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STANDARD (H3664) 011
Premium Subsidy Monthly Plan Premium
100% $32.20
75% $38.90
50% $45.60
25% $52.30


PLUS (H3664) 001
Premium Subsidy Monthly Plan Premium
100% $56.20
75% $62.90
50% $69.60
25% $76.30


PREMIER (H3664) 012
Premium Subsidy Monthly Plan Premium
100% $98.20
75% $104.90
50% $111.60
25% $118.30


ESSENTIAL (H3664) 016
Premium Subsidy Monthly Plan Premium
100% $16.20
75% $22.90
50% $29.60
25% $36.30


PREMIER ADVANTAGE (H3664) 013
Premium Subsidy Monthly Plan Premium
100% $213.20
75% $219.90
50% $226.60
25% $233.30


PRIME PPO (H3620) 001
Premium Subsidy Monthly Plan Premium
100% $44.20
75% $50.90
50% $57.60
25% $64.30


PRIME PFFS SELECT (H5485) 001
Premium Subsidy Monthly Plan Premium
100% $44.20
75% $50.90
50% $57.60
25% $64.30
 
 

PrimeTime Health Plan

P.O. Box 6905
Canton, OH 44706

(330) 363-7407 or 1-800-577-5084
TTY/TDD users should call (330) 580-6460 or 1-800-617-7446

Hours of operation: 8:00 a.m. to 4:30 p.m. Monday through Friday.
Call Center Hours: 8:00 a.m. to 8:00 p.m. Monday through Friday.


Copyright © 2005  PrimeTime Health Plan