ACA plans available
31
Plan year
2026 data Public-data reference. official source
Sheboygan, Wisconsin Health Insurance
Open-data reference.
31 ACA plans from 3 issuers — Plan year 2026
Sheboygan, Wisconsin offers 31 ACA marketplace plans from 3 issuers for plan year 2026. Bronze plans start at $417/mo and Silver plans start at $470/mo (age 27, before subsidies). Use the tables below to compare premiums, deductibles, and issuers across all metal tiers.
$526
Avg Silver Premium/mo
$470
Benchmark Premium/mo
+20.4%
Year-over-Year Change
$4,721
Avg Deductible
What the Numbers Say About Sheboygan
Sheboygan, Wisconsin has 31 ACA marketplace plans offered by 3 issuers for plan year 2026. The average Silver-tier premium comes in at $526/mo for a 27-year-old non-tobacco user, with the lowest Silver at $470 and the highest at $563. Bronze plans start at $417/mo — useful for healthy enrollees who want catastrophic protection with the lowest monthly outlay.
The benchmark (second-lowest Silver) premium is $470/mo, the figure the IRS uses to calculate your Advance Premium Tax Credit. Enrollees whose expected income-based contribution falls below this amount receive a subsidy for the difference. Across all plans, the average annual deductible is $4,721 and the average out-of-pocket maximum is $8,931 — numbers that matter more than the sticker premium once you actually use care. Year-over-year, average premiums in Sheboygan shifted by +20.4%, a signal of how local issuer pricing and risk-pool dynamics are trending.
Issuer count is one of the strongest predictors of affordability: with 3 issuers active in Sheboygan, consumers have some competitive choice, though narrower than the most competitive counties. This page is informational only and is not insurance, medical, or tax advice — verify your eligibility, network coverage, and final pricing at HealthCare.gov before enrolling. Source: CMS Marketplace PUF, plan year 2026.
Premiums by Metal Level
Bronze
1 plan$417/mo avg
$417 — $417
Silver
11 plans$526/mo avg
$470 — $563
Gold
9 plans$572/mo avg
$533 — $612
Benchmark Premium & Subsidies
The benchmark premium (2nd-lowest Silver plan) in Sheboygan is $470/mo for a 27-year-old. This is the amount used to calculate your premium tax credit. If your expected contribution (based on income) is less than the benchmark, you receive a subsidy for the difference. The higher the benchmark, the larger the potential subsidy.
Issuers in market
3
Some competition
Benchmark Silver
$470 /mo
Sets your subsidy ceiling
Avg deductible
$4,721
Across all metal tiers
Sheboygan ACA plans by premium and deductible
Each marker is the Sheboygan average for one metal tier (and the local Bronze low / Silver high extremes where data is available). The dashed line marks the federal out-of-pocket-maximum ceiling.
Source: CMS Marketplace PUF for Sheboygan, plan year 2026. Bronze = catastrophic-only zone (high deductible). Gold/Platinum = premium-heavy zone (low deductible).
Issuers in Sheboygan
| Issuer | Plans | Avg Premium (Age 27) |
|---|---|---|
| UnitedHealthcare | 13 | $534/mo |
| Dean Health Plan | 9 | $489/mo |
| Anthem Blue Cross and Blue Shield | 9 | $435/mo |
All Plans in Sheboygan
| Plan Name | Metal | Type | Premium (27) | Premium (40) | Deductible | OOP Max |
|---|---|---|---|---|---|---|
| UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) UnitedHealthcare | Bronze | HMO | $416.68 | $508.12 | $10,600 | $10,600 |
| Prevea360 Bronze Share Dean Health Plan | Expanded Bronze | HMO | $332.64 | $405.65 | $8,000 | $10,600 |
| Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) Anthem Blue Cross and Blue Shield | Expanded Bronze | HMO | $348.47 | $424.95 | $5,000 | $10,600 |
| Anthem Bronze Pathway/Lean HSA (+ Incentives) Anthem Blue Cross and Blue Shield | Expanded Bronze | HMO | $352.33 | $429.65 | $8,450 | $8,450 |
| Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) Anthem Blue Cross and Blue Shield | Expanded Bronze | HMO | $352.92 | $430.38 | $7,500 | $10,000 |
| Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) Anthem Blue Cross and Blue Shield | Expanded Bronze | HMO | $373.64 | $455.65 | $0 | $10,600 |
| Prevea360 Expanded Bronze Standard Dean Health Plan | Expanded Bronze | HMO | $391.31 | $477.18 | $7,500 | $10,000 |
| Prevea360 Bronze HSA Dean Health Plan | Expanded Bronze | HMO | $406.54 | $495.76 | $7,500 | $8,500 |
| UHC Bronze Standard (No Referrals) UnitedHealthcare | Expanded Bronze | HMO | $435.37 | $530.92 | $7,500 | $10,000 |
| UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) UnitedHealthcare | Expanded Bronze | HMO | $455.28 | $555.20 | $0 | $10,600 |
| UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) UnitedHealthcare | Expanded Bronze | HMO | $468.28 | $571.05 | $0 | $10,600 |
| Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) Anthem Blue Cross and Blue Shield | Silver | HMO | $469.50 | $572.54 | $6,000 | $8,900 |
| Anthem Silver Pathway/Lean 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) Anthem Blue Cross and Blue Shield | Silver | HMO | $469.60 | $572.66 | $4,000 | $9,400 |
| Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Anthem Blue Cross and Blue Shield | Silver | HMO | $469.88 | $573.00 | $5,500 | $9,200 |
| Prevea360 Silver $0 Copay PCP Visits Dean Health Plan | Silver | HMO | $528.42 | $644.39 | $3,500 | $10,450 |
| Prevea360 Silver Share Dean Health Plan | Silver | HMO | $540.27 | $658.84 | $3,525 | $8,850 |
| UHC Silver Standard (No Referrals) UnitedHealthcare | Silver | HMO | $542.99 | $662.16 | $6,000 | $8,900 |
| UHC Silver Value ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals) UnitedHealthcare | Silver | HMO | $543.01 | $662.18 | $4,000 | $8,750 |
| UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) UnitedHealthcare | Silver | HMO | $549.53 | $670.14 | $3,500 | $9,800 |
| Prevea360 Silver Standard Dean Health Plan | Silver | HMO | $552.81 | $674.13 | $6,000 | $8,900 |
| UHC Silver Value+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision, No Referrals) UnitedHealthcare | Silver | HMO | $556.01 | $678.03 | $4,000 | $8,750 |
| UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) UnitedHealthcare | Silver | HMO | $562.53 | $685.99 | $3,500 | $9,800 |
| Prevea360 Gold Share Dean Health Plan | Gold | HMO | $532.82 | $649.76 | $2,500 | $5,900 |
| Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) Anthem Blue Cross and Blue Shield | Gold | HMO | $539.33 | $657.70 | $1,000 | $7,200 |
| Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) Anthem Blue Cross and Blue Shield | Gold | HMO | $539.37 | $657.75 | $2,000 | $8,200 |
| Prevea360 Gold Standard Dean Health Plan | Gold | HMO | $552.45 | $673.69 | $2,000 | $8,200 |
| Prevea360 Gold HSA Dean Health Plan | Gold | HMO | $564.88 | $688.85 | $3,400 | $4,400 |
| UHC Gold Standard (No Referrals) UnitedHealthcare | Gold | HMO | $594.18 | $724.58 | $2,000 | $8,200 |
| UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) UnitedHealthcare | Gold | HMO | $598.64 | $730.02 | $1,500 | $7,000 |
| UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) UnitedHealthcare | Gold | HMO | $611.19 | $745.33 | $0 | $8,500 |
| UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) UnitedHealthcare | Gold | HMO | $611.64 | $745.87 | $1,500 | $7,000 |
Silver Premium Trend (2022-2026)
| Year | Avg Premium | Min | Max | Plans | Issuers |
|---|---|---|---|---|---|
| 2022 | $393/mo | $317 | $432 | 34 | 5 |
| 2023 | $418/mo | $331 | $477 | 44 | 6 |
| 2024 | $439/mo | $360 | $545 | 38 | 7 |
| 2025 | $472/mo | $395 | $568 | 30 | 7 |
| 2026 | $526/mo | $470 | $563 | 11 | 3 |
Health Insurance Guides
Choosing a Metal Level
Bronze vs Silver vs Gold vs Platinum — which tier fits your needs and budget
Understanding ACA Subsidies
How premium tax credits work and how to estimate your subsidy amount
Related Health & Cost Data
Find Doctors
PlainDoctor — Healthcare providers in Wisconsin
Hospital Quality Ratings
PlainHospital — CMS star ratings and safety scores
Medicare Plans
PlainMedicare — Medicare Advantage and Part D data
Community Health Data
PlainHealth — CDC community health indicators
Health Access Metrics
PlainHealthAccess — Uninsured rates and provider shortages
Cost of Living
PlainCost — BEA regional price parities
Homeowners Insurance
PlainInsure — Treasury FIO premiums
Frequently Asked Questions
How many ACA plans are available in Sheboygan, WI?
There are 31 ACA marketplace plans available in Sheboygan from 3 insurance issuers for plan year 2026.
What is the cheapest health insurance plan in Sheboygan?
The lowest-premium plan in Sheboygan starts at $417/mo (Bronze tier, age 27). Silver plans start at $470/mo. Actual premiums vary by age and may be reduced by premium tax credits.
What is the benchmark premium for Sheboygan?
The benchmark (second-lowest Silver) premium in Sheboygan is $470/mo for a 27-year-old. This amount determines how much premium tax credit subsidy you may be eligible for.
How have premiums changed in Sheboygan?
Average premiums in Sheboygan changed by +20.4% year-over-year. Premium trends are tracked from 2022 to 2026 across all metal levels.
What is the average deductible and out-of-pocket maximum in Sheboygan?
The average annual deductible across all plans in Sheboygan is $4,721, and the average out-of-pocket maximum is $8,931. Bronze plans generally have higher deductibles but lower premiums, while Gold and Platinum plans have lower deductibles but higher monthly costs.
Which insurance companies offer plans in Sheboygan?
There are 3 insurance issuers offering ACA marketplace plans in Sheboygan, including UnitedHealthcare, Dean Health Plan, Anthem Blue Cross and Blue Shield. Competition among issuers affects plan variety and pricing. More issuers generally mean more choices and potentially lower premiums.
Disclaimer: This page is for informational purposes only and does not constitute insurance or financial advice. Premiums shown are for a 27-year-old non-tobacco user unless otherwise noted. Your actual premium depends on age, location, tobacco use, and subsidy eligibility. Visit HealthCare.gov for official enrollment. Source: CMS Marketplace PUF, PY2026.
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- U.S. Census Bureau ACS — demographic + housing + income data. census.gov/programs-surveys/acs
- BLS Occupational Employment and Wage Statistics (OEWS) — wage + employment by occupation. bls.gov/oes
- BEA Regional Economic Accounts — GDP + personal income by state/metro. bea.gov/data/regional
- U.S. Census Bureau County Business Patterns — establishment + employment by industry. census.gov/cbp
- IRS Statistics of Income (SOI) — tax-return aggregate data. irs.gov/statistics
- data.gov — U.S. federal open-data portal — discovery layer for additional federal sources. data.gov
Related
Data sourced from official U.S. government datasets. See our methodology for details. Retrieved and formatted by PlainHealthPlan Editorial
