Benefit Options

  

Important Note:

Coverage grandfathered with respect to the Affordable Care Act (for members whose coverage began before March 23, 2010)

Plans for Current Members Only

 

2nd Quarter Rates

Plan	Individual	Two Person	Family
Individual HSABlue	$410.67	$821.34	$1,145.77
$3,500 Option	$551.25	$1,102.50	$1,537.99
$5,000 Option	$433.94	$867.88	$1,210.69
$7,500 Option	$362.04	$724.08	$1,010.09
$10,000 Option	$316.00	$632.00	$881.64

^{Monthly rates effective 2nd quarter 2013 (April - June)}

 

 

3rd Quarter Rates

Plan	Individual	Two Person	Family
Individual HSABlue	$418.92	$837.84	$1,168.79
$3,500 Option	$562.32	$1,124.64	$1,568.87
$5,000 Option	$442.67	$885.34	$1,235.05
$7,500 Option	$369.31	$738.62	$1,030.37
$10,000 Option	$322.36	$644.72	$899.38

^{Monthly rates effective 3rd quarter 2013 (July - September)}

 

Coverage before annual renewals beginning October 1, 2012

• Vermont Freedom Plan  -Individual HSABlue - $5,000
  
• Vermont Freedom Plan  -Individual - $3,500
  
• Vermont Freedom Plan - Individual - $5,000
  
• Vermont Freedom Plan - Individual - $7,500
  
• Vermont Freedom Plan -Individual - $10,000

  
   

Coverage following your first annual renewal after October 1, 2012

• Vermont Freedom Plan  -Individual HSABlue - $5,000
  
• Vermont Freedom Plan  -Individual - $3,500
  
• Vermont Freedom Plan - Individual - $5,000
  
• Vermont Freedom Plan - Individual - $7,500
  
• Vermont Freedom Plan -Individual - $10,000

  
   

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Non-grandfathered plans (for new members or members whose coverage began after March, 23 2010)

Plans for New Business

 

2nd Quarter Rates

Plan CHOICE	Individual	Two Person	Family
VT Freedom Plan	monthly rate	monthly rate	monthly rate
Individual - $5,000 Family - $10,000	$418.22	$836.44	$1,166.83
Individual - $10,000 Family - $20,000	$281.64	$563.28	$785.78

Monthly rates effective 2nd quarter 2013 (April - June)

 

 

3rd Quarter Rates

Plan CHOICE	Individual	Two Person	Family
VT Freedom Plan	monthly rate	monthly rate	monthly rate
Individual - $5,000 Family - $10,000	$426.64	$853.28	$1,190.33
Individual - $10,000 Family - $20,000	$287.31	$574.62	$801.59

Monthly rates effective 3rd quarter 2013 (July - September)

 

Coverage before renewals beginning October 1, 2012:

• Vermont Freedom Plan  -Individual - $5,000
• Vermont Freedom Plan  -Individual - $10,000

Coverage following your annual renewal after October 1, 2012:

• Vermont Freedom Plan  -Individual - $5,000
  
• Vermont Freedom Plan  -Individual - $10,000
  
   

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Make sure to consider

Certain plan restrictions may apply, so be sure to read all your contract documents and verify coverage before receiving services.  Make special note of :

• Waiting periods
• Prior approval guidelines
• Benefit exclusions

Eligibility

Not everyone is eligible for the Vermont Freedom Plan.  You may be eligible if: 

• You and your spouse are not eligible for group coverage (employer sponsored)
• You are a Vermont resident between the ages of 18-65 and not receiving Medicare or COBRA Benefits 

Enroll

To enroll, complete one of the following enrollment application forms:

• Online Application Form
• Paper Application
   

Need Help?

Call one of our sales representatives for plan advice and quote information, 1-800-625-6406

 

Updated: 05/09/13