THE BEST WAY TO FIND THE RIGHT FIT? TAKE A LOOK AT A FEW DIFFERENT SIZES.

2021 Entrust HMO Benefit Plans

(Select the Tier below and click on the Plan name to view the Summary of Benefits and Schedule of Benefits)


Entrust Gold Tier

Summary of Benefits Schedule of Benefits

Entrust Gold 125

Entrust Gold 125

Entrust Gold 125 Zero Cost Share

Entrust Gold 125 Zero Cost Share

Entrust Gold 125 Limited Cost Share

Entrust Gold 125 Limited Cost Share

Entrust Gold 125 Adult Dental + Vision

Entrust Gold 125 Adult Dental + Vision

Entrust Gold 125 Adult Dental + Vision Zero Cost Share

Entrust Gold 125 Adult Dental + Vision Zero Cost Share

Entrust Gold 125 Adult Dental + Vision Limited Cost Share

Entrust Gold 125 Adult Dental + Vision Limited Cost Share

Entrust Silver Tier

Summary of Benefits Schedule of Benefits

Entrust Silver 300

Entrust Silver 300

Entrust Silver 300 Zero Cost Share

Entrust Silver 300 Zero Cost Share

Entrust Silver 300 Limited Cost Share

Entrust Silver 300 Limited Cost Share

Entrust Silver 300 73% AV

Entrust Silver 300 73% AV

Entrust Silver 300 87% AV

Entrust Silver 300 87% AV

Entrust Silver 300 94% AV

Entrust Silver 300 94% AV

Entrust Silver 350

Entrust Silver 350

Entrust Silver 350 Zero Cost Share

Entrust Silver 350 Zero Cost Share

Entrust Silver 350 Limited Cost Share

Entrust Silver 350 Limited Cost Share

Entrust Silver 350 73% AV

Entrust Silver 350 73% AV

Entrust Silver 350 87% AV

Entrust Silver 350 87% AV

Entrust Silver 350 94% AV

Entrust Silver 350 94% AV

Entrust Silver 500

Entrust Silver 500

Entrust Silver 500 Zero Cost Share

Entrust Silver 500 Zero Cost Share

Entrust Silver 500 Limited Cost Share

Entrust Silver 500 Limited Cost Share

Entrust Silver 500 73% AV

Entrust Silver 500 73% AV

Entrust Silver 500 87% AV

Entrust Silver 500 87% AV

Entrust Silver 500 94% AV

Entrust Silver 500 94% AV

Entrust Silver 550

Entrust Silver 550

Entrust Silver 550 Zero Cost Share

Entrust Silver 550 Zero Cost Share
Entrust Silver 550 Limited Cost Share Entrust Silver 550 Limited Cost Share
Entrust Silver 550 73% AV Entrust Silver 550 73% AV

Entrust Silver 550 87% AV

Entrust Silver 550 87% AV

Entrust Silver 550 94% AV

Entrust Silver 550 94% AV

Entrust Silver 300 Adult Dental + Vision

Entrust Silver 300 Adult Dental + Vision

Entrust Silver 300 Adult Dental + Vision Zero Cost Share

Entrust Silver 300 Adult Dental + Vision Zero Cost Share

Entrust Silver 300 Adult Dental + Vision Limited Cost Share

Entrust Silver 300 Adult Dental + Vision Limited Cost Share

Entrust Silver 300 Adult Dental + Vision 73% AV

Entrust Silver 300 Adult Dental + Vision 73% AV

Entrust Silver 300 Adult Dental + Vision 87% AV

Entrust Silver 300 Adult Dental + Vision 87% AV

Entrust Silver 300 Adult Dental + Vision 94% AV

Entrust Silver 300 Adult Dental + Vision 94% AV
Entrust Silver 350 Adult Dental + Vision Entrust Silver 350 Adult Dental + Vision

Entrust Silver 350 Adult Dental + Vision Zero Cost Share

Entrust Silver 350 Adult Dental + Vision Zero Cost Share
Entrust Silver 350 Adult Dental + Vision Limited Cost Share Entrust Silver 350 Adult Dental + Vision Limited Cost Share

Entrust Silver 350 Adult Dental + Vision 73% AV

Entrust Silver 350 Adult Dental + Vision 73% AV

Entrust Silver 350 Adult Dental + Vision 87% AV

Entrust Silver 350 Adult Dental + Vision 87% AV

Entrust Silver 350 Adult Dental + Vision 94% AV

Entrust Silver 350 Adult Dental + Vision 94% AV

Entrust Silver 500 Adult Dental + Vision

Entrust Silver 500 Adult Dental + Vision

Entrust Silver 500 Adult Dental + Vision Zero Cost Share

Entrust Silver 500 Adult Dental + Vision Zero Cost Share

Entrust Silver 500 Adult Dental + Vision Limited Cost Share

Entrust Silver 500 Adult Dental + Vision Limited Cost Share

Entrust Silver 500 Adult Dental + Vision 73% AV

Entrust Silver 500 Adult Dental + Vision 73% AV

Entrust Silver 500 Adult Dental + Vision 87% AV

Entrust Silver 500 Adult Dental + Vision 87% AV

Entrust Silver 500 Adult Dental + Vision 94% AV

Entrust Silver 500 Adult Dental + Vision 94% AV

Entrust Silver 500 - Off Exchange

Entrust Silver 500 - Off Exchange

 

Entrust Bronze Tier

Summary of Benefits Schedule of Benefits

Entrust Bronze 600

Entrust Bronze 600
Entrust Bronze 600 Zero Cost Share Entrust Bronze 600 Zero Cost Share

Entrust Bronze 600 Limited Cost Share

Entrust Bronze 600 Limited Cost Share

Entrust Bronze 650

Entrust Bronze 650

Entrust Bronze 650 Zero Cost Share

Entrust Bronze 650 Zero Cost Share

Entrust Bronze 650 Limited Cost Share

Entrust Bronze 650 Limited Cost Share

 

Entrust Catastrophic Tier

Summary of Benefits Schedule of Benefits

Entrust Catastrophic 100

Entrust Catastrophic 100
 

 

2021 Point of Service (POS) Benefit Plans

(Select the Tier below and click on the Plan name to view the Summary of Benefits and Schedule of Benefits)


POS Gold Tier

Summary of Benefits Schedule of Benefits
Empower MG225-IN21 IFP Empower MG225-IN21

 

POS Silver Tier

Summary of Benefits Schedule of Benefits
IFP Empower MS300-IN21 IFP Empower MS300-IN21
IFP Empower MS400-IN21 IFP Empower MS400-IN21
IFP Empower MS500-IN21 IFP Empower MS500-IN21
IFP Empower HSAQ MS350-IN21 IFP Empower HSAQ MS350-IN21

 

POS Bronze Tier

Summary of Benefits Schedule of Benefits
IFP Empower MB600-IN21 IFP Empower MB600-IN21
IFP Empower MB650-IN21 IFP Empower MB650-IN21

 

2021 HMO Benefit Plans

(Select the Tier below and click on the Plan name to view the Summary of Benefits and Schedule of Benefits)


HMO Gold Tier

Summary of Benefits Schedule of Benefits
IFP Engage LG125-IN21 IFP Engage LG125-IN21

 

HMO Silver Tier

Summary of Benefits Schedule of Benefits
IFP Engage LS300-IN21 IFP Engage LS300-IN21
IFP Engage LS500-IN21 IFP Engage LS500-IN21
IFP Engage LS550-IN21 IFP Engage LS550-IN21
IFP Engage HSAQ LS350-IN21 IFP Engage HSAQ LS350-IN21

 

HMO Bronze Tier

Summary of Benefits Schedule of Benefits
IFP Engage LB600-IN21 IFP Engage LB600-IN21
IFP Engage LB650-IN21 IFP Engage LB650-IN21

 

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