Disclaimer

Rates shown are estimates

Every premium figure on this site is an estimate generated from a simplified pricing model based on your age band, sex, coverage type, and state. It is not a quote. It does not constitute an offer of insurance. Final premiums depend on suitability review, underwriting class, plan selected, and carrier-specific adjustments that happen after you start enrollment. Expect the actual number to differ from what the calculator shows.

Savings comparisons are directional

The "save 25% to 45% vs ACA" claim, and the calculator's comparison against ACA marketplace, private PPO, and COBRA, is derived from publicly available averages and a simplified internal multiplier. It is not a prediction of your individual savings. The ACA marketplace number we show is an unsubsidized estimate. If you qualify for ACA subsidies your marketplace premium can be lower, and that can narrow or close the gap against a group plan.

MaxGuard Limited is not major medical

The MaxGuard Limited Medical plan is a limited benefit medical plan offered through the First Health Network. It is not major medical health insurance. It does not meet minimum essential coverage under the Affordable Care Act and does not satisfy the individual mandate in states that have one. It pays fixed benefit amounts for office visits, urgent care, ER visits, telehealth, and hospitalization up to plan limits. Before picking it, read the full benefit schedule.

State availability varies

Coverage is currently live in 40 states. The 11 states not yet live are California, Connecticut, Hawaii, Maryland, Minnesota, New Hampshire, Oregon, Pennsylvania, Vermont, Washington, and Wisconsin. A specific plan's availability inside a live state can still depend on carrier footprint and regulatory filings, and any of that can change.

Reference-Based Pricing trade-offs

The PSM of TN (RBP) plan uses Reference-Based Pricing, which pays providers a multiple of Medicare rates rather than a pre-negotiated network rate. Premiums are typically lower for this reason. A small number of providers may bill the member for the difference between their list price and what the plan paid (a "balance bill"). The plan administrator includes support for negotiating or defending against balance bills when they occur. If you have a planned major procedure, talk to the administrator about your specific situation before choosing RBP.

Working Owner eligibility

These plans are group health plans for Working Owners. Enrollment requires passing a suitability check that confirms you meet the Working Owner requirements (typically self-employed, 1099, freelance, gig, or an LLC owner, or a W-2 employee without employer-sponsored coverage). Not everyone who visits this site will qualify. The monthly health survey is a required part of being a member of the group.

Not medical, legal, or tax advice

Nothing on this site is medical advice, legal advice, or tax advice. HSA rules, ACA subsidy eligibility, and the tax treatment of premiums and benefits depend on your individual situation. Talk to a licensed professional before relying on anything here for tax planning, coverage decisions, or medical decisions.

Plan administrator and carriers

Plans are administered by Detego Health LLC and offered through group programs associated with Population Science Management. Carriers mentioned on this site (Aetna, Blue Cross Blue Shield of Nebraska, First Health Network, PSM of Tennessee, PSN of Tennessee, MyLiveDoc, PHCS) are independent companies and all trademarks are the property of their respective owners. Their inclusion here identifies the network behind a plan and does not imply sponsorship or endorsement of this site.

This website is not a binding offer of coverage

The binding offer happens during enrollment with the plan administrator after suitability is confirmed. Everything on this site is preparatory information to help you decide whether to start that process.