Individual & Family Health Plans 2024

Common Ground Healthcare Cooperative
is different from other health insurance companies. 

  • We are a nonprofit cooperative
  • We are governed by our members
  • We place principles over profits
  • We speak the truth
  • And we answer to you, always

At Common Ground Healthcare Cooperative, you are more than a customer, you are a member of the cooperative!

CGHC Member

 Individual and Family Health Plans

2024 Plan Year 

On-Exchange Plans

Multiethnic Parents Giving Children Piggyback Ride

Off-Exchange Plans

Family trekking in the woods

Click the links below to access the Schedule of Benefits (SOB) for the 2024 On-Exchange health plans:
(Click Here for 2023 Plans)

 

Gold Plans

 

Silver Plans

 

Bronze/Catastrophic Plans

 

 

All On-Exchange plans offer variants with Adult Vision and some with Preventive Dental add-on options. Click here to learn more (PDF).

 

Prescription Drug List   |   Certificate of Coverage

Click the links below to access the Schedule of Benefits for these 2024 Cost Share Reduction (CSR) health plans:
(Click Here for 2023 Plans)

 

73% CSR Plans

 

87% CSR Plans

 

94% CSR Plans

 

 

All On-Exchange plans offer variants with Adult Vision and some with Preventive Dental add-on options. Click here to learn more (PDF).

 

Prescription Drug List   |   Certificate of Coverage

Click the links below to access the Schedule of Benefits for the 2024 Off-Exchange health plans:
(Click Here for 2023 Plans)

 

Gold Plans

 

Silver Plans

 

Bronze/Catastrophic Plans

 

Prescription Drug List   |   Certificate of Coverage

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 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.

 

To access your plan’s Summary of Benefits and Coverage (SBC), click here.

 


 

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.