175.58	913.74	989.2	1069.12	1353.02	1091.18	1166.64	1246.56	1530.46	456.87	494.6	534.56	676.51	634.31	672.04	712	853.95	811.75	849.48	889.44	1031.39	6250	Included in Medical	12500	Included in Medical	6250	Included in Medical	12500	Included in Medical	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible
NV	Churchill	Gold	Nevada Health CO-OP	34996NV0060005	Frontier Simple/Fácil Gold	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	264.31	416.23	436.21	472.42	531.94	743.39	1129.65	832.46	944.84	1063.88	1486.78	2259.3	1096.77	1209.15	1328.19	1751.09	1361.08	1473.46	1592.5	2015.4	1625.39	1737.77	1856.81	2279.71	680.54	736.73	796.25	1007.7	944.85	1001.04	1060.56	1272.01	1209.16	1265.35	1324.87	1536.32	650	Included in Medical	1300	Included in Medical	6350	Included in Medical	12700	Included in Medical	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	No Charge	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible
NV	Churchill	Platinum	Nevada Health CO-OP	34996NV0060008	Frontier Simple/Fácil Platinum	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	304.02	478.77	501.75	543.4	611.86	855.08	1299.37	957.54	1086.8	1223.72	1710.16	2598.74	1261.56	1390.82	1527.74	2014.18	1565.58	1694.84	1831.76	2318.2	1869.6	1998.86	2135.78	2622.22	782.79	847.42	915.88	1159.1	1086.81	1151.44	1219.9	1463.12	1390.83	1455.46	1523.92	1767.14	250	Included in Medical	500	Included in Medical	6350	Included in Medical	12700	Included in Medical	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	No Charge	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible
NV	Churchill	Silver	Nevada Health CO-OP	34996NV0060006	Frontier Simple/Fácil Silver	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	226.39	356.53	373.64	404.66	455.64	636.76	967.61	713.06	809.32	911.28	1273.52	1935.22	939.45	1035.71	1137.67	1499.91	1165.84	1262.1	1364.06	1726.3	1392.23	1488.49	1590.45	1952.69	582.92	631.05	682.03	863.15	809.31	857.44	908.42	1089.54	1035.7	1083.83	1134.81	1315.93	1500	Included in Medical	3000	Included in Medical	6350	Included in Medical	12700	Included in Medical	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	No Charge	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible
NV	Clark	Bronze	Nevada Health CO-OP	34996NV0050003	Southern Simple/Fácil Bronze	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Southern-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Southern-Simple-Bronze.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Southern-Simple-Bronze.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	88.65	139.6	146.3	158.45	178.41	249.33	378.88	279.2	316.9	356.82	498.66	757.76	367.85	405.55	445.47	587.31	456.5	494.2	534.12	675.96	545.15	582.85	622.77	764.61	228.25	247.1	267.06	337.98	316.9	335.75	355.71	426.63	405.55	424.4	444.36	515.28	6250	Included in Medical	12500	Included in Medical	6250	Included in Medical	12500	Included in Medical	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible
NV	Clark	Bronze	Nevada Health CO-OP	34996NV0270003	Southern Simple/Facil Bronze HSA	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Southern-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Southern-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Southern-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	92.44	145.57	152.56	165.23	186.04	260	395.09	291.14	330.46	372.08	520	790.18	383.58	422.9	464.52	612.44	476.02	515.34	556.96	704.88	568.46	607.78	649.4	797.32	238.01	257.67	278.48	352.44	330.45	350.11	370.92	444.88	422.89	442.55	463.36	537.32	4000	Included in Medical	8000	Included in Medical	6450	Included in Medical	12900	Included in Medical	50% Coinsurance after deductible	50% Coinsurance after deductible	50% Coinsurance after deductible	50% Coinsurance after deductible	50% Coinsurance after deductible	50% Coinsurance after deductible	50% Coinsurance after deductible	50% Coinsurance after deductible	50% Coinsurance after deductible
NV	Clark	Gold	Nevada Health CO-OP	34996NV0050001	Southern Simple/Fácil Gold	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Southern-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Southern-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Southern-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	147.85	232.83	244.01	264.26	297.56	415.83	631.9	465.66	528.52	595.12	831.66	1263.8	613.51	676.37	742.97	979.51	761.36	824.22	890.82	1127.36	909.21	972.07	1038.67	1275.21	380.68	412.11	445.41	563.68	528.53	559.96	593.26	711.53	676.38	707.81	741.11	859.38	500	Included in Medical	1000	Included in Medical	6350	Included in Medical	12700	Included in Medical	$20	$50	$600	20% Coinsurance after deductible	No Charge	$10	$25	$75	20% Coinsurance after deductible
NV	Clark	Gold	Nevada Health CO-OP	34996NV0070002	Southern Star/Estrella Gold	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Southern-and-Union-Star-Tier-1.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Southern-Star-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Southern-Star-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	142.54	224.47	235.24	254.77	286.87	400.9	609.21	448.94	509.54	573.74	801.8	1218.42	591.48	652.08	716.28	944.34	734.02	794.62	858.82	1086.88	876.56	937.16	1001.36	1229.42	367.01	397.31	429.41	543.44	509.55	539.85	571.95	685.98	652.09	682.39	714.49	828.52	500	Included in Medical	1000	Included in Medical	3500	Included in Medical	7000	Included in Medical	$10	$40	$600	20% Coinsurance after deductible	No Charge	$10	$35	$75	20% Coinsurance after deductible
NV	Clark	Gold	Nevada Health CO-OP	34996NV0070005	Union Star/Estrella Gold	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Southern-and-Union-Star-Tier-1.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Union-Star-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Union-Star-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-Union	142.54	224.47	235.24	254.77	286.87	400.9	609.21	448.94	509.54	573.74	801.8	1218.42	591.48	652.08	716.28	944.34	734.02	794.62	858.82	1086.88	876.56	937.16	1001.36	1229.42	367.01	397.31	429.41	543.44	509.55	539.85	571.95	685.98	652.09	682.39	714.49	828.52	500	Included in Medical	1000	Included in Medical	3500	Included in Medical	7000	Included in Medical	$10	$40	$600	20% Coinsurance after deductible	No Charge	$10	$35	$75	20% Coinsurance after deductible
NV	Clark	Gold	Nevada Health CO-OP	34996NV0080001	VIP Gold	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-VIP-Plan-Tier-1.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-VIP-Plan-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-VIP-Plan-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	143.66	226.24	237.1	256.79	289.14	404.07	614.02	452.48	513.58	578.28	808.14	1228.04	596.14	657.24	721.94	951.8	739.8	800.9	865.6	1095.46	883.46	944.56	1009.26	1239.12	369.9	400.45	432.8	547.73	513.56	544.11	576.46	691.39	657.22	687.77	720.12	835.05	500	Included in Medical	1000	Included in Medical	4500	Included in Medical	9000	Included in Medical	No Charge	$40	$600	20% Coinsurance after deductible	No Charge	$5	$35	$75	20% Coinsurance after deductible
NV	Clark	Gold	Nevada Health CO-OP	34996NV0260002	Connected/Conectado Gold	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Connected-Connectado.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Connected-Conectado-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Connected-Conectado-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	136.74	215.34	225.68	244.42	275.21	384.6	584.44	430.68	488.84	550.42	769.2	1168.88	567.42	625.58	687.16	905.94	704.16	762.32	823.9	1042.68	840.9	899.06	960.64	1179.42	352.08	381.16	411.95	521.34	488.82	517.9	548.69	658.08	625.56	654.64	685.43	794.82	500	Included in Medical	1000	Included in Medical	6000	Included in Medical	12000	Included in Medical	$10	$40	$600	20% Coinsurance after deductible	No Charge	$10	$35	$75	20% Coinsurance after deductible
NV	Clark	Gold	Nevada Health CO-OP	34996NV0270001	Southern Simple/Facil Gold HSA	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Southern-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Southern-Simple-Gold-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Southern-Simple-Gold-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	142.46	224.34	235.11	254.63	286.71	400.67	608.86	448.68	509.26	573.42	801.34	1217.72	591.14	651.72	715.88	943.8	733.6	794.18	858.34	1086.26	876.06	936.64	1000.8	1228.72	366.8	397.09	429.17	543.13	509.26	539.55	571.63	685.59	651.72	682.01	714.09	828.05	1300	Included in Medical	2600	Included in Medical	6000	Included in Medical	12000	Included in Medical	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible
NV	Clark	Platinum	Nevada Health CO-OP	34996NV0050004	Southern Simple/Fácil Platinum	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Southern-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Southern-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Southern-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	167.21	263.32	275.96	298.87	336.53	470.3	714.66	526.64	597.74	673.06	940.6	1429.32	693.85	764.95	840.27	1107.81	861.06	932.16	1007.48	1275.02	1028.27	1099.37	1174.69	1442.23	430.53	466.08	503.74	637.51	597.74	633.29	670.95	804.72	764.95	800.5	838.16	971.93	0	Included in Medical	0	Included in Medical	2500	Included in Medical	5000	Included in Medical	$15	$40	$450	10% Coinsurance after deductible	No Charge	$10	$20	$75	10% Coinsurance after deductible
NV	Clark	Platinum	Nevada Health CO-OP	34996NV0070001	Southern Star/Estrella Platinum	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Southern-and-Union-Star-Tier-1.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Southern-Star-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Southern-Star-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	161.09	253.68	265.86	287.93	324.21	453.08	688.5	507.36	575.86	648.42	906.16	1377	668.45	736.95	809.51	1067.25	829.54	898.04	970.6	1228.34	990.63	1059.13	1131.69	1389.43	414.77	449.02	485.3	614.17	575.86	610.11	646.39	775.26	736.95	771.2	807.48	936.35	400	Included in Medical	800	Included in Medical	2000	Included in Medical	4000	Included in Medical	$5	$25	$450	10% Coinsurance after deductible	No Charge	No Charge	$15	$30	10% Coinsurance after deductible
NV	Clark	Platinum	Nevada Health CO-OP	34996NV0070004	Union Star/Estrella Platinum	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Southern-and-Union-Star-Tier-1.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Union-Star-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Union-Star-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-Union	161.09	253.68	265.86	287.93	324.21	453.08	688.5	507.36	575.86	648.42	906.16	1377	668.45	736.95	809.51	1067.25	829.54	898.04	970.6	1228.34	990.63	1059.13	1131.69	1389.43	414.77	449.02	485.3	614.17	575.86	610.11	646.39	775.26	736.95	771.2	807.48	936.35	400	Included in Medical	800	Included in Medical	2000	Included in Medical	4000	Included in Medical	$5	$25	$450	10% Coinsurance after deductible	No Charge	No Charge	$15	$30	10% Coinsurance after deductible
NV	Clark	Platinum	Nevada Health CO-OP	34996NV0080003	VIP Platinum	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-VIP-Plan-Tier-1.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-VIP-Plan-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-VIP-Plan-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	167.13	263.2	275.83	298.73	336.37	470.07	714.32	526.4	597.46	672.74	940.14	1428.64	693.53	764.59	839.87	1107.27	860.66	931.72	1007	1274.4	1027.79	1098.85	1174.13	1441.53	430.33	465.86	503.5	637.2	597.46	632.99	670.63	804.33	764.59	800.12	837.76	971.46	200	Included in Medical	400	Included in Medical	2500	Included in Medical	5000	Included in Medical	No Charge	$30	$450	10% Coinsurance after deductible	No Charge	$5	$25	$75	10% Coinsurance after deductible
NV	Clark	Platinum	Nevada Health CO-OP	34996NV0260001	Connected/Conectado Platinum	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Connected-Connectado.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Connected-Conectado-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Connected-Conectado-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	153.03	240.99	252.56	273.53	307.99	430.41	654.05	481.98	547.06	615.98	860.82	1308.1	635.01	700.09	769.01	1013.85	788.04	853.12	922.04	1166.88	941.07	1006.15	1075.07	1319.91	394.02	426.56	461.02	583.44	547.05	579.59	614.05	736.47	700.08	732.62	767.08	889.5	250	Included in Medical	500	Included in Medical	2000	Included in Medical	4000	Included in Medical	$5	$35	$450	10% Coinsurance after deductible	No Charge	$10	$25	$75	10% Coinsurance after deductible
NV	Clark	Silver	Nevada Health CO-OP	34996NV0050002	Southern Simple/Fácil Silver	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Southern-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Southern-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Southern-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	125.42	197.51	206.99	224.18	252.42	352.76	536.05	395.02	448.36	504.84	705.52	1072.1	520.44	573.78	630.26	830.94	645.86	699.2	755.68	956.36	771.28	824.62	881.1	1081.78	322.93	349.6	377.84	478.18	448.35	475.02	503.26	603.6	573.77	600.44	628.68	729.02	3000	Included in Medical	6000	Included in Medical	6350	Included in Medical	12700	Included in Medical	$40	$80	$600	30% Coinsurance after deductible	No Charge	$10	$35	$100	30% Coinsurance after deductible
NV	Clark	Silver	Nevada Health CO-OP	34996NV0070003	Southern Star/Estrella Silver	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Southern-and-Union-Star-Tier-1.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Southern-Star-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Southern-Star-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	118.1	185.98	194.91	211.09	237.69	332.17	504.76	371.96	422.18	475.38	664.34	1009.52	490.06	540.28	593.48	782.44	608.16	658.38	711.58	900.54	726.26	776.48	829.68	1018.64	304.08	329.19	355.79	450.27	422.18	447.29	473.89	568.37	540.28	565.39	591.99	686.47	4250	Included in Medical	8500	Included in Medical	6350	Included in Medical	12700	Included in Medical	$15	$50	$600	30% Coinsurance after deductible	No Charge	$10	$35	$50	30% Coinsurance after deductible
NV	Clark	Silver	Nevada Health CO-OP	34996NV0070006	Union Star/Estrella Silver	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Southern-and-Union-Star-Tier-1.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Union-Star-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Union-Star-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-Union	118.1	185.98	194.91	211.09	237.69	332.17	504.76	371.96	422.18	475.38	664.34	1009.52	490.06	540.28	593.48	782.44	608.16	658.38	711.58	900.54	726.26	776.48	829.68	1018.64	304.08	329.19	355.79	450.27	422.18	447.29	473.89	568.37	540.28	565.39	591.99	686.47	4250	Included in Medical	8500	Included in Medical	6350	Included in Medical	12700	Included in Medical	$15	$50	$600	30% Coinsurance after deductible	No Charge	$10	$35	$50	30% Coinsurance after deductible
NV	Clark	Silver	Nevada Health CO-OP	34996NV0080002	VIP Silver	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-VIP-Plan-Tier-1.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-VIP-Plan-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-VIP-Plan-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	118.93	187.3	196.29	212.58	239.37	334.52	508.33	374.6	425.16	478.74	669.04	1016.66	493.53	544.09	597.67	787.97	612.46	663.02	716.6	906.9	731.39	781.95	835.53	1025.83	306.23	331.51	358.3	453.45	425.16	450.44	477.23	572.38	544.09	569.37	596.16	691.31	5500	Included in Medical	11000	Included in Medical	6350	Included in Medical	12700	Included in Medical	No Charge	$50	$600	30% Coinsurance after deductible	No Charge	$10	$35	$50	30% Coinsurance after deductible
NV	Clark	Silver	Nevada Health CO-OP	34996NV0260003	Connected/Conectado Silver	POS	Rating Area 1	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Connected-Connectado.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Connected-Conectado-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Connected-Conectado-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	115.85	182.44	191.2	207.07	233.16	325.84	495.14	364.88	414.14	466.32	651.68	990.28	480.73	529.99	582.17	767.53	596.58	645.84	698.02	883.38	712.43	761.69	813.87	999.23	298.29	322.92	349.01	441.69	414.14	438.77	464.86	557.54	529.99	554.62	580.71	673.39	5000	Included in Medical	10000	Included in Medical	6450	Included in Medical	12900	Included in Medical	$15	$50	$600	30% Coinsurance after deductible	No Charge	$10	$35	$75	30% Coinsurance after deductible
NV	Douglas	Bronze	Nevada Health CO-OP	34996NV0060003	Northern Simple/Fácil Bronze HSA	POS	Rating Area 3	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Northern-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Northern-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Northern-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	126.63	199.42	208.99	226.34	254.86	356.17	541.23	398.84	452.68	509.72	712.34	1082.46	525.47	579.31	636.35	838.97	652.1	705.94	762.98	965.6	778.73	832.57	889.61	1092.23	326.05	352.97	381.49	482.8	452.68	479.6	508.12	609.43	579.31	606.23	634.75	736.06	6250	Included in Medical	12500	Included in Medical	6250	Included in Medical	12500	Included in Medical	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible
NV	Douglas	Gold	Nevada Health CO-OP	34996NV0060001	Northern Simple/Fácil Gold	POS	Rating Area 3	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Northern-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Northern-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Northern-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	188.63	297.05	311.31	337.15	379.63	530.53	806.19	594.1	674.3	759.26	1061.06	1612.38	782.73	862.93	947.89	1249.69	971.36	1051.56	1136.52	1438.32	1159.99	1240.19	1325.15	1626.95	485.68	525.78	568.26	719.16	674.31	714.41	756.89	907.79	862.94	903.04	945.52	1096.42	650	Included in Medical	1300	Included in Medical	6350	Included in Medical	12700	Included in Medical	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	No Charge	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible
NV	Douglas	Platinum	Nevada Health CO-OP	34996NV0060004	Northern Simple/Fácil Platinum	POS	Rating Area 3	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Northern-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Northern-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Northern-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	216.97	341.68	358.08	387.81	436.67	610.24	927.32	683.36	775.62	873.34	1220.48	1854.64	900.33	992.59	1090.31	1437.45	1117.3	1209.56	1307.28	1654.42	1334.27	1426.53	1524.25	1871.39	558.65	604.78	653.64	827.21	775.62	821.75	870.61	1044.18	992.59	1038.72	1087.58	1261.15	250	Included in Medical	500	Included in Medical	6350	Included in Medical	12700	Included in Medical	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	No Charge	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible
NV	Douglas	Silver	Nevada Health CO-OP	34996NV0060002	Northern Simple/Fácil Silver	POS	Rating Area 3	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Northern-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Northern-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Northern-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	161.57	254.44	266.65	288.79	325.18	454.43	690.55	508.88	577.58	650.36	908.86	1381.1	670.45	739.15	811.93	1070.43	832.02	900.72	973.5	1232	993.59	1062.29	1135.07	1393.57	416.01	450.36	486.75	616	577.58	611.93	648.32	777.57	739.15	773.5	809.89	939.14	1500	Included in Medical	3000	Included in Medical	6350	Included in Medical	12700	Included in Medical	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	No Charge	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible
NV	Elko	Bronze	Nevada Health CO-OP	34996NV0060007	Frontier Simple/Fácil Bronze HSA	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	177.44	279.43	292.85	317.16	357.12	499.07	758.38	558.86	634.32	714.24	998.14	1516.76	736.3	811.76	891.68	1175.58	913.74	989.2	1069.12	1353.02	1091.18	1166.64	1246.56	1530.46	456.87	494.6	534.56	676.51	634.31	672.04	712	853.95	811.75	849.48	889.44	1031.39	6250	Included in Medical	12500	Included in Medical	6250	Included in Medical	12500	Included in Medical	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible
NV	Elko	Gold	Nevada Health CO-OP	34996NV0060005	Frontier Simple/Fácil Gold	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	264.31	416.23	436.21	472.42	531.94	743.39	1129.65	832.46	944.84	1063.88	1486.78	2259.3	1096.77	1209.15	1328.19	1751.09	1361.08	1473.46	1592.5	2015.4	1625.39	1737.77	1856.81	2279.71	680.54	736.73	796.25	1007.7	944.85	1001.04	1060.56	1272.01	1209.16	1265.35	1324.87	1536.32	650	Included in Medical	1300	Included in Medical	6350	Included in Medical	12700	Included in Medical	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	No Charge	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible
NV	Elko	Platinum	Nevada Health CO-OP	34996NV0060008	Frontier Simple/Fácil Platinum	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	304.02	478.77	501.75	543.4	611.86	855.08	1299.37	957.54	1086.8	1223.72	1710.16	2598.74	1261.56	1390.82	1527.74	2014.18	1565.58	1694.84	1831.76	2318.2	1869.6	1998.86	2135.78	2622.22	782.79	847.42	915.88	1159.1	1086.81	1151.44	1219.9	1463.12	1390.83	1455.46	1523.92	1767.14	250	Included in Medical	500	Included in Medical	6350	Included in Medical	12700	Included in Medical	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	No Charge	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible
NV	Elko	Silver	Nevada Health CO-OP	34996NV0060006	Frontier Simple/Fácil Silver	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	226.39	356.53	373.64	404.66	455.64	636.76	967.61	713.06	809.32	911.28	1273.52	1935.22	939.45	1035.71	1137.67	1499.91	1165.84	1262.1	1364.06	1726.3	1392.23	1488.49	1590.45	1952.69	582.92	631.05	682.03	863.15	809.31	857.44	908.42	1089.54	1035.7	1083.83	1134.81	1315.93	1500	Included in Medical	3000	Included in Medical	6350	Included in Medical	12700	Included in Medical	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	No Charge	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible
NV	Esmeralda	Bronze	Nevada Health CO-OP	34996NV0060007	Frontier Simple/Fácil Bronze HSA	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	177.44	279.43	292.85	317.16	357.12	499.07	758.38	558.86	634.32	714.24	998.14	1516.76	736.3	811.76	891.68	1175.58	913.74	989.2	1069.12	1353.02	1091.18	1166.64	1246.56	1530.46	456.87	494.6	534.56	676.51	634.31	672.04	712	853.95	811.75	849.48	889.44	1031.39	6250	Included in Medical	12500	Included in Medical	6250	Included in Medical	12500	Included in Medical	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible
NV	Esmeralda	Gold	Nevada Health CO-OP	34996NV0060005	Frontier Simple/Fácil Gold	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	264.31	416.23	436.21	472.42	531.94	743.39	1129.65	832.46	944.84	1063.88	1486.78	2259.3	1096.77	1209.15	1328.19	1751.09	1361.08	1473.46	1592.5	2015.4	1625.39	1737.77	1856.81	2279.71	680.54	736.73	796.25	1007.7	944.85	1001.04	1060.56	1272.01	1209.16	1265.35	1324.87	1536.32	650	Included in Medical	1300	Included in Medical	6350	Included in Medical	12700	Included in Medical	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	No Charge	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible
NV	Esmeralda	Platinum	Nevada Health CO-OP	34996NV0060008	Frontier Simple/Fácil Platinum	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	304.02	478.77	501.75	543.4	611.86	855.08	1299.37	957.54	1086.8	1223.72	1710.16	2598.74	1261.56	1390.82	1527.74	2014.18	1565.58	1694.84	1831.76	2318.2	1869.6	1998.86	2135.78	2622.22	782.79	847.42	915.88	1159.1	1086.81	1151.44	1219.9	1463.12	1390.83	1455.46	1523.92	1767.14	250	Included in Medical	500	Included in Medical	6350	Included in Medical	12700	Included in Medical	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	No Charge	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible
NV	Esmeralda	Silver	Nevada Health CO-OP	34996NV0060006	Frontier Simple/Fácil Silver	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	226.39	356.53	373.64	404.66	455.64	636.76	967.61	713.06	809.32	911.28	1273.52	1935.22	939.45	1035.71	1137.67	1499.91	1165.84	1262.1	1364.06	1726.3	1392.23	1488.49	1590.45	1952.69	582.92	631.05	682.03	863.15	809.31	857.44	908.42	1089.54	1035.7	1083.83	1134.81	1315.93	1500	Included in Medical	3000	Included in Medical	6350	Included in Medical	12700	Included in Medical	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	No Charge	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible
NV	Eureka	Bronze	Nevada Health CO-OP	34996NV0060007	Frontier Simple/Fácil Bronze HSA	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	177.44	279.43	292.85	317.16	357.12	499.07	758.38	558.86	634.32	714.24	998.14	1516.76	736.3	811.76	891.68	1175.58	913.74	989.2	1069.12	1353.02	1091.18	1166.64	1246.56	1530.46	456.87	494.6	534.56	676.51	634.31	672.04	712	853.95	811.75	849.48	889.44	1031.39	6250	Included in Medical	12500	Included in Medical	6250	Included in Medical	12500	Included in Medical	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible
NV	Eureka	Gold	Nevada Health CO-OP	34996NV0060005	Frontier Simple/Fácil Gold	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	264.31	416.23	436.21	472.42	531.94	743.39	1129.65	832.46	944.84	1063.88	1486.78	2259.3	1096.77	1209.15	1328.19	1751.09	1361.08	1473.46	1592.5	2015.4	1625.39	1737.77	1856.81	2279.71	680.54	736.73	796.25	1007.7	944.85	1001.04	1060.56	1272.01	1209.16	1265.35	1324.87	1536.32	650	Included in Medical	1300	Included in Medical	6350	Included in Medical	12700	Included in Medical	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	No Charge	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible
NV	Eureka	Platinum	Nevada Health CO-OP	34996NV0060008	Frontier Simple/Fácil Platinum	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	304.02	478.77	501.75	543.4	611.86	855.08	1299.37	957.54	1086.8	1223.72	1710.16	2598.74	1261.56	1390.82	1527.74	2014.18	1565.58	1694.84	1831.76	2318.2	1869.6	1998.86	2135.78	2622.22	782.79	847.42	915.88	1159.1	1086.81	1151.44	1219.9	1463.12	1390.83	1455.46	1523.92	1767.14	250	Included in Medical	500	Included in Medical	6350	Included in Medical	12700	Included in Medical	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	No Charge	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible
NV	Eureka	Silver	Nevada Health CO-OP	34996NV0060006	Frontier Simple/Fácil Silver	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	226.39	356.53	373.64	404.66	455.64	636.76	967.61	713.06	809.32	911.28	1273.52	1935.22	939.45	1035.71	1137.67	1499.91	1165.84	1262.1	1364.06	1726.3	1392.23	1488.49	1590.45	1952.69	582.92	631.05	682.03	863.15	809.31	857.44	908.42	1089.54	1035.7	1083.83	1134.81	1315.93	1500	Included in Medical	3000	Included in Medical	6350	Included in Medical	12700	Included in Medical	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	No Charge	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible
NV	Humboldt	Bronze	Nevada Health CO-OP	34996NV0060007	Frontier Simple/Fácil Bronze HSA	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	177.44	279.43	292.85	317.16	357.12	499.07	758.38	558.86	634.32	714.24	998.14	1516.76	736.3	811.76	891.68	1175.58	913.74	989.2	1069.12	1353.02	1091.18	1166.64	1246.56	1530.46	456.87	494.6	534.56	676.51	634.31	672.04	712	853.95	811.75	849.48	889.44	1031.39	6250	Included in Medical	12500	Included in Medical	6250	Included in Medical	12500	Included in Medical	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible
NV	Humboldt	Gold	Nevada Health CO-OP	34996NV0060005	Frontier Simple/Fácil Gold	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	264.31	416.23	436.21	472.42	531.94	743.39	1129.65	832.46	944.84	1063.88	1486.78	2259.3	1096.77	1209.15	1328.19	1751.09	1361.08	1473.46	1592.5	2015.4	1625.39	1737.77	1856.81	2279.71	680.54	736.73	796.25	1007.7	944.85	1001.04	1060.56	1272.01	1209.16	1265.35	1324.87	1536.32	650	Included in Medical	1300	Included in Medical	6350	Included in Medical	12700	Included in Medical	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	No Charge	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible
NV	Humboldt	Platinum	Nevada Health CO-OP	34996NV0060008	Frontier Simple/Fácil Platinum	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	304.02	478.77	501.75	543.4	611.86	855.08	1299.37	957.54	1086.8	1223.72	1710.16	2598.74	1261.56	1390.82	1527.74	2014.18	1565.58	1694.84	1831.76	2318.2	1869.6	1998.86	2135.78	2622.22	782.79	847.42	915.88	1159.1	1086.81	1151.44	1219.9	1463.12	1390.83	1455.46	1523.92	1767.14	250	Included in Medical	500	Included in Medical	6350	Included in Medical	12700	Included in Medical	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	No Charge	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible
NV	Humboldt	Silver	Nevada Health CO-OP	34996NV0060006	Frontier Simple/Fácil Silver	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	226.39	356.53	373.64	404.66	455.64	636.76	967.61	713.06	809.32	911.28	1273.52	1935.22	939.45	1035.71	1137.67	1499.91	1165.84	1262.1	1364.06	1726.3	1392.23	1488.49	1590.45	1952.69	582.92	631.05	682.03	863.15	809.31	857.44	908.42	1089.54	1035.7	1083.83	1134.81	1315.93	1500	Included in Medical	3000	Included in Medical	6350	Included in Medical	12700	Included in Medical	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	No Charge	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible
NV	Lander	Bronze	Nevada Health CO-OP	34996NV0060007	Frontier Simple/Fácil Bronze HSA	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Bronze-HSA.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	177.44	279.43	292.85	317.16	357.12	499.07	758.38	558.86	634.32	714.24	998.14	1516.76	736.3	811.76	891.68	1175.58	913.74	989.2	1069.12	1353.02	1091.18	1166.64	1246.56	1530.46	456.87	494.6	534.56	676.51	634.31	672.04	712	853.95	811.75	849.48	889.44	1031.39	6250	Included in Medical	12500	Included in Medical	6250	Included in Medical	12500	Included in Medical	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible	No Charge after Deductible
NV	Lander	Gold	Nevada Health CO-OP	34996NV0060005	Frontier Simple/Fácil Gold	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Gold.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	264.31	416.23	436.21	472.42	531.94	743.39	1129.65	832.46	944.84	1063.88	1486.78	2259.3	1096.77	1209.15	1328.19	1751.09	1361.08	1473.46	1592.5	2015.4	1625.39	1737.77	1856.81	2279.71	680.54	736.73	796.25	1007.7	944.85	1001.04	1060.56	1272.01	1209.16	1265.35	1324.87	1536.32	650	Included in Medical	1300	Included in Medical	6350	Included in Medical	12700	Included in Medical	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	No Charge	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible	20% Coinsurance after deductible
NV	Lander	Platinum	Nevada Health CO-OP	34996NV0060008	Frontier Simple/Fácil Platinum	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Platinum.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	304.02	478.77	501.75	543.4	611.86	855.08	1299.37	957.54	1086.8	1223.72	1710.16	2598.74	1261.56	1390.82	1527.74	2014.18	1565.58	1694.84	1831.76	2318.2	1869.6	1998.86	2135.78	2622.22	782.79	847.42	915.88	1159.1	1086.81	1151.44	1219.9	1463.12	1390.83	1455.46	1523.92	1767.14	250	Included in Medical	500	Included in Medical	6350	Included in Medical	12700	Included in Medical	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	No Charge	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible	10% Coinsurance after deductible
NV	Lander	Silver	Nevada Health CO-OP	34996NV0060006	Frontier Simple/Fácil Silver	POS	Rating Area 4	Allows Adult and Child-Only	SERFF	1-702-823-2667	1-855-606-2667	711	http://nevadahealthcoop.org/wp-content/uploads/2014/11/PD15-Frontier-Simple.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/DBS-SHOP-Frontier-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/SBC-SHOP-Frontier-Simple-Silver.pdf	http://nevadahealthcoop.org/wp-content/uploads/2014/11/RXF15-One	226.39	356.53	373.64	404.66	455.64	636.76	967.61	713.06	809.32	911.28	1273.52	1935.22	939.45	1035.71	1137.67	1499.91	1165.84	1262.1	1364.06	1726.3	1392.23	1488.49	1590.45	1952.69	582.92	631.05	682.03	863.15	809.31	857.44	908.42	1089.54	1035.7	1083.83	1134.81	1315.93	1500	Included in Medical	3000	Included in Medical	6350	Included in Medical	12700	Included in Medical	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	No Charge	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible	30% Coinsurance after deductible

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