| Area | flav | Metal | PN | Description | Product | CPID | SHOP |
Click For
| Start | End |
| DC | M | Bronze | 27018 | BLUECHOICE ADVANTAGE POS BRONZE $6,000 (HSA/HRA) | POS | 100035907 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Bronze | 27017 | BLUECHOICE ADVANTAGE POS BRONZE $6,100 (HSA/HRA) | POS | 100035889 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Bronze | 27095 | BLUECHOICE HMO 90 BRONZE $6,500 (HSA/HRA) | HMO | 100035927 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Bronze | 27092 | BLUECHOICE HMO BRONZE $6,000 (HSA/HRA) | HMO | 100035933 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Bronze | 27094 | BLUECHOICE HMO BRONZE $6,100 (HSA/HRA) | HMO | 100035916 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Bronze | 27055 | BLUECHOICE HMO REFERRAL BRONZE $8,250 (HSA/HRA) | HMO | 100035938 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Bronze | 27177 | BLUECHOICE PLUS POS BRONZE $6,100 (HSA/HRA) | POS | 100035946 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27020 | BLUECHOICE ADVANTAGE POS 90 GOLD $1,500 (HSA/HRA) | POS | 100035901 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27046 | BLUECHOICE ADVANTAGE POS GOLD $0 (Rx Ded $0) | POS | 100035908 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27035 | BLUECHOICE ADVANTAGE POS GOLD $1,000 (Rx Ded $250) | POS | 100035883 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27021 | BLUECHOICE ADVANTAGE POS GOLD $1,500 (HSA/HRA) | POS | 100035893 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27036 | BLUECHOICE ADVANTAGE POS GOLD $3,000 (Rx Ded $250) | POS | 100035898 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27047 | BLUECHOICE ADVANTAGE POS GOLD $500 (Rx Ded $250) | POS | 100035884 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27098 | BLUECHOICE HMO 90 GOLD $1,500 (HSA/HRA) | HMO | 100035925 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27099 | BLUECHOICE HMO GOLD $1,500 (HSA/HRA) | HMO | 100035921 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27127 | BLUECHOICE HMO GOLD $1,500 (Rx Ded $250) | HMO | 100035909 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27128 | BLUECHOICE HMO GOLD $3,000 (Rx Ded $250) | HMO | 100035924 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27063 | BLUECHOICE HMO GOLD $500 (Rx Ded $250) | HMO | 100035910 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27115 | BLUECHOICE HMO REFERRAL GOLD $0 (Rx Ded $0) | HMO | 100035936 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27116 | BLUECHOICE HMO REFERRAL GOLD $500 (Rx Ded $250) | HMO | 100035935 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27183 | BLUECHOICE PLUS POS GOLD $1,000 (Rx Ded $250) | POS | 100035944 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27185 | BLUECHOICE PLUS POS GOLD $500 (Rx Ded $250) | POS | 100035945 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27144 | BLUEPREFERRED PPO 90/70 GOLD $1,000 (HRA) | PPO | 100035878 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27156 | BLUEPREFERRED PPO GOLD $1,000 (Rx Ded $250) | PPO | 100035868 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27157 | BLUEPREFERRED PPO GOLD $1,500 (Rx Ded $250) | PPO | 100035877 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Gold | 27165 | BLUEPREFERRED PPO GOLD $500 (Rx Ded $250) | PPO | 100035869 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Platinum | 27049 | BLUECHOICE ADVANTAGE POS PLATINUM $0 (Rx Ded $0) | POS | 100035885 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Platinum | 27064 | BLUECHOICE HMO PLATINUM $0 (Rx Ded $0) | HMO | 100035911 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Platinum | 27117 | BLUECHOICE HMO REFERRAL PLATINUM $0 (Rx Ded $0) | HMO | 100035934 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Platinum | 27171 | BLUECHOICE PLUS POS OPTOUT PLATINUM $0 (Rx Ded $0) | POS | 100035950 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Platinum | 27167 | BLUEPREFERRED PPO PLATINUM $0 (Rx Ded $0) | PPO | 100035874 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Platinum | 27168 | BLUEPREFERRED PPO PLATINUM $500 (Rx Ded $0) | PPO | 100035875 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Platinum | 27189 | HEALTHYBLUE ADVANTAGE POS PLATINUM $500 (Rx Ded $0) | POS | 100035888 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Platinum | 27187 | HEALTHYBLUE PLUS POS PLATINUM $500 (Rx Ded $0) | POS | 100035943 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27025 | BLUECHOICE ADVANTAGE POS 70 SILVER $2,100 (HSA/HRA) | POS | 100035903 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27026 | BLUECHOICE ADVANTAGE POS 70 SILVER $3,000 (HSA/HRA) | POS | 100035905 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27022 | BLUECHOICE ADVANTAGE POS SILVER $1,500 (HSA/HRA) | POS | 100035886 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27023 | BLUECHOICE ADVANTAGE POS SILVER $1,500 (HSA/HRA) | POS | 100035896 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27024 | BLUECHOICE ADVANTAGE POS SILVER $2,000 (HSA/HRA) | POS | 100035899 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27027 | BLUECHOICE ADVANTAGE POS SILVER $3,000 (HSA/HRA) | POS | 100035891 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27037 | BLUECHOICE ADVANTAGE POS SILVER $4,000 (Rx Ded $400) | POS | 100035895 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27038 | BLUECHOICE ADVANTAGE POS SILVER $5,000 (Rx Ded $450) | POS | 100035897 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27103 | BLUECHOICE HMO 70 SILVER $2,100 (HSA/HRA) | HMO | 100035929 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27107 | BLUECHOICE HMO 70 SILVER $3,000 (HSA/HRA) | HMO | 100035931 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27058 | BLUECHOICE HMO REFERRAL SILVER $4,000 (Rx Ded $400) | HMO | 100035937 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27101 | BLUECHOICE HMO SILVER $1,500 (HSA/HRA) | HMO | 100035912 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27130 | BLUECHOICE HMO SILVER $1,500 (Rx Ded $250) | HMO | 100035920 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27102 | BLUECHOICE HMO SILVER $2,000 (HSA/HRA) | HMO | 100035914 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27108 | BLUECHOICE HMO SILVER $3,000 (HSA/HRA) | HMO | 100035918 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27131 | BLUECHOICE HMO SILVER $5,000 (Rx Ded $450) | HMO | 100035923 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27179 | BLUECHOICE PLUS POS SILVER $1,500 (HSA/HRA) | POS | 100035939 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27180 | BLUECHOICE PLUS POS SILVER $2,500 (HSA/HRA) | POS | 100035948 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27178 | BLUECHOICE PLUS POS SILVER $3,000 (HSA/HRA) | POS | 100035941 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27148 | BLUEPREFERRED PPO 70 SILVER $2,100 (HSA/HRA) | PPO | 100035881 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27150 | BLUEPREFERRED PPO 80/60 SILVER $2,400 (HSA/HRA) | PPO | 100035879 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27145 | BLUEPREFERRED PPO SILVER $1,500 (HSA/HRA) | PPO | 100035880 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27146 | BLUEPREFERRED PPO SILVER $1,500 (HSA/HRA) | PPO | 100035870 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27158 | BLUEPREFERRED PPO SILVER $1,500 (Rx Ded $250) | PPO | 100035876 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | M | Silver | 27147 | BLUEPREFERRED PPO SILVER $2,000 (HSA/HRA) | PPO | 100035872 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Bronze | 27001 | BLUECHOICE ADVANTAGE POS BRONZE $6,000 | POS | 100035634 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Bronze | 27016 | BLUECHOICE ADVANTAGE POS BRONZE $6,100 (HSA/HRA) | POS | 100035510 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Bronze | 27193 | BLUECHOICE ADVANTAGE POS BRONZE $6,100 (HSA/HRA) | POS | 100035519 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Bronze | 27070 | BLUECHOICE HMO 90 BRONZE $6,500 (HSA/HRA) | HMO | 100035654 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Bronze | 27091 | BLUECHOICE HMO BRONZE $6,000 | HMO | 100035709 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Bronze | 27066 | BLUECHOICE HMO BRONZE $6,000 (HRA) | HMO | 100035707 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Bronze | 27068 | BLUECHOICE HMO BRONZE $6,100 (HSA/HRA) | HMO | 100035652 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Bronze | 27093 | BLUECHOICE HMO BRONZE $6,100 (HSA/HRA) | HMO | 100035648 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Bronze | 27053 | BLUECHOICE HMO REFERRAL BRONZE $6,200 (HSA/HRA) | HMO | 100035637 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Bronze | 27050 | BLUECHOICE HMO REFERRAL BRONZE $6,200 (HSA/HRA) | HMO | 100035639 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Bronze | 27054 | BLUECHOICE HMO REFERRAL BRONZE $8,250 | HMO | 100035713 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Bronze | 27052 | BLUECHOICE HMO REFERRAL BRONZE $8,250 (HRA) | HMO | 100035715 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Bronze | 27173 | BLUECHOICE PLUS POS BRONZE $6,100 (HSA/HRA) | POS | 100035732 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Bronze | 27132 | BLUEPREFERRED PPO BRONZE $6,200 (HSA/HRA) | PPO | 100035787 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Bronze | 27207 | BLUEPREFERRED PPO BRONZE $6,200 (HSA/HRA) | PPO | 100035825 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27003 | BLUECHOICE ADVANTAGE POS 90 GOLD $1,500 (HSA/HRA) | POS | 100035587 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27040 | BLUECHOICE ADVANTAGE POS GOLD $0 (Rx Ded $0) | POS | 100035630 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27034 | BLUECHOICE ADVANTAGE POS GOLD $1,000 (Rx Ded $250) | POS | 100035576 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27029 | BLUECHOICE ADVANTAGE POS GOLD $1,000 (Rx Ded $250) | POS | 100035578 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27019 | BLUECHOICE ADVANTAGE POS GOLD $1,500 (HSA/HRA) | POS | 100035544 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27196 | BLUECHOICE ADVANTAGE POS GOLD $1,500 (HSA/HRA) | POS | 100035551 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27194 | BLUECHOICE ADVANTAGE POS GOLD $3,000 (Rx Ded $250) | POS | 100035573 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27042 | BLUECHOICE ADVANTAGE POS GOLD $500 (Rx Ded $250) | POS | 100035593 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27075 | BLUECHOICE HMO 90 GOLD $1,500 (HSA/HRA) | HMO | 100035693 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27097 | BLUECHOICE HMO GOLD $1,000 | HMO | 100035699 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27072 | BLUECHOICE HMO GOLD $1,000 (HRA) | HMO | 100035696 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27077 | BLUECHOICE HMO GOLD $1,500 (HSA/HRA) | HMO | 100035689 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27126 | BLUECHOICE HMO GOLD $1,500 (Rx Ded $250) | HMO | 100035723 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27119 | BLUECHOICE HMO GOLD $1,500 (Rx Ded $250) | HMO | 100035724 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27120 | BLUECHOICE HMO GOLD $3,000 (Rx Ded $250) | HMO | 100035721 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27060 | BLUECHOICE HMO GOLD $500 (Rx Ded $250) | HMO | 100035646 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27110 | BLUECHOICE HMO REFERRAL GOLD $0 (Rx Ded $0) | HMO | 100035710 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27112 | BLUECHOICE HMO REFERRAL GOLD $500 (Rx Ded $250) | HMO | 100035711 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27182 | BLUECHOICE PLUS POS GOLD $1,000 (Rx Ded $250) | POS | 100035774 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27197 | BLUECHOICE PLUS POS GOLD $500 (Rx Ded $250) | POS | 100035778 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27204 | BLUEPREFERRED PPO 90/70 GOLD $1,000 | PPO | 100035852 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27206 | BLUEPREFERRED PPO 90/70 GOLD $1,000 (HRA) | PPO | 100035853 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27201 | BLUEPREFERRED PPO GOLD $1,000 (Rx Ded $250) | PPO | 100035860 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27153 | BLUEPREFERRED PPO GOLD $1,500 (Rx Ded $250) | PPO | 100035821 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Gold | 27160 | BLUEPREFERRED PPO GOLD $500 (Rx Ded $250) | PPO | 100035822 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Platinum | 27190 | BLUECHOICE ADVANTAGE POS PLATINUM $0 (Rx Ded $0) | POS | 100035596 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Platinum | 27062 | BLUECHOICE HMO PLATINUM $0 (Rx Ded $0) | HMO | 100035647 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Platinum | 27114 | BLUECHOICE HMO REFERRAL PLATINUM $0 (Rx Ded $0) | HMO | 100035712 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Platinum | 27170 | BLUECHOICE PLUS POS OPTOUT PLATINUM $0 (Rx Ded $0) | POS | 100035731 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Platinum | 27202 | BLUEPREFERRED PPO PLATINUM $0 (Rx Ded $0) | PPO | 100035866 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Platinum | 27203 | BLUEPREFERRED PPO PLATINUM $500 (Rx Ded $0) | PPO | 100035867 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Platinum | 27209 | HEALTHYBLUE ADVANTAGE POS PLATINUM $500 (Rx Ded $0) | POS | 100035628 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Platinum | 27210 | HEALTHYBLUE PLUS POS PLATINUM $500 (Rx Ded $0) | POS | 100035781 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27011 | BLUECHOICE ADVANTAGE POS 70 SILVER $2,100 (HSA/HRA) | POS | 100035619 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27013 | BLUECHOICE ADVANTAGE POS 70 SILVER $3,000 (HSA/HRA) | POS | 100035599 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27006 | BLUECHOICE ADVANTAGE POS SILVER $1,500 (HSA/HRA) | POS | 100035535 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27008 | BLUECHOICE ADVANTAGE POS SILVER $2,000 (HSA/HRA) | POS | 100035610 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27015 | BLUECHOICE ADVANTAGE POS SILVER $3,000 (HSA/HRA) | POS | 100035526 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27191 | BLUECHOICE ADVANTAGE POS SILVER $3,000 (HSA/HRA) | POS | 100035521 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27195 | BLUECHOICE ADVANTAGE POS SILVER $4,000 (Rx Ded $400) | POS | 100035567 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27192 | BLUECHOICE ADVANTAGE POS SILVER $5,000 (Rx Ded $450) | POS | 100035555 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27032 | BLUECHOICE ADVANTAGE POS SILVER $5,000 (Rx Ded $450) | POS | 100035557 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27083 | BLUECHOICE HMO 70 SILVER $2,100 (HSA/HRA) | HMO | 100035675 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27088 | BLUECHOICE HMO 70 SILVER $3,000 (HSA/HRA) | HMO | 100035668 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27057 | BLUECHOICE HMO REFERRAL SILVER $4,000 (Rx Ded $400) | HMO | 100035644 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27079 | BLUECHOICE HMO SILVER $1,500 (HSA/HRA) | HMO | 100035701 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27100 | BLUECHOICE HMO SILVER $1,500 (HSA/HRA) | HMO | 100035700 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27124 | BLUECHOICE HMO SILVER $1,500 (Rx Ded $250) | HMO | 100035718 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27081 | BLUECHOICE HMO SILVER $2,000 (HSA/HRA) | HMO | 100035674 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27085 | BLUECHOICE HMO SILVER $2,400 (HSA/HRA) | HMO | 100035681 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27105 | BLUECHOICE HMO SILVER $2,400 (HSA/HRA) | HMO | 100035685 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27106 | BLUECHOICE HMO SILVER $3,000 (HSA/HRA) | HMO | 100035659 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27090 | BLUECHOICE HMO SILVER $3,000 (HSA/HRA) | HMO | 100035662 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27129 | BLUECHOICE HMO SILVER $5,000 (Rx Ded $450) | HMO | 100035727 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27122 | BLUECHOICE HMO SILVER $5,000 (Rx Ded $450) | HMO | 100035729 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27200 | BLUECHOICE PLUS POS SILVER $1,500 (HSA/HRA) | POS | 100035759 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27198 | BLUECHOICE PLUS POS SILVER $2,500 (HSA/HRA) | POS | 100035770 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27199 | BLUECHOICE PLUS POS SILVER $3,000 (HSA/HRA) | POS | 100035747 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27139 | BLUEPREFERRED PPO 70 SILVER $2,100 (HSA/HRA) | PPO | 100035804 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27141 | BLUEPREFERRED PPO 80/60 SILVER $2,400 (HSA/HRA) | PPO | 100035795 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27208 | BLUEPREFERRED PPO 80/60 SILVER $2,400 (HSA/HRA) | PPO | 100035836 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27136 | BLUEPREFERRED PPO SILVER $1,500 (HSA/HRA) | PPO | 100035789 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27155 | BLUEPREFERRED PPO SILVER $1,500 (Rx Ded $250) | PPO | 100035815 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| MD | M | Silver | 27205 | BLUEPREFERRED PPO SILVER $2,000 (HSA/HRA) | PPO | 100035845 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Bronze | 27000 | BLUECHOICE ADVANTAGE POS BRONZE $6,000 (HRA) | POS | 100035423 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Bronze | 27002 | BLUECHOICE ADVANTAGE POS BRONZE $6,100 (HSA/HRA) | POS | 100035152 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Bronze | 27069 | BLUECHOICE HMO 90 BRONZE $6,500 (HSA/HRA) | HMO | 100035234 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Bronze | 27065 | BLUECHOICE HMO BRONZE $6,000 (HRA) | HMO | 100035425 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Bronze | 27067 | BLUECHOICE HMO BRONZE $6,100 (HSA/HRA) | HMO | 100035232 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Bronze | 27051 | BLUECHOICE HMO REFERRAL BRONZE $8,250 (HRA) | HMO | 100035284 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Bronze | 27172 | BLUECHOICE PLUS POS BRONZE $6,100 (HSA/HRA) | POS | 100035297 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27004 | BLUECHOICE ADVANTAGE POS 90 GOLD $1,500 (HSA/HRA) | POS | 100035163 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27039 | BLUECHOICE ADVANTAGE POS GOLD $0 (Rx Ded $0) | POS | 100035208 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27028 | BLUECHOICE ADVANTAGE POS GOLD $1,000 (Rx Ded $250) | POS | 100035195 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27005 | BLUECHOICE ADVANTAGE POS GOLD $1,500 (HSA/HRA) | POS | 100035160 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27030 | BLUECHOICE ADVANTAGE POS GOLD $3,000 (Rx Ded $250) | POS | 100035199 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27041 | BLUECHOICE ADVANTAGE POS GOLD $500 (Rx Ded $250) | POS | 100035200 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27074 | BLUECHOICE HMO 90 GOLD $1,500 (HSA/HRA) | HMO | 100035245 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27096 | BLUECHOICE HMO GOLD $1,000 | HMO | 100035216 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27071 | BLUECHOICE HMO GOLD $1,000 (HRA) | HMO | 100035218 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27073 | BLUECHOICE HMO GOLD $1,000 SE | HMO | 100035220 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27076 | BLUECHOICE HMO GOLD $1,500 (HSA/HRA) | HMO | 100035238 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27118 | BLUECHOICE HMO GOLD $1,500 (Rx Ded $250) | HMO | 100035274 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27121 | BLUECHOICE HMO GOLD $3,000 (Rx Ded $250) | HMO | 100035276 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27059 | BLUECHOICE HMO GOLD $500 (Rx Ded $250) | HMO | 100035279 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27109 | BLUECHOICE HMO REFERRAL GOLD $0 (Rx Ded $0) | HMO | 100035289 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27111 | BLUECHOICE HMO REFERRAL GOLD $500 (Rx Ded $250) | HMO | 100035285 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27181 | BLUECHOICE PLUS POS GOLD $1,000 (Rx Ded $250) | POS | 100035319 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27184 | BLUECHOICE PLUS POS GOLD $500 (Rx Ded $250) | POS | 100035369 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27143 | BLUEPREFERRED PPO 90/70 GOLD $1,000 | PPO | 100035321 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27133 | BLUEPREFERRED PPO 90/70 GOLD $1,000 (HRA) | PPO | 100035323 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27134 | BLUEPREFERRED PPO 90/70 GOLD $1,000 SE (HRA) | PPO | 100035327 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27151 | BLUEPREFERRED PPO GOLD $1,000 (Rx Ded $250) | PPO | 100035357 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27152 | BLUEPREFERRED PPO GOLD $1,500 (Rx Ded $250) | PPO | 100035361 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Gold | 27159 | BLUEPREFERRED PPO GOLD $500 (Rx Ded $250) | PPO | 100035363 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Platinum | 27048 | BLUECHOICE ADVANTAGE POS 90/70 PLATINUM $0 (Rx Ded $0) | POS | 100035191 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Platinum | 27043 | BLUECHOICE ADVANTAGE POS 90/70 PLATINUM $0 (Rx Ded $0) | POS | 100035192 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Platinum | 27045 | BLUECHOICE ADVANTAGE POS 90/70 PLATINUM SE $0 (Rx Ded $0) | POS | 100035193 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Platinum | 27044 | BLUECHOICE ADVANTAGE POS PLATINUM $0 (Rx Ded $0) | POS | 100035201 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Platinum | 27061 | BLUECHOICE HMO PLATINUM $0 (Rx Ded $0) | HMO | 100035280 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Platinum | 27113 | BLUECHOICE HMO REFERRAL PLATINUM $0 (Rx Ded $0) | HMO | 100035290 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Platinum | 27169 | BLUECHOICE PLUS POS OPTOUT PLATINUM $0 (Rx Ded $0) | POS | 100035320 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Platinum | 27166 | BLUEPREFERRED PPO 100/80 PLATINUM $0 (Rx Ded $0) | PPO | 100035339 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Platinum | 27161 | BLUEPREFERRED PPO 100/80 PLATINUM $0 (Rx Ded $0) | PPO | 100035340 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Platinum | 27164 | BLUEPREFERRED PPO 100/80 PLATINUM SE $0 (Rx Ded $0) | PPO | 100035341 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Platinum | 27162 | BLUEPREFERRED PPO PLATINUM $0 (Rx Ded $0) | PPO | 100035364 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Platinum | 27163 | BLUEPREFERRED PPO PLATINUM $500 (Rx Ded $0) | PPO | 100035365 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Platinum | 27188 | HEALTHYBLUE ADVANTAGE POS PLATINUM $500 (Rx Ded $0) | POS | 100035367 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Platinum | 27186 | HEALTHYBLUE PLUS POS PLATINUM $500 (Rx Ded $0) | POS | 100035368 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27010 | BLUECHOICE ADVANTAGE POS 70 SILVER $2,100 (HSA/HRA) | POS | 100035176 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27012 | BLUECHOICE ADVANTAGE POS 70 SILVER $3,000 (HSA/HRA) | POS | 100035187 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27007 | BLUECHOICE ADVANTAGE POS SILVER $1,500 (HSA/HRA) | POS | 100035166 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27009 | BLUECHOICE ADVANTAGE POS SILVER $2,000 (HSA/HRA) | POS | 100035171 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27014 | BLUECHOICE ADVANTAGE POS SILVER $3,000 (HSA/HRA) | POS | 100035184 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27031 | BLUECHOICE ADVANTAGE POS SILVER $4,000 (Rx Ded $400) | POS | 100035203 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27033 | BLUECHOICE ADVANTAGE POS SILVER $5,000 (Rx Ded $450) | POS | 100035205 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27082 | BLUECHOICE HMO 70 SILVER $2,100 (HSA/HRA) | HMO | 100035260 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27087 | BLUECHOICE HMO 70 SILVER $3,000 (HSA/HRA) | HMO | 100035268 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27056 | BLUECHOICE HMO REFERRAL SILVER $4,000 (Rx Ded $400) | HMO | 100035288 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27078 | BLUECHOICE HMO SILVER $1,500 (HSA/HRA) | HMO | 100035252 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27123 | BLUECHOICE HMO SILVER $1,500 (Rx Ded $250) | HMO | 100035291 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27080 | BLUECHOICE HMO SILVER $2,000 (HSA/HRA) | HMO | 100035257 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27084 | BLUECHOICE HMO SILVER $2,400 (HSA/HRA) | HMO | 100035214 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27104 | BLUECHOICE HMO SILVER $2,400 (HSA/HRA) | HMO | 100035210 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27086 | BLUECHOICE HMO SILVER $2,400 SE (HSA/HRA) | HMO | 100035225 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27089 | BLUECHOICE HMO SILVER $3,000 (HSA/HRA) | HMO | 100035265 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27125 | BLUECHOICE HMO SILVER $5,000 (Rx Ded $450) | HMO | 100035295 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27174 | BLUECHOICE PLUS POS SILVER $1,500 (HSA/HRA) | POS | 100035303 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27175 | BLUECHOICE PLUS POS SILVER $2,500 (HSA/HRA) | POS | 100035309 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27176 | BLUECHOICE PLUS POS SILVER $3,000 (HSA/HRA) | POS | 100035312 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27138 | BLUEPREFERRED PPO 70 SILVER $2,100 (HSA/HRA) | PPO | 100035353 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27149 | BLUEPREFERRED PPO 80/60 SILVER $2,400 (HSA/HRA) | PPO | 100035328 | ON-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27140 | BLUEPREFERRED PPO 80/60 SILVER $2,400 (HSA/HRA) | PPO | 100035331 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27142 | BLUEPREFERRED PPO 80/60 SILVER $2,400 SE (HSA/HRA) | PPO | 100035336 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27135 | BLUEPREFERRED PPO SILVER $1,500 (HSA/HRA) | PPO | 100035346 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27154 | BLUEPREFERRED PPO SILVER $1,500 (Rx Ded $250) | PPO | 100035366 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| VA | M | Silver | 27137 | BLUEPREFERRED PPO SILVER $2,000 (HSA/HRA) | PPO | 100035347 | OFF-SHOP |
Benefits
| 1/1/2021 | 9/30/2021 | |
| DC | D | N/A | 5201 | BlueDental Basic (Std Fee) | DEN | 5201 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5335 | BlueDental EPO | DEN | 5335 | N/A |
Benefits
| 6/1/2019 | 7/31/2021 | |
| DC | D | N/A | 5336 | BlueDental EPO w/Ortho | DEN | 5336 | N/A |
Benefits
| 6/1/2019 | 7/31/2021 | |
| DC | D | N/A | 5238 | BlueDental Plus Plan 1 ORTHO (90 Fee) | DEN | 5238 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5236 | BlueDental Plus Plan 1 ORTHO (Std Fee) | DEN | 5236 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5237 | BlueDental Plus Plan 1 (90 Fee) | DEN | 5237 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5235 | BlueDental Plus Plan 1 (Std Fee) | DEN | 5235 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5242 | BlueDental Plus Plan 2 ORTHO (90 Fee) | DEN | 5242 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5240 | BlueDental Plus Plan 2 ORTHO (Std Fee) | DEN | 5240 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5241 | BlueDental Plus Plan 2 (90 Fee) | DEN | 5241 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5239 | BlueDental Plus Plan 2 (Std Fee) | DEN | 5239 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5246 | BlueDental Plus Plan 3 ORTHO (90 Fee) | DEN | 5246 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5244 | BlueDental Plus Plan 3 ORTHO (Std Fee) | DEN | 5244 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5245 | BlueDental Plus Plan 3 (90 Fee) | DEN | 5245 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5243 | BlueDental Plus Plan 3 (Std Fee) | DEN | 5243 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5250 | BlueDental Plus Plan 4 ORTHO (90 Fee) | DEN | 5250 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5248 | BlueDental Plus Plan 4 ORTHO (Std Fee) | DEN | 5248 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5249 | BlueDental Plus Plan 4 (90 Fee) | DEN | 5249 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5247 | BlueDental Plus Plan 4 (Std Fee) | DEN | 5247 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5254 | BlueDental Plus Plan 5 ORTHO (90 Fee) | DEN | 5254 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5252 | BlueDental Plus Plan 5 ORTHO (Std Fee) | DEN | 5252 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5253 | BlueDental Plus Plan 5 (90 Fee) | DEN | 5253 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5251 | BlueDental Plus Plan 5 (Std Fee) | DEN | 5251 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5258 | BlueDental Plus Plan 6 ORTHO (90 Fee) | DEN | 5258 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5256 | BlueDental Plus Plan 6 ORTHO (Std Fee) | DEN | 5256 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5257 | BlueDental Plus Plan 6 (90 Fee) | DEN | 5257 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5255 | BlueDental Plus Plan 6 (Std Fee) | DEN | 5255 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5262 | BlueDental Plus Plan 7 ORTHO (90 Fee) | DEN | 5262 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5260 | BlueDental Plus Plan 7 ORTHO (Std Fee) | DEN | 5260 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5261 | BlueDental Plus Plan 7 (90 Fee) | DEN | 5261 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5259 | BlueDental Plus Plan 7 (Std Fee) | DEN | 5259 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5266 | BlueDental Plus Plan 8 ORTHO (90 Fee) | DEN | 5266 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5264 | BlueDental Plus Plan 8 ORTHO (Std Fee) | DEN | 5264 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5265 | BlueDental Plus Plan 8 (90 Fee) | DEN | 5265 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5263 | BlueDental Plus Plan 8 (Std Fee) | DEN | 5263 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| DC | D | N/A | 5420 | Preferred Dental PPO Option 1 | DEN | 5420 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| DC | D | N/A | 5421 | Preferred Dental PPO Option 2 | DEN | 5421 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| DC | D | N/A | 5422 | Preferred Dental PPO Option 3 | DEN | 5422 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| DC | D | N/A | 5423 | Preferred Dental PPO Option 4 | DEN | 5423 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| DC | D | N/A | 5424 | Preferred Dental PPO Plan 1 ORTHO | DEN | 5424 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| DC | D | N/A | 5425 | Preferred Dental PPO Plan 2 ORTHO | DEN | 5425 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| DC | D | N/A | 5426 | Preferred Dental PPO Plan 3 ORTHO | DEN | 5426 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| DC | D | N/A | 5427 | Preferred Dental PPO Plan 4 ORTHO | DEN | 5427 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| DC | D | N/A | 5433 | Traditional Dental Plan 1 | DEN | 5433 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| DC | D | N/A | 5428 | Traditional Dental Plan 1 ORTHO | DEN | 5428 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| DC | D | N/A | 5434 | Traditional Dental Plan 2 | DEN | 5434 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| DC | D | N/A | 5429 | Traditional Dental Plan 2 ORTHO | DEN | 5429 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| DC | D | N/A | 5435 | Traditional Dental Plan 3 | DEN | 5435 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| DC | D | N/A | 5430 | Traditional Dental Plan 3 ORTHO | DEN | 5430 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| DC | D | N/A | 5431 | Traditional Dental Plan 4 | DEN | 5431 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| DC | D | N/A | 5432 | Traditional Dental Plan 4 ORTHO | DEN | 5432 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| DC | V | None | 5625 | BlueVision Plus Option 1 (FS/ER) | VIS | 5625 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| DC | V | None | 5627 | BlueVision Plus Option 2 (FS/ER) | VIS | 5627 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| DC | V | None | 5629 | BlueVision Plus Option 3 (FS/ER) | VIS | 5629 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| DC | V | None | 5631 | BlueVision Plus Option 4 (FS/ER) | VIS | 5631 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| DC | V | None | 5633 | BlueVision Plus Option A (FS/ER) Increased Allowances | VIS | 5633 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| DC | V | None | 5635 | BlueVision Plus Option A (FS/VL) Increased Allowances | VIS | 5635 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| DC | V | None | 5637 | BlueVision Plus Option B (FS/ER) Increased Allowances | VIS | 5637 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| DC | V | None | 5639 | BlueVision Plus Option B (FS/VL) Increased Allowances | VIS | 5639 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| DC | V | None | 5641 | BlueVision Plus Option C (FS/ER) Increased Allowances | VIS | 5641 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| DC | V | None | 5643 | BlueVision Plus Option C (FS/VL) Increased Allowances | VIS | 5643 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| DC | V | None | 5645 | BlueVision Plus Option D (FS/ER) Increased Allowances | VIS | 5645 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| DC | V | None | 5647 | BlueVision Plus Option D (FS/VL) Increased Allowances | VIS | 5647 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5200 | BlueDental Basic (Std Fee) | DEN | 5200 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5333 | BlueDental EPO | DEN | 5333 | N/A |
Benefits
| 6/1/2019 | 7/31/2021 | |
| MD | D | N/A | 5334 | BlueDental EPO w/Ortho | DEN | 5334 | N/A |
Benefits
| 6/1/2019 | 7/31/2021 | |
| MD | D | N/A | 5206 | BlueDental Plus Plan 1 ORTHO (90 Fee) | DEN | 5206 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5204 | BlueDental Plus Plan 1 ORTHO (Std Fee) | DEN | 5204 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5205 | BlueDental Plus Plan 1 (90 Fee) | DEN | 5205 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5203 | BlueDental Plus Plan 1 (Std Fee) | DEN | 5203 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5210 | BlueDental Plus Plan 2 ORTHO (90 Fee) | DEN | 5210 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5208 | BlueDental Plus Plan 2 ORTHO (Std Fee) | DEN | 5208 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5209 | BlueDental Plus Plan 2 (90 Fee) | DEN | 5209 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5207 | BlueDental Plus Plan 2 (Std Fee) | DEN | 5207 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5214 | BlueDental Plus Plan 3 ORTHO (90 Fee) | DEN | 5214 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5212 | BlueDental Plus Plan 3 ORTHO (Std Fee) | DEN | 5212 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5213 | BlueDental Plus Plan 3 (90 Fee) | DEN | 5213 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5211 | BlueDental Plus Plan 3 (Std Fee) | DEN | 5211 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5218 | BlueDental Plus Plan 4 ORTHO (90 Fee) | DEN | 5218 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5216 | BlueDental Plus Plan 4 ORTHO (Std Fee) | DEN | 5216 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5217 | BlueDental Plus Plan 4 (90 Fee) | DEN | 5217 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5215 | BlueDental Plus Plan 4 (Std Fee) | DEN | 5215 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5222 | BlueDental Plus Plan 5 ORTHO (90 Fee) | DEN | 5222 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5220 | BlueDental Plus Plan 5 ORTHO (Std Fee) | DEN | 5220 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5221 | BlueDental Plus Plan 5 (90 Fee) | DEN | 5221 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5219 | BlueDental Plus Plan 5 (Std Fee) | DEN | 5219 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5226 | BlueDental Plus Plan 6 ORTHO (90 Fee) | DEN | 5226 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5224 | BlueDental Plus Plan 6 ORTHO (Std Fee) | DEN | 5224 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5225 | BlueDental Plus Plan 6 (90 Fee) | DEN | 5225 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5223 | BlueDental Plus Plan 6 (Std Fee) | DEN | 5223 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5230 | BlueDental Plus Plan 7 ORTHO (90 Fee) | DEN | 5230 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5228 | BlueDental Plus Plan 7 ORTHO (Std Fee) | DEN | 5228 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5229 | BlueDental Plus Plan 7 (90 Fee) | DEN | 5229 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5227 | BlueDental Plus Plan 7 (Std Fee) | DEN | 5227 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5234 | BlueDental Plus Plan 8 ORTHO (90 Fee) | DEN | 5234 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5232 | BlueDental Plus Plan 8 ORTHO (Std Fee) | DEN | 5232 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5233 | BlueDental Plus Plan 8 (90 Fee) | DEN | 5233 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5231 | BlueDental Plus Plan 8 (Std Fee) | DEN | 5231 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| MD | D | N/A | 5404 | Preferred Dental PPO Plan 1 | DEN | 5404 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| MD | D | N/A | 5408 | Preferred Dental PPO Plan 1 ORTHO | DEN | 5408 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| MD | D | N/A | 5405 | Preferred Dental PPO Plan 2 | DEN | 5405 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| MD | D | N/A | 5409 | Preferred Dental PPO Plan 2 ORTHO | DEN | 5409 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| MD | D | N/A | 5406 | Preferred Dental PPO Plan 3 | DEN | 5406 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| MD | D | N/A | 5410 | Preferred Dental PPO Plan 3 ORTHO | DEN | 5410 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| MD | D | N/A | 5407 | Preferred Dental PPO Plan 4 | DEN | 5407 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| MD | D | N/A | 5411 | Preferred Dental PPO Plan 4 ORTHO | DEN | 5411 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| MD | D | N/A | 5417 | Traditional Dental Plan 1 | DEN | 5417 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| MD | D | N/A | 5412 | Traditional Dental Plan 1 ORTHO | DEN | 5412 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| MD | D | N/A | 5418 | Traditional Dental Plan 2 | DEN | 5418 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| MD | D | N/A | 5413 | Traditional Dental Plan 2 ORTHO | DEN | 5413 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| MD | D | N/A | 5419 | Traditional Dental Plan 3 | DEN | 5419 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| MD | D | N/A | 5414 | Traditional Dental Plan 3 ORTHO | DEN | 5414 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| MD | D | N/A | 5415 | Traditional Dental Plan 4 | DEN | 5415 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| MD | D | N/A | 5416 | Traditional Dental Plan 4 ORTHO | DEN | 5416 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| MD | V | None | 5601 | BlueVision Plus Option 1 (FS/ER) | VIS | 5601 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| MD | V | None | 5603 | BlueVision Plus Option 2 (FS/ER) | VIS | 5603 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| MD | V | None | 5605 | BlueVision Plus Option 3 (FS/ER) | VIS | 5605 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| MD | V | None | 5607 | BlueVision Plus Option 4 (FS/ER) | VIS | 5607 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| MD | V | None | 5609 | BlueVision Plus Option A (FS/ER) Increased Allowances | VIS | 5609 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| MD | V | None | 5611 | BlueVision Plus Option A (FS/VL) Increased Allowances | VIS | 5611 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| MD | V | None | 5613 | BlueVision Plus Option B (FS/ER) Increased Allowances | VIS | 5613 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| MD | V | None | 5615 | BlueVision Plus Option B (FS/VL) Increased Allowances | VIS | 5615 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| MD | V | None | 5617 | BlueVision Plus Option C (FS/ER) Increased Allowances | VIS | 5617 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| MD | V | None | 5619 | BlueVision Plus Option C (FS/VL) Increased Allowances | VIS | 5619 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| MD | V | None | 5621 | BlueVision Plus Option D (FS/ER) Increased Allowances | VIS | 5621 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| MD | V | None | 5623 | BlueVision Plus Option D (FS/VL) Increased Allowances | VIS | 5623 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5202 | BlueDental Basic (Std Fee) | DEN | 5202 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5337 | BlueDental EPO | DEN | 5337 | N/A |
Benefits
| 6/1/2019 | 7/31/2021 | |
| VA | D | N/A | 5338 | BlueDental EPO w/Ortho | DEN | 5338 | N/A |
Benefits
| 6/1/2019 | 7/31/2021 | |
| VA | D | N/A | 5270 | BlueDental Plus Plan 1 ORTHO (90 Fee) | DEN | 5270 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5268 | BlueDental Plus Plan 1 ORTHO (Std Fee) | DEN | 5268 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5269 | BlueDental Plus Plan 1 (90 Fee) | DEN | 5269 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5267 | BlueDental Plus Plan 1 (Std Fee) | DEN | 5267 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5274 | BlueDental Plus Plan 2 ORTHO (90 Fee) | DEN | 5274 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5272 | BlueDental Plus Plan 2 ORTHO (Std Fee) | DEN | 5272 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5273 | BlueDental Plus Plan 2 (90 Fee) | DEN | 5273 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5271 | BlueDental Plus Plan 2 (Std Fee) | DEN | 5271 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5278 | BlueDental Plus Plan 3 ORTHO (90 Fee) | DEN | 5278 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5276 | BlueDental Plus Plan 3 ORTHO (Std Fee) | DEN | 5276 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5277 | BlueDental Plus Plan 3 (90 Fee) | DEN | 5277 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5275 | BlueDental Plus Plan 3 (Std Fee) | DEN | 5275 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5282 | BlueDental Plus Plan 4 ORTHO (90 Fee) | DEN | 5282 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5280 | BlueDental Plus Plan 4 ORTHO (Std Fee) | DEN | 5280 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5281 | BlueDental Plus Plan 4 (90 Fee) | DEN | 5281 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5279 | BlueDental Plus Plan 4 (Std Fee) | DEN | 5279 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5286 | BlueDental Plus Plan 5 ORTHO (90 Fee) | DEN | 5286 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5284 | BlueDental Plus Plan 5 ORTHO (Std Fee) | DEN | 5284 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5285 | BlueDental Plus Plan 5 (90 Fee) | DEN | 5285 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5283 | BlueDental Plus Plan 5 (Std Fee) | DEN | 5283 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5290 | BlueDental Plus Plan 6 ORTHO (90 Fee) | DEN | 5290 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5288 | BlueDental Plus Plan 6 ORTHO (Std Fee) | DEN | 5288 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5289 | BlueDental Plus Plan 6 (90 Fee) | DEN | 5289 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5287 | BlueDental Plus Plan 6 (Std Fee) | DEN | 5287 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5294 | BlueDental Plus Plan 7 ORTHO (90 Fee) | DEN | 5294 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5292 | BlueDental Plus Plan 7 ORTHO (Std Fee) | DEN | 5292 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5293 | BlueDental Plus Plan 7 (90 Fee) | DEN | 5293 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5291 | BlueDental Plus Plan 7 (Std Fee) | DEN | 5291 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5298 | BlueDental Plus Plan 8 ORTHO (90 Fee) | DEN | 5298 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5296 | BlueDental Plus Plan 8 ORTHO (Std Fee) | DEN | 5296 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5297 | BlueDental Plus Plan 8 (90 Fee) | DEN | 5297 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5295 | BlueDental Plus Plan 8 (Std Fee) | DEN | 5295 | N/A |
Benefits
| 7/1/2015 | 7/31/2021 | |
| VA | D | N/A | 5436 | Preferred Dental PPO Plan 1 | DEN | 5436 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| VA | D | N/A | 5440 | Preferred Dental PPO Plan 1 ORTHO | DEN | 5440 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| VA | D | N/A | 5437 | Preferred Dental PPO Plan 2 | DEN | 5437 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| VA | D | N/A | 5441 | Preferred Dental PPO Plan 2 ORTHO | DEN | 5441 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| VA | D | N/A | 5438 | Preferred Dental PPO Plan 3 | DEN | 5438 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| VA | D | N/A | 5442 | Preferred Dental PPO Plan 3 ORTHO | DEN | 5442 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| VA | D | N/A | 5439 | Preferred Dental PPO Plan 4 | DEN | 5439 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| VA | D | N/A | 5443 | Preferred Dental PPO Plan 4 ORTHO | DEN | 5443 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| VA | D | N/A | 5448 | Traditional Dental Plan 1 | DEN | 5448 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| VA | D | N/A | 5444 | Traditional Dental Plan 1 ORTHO | DEN | 5444 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| VA | D | N/A | 5449 | Traditional Dental Plan 2 | DEN | 5449 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| VA | D | N/A | 5445 | Traditional Dental Plan 2 ORTHO | DEN | 5445 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| VA | D | N/A | 5450 | Traditional Dental Plan 3 | DEN | 5450 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| VA | D | N/A | 5446 | Traditional Dental Plan 3 ORTHO | DEN | 5446 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| VA | D | N/A | 5451 | Traditional Dental Plan 4 | DEN | 5451 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| VA | D | N/A | 5447 | Traditional Dental Plan 4 ORTHO | DEN | 5447 | N/A |
Benefits
| 1/1/2017 | 7/31/2021 | |
| VA | V | None | 5649 | BlueVision Plus Option 1 (FS/ER) | VIS | 5649 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| VA | V | None | 5651 | BlueVision Plus Option 2 (FS/ER) | VIS | 5651 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| VA | V | None | 5653 | BlueVision Plus Option 3 (FS/ER) | VIS | 5653 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| VA | V | None | 5655 | BlueVision Plus Option 4 (FS/ER) | VIS | 5655 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| VA | V | None | 5657 | BlueVision Plus Option A (FS/ER) Increased Allowances | VIS | 5657 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| VA | V | None | 5659 | BlueVision Plus Option A (FS/VL) Increased Allowances | VIS | 5659 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| VA | V | None | 5661 | BlueVision Plus Option B (FS/ER) Increased Allowances | VIS | 5661 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| VA | V | None | 5663 | BlueVision Plus Option B (FS/VL) Increased Allowances | VIS | 5663 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| VA | V | None | 5665 | BlueVision Plus Option C (FS/ER) Increased Allowances | VIS | 5665 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| VA | V | None | 5667 | BlueVision Plus Option C (FS/VL) Increased Allowances | VIS | 5667 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| VA | V | None | 5669 | BlueVision Plus Option D (FS/ER) Increased Allowances | VIS | 5669 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| VA | V | None | 5671 | BlueVision Plus Option D (FS/VL) Increased Allowances | VIS | 5671 | N/A |
Benefits
| 1/1/2015 | 7/31/2021 | |
| DC | M | Bronze | 26613 | BLUECHOICE ADVANTAGE BRONZE PLAN - $6,500 (can be HRA) | POS | 100032170 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Bronze | 26633 | BLUECHOICE ADVANTAGE HDHP/HSA/HRA BRONZE PLAN - $6,000 | POS | 100032166 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Bronze | 26654 | BLUECHOICE HMO HDHP/HSA/HRA 90 BRONZE PLAN - $6,000 | HMO | 100032207 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Bronze | 26621 | BLUECHOICE HMO HDHP/HSA/HRA BRONZE PLAN - $6,000 | HMO | 100032194 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Bronze | 26639 | BLUECHOICE HMO REFERRAL BRONZE PLAN - $6,500 (can be HRA) | HMO | 100032215 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Bronze | 26658 | BLUECHOICE HMO REFERRAL BRONZE PLAN - $8,150 (can be HRA) | HMO | 100032218 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Bronze | 26649 | BLUECHOICE PLUS HDHP/HSA/HRA BRONZE PLAN - $6,000 | POS | 100032226 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26632 | BLUECHOICE ADVANTAGE GOLD PLAN - $1,000 (can be HRA) | POS | 100032160 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26636 | BLUECHOICE ADVANTAGE GOLD PLAN - $3,000 (can be HRA) | POS | 100032178 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26608 | BLUECHOICE ADVANTAGE GOLD PLAN - $500 | POS | 100032161 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26618 | BLUECHOICE ADVANTAGE HDHP/HSA/HRA 90 GOLD PLAN - $1,500 | POS | 100032181 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26617 | BLUECHOICE ADVANTAGE HDHP/HSA/HRA GOLD PLAN - $1,500 | POS | 100032171 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26645 | BLUECHOICE HMO GOLD PLAN - $1,500 (can be HRA) | HMO | 100032187 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26620 | BLUECHOICE HMO GOLD PLAN - $500 | HMO | 100032188 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26653 | BLUECHOICE HMO HDHP GOLD PLAN - $3,000 | HMO | 100032204 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26622 | BLUECHOICE HMO HDHP/HSA/HRA 90 GOLD PLAN - $1,500 | HMO | 100032205 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26604 | BLUECHOICE HMO HDHP/HSA/HRA GOLD PLAN - $1,500 | HMO | 100032199 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26656 | BLUECHOICE HMO REFERRAL GOLD PLAN | HMO | 100032216 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26638 | BLUECHOICE HMO REFERRAL GOLD PLAN - $500 | HMO | 100032214 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26629 | BLUECHOICE PLUS GOLD PLAN - $1,000 (can be HRA) | POS | 100032224 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26606 | BLUECHOICE PLUS GOLD PLAN - $500 | POS | 100032225 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26650 | BLUEPREFERRED PPO 90/70 GOLD PLAN - $1,000 (can be HRA) | PPO | 100032155 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26614 | BLUEPREFERRED PPO GOLD PLAN - $1,000 (can be HRA) | PPO | 100032145 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26624 | BLUEPREFERRED PPO GOLD PLAN - $1,500 (can be HRA) | PPO | 100032154 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Gold | 26600 | BLUEPREFERRED PPO GOLD PLAN - $500 | PPO | 100032146 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Platinum | 26615 | BLUECHOICE ADVANTAGE PLATINUM PLAN | POS | 100032162 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Platinum | 26603 | BLUECHOICE HMO PLATINUM PLAN | HMO | 100032189 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Platinum | 26609 | BLUECHOICE HMO REFERRAL PLATINUM PLAN | HMO | 100032213 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Platinum | 26641 | BLUECHOICE PLUS OPT-OUT PLATINUM PLAN | POS | 100032230 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Platinum | 26611 | BLUEPREFERRED PPO PLATINUM PLAN | PPO | 100032151 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Platinum | 26623 | BLUEPREFERRED PPO PLATINUM PLAN - $500 | PPO | 100032152 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Platinum | 26602 | HEALTHYBLUE ADVANTAGE PLATINUM PLAN- $500 | POS | 100032165 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Platinum | 26610 | HEALTHYBLUE PLUS PLATINUM PLAN -$500 | POS | 100032223 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26652 | BLUECHOICE ADVANTAGE HDHP/HSA/HRA 70 SILVER PLAN - $2,000 | POS | 100032183 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26619 | BLUECHOICE ADVANTAGE HDHP/HSA/HRA 70 SILVER PLAN - $3,000 | POS | 100032185 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26616 | BLUECHOICE ADVANTAGE HDHP/HSA/HRA SILVER PLAN - $1,500 | POS | 100032163 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26644 | BLUECHOICE ADVANTAGE HDHP/HSA/HRA SILVER PLAN - $2,000 | POS | 100032179 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26643 | BLUECHOICE ADVANTAGE HDHP/HSA/HRA SILVER PLAN - $2,500 | POS | 100032175 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26634 | BLUECHOICE ADVANTAGE HDHP/HSA/HRA SILVER PLAN - $3,000 | POS | 100032168 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26625 | BLUECHOICE ADVANTAGE HSA BLUEFUND SILVER PLAN - $1,500 | POS | 100032174 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26635 | BLUECHOICE ADVANTAGE SILVER PLAN - $4,000 (can be HRA) | POS | 100032173 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26651 | BLUECHOICE ADVANTAGE SILVER PLAN - $5,000 (can be HRA) | POS | 100032177 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26655 | BLUECHOICE HMO HDHP/HSA/HRA 70 SILVER PLAN - $2,000 | HMO | 100032209 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26627 | BLUECHOICE HMO HDHP/HSA/HRA 70 SILVER PLAN - $3,000 | HMO | 100032211 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26646 | BLUECHOICE HMO HDHP/HSA/HRA SILVER PLAN - $1,500 | HMO | 100032190 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26647 | BLUECHOICE HMO HDHP/HSA/HRA SILVER PLAN - $2,000 | HMO | 100032192 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26637 | BLUECHOICE HMO HDHP/HSA/HRA SILVER PLAN - $2,500 | HMO | 100032201 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26648 | BLUECHOICE HMO HDHP/HSA/HRA SILVER PLAN - $3,000 | HMO | 100032196 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26657 | BLUECHOICE HMO REFERRAL SILVER PLAN - $4,000 (can be HRA) | HMO | 100032217 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26626 | BLUECHOICE HMO SILVER PLAN - $1,500 (can be HRA) | HMO | 100032198 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26605 | BLUECHOICE HMO SILVER PLAN - $5,000 (can be HRA) | HMO | 100032203 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26640 | BLUECHOICE PLUS HDHP/HSA/HRA SILVER - $3,000 | POS | 100032221 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26628 | BLUECHOICE PLUS HDHP/HSA/HRA SILVER PLAN - $1,500 | POS | 100032219 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26659 | BLUECHOICE PLUS HDHP/HSA/HRA SILVER PLAN - $2,500 | POS | 100032228 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26612 | BLUEPREFERRED PPO HDHP/HSA/HRA 70 SILVER PLAN - $2,000 | PPO | 100032158 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26601 | BLUEPREFERRED PPO HDHP/HSA/HRA 80/60 SILVER PLAN - $2,300 | PPO | 100032156 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26607 | BLUEPREFERRED PPO HDHP/HSA/HRA SILVER PLAN - $2,000 | PPO | 100032149 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26642 | BLUEPREFERRED PPO HRA SILVER PLAN - $1,500 | PPO | 100032147 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26631 | BLUEPREFERRED PPO HSA BLUEFUND SILVER PLAN - $1,500 | PPO | 100032157 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| DC | M | Silver | 26630 | BLUEPREFERRED PPO SILVER PLAN - $1,500 (can be HRA) | PPO | 100032153 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Bronze | 26709 | BlueChoice Advantage Bronze Plan - $6,500 (can be HRA) | POS | 100032336 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Bronze | 26700 | BlueChoice Advantage HRA/HSA Bronze Plan - $6,000 | POS | 100032284 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Bronze | 26724 | BlueChoice HMO HRA/HSA 90 Bronze Plan - $6,000 | HMO | 100032428 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Bronze | 26723 | BlueChoice HMO HRA/HSA Bronze Plan - $6,000 | HMO | 100032425 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Bronze | 26719 | BlueChoice HMO Referral Bronze Plan - $6,500 (can be HRA) | HMO | 100032418 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Bronze | 26717 | BlueChoice HMO Referral Bronze Plan - $8,150 (can be HRA) | HMO | 100032484 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Bronze | 26718 | BlueChoice HMO Referral HRA/HSA Bronze Plan - $5,500 | HMO | 100032407 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Bronze | 26716 | BlueChoice HMO Referral HRA/HSA Bronze Plan - $5,500 | HMO | 100032412 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Bronze | 26760 | BlueChoice Plus HRA/HSA Bronze Plan - $6,000 | POS | 100032509 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Bronze | 26744 | BluePreferred PPO HRA/HSA Bronze Plan - $5,500 | PPO | 100032598 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Bronze | 26750 | BluePreferred PPO HRA/HSA Bronze Plan - $5,500 | PPO | 100032593 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26714 | BlueChoice Advantage Gold Plan - $500 | POS | 100032372 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26710 | BlueChoice Advantage Gold Plan - $1,000 (can be HRA) | POS | 100032355 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26711 | BlueChoice Advantage Gold Plan - $3,000 (can be HRA) | POS | 100032350 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26701 | BlueChoice Advantage HRA/HSA 90 Gold Plan - $1,500 | POS | 100032361 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26702 | BlueChoice Advantage HRA/HSA Gold Plan - $1,500 | POS | 100032317 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26735 | BlueChoice HMO Gold Plan - $1,000 | HMO | 100032470 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26721 | BlueChoice HMO Gold Plan - $500 | HMO | 100032419 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26725 | BlueChoice HMO Gold Plan - $1,000 (can be HRA) | HMO | 100032469 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26740 | BlueChoice HMO Gold Plan - $1,500 (can be HRA) | HMO | 100032494 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26741 | BlueChoice HMO Gold Plan - $3,000 (can be HRA) | HMO | 100032491 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26726 | BlueChoice HMO HRA/HSA 90 Gold Plan - $1,500 | HMO | 100032464 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26727 | BlueChoice HMO HRA/HSA Gold Plan - $1,500 | HMO | 100032459 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26737 | BlueChoice HMO Referral Gold Plan | HMO | 100032481 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26738 | BlueChoice HMO Referral Gold Plan - $500 | HMO | 100032482 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26765 | BlueChoice Plus Gold Plan - $500 | POS | 100032547 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26764 | BlueChoice Plus Gold Plan - $1,000 (can be HRA) | POS | 100032541 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26751 | BluePreferred PPO 90 Gold Plan - $1,000 | PPO | 100032577 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26756 | BluePreferred PPO Gold Plan - $500 | PPO | 100032590 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26745 | BluePreferred PPO 90 Gold Plan - $1,000 (can be HRA) | PPO | 100032623 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26753 | BluePreferred PPO Gold Plan - $1,000 (can be HRA) | PPO | 100032629 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Gold | 26754 | BluePreferred PPO Gold Plan - $1,500 (can be HRA) | PPO | 100032589 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Platinum | 26715 | BlueChoice Advantage Platinum Plan | POS | 100032373 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Platinum | 26722 | BlueChoice HMO Platinum Plan | HMO | 100032420 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Platinum | 26739 | BlueChoice HMO Referral Platinum Plan | HMO | 100032483 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Platinum | 26759 | BlueChoice Plus Opt-Out Platinum Plan | POS | 100032499 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Platinum | 26757 | BluePreferred PPO Platinum Plan | PPO | 100032634 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Platinum | 26758 | BluePreferred PPO Platinum Plan- $500 | PPO | 100032592 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Platinum | 26767 | HealthyBlue Advantage Platinum Plan - $500 | POS | 100032405 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Platinum | 26766 | HealthyBlue Plus Platinum Plan- $500 | POS | 100032548 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26704 | BlueChoice Advantage HRA/HSA 70 Silver Plan - $2,000 | POS | 100032396 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26707 | BlueChoice Advantage HRA/HSA 70 Silver Plan - $3,000 | POS | 100032375 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26703 | BlueChoice Advantage HRA/HSA Silver Plan - $1,500 | POS | 100032301 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26705 | BlueChoice Advantage HRA/HSA Silver Plan - $2,000 | POS | 100032391 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26706 | BlueChoice Advantage HRA/HSA Silver Plan - $2,500 | POS | 100032323 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26708 | BlueChoice Advantage HRA/HSA Silver Plan - $3,000 | POS | 100032292 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26712 | BlueChoice Advantage Silver Plan - $4,000 (can be HRA) | POS | 100032346 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26713 | BlueChoice Advantage Silver Plan - $5,000 (can be HRA) | POS | 100032339 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26729 | BlueChoice HMO HRA/HSA 70 Silver Plan - $2,000 | HMO | 100032450 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26733 | BlueChoice HMO HRA/HSA 70 Silver Plan - $3,000 | HMO | 100032440 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26728 | BlueChoice HMO HRA/HSA Silver Plan - $1,500 | HMO | 100032477 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26730 | BlueChoice HMO HRA/HSA Silver Plan - $2,000 | HMO | 100032442 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26731 | BlueChoice HMO HRA/HSA Silver Plan - $2,300 | HMO | 100032451 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26736 | BlueChoice HMO HRA/HSA Silver Plan - $2,300 | HMO | 100032456 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26732 | BlueChoice HMO HRA/HSA Silver Plan - $2,500 | HMO | 100032475 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26734 | BlueChoice HMO HRA/HSA Silver Plan - $3,000 | HMO | 100032434 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26720 | BlueChoice HMO Referral Silver Plan - $4,000 (can be HRA) | HMO | 100032415 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26742 | BlueChoice HMO Silver Plan - $1,500 (can be HRA) | HMO | 100032487 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26743 | BlueChoice HMO Silver Plan - $5,000 (can be HRA) | HMO | 100032497 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26761 | BlueChoice Plus HRA/HSA Silver Plan - $1,500 | POS | 100032527 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26762 | BlueChoice Plus HRA/HSA Silver Plan - $2,500 | POS | 100032539 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26763 | BlueChoice Plus HRA/HSA Silver Plan - $3,000 | POS | 100032510 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26747 | BluePreferred PPO HRA/HSA 70 Silver Plan - $2,000 | PPO | 100032575 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26746 | BluePreferred PPO HRA/HSA Silver Plan - $1,500 | PPO | 100032560 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26748 | BluePreferred PPO HRA/HSA Silver Plan - $2,000 | PPO | 100032613 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26749 | BluePreferred PPO HRA/HSA Silver Plan - $2,300 | PPO | 100032607 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26752 | BluePreferred PPO HRA/HSA Silver Plan - $2,300 | PPO | 100032604 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| MD | M | Silver | 26755 | BluePreferred PPO Silver Plan - $1,500 (can be HRA) | PPO | 100032626 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Bronze | 26809 | BlueChoice Advantage Bronze Plan - $6,500 (can be HRA) | POS | 100032773 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Bronze | 26800 | BlueChoice Advantage HRA/HSA Bronze Plan - $6,000 | POS | 100032722 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Bronze | 26825 | BlueChoice HMO HRA/HSA 90 Bronze Plan - $6,000 | HMO | 100032802 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Bronze | 26824 | BlueChoice HMO HRA/HSA Bronze Plan - $6,000 | HMO | 100032807 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Bronze | 26820 | BlueChoice HMO Referral Bronze Plan - $6,500 (can be HRA) | HMO | 100032792 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Bronze | 26819 | BlueChoice HMO Referral Bronze Plan - $8,150 (can be HRA) | HMO | 100032786 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Bronze | 26866 | BlueChoice Plus HRA/HSA Bronze Plan - $6,000 | POS | 100032943 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26814 | BlueChoice Advantage Gold Plan - $500 | POS | 100032781 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26810 | BlueChoice Advantage Gold Plan - $1,000 (can be HRA) | POS | 100032771 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26811 | BlueChoice Advantage Gold Plan- $3000 (can be HRA) | POS | 100032768 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26801 | BlueChoice Advantage HRA/HSA 90 Gold Plan - $1,500 | POS | 100032762 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26802 | BlueChoice Advantage HRA/HSA Gold Plan - $1,500 | POS | 100032724 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26838 | BlueChoice HMO Gold Plan - $1,000 | HMO | 100032819 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26822 | BlueChoice HMO Gold Plan - $500 | HMO | 100032794 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26826 | BlueChoice HMO Gold Plan - $1,000 (can be HRA) | HMO | 100032822 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26827 | BlueChoice HMO Gold Plan - $1,000 SE (can be HRA) | HMO | 100032817 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26843 | BlueChoice HMO Gold Plan - $1,500 (can be HRA) | HMO | 100032876 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26844 | BlueChoice HMO Gold Plan- $3000 (can be HRA) | HMO | 100032874 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26828 | BlueChoice HMO HRA/HSA 90 Gold Plan - $1,500 | HMO | 100032857 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26829 | BlueChoice HMO HRA/HSA Gold Plan - $1,500 | HMO | 100032797 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26840 | BlueChoice HMO Referral Gold Plan | HMO | 100032864 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26841 | BlueChoice HMO Referral Gold Plan - $500 | HMO | 100032865 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26871 | BlueChoice Plus Gold Plan - $500 | POS | 100032948 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26870 | BlueChoice Plus Gold Plan - $1,000 (can be HRA) | POS | 100032946 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26854 | BluePreferred PPO 90 Gold Plan - $1,000 | PPO | 100032910 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26859 | BluePreferred PPO Gold Plan - $500 | PPO | 100032923 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26847 | BluePreferred PPO 90 Gold Plan - $1,000 (can be HRA) | PPO | 100032879 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26848 | BluePreferred PPO 90 Gold Plan - $1,000 SE (can be HRA) | PPO | 100032893 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26856 | BluePreferred PPO Gold Plan - $1,000 (can be HRA) | PPO | 100032915 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Gold | 26857 | BluePreferred PPO Gold Plan - $1,500 (can be HRA) | PPO | 100032912 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Platinum | 26815 | BlueChoice Advantage 90 Platinum Plan | POS | 100032779 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Platinum | 26818 | BlueChoice Advantage 90 Platinum Plan | POS | 100032783 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Platinum | 26817 | BlueChoice Advantage 90 Platinum Plan SE | POS | 100032782 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Platinum | 26816 | BlueChoice Advantage Platinum Plan | POS | 100032780 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Platinum | 26823 | BlueChoice HMO Platinum Plan | HMO | 100032793 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Platinum | 26842 | BlueChoice HMO Referral Platinum Plan | HMO | 100032863 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Platinum | 26865 | BlueChoice Plus Opt-Out Platinum Plan | POS | 100032924 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Platinum | 26864 | BluePreferred PPO Platinum 100/80 | PPO | 100032920 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Platinum | 26863 | BluePreferred PPO Platinum 100/80 - SE | PPO | 100032918 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Platinum | 26861 | BluePreferred PPO Platinum Plan | PPO | 100032922 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Platinum | 26862 | BluePreferred PPO Platinum Plan - $500 | PPO | 100032921 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Platinum | 26873 | HealthyBlue Advantage Platinum Plan - $500 | POS | 100032950 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Platinum | 26872 | HealthyBlue Plus Platinum Plan - $500 | POS | 100032949 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26804 | BlueChoice Advantage HRA/HSA 70 Silver Plan - $2,000 | POS | 100032750 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26807 | BlueChoice Advantage HRA/HSA 70 Silver Plan - $3,000 | POS | 100032748 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26803 | BlueChoice Advantage HRA/HSA Silver Plan - $1,500 | POS | 100032730 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26805 | BlueChoice Advantage HRA/HSA Silver Plan - $2,000 | POS | 100032756 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26806 | BlueChoice Advantage HRA/HSA Silver Plan - $2,500 | POS | 100032738 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26808 | BlueChoice Advantage HRA/HSA Silver Plan - $3,000 | POS | 100032742 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26812 | BlueChoice Advantage Silver Plan - $4,000 (can be HRA) | POS | 100032766 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26813 | BlueChoice Advantage Silver Plan- $5000 (can be HRA) | POS | 100032777 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26832 | BlueChoice HMO HRA/HSA 70 Silver Plan - $2,000 | HMO | 100032842 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26836 | BlueChoice HMO HRA/HSA 70 Silver Plan - $3,000 | HMO | 100032823 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26830 | BlueChoice HMO HRA/HSA Silver Plan - $1,500 | HMO | 100032848 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26831 | BlueChoice HMO HRA/HSA Silver Plan - $2,000 | HMO | 100032845 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26833 | BlueChoice HMO HRA/HSA Silver Plan - $2,300 | HMO | 100032860 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26839 | BlueChoice HMO HRA/HSA Silver Plan - $2,300 | HMO | 100032815 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26834 | BlueChoice HMO HRA/HSA Silver Plan - $2,300 SE | HMO | 100032811 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26835 | BlueChoice HMO HRA/HSA Silver Plan - $2,500 | HMO | 100032835 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26837 | BlueChoice HMO HRA/HSA Silver Plan - $3,000 | HMO | 100032832 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26821 | BlueChoice HMO Referral Silver Plan - $4,000 (can be HRA) | HMO | 100032789 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26845 | BlueChoice HMO Silver Plan - $1,500 (can be HRA) | HMO | 100032869 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26846 | BlueChoice HMO Silver Plan- $5000 (can be HRA) | HMO | 100032868 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26867 | BlueChoice Plus HRA/HSA Silver Plan - $1,500 | POS | 100032939 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26868 | BlueChoice Plus HRA/HSA Silver Plan - $2,500 | POS | 100032934 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26869 | BlueChoice Plus HRA/HSA Silver Plan - $3,000 | POS | 100032926 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26858 | BluePreferred PPO Silver Plan - $1,500 | PPO | 100032917 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26850 | BluePreferred PPO HRA/HSA 70 Silver Plan - $2,000 | PPO | 100032896 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26849 | BluePreferred PPO HRA/HSA Silver Plan - $1,500 | PPO | 100032909 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26851 | BluePreferred PPO HRA/HSA Silver Plan - $2,000 | PPO | 100032900 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26852 | BluePreferred PPO HRA/HSA Silver Plan - $2,300 | PPO | 100032888 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26855 | BluePreferred PPO HRA/HSA Silver Plan - $2,300 | PPO | 100032891 | ON-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |
| VA | M | Silver | 26853 | BluePreferred PPO HRA/HSA Silver Plan - $2,300 SE | PPO | 100032885 | OFF-SHOP |
Benefits
| 1/1/2020 | 12/31/2020 | |