Member Services: 877-514-2442

When did straight answers go out of style? When did fairness become optional?
We’re a non-profit health insurance cooperative. We’re governed by our members.
We place principles over profits. We speak the truth. And we answer to you. Always.
Compare all plan options below.

2020 Individual and Family Plans

View a list of important insurance definitions here.
For resources designed to help you choose the best health insurance plan for you, visit GetCovered.WI.gov for more information.

Catastrophic5 Bronze HSA Bronze 8150/100
Deductible – In-Network (Single/Family) $8,150/$16,300 $6,750/$13,500 $8,150/$16,300
Out-of-Pocket Maximum – In-Network (Single/Family) $8,150/$16,300 $6,750/$13,500 $8,150/$16,300
Coinsurance In-Network (you pay)  0%  0%  0%
PCP1 (In-Network) $0 Deductible/Coinsurance $35
Specialist (In-Network) Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
Urgent Care (In-Network) Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
Aurora QuickCare /Bellin FastCare $0 Deductible/Coinsurance $20 Copay
Emergency Room2 (In-Network) Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
In-Network Preventive Care3 $0 $0 $0
Prescription Drugs (Tier 1) Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
Prescription Drugs (Tier 2) Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
Prescription Drugs (Tier 3) Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
Prescription Drugs (Specialty) Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
More Details More Details More Details
Silver 4000/75 Silver 3000/75/ Copay 40 Silver 6500/754
Deductible – In-Network (Single/Family) $4,000/$8,000 $3,000/$6,000 $6,500/$13,000
Out-of-Pocket Maximum In-Network (Single/Family) $8,150/$16,300 $8,150/$16,300 $8,150/$16,300
Coinsurance In-Network (you pay) 25% 25% 25%
PCP1 (In-Network) $50 Copay $40 Copay $60 Copay
Specialist (In-Network) $80 Copay $80 Copay $100 Copay
Urgent Care (In-Network) $100 Copay $100 Copay Deductible/Coinsurance
Aurora QuickCare /Bellin FastCare $20 Copay $20 Copay $20 Copay
Emergency Room2 (In-Network) Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
In-Network Preventive Care3 $0 $0 $0
Prescription Drugs (Tier 1) $20 Copay $25 Copay $10 Copay
Prescription Drugs (Tier 2) Deductible; then $75 Deductible; then $75 $100 Copay
Prescription Drugs (Tier 3) Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
Prescription Drugs (Specialty) Deductible; then 30% Deductible; then 30% Deductible; then 40%
More Details More Details More Details
Gold 2000/80
Deductible – In-Network (Single/Family) $2,000/$4,000
Out-of-Pocket Maximum – In-Network (Single/Family) $8,150/$16,300
Coinsurance In-Network (you pay) 20%
PCP1 (In-Network) $40 Copay
Specialist (In-Network) $60 Copay
Urgent Care (In-Network) $75 Copay
Aurora QuickCare /Bellin FastCare $15 Copay
Emergency Room2 (In-Network) $300 Copay
In-Network Preventive Care3 $0
Prescription Drugs (Tier 1) $10 Copay
Prescription Drugs (Tier 2) $50 Copay
Prescription Drugs (Tier 3) Deductible; then $100
Prescription Drugs (Specialty) Deductible; then 30%
More Details

Click the links below to access the Schedule of Benefits for these 2019 plans:

Catastrophic 7900/100 |   Bronze 7900/100  |   Bronze HSA 6650/100

Silver 3000/75/Copay 40  |  Silver 6000/75 | Silver HSA 3500/75

Silver 4000/75  |   Gold 2000/80

All plans offer the American Indian/Alaskan Native Plan Variations (Limited Cost Sharing and No Cost Sharing) for eligible individuals.  Please click here for more information about those plan variations.

1 PCP = Primary Care Provider (includes general pediatrics, internal medicine, OB/GYN, family practice, general medicine, chiropractor and geriatrics) Urgent = Urgent Care Services Emergency = Emergency Room Care Services

2 Services that meet the definition of emergency are paid at the in-network rate even when care is delivered in a non-network ER. Because we do not have a contract with out of network ER facilities, we cannot prevent these facilities from billing our members for the balance of the charge. The copay applies to the facility charge only. All other charges related to ER visit are subject to deductible/coinsurance.

3 Preventive Care received out of network is not covered

4 Silver 6500/75 plan has a separate prescription drug deductible of $4,500 associated with it *ONLY for tier 3 and specialty medications*.

5 Catastrophic plan applies to persons under age 30 or those with a hardship exemption from the federal Marketplace (healthcare.gov)

Our Deductibles, Explained: All plans have a January 1 to December 31 deductible. All deductibles, coinsurance, and copayments accumulate toward the out-of-pocket maximum. Deductibles and out-of-pocket maximums must be satisfied separately. All plans described on this page have embedded deductibles for family coverage. This means that if you are enrolled in 2-person or family coverage, an individual family member only has to satisfy the single person deductible before the plan begins to make payment for covered services for that family member. 

Cost Share Reduction Plans (Silver Base Plans)

73% – 3300 CSR 87% – 500 CSR 94% – 50 CSR
Deductible – In-Network (Single/Family) $3,300/$6,600 $500/$1000 $50/$100
Out-of-Pocket Maximum In-Network (Single/Family) $6,500/$13,000 $2,700/$5,400 $1,500/$3,000
Coinsurance In-Network (you pay) 25% 20% 20%
PCP1 (In-Network) $40 Copay $15 Copay $5 Copay
Specialist (In-Network) $80 Copay $30 Copay $20 Copay
Urgent Care (In-Network) Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
Aurora QuickCare /Bellin FastCare $15 Copay $15 Copay $5 Copay
Emergency Room2(In- & Out-of-Network) Deductible; Coinsurance Deductible; Coinsurance Deductible; Coinsurance
In-Network Preventive Care3 $0 $0 $0
Prescription Drugs (Tier 1) $10 Copay $10 Copay $0
Prescription Drugs (Tier 2) $75 Copay $55 Copay $15 Copay
Prescription Drugs (Tier 3) Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
Prescription Drugs (Specialty) Deductible; then 30% Deductible; then 30% Deductible; then 30%
More Details More Details More Details
73% – 3000 CSR 87% – 550 CSR 94% – 150 CSR
Deductible – In-Network (Single/Family) $3,000/$6,000 $550/$1,100 $150/$300
Out-of-Pocket Maximum In-Network (Single/Family) $6,500/$13,000 $2,700/$5,400 $1,500/$3,000
Coinsurance In-Network (you pay) 25% 20% 20%
PCP1 (In-Network) $40 Copay $15 Copay $5 Copay
Specialist (In-Network) $80 Copay $30 Copay $20 Copay
Urgent Care (In-Network) $75 Copay $60 Copay $30 Copay
Aurora QuickCare /Bellin FastCare $15 Copay $15 Copay $5 Copay
Emergency Room2 (In-Network) Deductible; Coinsurance Deductible; Coinsurance Deductible; Coinsurance
In-Network Preventive Care3 $0 $0 $0
Prescription Drugs (Tier 1) $20 Copay $10 Copay $0 Copay
Prescription Drugs (Tier 2) $75 Copay $55 Copay $15 Copay
Prescription Drugs (Tier 3) Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
Prescription Drugs (Specialty) Deductible; then 30% Deductible; then 30% Deductible; then 30%
More Details More Details More Details
73% – 3400 CSR 87% – 600 CSR 94% – 200 CSR
Deductible – In-Network (Single/Family) $3,400/$6,800 $600/$1,200 $200/$400
Out-of-Pocket Maximum In-Network (Single/Family) $6,500/$13,000 $2,700/$5,400 $1,500/$3,000
Coinsurance In-Network (you pay) 25% 20% 20%
PCP1 (In-Network) $40 $15 $5
Specialist (In-Network) $80 $30 $20
Urgent Care (In-Network) $75 $60 $30
Aurora QuickCare /Bellin FastCare $15 $15 $5
Emergency Room2 (In-Network) Deductible; Coinsurance Deductible; Coinsurance Deductible; Coinsurance
In-Network Preventive Care3 $0 $0 $0
Prescription Drugs (Tier 1) $10 $10 $0
Prescription Drugs (Tier 2) $75 $55 $15
Prescription Drugs (Tier 3) Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
Prescription Drugs (Specialty) Deductible; then 30% Deductible; then 30% Deductible; then 30%
More Details More Details More Details

Click the links below to access the Schedule of Benefits for these 2019 plans:

 Silver 4000/75

2850 CSR   |  400 CSR  | 200 CSR

Silver HSA 3500/75

2000 CSR   |  450 CSR  |  100 CSR

Silver 3000/75/Copay 40

2750 CSR   |  350 CSR  |  150 CSR

Silver 6000/75

2700 CSR   |   300 CSR  |   50 CSR

1 PCP = Primary Care Provider (includes general pediatrics, internal medicine, OB/GYN, family practice, general medicine, chiropractor and geriatrics) Urgent = Urgent Care Services Emergency = Emergency Room Care Services

2 Services that meet the definition of emergency are paid at the in-network rate even when care is delivered in a non-network ER. Because we do not have a contract with out of network ER facilities, we cannot prevent these facilities from billing our members for the balance of the charge. The copay applies to the facility charge only. All other charges related to ER visit are subject to deductible/coinsurance.

3 Preventive Care received out of network is not covered.

Our Deductibles, Explained: All plans have a January 1 to December 31 deductible. All deductibles, coinsurance, and copayments accumulate toward the out-of-pocket maximum.  All plans described on this page have embedded deductibles for family coverage. This means that if you are enrolled in 2-person or family coverage, an individual family member only has to satisfy the single person deductible before the plan begins to make payment for covered services for that family member. 

Common Ground Healthcare Cooperative does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations.

This page provides summary information.  Please refer to the certificate of coverage and schedule of benefits for a complete listing of benefits and terms of coverage.  A list of exclusions and limitations can be found here.