SBC and Rates
Platinum
SimpleCare Platinum PPO 50080
OFF Marketplace
Gold
SimpleCare Gold PPO 50086
OFF Marketplace
Silver
Bronze
SimpleCare Bronze PPO 50072
OFF Marketplace
SimpleCare Platinum PPO 50082
OFF Marketplace
SimpleCare Gold PPO 50088
OFF Marketplace
SimpleCare Bronze PPO 50074
OFF Marketplace
SimpleCare Platinum Copay 50096
OFF Marketplace
SimpleCare Gold PPO 50092
OFF Marketplace
SimpleCare Silver PPO 50062
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
OFF Marketplace – 80000 Series – Dual Network Option (access to both networks)
Alliant Health Plans Network & PHCS Wrap Network
Platinum
SimpleCare Platinum PPO 80040
OFF Marketplace
Gold
SimpleCare Gold PPO 80046
OFF Marketplace
Silver
Bronze
SimpleCare Bronze PPO 80112
OFF Marketplace
SimpleCare Platinum PPO 80042
OFF Marketplace
SimpleCare Gold PPO 80048
OFF Marketplace
SimpleCare Bronze PPO 80114
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
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 PPO 50080
OFF Marketplace
Gold
SimpleCare Gold PPO 50086
OFF Marketplace
Silver
Bronze
SimpleCare Bronze PPO 50072
OFF Marketplace
SimpleCare Platinum PPO 50082
OFF Marketplace
SimpleCare Gold PPO 50088
OFF Marketplace
SimpleCare Bronze PPO 50074
OFF Marketplace
SimpleCare Platinum Copay 50096
OFF Marketplace
SimpleCare Gold PPO 50092
OFF Marketplace
SimpleCare Silver PPO 50062
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
OFF Marketplace – 80000 Series – Dual Network Option (access to both networks)
Alliant Health Plans Network & PHCS Wrap Network
Platinum
SimpleCare Platinum PPO 80040
OFF Marketplace
Gold
SimpleCare Gold PPO 80046
OFF Marketplace
Silver
Bronze
SimpleCare Bronze PPO 80112
OFF Marketplace
SimpleCare Platinum PPO 80042
OFF Marketplace
SimpleCare Gold PPO 80048
OFF Marketplace
SimpleCare Bronze PPO 80114
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
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.
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