SoloCare Summary of Benefits and Coverage Plans
Individual / Family

2021 SoloCare
Summary of Benefits and Coverage Plans
Individual / Family

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.

ON & OFF Marketplace – 40000 Series, Copay and HDHP Plans

Please note that 02 – 06 Levels are cost-sharing subsidy.
Alliant Health Plans Network
All SoloCare Plans listed below are ICHRA eligible

Platinum

solocare-platinum-768x768-1
SoloCare Platinum

Copay
40184
OFF Marketplace
ON Marketplace
01 02 –  03

Gold 

solocare-gold

SoloCare Gold
PPO 40002
OFF Marketplace
ON Marketplace
010203

solocare-goldOff Market Plan
SoloCare Gold HDHP 40324
OFF Marketplace

Silver

solocare-silver

Off Market Plan
SoloCare Silver PPO 40007
OFF Marketplace

 

solocare-silverSoloCare Silver PPO 40017
OFF Marketplace
ON Marketplace
010203040506

solocare-silverSoloCare Silver Copay 40232
OFF Marketplace
ON Marketplace 010203040506

Bronze

solocare-bronzeSoloCare Bronze PPO 40021
OFF Marketplace
ON Marketplace
01 0203

solocare-bronzeSoloCare Bronze HDHP 40031
OFF Marketplace
ON Marketplace
01 0203

2022 SoloCare
Summary of Benefits and Coverage Plans
Individual/Family

Review the 2022 Plans Available by County document to locate the plans available in your area.

2022 SoloCare Health Plans - Group A

Atkinson, Baldwin, Banks, Baker, Barrow, Ben Hill, Berrien, Bibb, Bleckley, Brooks, Burke, Calhoun, Carroll, Catoosa, Chattahoochee, Chattooga, Clark, Clay, Clinch, Coffee, Columbia, Colquitt, Cook, Crawford, Crisp, Dade, Dawson, Decatur, Dodge, Dooly, Early, Echols, Elbert, Fannin, Franklin, Floyd, Gilmer, Glascock, Gordon, Grady, Greene, Habersham, Hancock, Haralson, Harris, Hart, Hall, Heard, Houston, Irwin, Jackson, Jefferson, Jeff Davis, Jenkins, Jones, Lamar, Lanier, Lee, Lincoln, Lowndes, Lumpkin, Macon, Madison, Marion, McDuffie, Meriweather, Miller, Mitchell, Monroe, Morgan, Murray, Muscogee, Oconee, Oglethorpe, Peach, Pickens, Pike, Polk, Pulaski, Putnam, Quitman, Rabun, Randolph, Richmond, Schely, Seminole, Stephens, Stewart, Talbot, Taliaferro, Taylor, Telfair, Terrell, Thomas, Tift, Troup, Towns, Turner, Twiggs, Union, Upson, Walker, Walton, Washington, Webster, Wheeler, White, Whitfield, Wilcox, Wilkes, Wilkinson, Worth
Plans NamesMetal TypeOff MarketplaceOn Marketplace
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay) 40336Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Platinum PPO Copay Plan (3 Free PCP Visits + Dental) 40348Platinum 0001 | 02 | 03
SoloCare Platinum PPO Copay Plan (3 Free PCP Visits + Chiro + Dental) 40349Platinum 0001 | 02 | 03
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay) 40331Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Gold PPO (3 Free PCP Visits + Chiro + Dental) 40358Gold0001 | 02 | 03
SoloCare Platinum PPO Copay Plan (3 Free PCP Visits) 40184Platinum 00
01 | 02 | 03
SoloCare Gold PPO (3 Free PCP Visits + Dental) 40357Gold 0001 | 02 | 03
SoloCare Gold PPO (3 Free PCP Visits + Dental) 40354Gold0001 | 02 | 03
SoloCare Gold PPO (3 Free PCP Visits + Chiro + Dental) 40355Gold 0001 | 02 | 03
SoloCare Gold PPO (3 Free PCP Visits) 40330Gold0001 | 02 | 03
SoloCare Gold PPO (3 Free PCP Visits) 40002Gold0001 | 02 | 03
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay + Dental) 40368Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay) 40367Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay + Dental) 40369Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + Chiro + $225 Specialty Drug Copay) 40371Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO Silver (3 Free PCP Visits + $225 Specialty Drug Copay + Dental) 40372Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + Chiro + $225 Specialty Drug Copay + Dental) 40373Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + Chiro + $225 Specialty Drug Copay + Dental) 40374Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay + Dental) 40375Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + Chiro + $225 Specialty Drug Copay + Dental) 40376Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay) 40017Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO 40007Silver00-
SoloCare Gold PPO HDHP 40324Gold00-
SoloCare Gold PPO HDHP 40345Gold00-
SoloCare Gold PPO HDHP 40344Gold00-
SoloCare Gold No Referral HMO (3 Free PCP Visits) 110003Gold0001 | 02 | 03
SoloCare Gold No Referral HMO (3 Free PCP Visits) 110004Gold0001 | 02 | 03
SoloCare Silver No Referral HMO (3 Free PCP Visits + $225 Specialty Drug Copay + Dental) 110008Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver No Referral HMO (3 Free PCP Visits + $225 Specialty Drug Copay) 110009Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver HMO (3 Free PCP Visits + $225 Specialty Drug Copay) 110010Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Bronze No Referral HMO ($250 Specialty Drug Copay) 110011Bronze0001 | 02 | 03
SoloCare Bronze No Referral HMO ($250 Specialty Drug Copay + Dental) 110013Bronze0001 | 02 | 03
SoloCare Bronze No Referral HMO 110015Bronze0001 | 02 | 03
SoloCare Bronze No Referral HMO (+ Dental) 110017Bronze0001 | 02 | 03
SoloCare Bronze No Referral HMO HDHP 110019Bronze0001 | 02 | 03
SoloCare Bronze No Referral HMO HDHP (+ Dental) 110021Bronze0001 | 02 | 03
SoloCare Catastrophic No Referral HMO 110023Catastrophic 0001

 

2022 SoloCare Health Plans - Group B

Barrow, Burke, Chattahoochee, Clark, Clay, Columbia, Elbert, Glascock, Greene, Haralson, Harris, Heard, Jackson, Jefferson, Jenkins, Lamar, Lee, Lincoln, Macon, Madison, Marion, McDuffie, Meriweather, Morgan, Muscogee, Oconee, Oglethorpe, Pike, Quitman, Richmond, Stewart, Talbot, Taliaferro Taylor, Troup, Upson, Walton, Webster, Wilkes
Plan NamesMetal Type Off Marketplace On Marketplace
SoloCare Silver PPO (3 Free PCP Visits + Chiro + $250 Specialty Drug Copay) 40374Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + Chiro + $250 Specialty Drug Copay) 40371Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + Chiro + $250 Specialty Drug Copay) 40367Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + Chiro + $250 Specialty Drug Copay + Dental) 40376Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + Chiro + $250 Specialty Drug Copay + Dental) 40373Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + Chiro + $250 Specialty Drug Copay + Dental) 40369Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $250 Specialty Drug Copay) 40336Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $250 Specialty Drug Copay) 40331Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $250 Specialty Drug Copay) 40017Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $250 Specialty Drug Copay + Dental) 40375Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $250 Specialty Drug Copay + Dental) 40372Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO 40007Silver00-
SoloCare Platinum PPO Copay Plan (3 Free PCP Visits + Dental) 40348Platinum 00
01 | 02 | 03
SoloCare Platinum PPO Copay Plan (3 Free PCP Visits + Chiro + Dental) 40349 Platinum
00
01 | 02 | 03
SoloCare Platinum PPO (3 Free PCP Visits) 40184Platinum 0001 | 02 | 03
SoloCare Platinum PPO (3 Free PCP Visits + Dental) 40348Platinum 0001 | 02 | 03
SoloCare Platinum PPO (3 Free PCP Visits + Chiro + Dental) 40349Platinum 0001 | 02 | 03
SoloCare Gold PPO HDHP 40345 Gold00-
SoloCare Gold PPO HDHP 40344 Gold00-
SoloCare Gold PPO HDHP 40324 Gold00-
SoloCare Gold PPO (3 Free PCP Visits) 40330Gold 0001 | 02 | 03
SoloCare Gold PPO (3 Free PCP Visits) 40002Gold 0001 | 02 | 03
SoloCare Gold PPO (3 Free PCP Visits + Dental) 40357Gold 0001 | 02 | 03
SoloCare Gold PPO (3 Free PCP Visits + Dental) 40354Gold 0001 | 02 | 03
SoloCare Gold PPO (3 Free PCP Visits + Chiro + Dental) 40358Gold 0001 | 02 | 03
SoloCare Gold No Referral HMO (3 Free PCP Visits) 110004Gold0001 | 02 | 03
SoloCare Silver No Referral HMO (3 Free PCP Visits + $225 Specialty Drug Copay + Dental) 110008Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver No Referral HMO (3 Free PCP Visits + $225 Specialty Drug Copay) 110009Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver HMO (3 Free PCP Visits + $225 Specialty Drug Copay) 110010Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Bronze No Referral HMO ($250 Specialty Drug Copay) 110011Bronze0001 | 02 | 03
SoloCare Bronze No Referral HMO ($250 Specialty Drug Copay + Dental) 110013Bronze0001 | 02 | 03
SoloCare Bronze No Referral HMO 110015Bronze0001 | 02 | 03
SoloCare Bronze No Referral HMO (+ Dental) 110017Bronze0001 | 02 | 03
SoloCare Bronze No Referral HMO HDHP 110019Bronze0001 | 02 | 03
SoloCare Bronze No Referral HMO HDHP (+ Dental) 110021Bronze0001 | 02 | 03
SoloCare Catastrophic No Referral HMO 110023Catastrophic 0001

 

2022 SoloCare Health Plans - Group C

Dougherty, Sumter
Plan NameMedial TypeOff Marketplace On Marketplace
SoloCare Platinum PPO Copay Plan (3 Free PCP Visits + Chiro + Dental) 40349Platinum 0001 | 02 | 03
SoloCare Platinum PPO Copay Plan (3 Free PCP Visits + Dental) 40348Platinum 0001 | 02 | 03
SoloCare Platinum PPO Copay Plan (3 Free PCP Visits) 40184Platinum 0001 | 02 | 03
SoloCare Gold PPO (3 Free PCP Visits) 40002
Gold 0001 | 02 | 03
SoloCare Gold PPO (3 Free PCP Visits) 40330
Gold 0001 | 02 | 03
SoloCare Gold PPO (3 Free PCP Visits + Dental) 40354
Gold 0001 | 02 | 03
SoloCare Gold PPO (3 Free PCP Visits + Chiro + Dental) 40355
Gold 0001 | 02 | 03
SoloCare Gold PPO (3 Free PCP Visits + Dental) 40357
Gold 0001 | 02 | 03
SoloCare Gold PPO (3 Free PCP Visits + Chiro + Dental) 40358
Gold 0001 | 02 | 03
SoloCare PPO Gold HDHP 40324Gold 00-
SoloCare PPO Gold HDHP 40344
Gold 00-
SoloCare PPO Silver HDHP 40345Silver 00-
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay + Dental) 40372Silver 0001 | 02 | 03
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay + Dental) 40375Silver 0001 | 02 | 03
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay) 40017Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay) 40331Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay) 40336Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay + Dental) 40369Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay + Dental) 40373Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay + Dental) 40376Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay) 40367Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay) 40371Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + Chiro + $250 Specialty Drug Copay) 40374Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO (3 Free PCP Visits + $225 Specialty Drug Copay + Dental) 40368Silver 0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver PPO 40007Silver 00
SoloCare Gold No Referral HMO (3 Free PCP Visits) 110003Gold0001 | 02 | 03
SoloCare Gold No Referral HMO (3 Free PCP Visits) 110004Gold0001 | 02 | 03
SoloCare Silver No Referral HMO (3 Free PCP Visits + $225 Specialty Drug Copay + Dental) 110008Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver No Referral HMO (3 Free PCP Visits + $225 Specialty Drug Copay) 110009Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Silver HMO (3 Free PCP Visits + $225 Specialty Drug Copay) 110010Silver0001 | 02 | 03 | 04 | 05 | 06
SoloCare Bronze No Referral HMO ($250 Specialty Drug Copay) 110011Bronze0001 | 02 | 03
SoloCare Bronze No Referral HMO ($250 Specialty Drug Copay + Dental) 110013Bronze0001 | 02 | 03
SoloCare Bronze No Referral HMO 110015Bronze0001 | 02 | 03
SoloCare Bronze No Referral HMO (+ Dental) 110017Bronze0001 | 02 | 03
SoloCare Bronze No Referral HMO HDHP 110019Bronze0001 | 02 | 03
SoloCare Bronze No Referral HMO HDHP (+ Dental) 110021Bronze0001 | 02 | 03
SoloCare Catastrophic No Referral HMO 110023Catastrophic 0001