State County Issuer Name FL ORANGE Aetna FL ORANGE Aetna FL ORANGE Aetna FL ORANGE Aetna FL ORANGE Aetna FL ORANGE Aetna FL ORANGE Aetna FL ORANGE Cigna Healthcare FL ORANGE Cigna Healthcare FL ORANGE Cigna Healthcare FL ORANGE Cigna Healthcare FL ORANGE Cigna Healthcare FL ORANGE Cigna Healthcare FL ORANGE Cigna Healthcare FL ORANGE Cigna Healthcare FL ORANGE Cigna Healthcare FL ORANGE Cigna Healthcare FL ORANGE Cigna Healthcare Page 1 of 24 01/07/2016
Plan Marketing Name Aetna Advantage 5750 PD 1-855-586-6960 Aetna Advantage 6350 1-855-586-6960 Aetna AdvantagePlus 5500 PD 1-855-586-6960 Aetna Basic 1-855-586-6960 Aetna Premier 2000 PD 1-855-586-6960 Aetna Classic 3500 PD 1-855-586-6960 Aetna Classic 5000 1-855-586-6960 mycigna Copay Assure Gold 1-877-900-1237 mycigna Health Flex 1250 1-877-900-1237 mycigna Health Flex 1900 1-877-900-1237 mycigna Copay Assure Silver 1-877-900-1237 mycigna Health Flex 5000 1-877-900-1237 mycigna Health Flex 2750 1-877-900-1237 mycigna Health Flex 1500 1-877-900-1237 mycigna Health Savings 3400 1-877-900-1237 mycigna Health Flex 5100 1-877-900-1237 mycigna Health Flex 5500 1-877-900-1237 mycigna Health Savings 6100 1-877-900-1237 BlueOptions Everyday Health Premier 1418V BlueOptions Everyday Health Premier 1420V Customer Service Phone Number Toll Free Page 2 of 24 01/07/2016
Customer Service Phone Number Local 1-855-586-6960 1-855-586-6960 1-855-586-6960 1-855-586-6960 1-855-586-6960 1-855-586-6960 1-855-586-6960 1-855-586-6960 1-855-586-6960 1-855-586-6960 1-855-586-6960 1-855-586-6960 1-855-586-6960 1-855-586-6960 1-877-900-1237 1-877-900-1237 1-877-900-1237 1-877-900-1237 1-877-900-1237 1-877-900-1237 1-877-900-1237 1-877-900-1237 1-877-900-1237 1-877-900-1237 1-877-900-1237 Customer Service Phone Number TTY Page 3 of 24 01/07/2016
Plan ID - Standard Component 23841FL0080001 23841FL0080002 23841FL0080004 23841FL0080005 23841FL0080007 23841FL0080008 23841FL0080009 48121FL0020011 48121FL0020010 48121FL0020009 48121FL0020008 48121FL0020007 48121FL0020006 48121FL0020005 48121FL0020004 48121FL0020003 48121FL0020002 48121FL0020001 16842FL0070106 16842FL0070107 Page 4 of 24 01/07/2016
Page 5 of 24 01/07/2016
BlueOptions Everyday Health 1416 BlueOptions Everyday Health Plus 1416P BlueOptions All Copay 1424 BlueOptions All Copay Plus 1424P BlueOptions Predictable Cost 1413 BlueOptions Everyday Health 1410 BlueOptions Everyday Health Plus 1410P BlueSelect Predictable Cost 1446 BlueSelect Predictable Cost 1456 BlueSelect Predictable Cost Plus 1446P BlueSelect Predictable Cost Plus 1456P BlueSelect Essential 1434 BlueSelect Essential 1439 BlueSelect Essential (HSA) 1452 BlueSelect Essential (HSA) 1463 BlueSelect Essential Plus 1434P BlueSelect Essential Plus 1439P BlueSelect Essential (HSA) Plus 1452P BlueSelect Essential (HSA) Plus 1463P BlueSelect Everyday Health Premier 1453V BlueSelect Everyday Health 1464 BlueSelect Everyday Health Plus 1464P Page 6 of 24 01/07/2016
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16842FL0070108 16842FL0070109 16842FL0070110 16842FL0070111 16842FL0070072 16842FL0070114 16842FL0070115 16842FL0120032 16842FL0120033 16842FL0120034 16842FL0120035 16842FL0120036 16842FL0120041 16842FL0120044 16842FL0120047 16842FL0120048 16842FL0120053 16842FL0120056 16842FL0120059 16842FL0120067 16842FL0120060 16842FL0120061 Page 8 of 24 01/07/2016
Page 9 of 24 01/07/2016
BlueSelect Everyday Health 1451 BlueSelect Everyday Health 1453 BlueSelect Everyday Health Plus 1451P BlueSelect Everyday Health Plus 1453P BlueSelect Everyday Health Premier 1451V BlueSelect Everyday Health 1449 BlueSelect Everyday Health Plus 1449P BlueSelect All Copay 1457 BlueSelect All Copay Plus 1457P BlueSelect Everyday Health 1443 BlueSelect Everyday Health Plus 1443P BlueOptions Catastrophic 1433 BlueOptions Predictable Cost 1423 BlueOptions Predictable Cost Plus 1413P BlueOptions Predictable Cost Plus 1423P BlueOptions Essential 1401 BlueOptions Essential 1406 BlueOptions Essential (HSA) 1419 BlueOptions Essential (HSA) 1430 BlueOptions Essential Plus 1401P BlueOptions Essential Plus 1406P Page 10 of 24 01/07/2016
Page 11 of 24 01/07/2016
16842FL0120062 16842FL0120063 16842FL0120064 16842FL0120065 16842FL0120066 16842FL0120068 16842FL0120069 16842FL0120070 16842FL0120071 16842FL0120072 16842FL0120073 16842FL0070112 16842FL0070073 16842FL0070074 16842FL0070075 16842FL0070076 16842FL0070081 16842FL0070084 16842FL0070087 16842FL0070088 16842FL0070093 Page 12 of 24 01/07/2016
Page 13 of 24 01/07/2016
BlueOptions Essential (HSA) Plus 1419P BlueOptions Essential (HSA) Plus 1430P BlueOptions Everyday Health 1431 BlueOptions Everyday Health Plus 1431P BlueOptions Everyday Health 1418 BlueOptions Everyday Health 1420 BlueOptions Everyday Health Plus 1418P BlueOptions Everyday Health Plus 1420P BlueCare Essential (HSA) Plus 1497P BlueCare Everyday Health 1498 BlueCare Everyday Health Plus 1498P BlueCare Everyday Health 1485 BlueCare Everyday Health 1487 BlueCare Everyday Health Plus 1485P BlueCare Everyday Health Plus 1487P BlueCare Everyday Health 1483 Page 14 of 24 01/07/2016
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16842FL0070096 16842FL0070099 16842FL0070100 16842FL0070101 16842FL0070102 16842FL0070103 16842FL0070104 16842FL0070105 30252FL0020059 30252FL0020060 30252FL0020061 30252FL0020062 30252FL0020063 30252FL0020064 30252FL0020065 30252FL0020066 Page 16 of 24 01/07/2016
Page 17 of 24 01/07/2016
BlueCare Everyday Health Plus 1483P BlueCare All Copay 1491 BlueCare All Copay Plus 1491P BlueCare Everyday Health 1477 BlueCare Everyday Health Plus 1477P BlueCare Essential 1473 BlueCare Essential 1468 BlueCare Predictable Cost Plus 1490P BlueCare Predictable Cost Plus 1480P BlueCare Predictable Cost 1490 BlueCare Predictable Cost 1480 BlueCare Essential (HSA) Plus 1486P BlueCare Essential Plus 1473P Page 18 of 24 01/07/2016
Page 19 of 24 01/07/2016
30252FL0020067 30252FL0020068 30252FL0020069 30252FL0020070 30252FL0020071 30252FL0020041 30252FL0020036 30252FL0020035 30252FL0020034 30252FL0020033 30252FL0020032 30252FL0020056 30252FL0020053 Page 20 of 24 01/07/2016
FL ORANGE Humana Medical Plan, Inc. FL ORANGE Humana Medical Plan, Inc. FL ORANGE Humana Medical Plan, Inc. FL ORANGE Humana Medical Plan, Inc. FL ORANGE Humana Medical Plan, Inc. FL ORANGE Humana Medical Plan, Inc. Page 21 of 24 01/07/2016
BlueCare Essential Plus 1468P BlueCare Essential (HSA) 1497 BlueCare Essential (HSA) 1486 Humana Direct Basic 6350/6350 Plan 1-877-720-4854 Humana Direct Bronze 6300/6300 Plan 1-877-720-4854 Humana Direct Bronze 4850/6350 Plan 1-877-720-4854 Humana Direct Silver 4600/6300 Plan 1-877-720-4854 Humana Direct Gold 2500/3500 Plan 1-877-720-4854 Humana Direct Platinum 1000/1500 Plan 1-877-720-4854 Page 22 of 24 01/07/2016
1-877-720-4854 1-800-325-2028 1-877-720-4854 1-800-325-2028 1-877-720-4854 1-800-325-2028 1-877-720-4854 1-800-325-2028 1-877-720-4854 1-800-325-2028 1-877-720-4854 1-800-325-2028 Page 23 of 24 01/07/2016
30252FL0020048 30252FL0020047 30252FL0020044 35783FL1150001 35783FL1150002 35783FL1150003 35783FL1150004 35783FL1150005 35783FL1150006 Page 24 of 24 01/07/2016