WARREN PHARMACY
Accepted Insurance Health Plans for NPI 1023148632
Pharmacy in Warren, IN
NPI Status: Active since March 06, 2007
- Aetna CVS Health
- Avera Health Plans
- BannerAetna
- Baylor Scott and White Health Plan
- BlueCross BlueShield of Tennessee
- Health Alliance
- Oscar Health Insurance
- Oscar Health Plan of North Carolina, Inc
- Oscar Health Plan, Inc.
- Oscar Insurance Company
- Oscar Insurance Company of Florida
- Oscar Insurance Corporation of Ohio
- Sanford Health Plan
Accepted Health Plans and Insurance Coverage
List of insurance companies accepted by WARREN PHARMACY. Use our filterable tables to quickly find the details of your health plan, including: Plan Name, Plan Type and Plan ID. Search this page to find if your specific insurance is accepted. Please verify directly with the provider to make sure your healthplan is currently accepted.
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Bronze 1 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay | HMO | 99129IL0120001 | No |
| Bronze 2 Advanced HSA: Aetna network + CVS Health Virtual Primary Care | EPO | 48161MO0200003 | No |
| Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care | EPO | 84600KS0130001 | No |
| Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care | HMO | 38927UT0380001 | No |
| Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care | HMO | 61671NC0100001 | No |
| Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care | HMO | 84867OH0100001 | No |
| Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care | HMO | 96992IN0060001 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160054 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060002 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130002 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100016 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100002 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 99129IL0120012 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | EPO | 84600KS0130010 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 18628FL0160060 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 61671NC0100022 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 84867OH0100010 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 96992IN0060010 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 99129IL0120032 | No |
| Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200028 | No |
| Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision | EPO | 48161MO0200040 | No |
| Bronze 4 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380002 | No |
| Bronze S: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200016 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160022 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060003 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130003 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380003 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100006 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100003 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 99129IL0120003 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160061 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060011 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130011 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100023 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100011 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 99129IL0120033 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | EPO | 84600KS0130012 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 18628FL0160062 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 61671NC0100024 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 84867OH0100012 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 96992IN0060012 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 99129IL0120034 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision | HMO | 58840TX0110147 | No |
| Gold 10 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380010 | No |
| Gold 10: $0 PCP at Aetna network & MinuteClinic Primary Care + $0 CVS Health Virtual Care | HMO | 58840TX0130001 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160055 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060004 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130004 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380004 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100017 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100004 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay | HMO | 99129IL0120017 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision | EPO | 84600KS0130013 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 18628FL0160063 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 61671NC0100025 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 96992IN0060013 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision + Rx Copay | HMO | 99129IL0120035 | No |
| Gold 3 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 | HMO | 58840TX0110075 | No |
| Gold 3 Advanced: Aetna network + $0 walk-in clinic + Adult Dental + Vision | HMO | 58840TX0110149 | No |
| Gold 4 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 | HMO | 58840TX0110085 | No |
| Gold S: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200019 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160030 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060005 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130005 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380005 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100007 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 67190DE0100008 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100005 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay | HMO | 99129IL0120005 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay | PPO | 72547IL0170005 | No |
| Gold S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 | HMO | 58840TX0110033 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160064 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060014 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130014 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100026 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100013 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 99129IL0120036 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | EPO | 84600KS0130015 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 18628FL0160065 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 61671NC0100027 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 84867OH0100014 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 96992IN0060015 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 99129IL0120037 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 | HMO | 58840TX0110151 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision | HMO | 58840TX0110152 | No |
| Silver 10 Advanced: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200044 | No |
| Silver 10 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision | EPO | 48161MO0200045 | No |
| Silver 10: $0 PCP at Aetna network & MinuteClinic Primary Care + $0 CVS Health Virtual Care | HMO | 58840TX0130002 | No |
| Silver 5 Advanced: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200015 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160029 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060006 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130006 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380006 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100019 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100006 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay | HMO | 99129IL0120006 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision + Rx Copay | HMO | 99129IL0120038 | No |
| Silver 5 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 | HMO | 58840TX0110103 | No |
| Silver 6 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380008 | No |
| Silver S: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200025 | No |
| Silver S: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental+Vision | EPO | 48161MO0200046 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision | HMO | 18628FL0160067 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision | HMO | 96992IN0060016 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 67190DE0100009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 99129IL0120009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | PPO | 72547IL0170009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision | EPO | 84600KS0130016 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision | HMO | 61671NC0100028 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision | HMO | 84867OH0100015 | No |
| Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 | HMO | 58840TX0110055 | No |
| Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision | HMO | 58840TX0110154 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Avera $1800 | PPO | 60536SD0020064 | No |
| Avera $1800 | PPO | 60536SD0020065 | No |
| Avera $2000 | PPO | 60536SD0020007 | No |
| Avera $2000 | PPO | 60536SD0020041 | No |
| Avera $4000 | PPO | 60536SD0020022 | No |
| Avera $4000 | PPO | 60536SD0020043 | No |
| Avera $4500 | PPO | 60536SD0020039 | No |
| Avera $4500 | PPO | 60536SD0020045 | No |
| Avera $6000 | PPO | 60536SD0020023 | No |
| Avera $6000 | PPO | 60536SD0020046 | No |
| Avera $7500 HSA Eligible HDHP | PPO | 60536SD0020024 | No |
| Avera $7500 HSA Eligible HDHP | PPO | 60536SD0020047 | No |
| Avera $9200 | PPO | 60536SD0020018 | No |
| Avera $9200 | PPO | 60536SD0020050 | No |
| Avera Standard $1500 | PPO | 60536SD0020051 | No |
| Avera Standard $1500 | PPO | 60536SD0020057 | No |
| Avera Standard $5000 | PPO | 60536SD0020052 | No |
| Avera Standard $5000 | PPO | 60536SD0020058 | No |
| Avera Standard $7500 | PPO | 60536SD0020066 | No |
| Avera Standard $7500 | PPO | 60536SD0020067 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) | HMO | 40788TX0460001 | No |
| BSW Elite Gold HMO 004 (Two free PCP visits, $0 Pediatric PCP visits) | HMO | 40788TX0460004 | No |
| BSW Elite Gold HMO 012 | HMO | 40788TX0460012 | No |
| BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) | HMO | 40788TX0460003 | No |
| BSW Prime Silver HMO 008 (Two free PCP visits, $0 Pediatric PCP visit) | HMO | 40788TX0460008 | No |
| BSW Prime Silver HMO 005 | HMO | 40788TX0460005 | No |
| BSW Savers Bronze HMO H S A 006 | HMO | 40788TX0460006 | No |
| BSW Vital Bronze HMO 007 (CMS Standardized Plan with $0 Pediatric PCP copay) | HMO | 40788TX0460007 | No |
| BSW Vital Bronze HMO 009 (One free PCP visit, $0 Pediatric PCP visit) | HMO | 40788TX0460009 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| BlueCross B07E HSA | EPO | 14002TN0400285 | No |
| BlueCross B07E HSA | EPO | 14002TN0400300 | No |
| BlueCross B07E HSA | EPO | 14002TN0400301 | No |
| BlueCross B07E HSA | EPO | 14002TN0400302 | No |
| BlueCross B07S HSA | EPO | 14002TN0400001 | No |
| BlueCross B07S HSA | EPO | 14002TN0400005 | No |
| BlueCross B15E $0 virtual care from Teladoc Health � | EPO | 14002TN0400239 | No |
| BlueCross B15E $0 virtual care from Teladoc Health � | EPO | 14002TN0400240 | No |
| BlueCross B15E $0 virtual care from Teladoc Health � | EPO | 14002TN0400287 | No |
| BlueCross B15E $0 virtual care from Teladoc Health � | EPO | 14002TN0400303 | No |
| BlueCross B15E $0 virtual care from Teladoc Health � | EPO | 14002TN0400304 | No |
| BlueCross B15E $0 virtual care from Teladoc Health � | EPO | 14002TN0400305 | No |
| BlueCross B15S $0 virtual care from Teladoc Health � | EPO | 14002TN0400091 | No |
| BlueCross B15S $0 virtual care from Teladoc Health � | EPO | 14002TN0400097 | No |
| BlueCross B16E $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400253 | No |
| BlueCross B16E $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400254 | No |
| BlueCross B16E $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400288 | No |
| BlueCross B16E $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400306 | No |
| BlueCross B16E $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400307 | No |
| BlueCross B16E $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400308 | No |
| BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400241 | No |
| BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400242 | No |
| BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400243 | No |
| BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400244 | No |
| BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400245 | No |
| BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400246 | No |
| BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400247 | No |
| BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400248 | No |
| BlueCross B17E $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400311 | No |
| BlueCross B17E $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400312 | No |
| BlueCross B17E $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400313 | No |
| BlueCross B17E $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400314 | No |
| BlueCross B17E $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400315 | No |
| BlueCross B17E $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400316 | No |
| BlueCross B17S $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400309 | No |
| BlueCross B17S $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400310 | No |
| BlueCross G06E $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400295 | No |
| BlueCross G06E $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400353 | No |
| BlueCross G06E $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400354 | No |
| BlueCross G06E $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400355 | No |
| BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400200 | No |
| BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400201 | No |
| BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400202 | No |
| BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400203 | No |
| BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400204 | No |
| BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400205 | No |
| BlueCross G08E $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400234 | No |
| BlueCross G08E $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400235 | No |
| BlueCross G08E $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400297 | No |
| BlueCross G08E $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400356 | No |
| BlueCross G08E $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400357 | No |
| BlueCross G08E $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400358 | No |
| BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400222 | No |
| BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400223 | No |
| BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400224 | No |
| BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400225 | No |
| BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400226 | No |
| BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400227 | No |
| BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400228 | No |
| BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400229 | No |
| BlueCross S25E $55 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400255 | No |
| BlueCross S25E $55 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400256 | No |
| BlueCross S25E $55 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400292 | No |
| BlueCross S25E $55 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400328 | No |
| BlueCross S25E $55 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400329 | No |
| BlueCross S25E $55 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400330 | No |
| BlueCross S25S $55 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400188 | No |
| BlueCross S25S $55 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400194 | No |
| BlueCross S26E $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400269 | No |
| BlueCross S26E $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400270 | No |
| BlueCross S26E $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400293 | No |
| BlueCross S26E $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400331 | No |
| BlueCross S26E $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400332 | No |
| BlueCross S26E $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400333 | No |
| BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400257 | No |
| BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400258 | No |
| BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400259 | No |
| BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400260 | No |
| BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400261 | No |
| BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400262 | No |
| BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400263 | No |
| BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400264 | No |
| BlueCross S27E $60 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400294 | No |
| BlueCross S27E $60 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400334 | No |
| BlueCross S27E $60 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400335 | No |
| BlueCross S27E $60 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400336 | No |
| BlueCross S27S $60 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400271 | No |
| BlueCross S27S $60 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400277 | No |
| BlueCross S29E $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400339 | No |
| BlueCross S29E $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400340 | No |
| BlueCross S29E $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400341 | No |
| BlueCross S29E $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400342 | No |
| BlueCross S29S $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400337 | No |
| BlueCross S29S $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400338 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| 2025 HMO 1500 Elite Gold | HMO | 20129IL0330090 | No |
| 2025 HMO 5000 Elite Silver | HMO | 20129IL0330091 | No |
| 2025 HMO 9200 Elite Catastrophic | HMO | 20129IL0330020 | No |
| 2025 POS 1000 Elite Gold | POS | 20129IL0340067 | No |
| 2025 POS 1500 Elite Gold | POS | 20129IL0340079 | No |
| 2025 POS 2500 Elite Gold | POS | 20129IL0340070 | No |
| 2025 POS 4200 Elite Silver | POS | 20129IL0340073 | No |
| 2025 POS 5000 Elite Silver | POS | 20129IL0340080 | No |
| 2025 POS 6500 Elite Bronze | POS | 20129IL0340035 | No |
| 2025 POS 7250 Elite Silver | POS | 20129IL0340045 | No |
| 2025 POS 7500 Elite Bronze | POS | 20129IL0340082 | No |
| 2025 POS HSA 7350 Elite Bronze | POS | 20129IL0340061 | No |
| 2025 Simplete Memorial HMO Limited Network 3500 Silver | HMO | 20129IL0330088 | No |
| 2025 Simplete Memorial HMO Limited Network 2500 Gold | HMO | 20129IL0330087 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Bronze Classic 4700 (Select) | HMO | 29341OH0100024 | No |
| Bronze Classic PCP Saver (Select) | HMO | 29341OH0100002 | No |
| Bronze Classic Standard (Select) | HMO | 29341OH0100050 | No |
| Gold Classic (Select) | HMO | 29341OH0100013 | No |
| Gold Classic Standard (Select) | HMO | 29341OH0100053 | No |
| Gold Elite Saver Plus (Select) | HMO | 29341OH0100035 | No |
| Secure (Select) | HMO | 29341OH0100011 | No |
| Silver Classic Standard (Select) | HMO | 29341OH0100052 | No |
| Silver Elite Saver Plus (Select) | HMO | 29341OH0100030 | No |
| Silver Simple Chronic Care CKM (Select) | HMO | 29341OH0100060 | No |
| Silver Simple PCP Saver (Select) | HMO | 29341OH0100025 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Bronze Classic 4700 | HMO | 69803NC0010024 | No |
| Bronze Classic 4700 | with Atrium Health | HMO | 69803NC0010061 | No |
| Bronze Classic Standard | HMO | 69803NC0010050 | No |
| Bronze Classic Standard | with Atrium Health | HMO | 69803NC0010055 | No |
| Bronze Elite + PCP Saver Plus | HMO | 69803NC0010005 | No |
| Bronze Elite + PCP Saver Plus | with Atrium Health | HMO | 69803NC0010062 | No |
| Gold Classic Standard | HMO | 69803NC0010053 | No |
| Gold Classic Standard | with Atrium Health | HMO | 69803NC0010057 | No |
| Gold Elite Saver Plus | HMO | 69803NC0010035 | No |
| Gold Elite Saver Plus | with Atrium Health | HMO | 69803NC0010066 | No |
| Secure | HMO | 69803NC0010011 | No |
| Secure | with Atrium Health | HMO | 69803NC0010060 | No |
| Silver Classic | HMO | 69803NC0010006 | No |
| Silver Classic | with Atrium Health | HMO | 69803NC0010063 | No |
| Silver Classic Standard | HMO | 69803NC0010052 | No |
| Silver Classic Standard | with Atrium Health | HMO | 69803NC0010056 | No |
| Silver Simple Diabetes | HMO | 69803NC0010045 | No |
| Silver Simple Diabetes | with Atrium Health | HMO | 69803NC0010064 | No |
| Silver Simple PCP Saver | HMO | 69803NC0010025 | No |
| Silver Simple PCP Saver | with Atrium Health | HMO | 69803NC0010065 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Bronze Classic 4700 | HMO | 13877AZ0070024 | No |
| Bronze Classic 4700 (Select) | HMO | 11574IL0020024 | No |
| Bronze Classic PCP Saver Plus Rx Copay (Select) | HMO | 11574IL0020021 | No |
| Bronze Classic Standard | HMO | 13877AZ0070050 | No |
| Bronze Classic Standard (Choice) | HMO | 11574IL0010050 | No |
| Bronze Classic Standard (Select) | HMO | 11574IL0020050 | No |
| Bronze Elite + PCP Saver Plus | HMO | 13877AZ0070005 | No |
| Gold Classic | HMO | 13877AZ0070013 | No |
| Gold Classic Standard | HMO | 13877AZ0070053 | No |
| Gold Classic Standard (Choice) | HMO | 11574IL0010053 | No |
| Gold Classic Standard (Select) | HMO | 11574IL0020053 | No |
| Secure | HMO | 13877AZ0070011 | No |
| Secure (Choice) | HMO | 11574IL0010011 | No |
| Silver Classic Standard | HMO | 13877AZ0070052 | No |
| Silver Classic Standard (Choice) | HMO | 11574IL0010052 | No |
| Silver Classic Standard (Select) | HMO | 11574IL0020052 | No |
| Silver Elite Saver Plus | HMO | 13877AZ0070030 | No |
| Silver Elite Saver Plus Rx Copay (Select) | HMO | 11574IL0020030 | No |
| Silver Simple Chronic Care CKM | HMO | 13877AZ0070060 | No |
| Silver Simple Diabetes (Choice) | HMO | 11574IL0010045 | No |
| Silver Simple Diabetes (Select) | HMO | 11574IL0020060 | No |
| Silver Simple PCP Saver | HMO | 13877AZ0070025 | No |
| Silver Simple PCP Saver (Select) | HMO | 11574IL0020025 | No |
| Silver Simple Specialist Saver with COPD | HMO | 13877AZ0070008 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Bronze Classic | EPO | 57424NE0010003 | No |
| Bronze Classic 4700 | EPO | 23552TN0020024 | No |
| Bronze Classic 4700 | EPO | 43490KS0010024 | No |
| Bronze Classic 4700 | EPO | 45819IA0010060 | No |
| Bronze Classic 4700 | EPO | 69512MO0010024 | No |
| Bronze Classic 4700 | EPO | 77739MI0070024 | No |
| Bronze Classic 4700 | PPO | 91908OK0010024 | No |
| Bronze Classic 4700 | MercyOne | EPO | 45819IA0010024 | No |
| Bronze Classic Standard | EPO | 23552TN0020050 | No |
| Bronze Classic Standard | EPO | 43490KS0010050 | No |
| Bronze Classic Standard | EPO | 45819IA0010065 | No |
| Bronze Classic Standard | EPO | 57424NE0010050 | No |
| Bronze Classic Standard | EPO | 69512MO0010050 | No |
| Bronze Classic Standard | EPO | 77739MI0070050 | No |
| Bronze Classic Standard | PPO | 91908OK0010050 | No |
| Bronze Classic Standard | MercyOne | EPO | 45819IA0010050 | No |
| Bronze Elite + PCP Saver | EPO | 43490KS0010005 | No |
| Bronze Elite + PCP Saver Plus | EPO | 23552TN0020005 | No |
| Bronze Elite + PCP Saver Plus | EPO | 45819IA0010056 | No |
| Bronze Elite + PCP Saver Plus | EPO | 57424NE0010005 | No |
| Bronze Elite + PCP Saver Plus | EPO | 69512MO0010005 | No |
| Bronze Elite + PCP Saver Plus | EPO | 77739MI0070005 | No |
| Bronze Elite + PCP Saver Plus | PPO | 91908OK0010005 | No |
| Bronze Elite + PCP Saver Plus | MercyOne | EPO | 45819IA0010005 | No |
| Gold Classic | EPO | 23552TN0020013 | No |
| Gold Classic Standard | EPO | 23552TN0020053 | No |
| Gold Classic Standard | EPO | 43490KS0010053 | No |
| Gold Classic Standard | EPO | 45819IA0010067 | No |
| Gold Classic Standard | EPO | 57424NE0010053 | No |
| Gold Classic Standard | EPO | 69512MO0010053 | No |
| Gold Classic Standard | EPO | 77739MI0070053 | No |
| Gold Classic Standard | PPO | 91908OK0010053 | No |
| Gold Classic Standard | MercyOne | EPO | 45819IA0010053 | No |
| Gold Elite | EPO | 23552TN0020036 | No |
| Gold Elite | EPO | 45819IA0010063 | No |
| Gold Elite | EPO | 57424NE0010036 | No |
| Gold Elite | MercyOne | EPO | 45819IA0010036 | No |
| Gold Elite Saver Plus | EPO | 77739MI0070035 | No |
| Secure | EPO | 23552TN0020011 | No |
| Secure | EPO | 43490KS0010011 | No |
| Secure | EPO | 45819IA0010058 | No |
| Secure | EPO | 57424NE0010011 | No |
| Secure | EPO | 69512MO0010011 | No |
| Secure | EPO | 77739MI0070011 | No |
| Secure | PPO | 91908OK0010011 | No |
| Secure | MercyOne | EPO | 45819IA0010011 | No |
| Silver Classic | EPO | 23552TN0020006 | No |
| Silver Classic | EPO | 43490KS0010006 | No |
| Silver Classic | EPO | 45819IA0010057 | No |
| Silver Classic | EPO | 57424NE0010006 | No |
| Silver Classic | EPO | 77739MI0070006 | No |
| Silver Classic | MercyOne | EPO | 45819IA0010006 | No |
| Silver Classic Standard | EPO | 23552TN0020052 | No |
| Silver Classic Standard | EPO | 43490KS0010052 | No |
| Silver Classic Standard | EPO | 45819IA0010066 | No |
| Silver Classic Standard | EPO | 57424NE0010052 | No |
| Silver Classic Standard | EPO | 69512MO0010052 | No |
| Silver Classic Standard | EPO | 77739MI0070052 | No |
| Silver Classic Standard | PPO | 91908OK0010052 | No |
| Silver Classic Standard | MercyOne | EPO | 45819IA0010052 | No |
| Silver Elite Saver Plus | EPO | 69512MO0010030 | No |
| Silver Elite Saver Plus | PPO | 91908OK0010030 | No |
| Silver Simple Breathe Easy with Enhanced COPD Benefits | EPO | 23552TN0020056 | No |
| Silver Simple Breathe Easy with Enhanced COPD Benefits | PPO | 91908OK0010055 | No |
| Silver Simple Diabetes | EPO | 23552TN0020055 | No |
| Silver Simple Diabetes | EPO | 43490KS0010045 | No |
| Silver Simple Diabetes | EPO | 45819IA0010064 | No |
| Silver Simple Diabetes | EPO | 57424NE0010045 | No |
| Silver Simple Diabetes | EPO | 69512MO0010045 | No |
| Silver Simple Diabetes | PPO | 91908OK0010045 | No |
| Silver Simple Diabetes | MercyOne | EPO | 45819IA0010045 | No |
| Silver Simple PCP Saver | EPO | 23552TN0020025 | No |
| Silver Simple PCP Saver | EPO | 43490KS0010025 | No |
| Silver Simple PCP Saver | EPO | 45819IA0010061 | No |
| Silver Simple PCP Saver | EPO | 57424NE0010025 | No |
| Silver Simple PCP Saver | EPO | 69512MO0010025 | No |
| Silver Simple PCP Saver | EPO | 77739MI0070025 | No |
| Silver Simple PCP Saver | PPO | 91908OK0010025 | No |
| Silver Simple PCP Saver | MercyOne | EPO | 45819IA0010025 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Bronze Classic 4700 | EPO | 40572FL0070024 | No |
| Bronze Classic 4700 | EPO | 40572FL0200024 | No |
| Bronze Classic Standard | EPO | 40572FL0070050 | No |
| Bronze Classic Standard | EPO | 40572FL0200050 | No |
| Bronze Elite + PCP Saver Plus | EPO | 40572FL0070005 | No |
| Bronze Elite + PCP Saver Plus | EPO | 40572FL0200005 | No |
| Gold Classic Standard | EPO | 40572FL0070053 | No |
| Gold Classic Standard | EPO | 40572FL0200053 | No |
| Gold Elite | EPO | 40572FL0070036 | No |
| Gold Elite Saver Plus | EPO | 40572FL0070035 | No |
| Secure | EPO | 40572FL0070011 | No |
| Secure | EPO | 40572FL0200011 | No |
| Silver Classic Standard | EPO | 40572FL0070052 | No |
| Silver Classic Standard | EPO | 40572FL0200052 | No |
| Silver Elite | EPO | 40572FL0070016 | No |
| Silver Elite | EPO | 40572FL0200016 | No |
| Silver Simple Chronic Care CKM | EPO | 40572FL0070060 | No |
| Silver Simple Chronic Care CKM | EPO | 40572FL0200060 | No |
| Silver Simple Diabetes | EPO | 40572FL0070061 | No |
| Silver Simple Diabetes | EPO | 40572FL0200061 | No |
| Silver Simple PCP Saver | EPO | 40572FL0070025 | No |
| Silver Simple PCP Saver | EPO | 40572FL0200025 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Bronze Classic PCP Saver | HMO | 45845OH0100002 | No |
| Bronze Classic Standard | HMO | 45845OH0100050 | No |
| Bronze Simple HSA | HMO | 45845OH0100014 | No |
| Gold Classic Standard | HMO | 45845OH0100053 | No |
| Gold Elite | HMO | 45845OH0100036 | No |
| Gold Elite Saver Plus | HMO | 45845OH0100035 | No |
| Secure | HMO | 45845OH0100011 | No |
| Silver Classic Standard | HMO | 45845OH0100052 | No |
| Silver Elite Saver Plus | HMO | 45845OH0100030 | No |
| Silver Simple Chronic Care CKM | HMO | 45845OH0100060 | No |
| Silver Simple Diabetes | HMO | 45845OH0100045 | No |
| Silver Simple PCP Saver | HMO | 45845OH0100025 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Sanford Individual Simplicity $1,750 | PPO | 31195SD0110001 | No |
| Sanford Individual Simplicity $1,750 | PPO | 89364ND0120001 | No |
| Sanford Individual Simplicity $3,500 | PPO | 31195SD0110003 | No |
| Sanford Individual Simplicity $3,500 | PPO | 89364ND0120003 | No |
| Sanford Individual Simplicity $4,750 | PPO | 31195SD0110005 | No |
| Sanford Individual Simplicity $4,750 | PPO | 89364ND0120005 | No |
| Sanford Individual Simplicity $6,000 | PPO | 31195SD0110007 | No |
| Sanford Individual Simplicity $6,000 | PPO | 89364ND0120007 | No |
| Sanford Individual Simplicity $7,100 HSA Qualified | PPO | 31195SD0110006 | No |
| Sanford Individual Simplicity $7,100 HSA Qualified | PPO | 89364ND0120006 | No |
| Sanford Individual Simplicity $9,200 | PPO | 31195SD0110009 | No |
| Sanford Individual Simplicity $9,200 | PPO | 89364ND0120009 | No |
| Sanford Individual Simplicity Standardized $1,500 | PPO | 31195SD0110018 | No |
| Sanford Individual Simplicity Standardized $1,500 | PPO | 89364ND0120018 | No |
| Sanford Individual Simplicity Standardized $5,000 | PPO | 31195SD0110017 | No |
| Sanford Individual Simplicity Standardized $5,000 | PPO | 89364ND0120017 | No |
| Sanford Individual Simplicity Standardized $7,500 | PPO | 31195SD0110016 | No |
| Sanford Individual Simplicity Standardized $7,500 | PPO | 89364ND0120016 | No |
| Sanford Individual TRUE $1,750 | HMO | 31195SD0080018 | No |
| Sanford Individual TRUE $1,750 | HMO | 89364ND0090018 | No |
| Sanford Individual TRUE $3,500 | HMO | 31195SD0080008 | No |
| Sanford Individual TRUE $3,500 | HMO | 89364ND0090008 | No |
| Sanford Individual TRUE $4,750 | HMO | 31195SD0080016 | No |
| Sanford Individual TRUE $4,750 | HMO | 89364ND0090016 | No |
| Sanford Individual TRUE $6,000 | HMO | 31195SD0080007 | No |
| Sanford Individual TRUE $6,000 | HMO | 89364ND0090007 | No |
| Sanford Individual TRUE $7,100 HSA Qualified | HMO | 31195SD0080009 | No |
| Sanford Individual TRUE $7,100 HSA Qualified | HMO | 89364ND0090009 | No |
| Sanford Individual TRUE $9,200 | HMO | 31195SD0080015 | No |
| Sanford Individual TRUE $9,200 | HMO | 89364ND0090015 | No |
| Sanford Individual TRUE Standardized $1,500 | HMO | 31195SD0080028 | No |
| Sanford Individual TRUE Standardized $1,500 | HMO | 89364ND0090028 | No |
| Sanford Individual TRUE Standardized $5,000 | HMO | 31195SD0080027 | No |
| Sanford Individual TRUE Standardized $5,000 | HMO | 89364ND0090027 | No |
| Sanford Individual TRUE Standardized $7,500 | HMO | 31195SD0080026 | No |
| Sanford Individual TRUE Standardized $7,500 | HMO | 89364ND0090026 | No |