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Claims payment policies & other information

The transparency in coverage section of this website is intended to provide general information concerning our plans to aid in the understanding of common health insurance concepts; but in all cases, the specific language of a member’s policy and related documents will always control over the more general descriptions outlined here.

Impacted Insurer and Plans

Insurer Name (HIOS Issuer#)

Health Advantage (13262)

2026 Health Advantage Individual On and Off Exchange

Plan NameHIOS Product ID
Silver AH13262AR0230002
Gold Standardized13262AR0230004
Silver Standardized13262AR0230005
Bronze National13262AR0230006
Bronze Exp Standardized13262AR0230007
Silver Premier National13262AR0230008
Gold Premier National13262AR0230009
Platinum Premier National13262AR0230010
Platinum Standardized13262AR0230011

2026 PY Health Advantage Individual Off Exchange Only

Plan NameHIOS Product ID
Silver Elite National13262AR0230012

2027 Health Advantage Individual On and Off Exchange

Plan NameHIOS Product ID
Silver AH13262AR0230002
Gold*13262AR0230004
Silver*13262AR0230005
Bronze National13262AR0230006
Bronze Exp*13262AR0230007
Gold Premier National13262AR0230009
Platinum Premier National13262AR0230010
Platinum*13262AR0230011
Catastrophic HSA**13262AR0230013

*The following plan names were changed: Silver Standardized changed to Silver, Gold Standardized changed to Gold, Platinum Standardized changed to Platinum, and Bronze Exp Standardized changed to Bronze Exp.

**Catastrophic HSA will be a new plan beginning 2027PY on the exchange.

2027 PY Health Advantage Individual Off Exchange Only

Plan NameHIOS Product ID
Silver Elite National13262AR0230012
Bronze Enhanced* 13262AR0230014

*Bronze Enhanced is a new plan beginning 2027PY not on the exchange.