SimpleCare Small Group (2 – 50)
SBC and Rates

 OFF Marketplace – 50000 Series – Single Network Option

Alliant Health Plans Network OR PHCS Primary Network

 

Subscribers (and all dependents) are assigned a network based upon their residential address.

  • Subscribers who reside within the Alliant Network Area are assigned the Alliant Only network.

  • Subscribers who reside outside the Alliant Network Area are assigned the PHCS Primary network; this assignment does not provide access to the Alliant network.

 

The Alliant Network Area is defined by the Georgia and Tennessee counties shown below.

Platinum 

simplecare-platinum-768x768-1SimpleCare Platinum PPO 50080
OFF Marketplace

 

Gold 

simplecare-goldSimpleCare Gold PPO 50086
OFF Marketplace

 

Silver 

simplecare-silverSimpleCare Silver PPO 50056
OFF Marketplace

 

 

Bronze 

simplecare-bronzeSimpleCare Bronze PPO 50072
OFF Marketplace

simplecare-platinum-768x768-1SimpleCare Platinum PPO 50082
OFF Marketplace

 

simplecare-goldSimpleCare Gold PPO 50088
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 50058
OFF Marketplace

 

 

simplecare-bronzeSimpleCare Bronze PPO 50074
OFF Marketplace

simplecare-platinum-768x768-1SimpleCare Platinum PPO 50084
OFF Marketplace

simplecare-goldSimpleCare Gold PPO 50090
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 50060
OFF Marketplace

 

 

simplecare-platinum-768x768-1SimpleCare Platinum Copay 50096
OFF Marketplace

 

simplecare-goldSimpleCare Gold PPO 50092
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 50062
OFF Marketplace

 

simplecare-goldSimpleCare Gold PPO 50094
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 50064
OFF Marketplace

 

 

simplecare-goldSimpleCare Gold Copay 50098
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 50066 
OFF Marketplace

 

 

simplecare-silverSimpleCare Silver PPO 50068
OFF Marketplace

 

 

simplecare-silver SimpleCare Silver PPO 50070
OFF Marketplace

 

 

simplecare-silverSimpleCare Silver Copay 50100
OFF Marketplace

 

 

OFF Marketplace – 100000 Series (High Deductible Health Plans) 

Single Network Option (see explanation for 50000 Series)

Alliant Health Plans Network OR PHCS Primary Network

Gold 

Silver 

Bronze 

simplecare-goldSimpleCare Gold HDHP 100012
OFF Marketplace

 

simplecare-silverSimpleCare Silver HDHP 100014
OFF Marketplace

 

 

simplecare-bronzeSimpleCare Bronze HDHP 100016
OFF Marketplace

simplecare-goldSimpleCare Gold HDHP 100013
OFF Marketplace

 

simplecare-silverSimpleCare Silver HDHP 100015
OFF Marketplace

 

 

simplecare-bronzeSimpleCare Bronze HDHP 100017
OFF Marketplace

OFF Marketplace – 80000 Series – Dual Network Option (access to both networks)

Alliant Health Plans Network & PHCS Wrap Network

Platinum 

simplecare-platinum-768x768-1SimpleCare Platinum PPO 80040
OFF Marketplace

 

Gold 

simplecare-goldSimpleCare Gold PPO 80046
OFF Marketplace

 

Silver 

simplecare-silverSimpleCare Silver PPO 80096
OFF Marketplace

 

 

Bronze 

simplecare-bronzeSimpleCare Bronze PPO 80112
OFF Marketplace

simplecare-platinum-768x768-1SimpleCare Platinum PPO 80042
OFF Marketplace

 

simplecare-goldSimpleCare Gold PPO 80048
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 80098
OFF Marketplace

 

 

simplecare-bronzeSimpleCare Bronze PPO 80114
OFF Marketplace

simplecare-platinum-768x768-1SimpleCare Platinum PPO 80044
OFF Marketplace

 

simplecare-goldSimpleCare Gold PPO 80050
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 80100
OFF Marketplace

 

 

simplecare-platinum-768x768-1SimpleCare Platinum Copay 80116
OFF Marketplace

 

simplecare-goldSimpleCare Gold PPO 80052
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 80102
OFF Marketplace

 

 

simplecare-goldSimpleCare Gold PPO 80054
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 80104
OFF Marketplace

 

 

simplecare-goldSimpleCare Gold Copay 80118
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 80106
OFF Marketplace

 

 

simplecare-silverSimpleCare Silver PPO 80108
OFF Marketplace

 

 

simplecare-silverSimpleCare Silver PPO 80110
OFF Marketplace

 

 

simplecare-silverSimpleCare Silver Copay 80120
OFF Marketplace

 

 

OFF Marketplace – 90000 Series (High Deductible Health Plans) – Dual Network Option (access to both networks)

Alliant Health Plans Network & PHCS Wrap Network

Gold 

Silver 

Bronze 

simplecare-goldSimpleCare Gold HDHP 90076
OFF Marketplace

 

simplecare-silverSimpleCare Silver HDHP 90088
OFF Marketplace

 

 

simplecare-bronzeSimpleCare Bronze HDHP 90090
OFF Marketplace

simplecare-goldSimpleCare Gold HDHP 90077
OFF Marketplace

 

simplecare-silverSimpleCare Silver HDHP 90089
OFF Marketplace

 

 

simplecare-bronzeSimpleCare Bronze HDHP 90091
OFF Marketplace

 OFF Marketplace – 50000 Series – Single Network Option

Alliant Health Plans Network OR PHCS Primary Network

 

Subscribers (and all dependents) are assigned a network based upon their residential address.

  • Subscribers who reside within the Alliant Network Area are assigned the Alliant Only network.

  • Subscribers who reside outside the Alliant Network Area are assigned the PHCS Primary network; this assignment does not provide access to the Alliant network.

 

The Alliant Network Area is defined by the Georgia and Tennessee counties shown below.

Platinum 

simplecare-platinum-768x768-1SimpleCare Platinum PPO 50080
OFF Marketplace

 

Gold 

simplecare-goldSimpleCare Gold PPO 50086
OFF Marketplace

 

Silver 

simplecare-silverSimpleCare Silver PPO 50056
OFF Marketplace

 

 

Bronze 
simplecare-bronzeSimpleCare Bronze PPO 50072
OFF Marketplace
simplecare-platinum-768x768-1SimpleCare Platinum PPO 50082
OFF Marketplace

 

simplecare-goldSimpleCare Gold PPO 50088
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 50058
OFF Marketplace

 

 

simplecare-bronzeSimpleCare Bronze PPO 50074
OFF Marketplace
simplecare-platinum-768x768-1SimpleCare Platinum PPO 50084
OFF Marketplace
simplecare-goldSimpleCare Gold PPO 50090
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 50060
OFF Marketplace

 

 

simplecare-platinum-768x768-1SimpleCare Platinum Copay 50096
OFF Marketplace

 

simplecare-goldSimpleCare Gold PPO 50092
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 50062
OFF Marketplace

 

simplecare-goldSimpleCare Gold PPO 50094
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 50064
OFF Marketplace

 

 

simplecare-goldSimpleCare Gold Copay 50098
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 50066 
OFF Marketplace

 

 

simplecare-silverSimpleCare Silver PPO 50068
OFF Marketplace

 

 

simplecare-silver SimpleCare Silver PPO 50070
OFF Marketplace

 

 

simplecare-silverSimpleCare Silver Copay 50100
OFF Marketplace

 

 

OFF Marketplace – 90000 Series (High Deductible Health Plans) – Single Network Option (see explanation for 50000 Series)

Alliant Health Plans Network OR PHCS Primary Network

Gold 

Silver 

Bronze 
simplecare-goldSimpleCare Gold HDHP 90086
OFF Marketplace

 

simplecare-silverSimpleCare Silver HDHP 90078
OFF Marketplace

 

 

simplecare-bronzeSimpleCare Bronze HDHP 90080
OFF Marketplace
simplecare-goldSimpleCare Gold HDHP 90087
OFF Marketplace

 

simplecare-silverSimpleCare Silver HDHP 90079
OFF Marketplace

 

 

simplecare-bronzeSimpleCare Bronze HDHP 90081
OFF Marketplace

OFF Marketplace – 80000 Series – Dual Network Option (access to both networks)

Alliant Health Plans Network & PHCS Wrap Network

Platinum 

simplecare-platinum-768x768-1SimpleCare Platinum PPO 80040
OFF Marketplace

 

Gold 

simplecare-goldSimpleCare Gold PPO 80046
OFF Marketplace

 

Silver 

simplecare-silverSimpleCare Silver PPO 80096
OFF Marketplace

 

 

Bronze 
simplecare-bronzeSimpleCare Bronze PPO 80112
OFF Marketplace
simplecare-platinum-768x768-1SimpleCare Platinum PPO 80042
OFF Marketplace

 

simplecare-goldSimpleCare Gold PPO 80048
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 80098
OFF Marketplace

 

 

simplecare-bronzeSimpleCare Bronze PPO 80114
OFF Marketplace
simplecare-platinum-768x768-1SimpleCare Platinum PPO 80044
OFF Marketplace

 

simplecare-goldSimpleCare Gold PPO 80050
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 80100
OFF Marketplace

 

 

simplecare-platinum-768x768-1SimpleCare Platinum Copay 80116
OFF Marketplace

 

simplecare-goldSimpleCare Gold PPO 80052
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 80102
OFF Marketplace

 

 

simplecare-goldSimpleCare Gold PPO 80054
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 80104
OFF Marketplace

 

 

simplecare-goldSimpleCare Gold Copay 80118
OFF Marketplace

 

simplecare-silverSimpleCare Silver PPO 80106
OFF Marketplace

 

 

simplecare-silverSimpleCare Silver PPO 80108
OFF Marketplace

 

 

simplecare-silverSimpleCare Silver PPO 80110
OFF Marketplace

 

 

simplecare-silverSimpleCare Silver Copay 80120
OFF Marketplace

 

 

OFF Marketplace – 90000 Series (High Deductible Health Plans) – Dual Network Option (access to both networks)

Alliant Health Plans Network & PHCS Wrap Network

Gold 

Silver 

Bronze 
simplecare-goldSimpleCare Gold HDHP 90076
OFF Marketplace

 

simplecare-silverSimpleCare Silver HDHP 90088
OFF Marketplace

 

 

simplecare-bronzeSimpleCare Bronze HDHP 90090
OFF Marketplace
simplecare-goldSimpleCare Gold HDHP 90077
OFF Marketplace

 

simplecare-silverSimpleCare Silver HDHP 90089
OFF Marketplace

 

 

simplecare-bronzeSimpleCare Bronze HDHP 90091
OFF Marketplace

OFF Marketplace – 50000 Series

Silver

simplecare-silver 50156
OFF Marketplace

simplecare-silver50158
OFF Marketplace
simplecare-silver50160
OFF Marketplace
simplecare-silver50162
OFF Marketplace
simplecare-silver50164
OFF Marketplace
simplecare-silver50166
OFF Marketplace
simplecare-silver50168
OFF Marketplace

Bronze

simplecare-bronze50172
OFF Marketplace
simplecare-bronze50174
OFF Marketplace

OFF Marketplace – 80000 Series

Alliant Health Plans Network & PHCS Wrap Network

Platinum

simplecare-platinum-768x768-180140
OFF Marketplace
simplecare-platinum-768x768-180142
OFF Marketplace

Gold

OFF Marketplace – 90000 Series (High Deductible Health Plans)

Alliant Health Plans Network & PHCS Wrap Network

Silver and Bronze Plans

Alliant Health Plans Network

Bronze
simplecare-bronze90180
OFF Marketplace

Transitional Plans

501
02 07 09
18 19 32
1002
02 07 09
18 19 32
2002
02 07 09
18 19 32
2505
02 07 09
18 19 32
5001
02 07 09
18 19 32
7501
02 07 09
18 19 32
502
02 07 09
19 Rx19
1500
02 07 09
18 19 32
2501
02 07 09
18 19 32
3001
02 07 09
18 19 32
5003
02 07 09
18 19 32
7502
02 07 09
18 19 32
1000
02 07 09
18 19 32
1501
02 07 09
18 19 32
2502
02 07 09
18 19 32
3002
02 07 09
18 19 32
5004
02 07 09
18 19 32
1001
02 07 09
18 19 32
2001
02 07 09
18 19 32
2504
02 07 09
18 19 32
3003
02 07 09
18 19 32
5005
02 07 09
18 19 32
1500
14


5000
14
2501
14

2502
14

3000
14

c