SoloCare Summary of Benefits and Coverage Plans
Individual / Family
2021
SoloCare Plans are available to residents of Atkinson, Baker, Baldwin, Banks, Barrow, Bibb, Bleckley, Burke, Calhoun, Carroll, Catoosa, Chattahoochee, Chattooga, Clarke, Clay, Clinch, Coffee, Colquitt, Columbia, Crawford, Crisp, Dade, Dawson, Decatur, Dodge, Dooly, Dougherty, Elbert, Fannin, Floyd, Franklin, Gilmer, Glascock, Gordon, Greene, Habersham, Hall, Hancock, Haralson, Harris, Hart, Heard, Houston, Jackson, Jeff Davis, Jefferson, Jenkins, Jones, Lee, Lincoln, Lumpkin, Macon, Madison, Marion, McDuffie, Meriwether, Mitchell, Monroe, Morgan, Murray, Muscogee, Oconee, Oglethorpe, Peach, Pickens, Polk, Pulaski, Putnam, Quitman, Rabun, Randolph, Richmond, Schley, Stephens, Stewart, Sumter, Talbot, Taliaferro, Taylor, Telfair, Terrell, Towns, Troup, Twiggs, Union, Upson, Walker, Walton, Warren, Washington, Webster, Wheeler, White, Whitfield, Wilcox, Wilkes, Wilkinson, and Worth counties.
Magellan Formulary List Magellan Formulary Look-Up Tool
2021 SoloCare Rate Tables Non-Tobacco 2021 SoloCare Rate Tables Tobacco
ON & OFF Marketplace – 40000 Series, Copay and HDHP Plans
02 – 06 Levels are cost-sharing subsidy
All SoloCare Plans listed below are ICHRA eligible
Platinum
SoloCare Platinum Copay 40184
OFF Marketplace
ON Marketplace
01 – 02 – 03
Gold
SoloCare Gold PPO 40002
OFF Marketplace
ON Marketplace
01 – 02 – 03
Off Market Plan
SoloCare Gold HDHP 40324
OFF Marketplace
Silver
Off Market Plan
SoloCare Silver PPO 40007
OFF Marketplace
Bronze
SoloCare Bronze PPO 40021
OFF Marketplace
ON Marketplace
01 – 02 – 03
SoloCare Bronze HDHP 40031
OFF Marketplace
ON Marketplace
01 – 02 – 03
2020
SoloCare Plans are available to residents of Baldwin, Banks, Barrow, Bibb, Chattooga, Crawford, Dawson, Fannin, Floyd, Franklin, Gilmer, Gordon, Habersham, Hall, Hart, Houston, Jones, Lumpkin, Monroe, Murray, Peach, Pickens, Polk, Rabun, Stephens, Towns, Twiggs, Union, White and Whitfield counties.
2020 PY Magellan Formulary List 2020 Magellan Formulary Look-Up Tool
2020 SoloCare Rate Tables Non- Tobacco 2020 SoloCare Rate Tables Tobacco
ON & OFF Marketplace – 40000 Series, Copay and HDHP Plans
02 – 06 Levels are cost-sharing subsidy
All SoloCare Plans listed below are ICHRA eligible
Platinum
SoloCare Platinum PPO 40023
OFF Marketplace
ON Marketplace
01 – 02 – 03
SoloCare Platinum Copay 40184
OFF Marketplace
ON Marketplace
01 – 02 – 03
Gold
SoloCare Gold PPO 40002
OFF Marketplace
ON Marketplace
01 – 02 – 03
Silver
Off Market Plan
SoloCare Silver PPO 40007
OFF Marketplace
Bronze
SoloCare Bronze PPO 40021
OFF Marketplace
ON Marketplace
01 – 02 – 03
SoloCare Bronze HDHP 40031
OFF Marketplace
ON Marketplace
01 – 02 – 03