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On my Form 1095-A, how do I know my “Monthly Premium Amount of Second Lowest Cost Silver Plan”?

The Second Lowest Cost Silver Plan is the premium for the second least expensive silver plan available to you and your covered household members based on their ages and home addresses.

Also known as your benchmark cost, this number is used to estimate how expensive it is for you to purchase health coverage and is provided in Part III, Column B of your Form 1095-A.

If your coverage household changed during the year or anyone covered under your policy moved and you did not report it to Maryland Health Connection, the amount of the Second Lowest Cost Silver Plan provided in your 1095-A may be incorrect. Use the tables below and examples to recalculate your SLCSP, or use our worksheet (PDF).

Worksheet for the Second Lowest Cost Silver Plan (PDF)

Using Tables 1 and 2, determine the individual monthly benchmark cost for each person covered under your policy and included on your 2015 taxes. For each person, you will need to know his or her age as of his or her coverage start date (listed in Part II, Column D of the 1095-A) and his or her geographic region. There are four geographic regions, which vary by county (see Table 1).

Add the individual benchmark costs together for each covered individual to get the monthly benchmark for your tax family.

Table 1: Regions for Benchmark Costs

County Name Region
Allegany 4
Anne Arundel 1
Baltimore City 1
Baltimore County 1
Calvert 2
Caroline 2
Carroll 4
Cecil 2
Charles 2
Dorchester 2
Frederick 4
Garrett 4
Harford 1
Howard 1
Kent 2
Montgomery 3
Prince George's 3
Queen Anne's 2
St Mary's 2
Somerset 2
Talbot 2
Washington 4
Wicomico 2
Worcester 2

Table 2: Monthly Benchmark Costs by Age and Region

2015 Benchmark Plan Rates Chart
* See Table 1 above for regions.