M.T.Donahoe & Associates, LLC

Area	flav	Metal	PN	Description	Product	CPID	SHOP	Click For	Start	End
DC	D	N/A	5201	BlueDental Basic (Std Fee)	DEN	5201	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5335	BlueDental EPO	DEN	5335	N/A	Benefits	6/1/2019	12/31/2020
DC	D	N/A	5336	BlueDental EPO w/Ortho	DEN	5336	N/A	Benefits	6/1/2019	12/31/2020
DC	D	N/A	5238	BlueDental Plus Plan 1 ORTHO (90 Fee)	DEN	5238	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5236	BlueDental Plus Plan 1 ORTHO (Std Fee)	DEN	5236	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5237	BlueDental Plus Plan 1 (90 Fee)	DEN	5237	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5235	BlueDental Plus Plan 1 (Std Fee)	DEN	5235	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5242	BlueDental Plus Plan 2 ORTHO (90 Fee)	DEN	5242	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5240	BlueDental Plus Plan 2 ORTHO (Std Fee)	DEN	5240	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5241	BlueDental Plus Plan 2 (90 Fee)	DEN	5241	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5239	BlueDental Plus Plan 2 (Std Fee)	DEN	5239	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5246	BlueDental Plus Plan 3 ORTHO (90 Fee)	DEN	5246	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5244	BlueDental Plus Plan 3 ORTHO (Std Fee)	DEN	5244	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5245	BlueDental Plus Plan 3 (90 Fee)	DEN	5245	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5243	BlueDental Plus Plan 3 (Std Fee)	DEN	5243	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5250	BlueDental Plus Plan 4 ORTHO (90 Fee)	DEN	5250	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5248	BlueDental Plus Plan 4 ORTHO (Std Fee)	DEN	5248	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5249	BlueDental Plus Plan 4 (90 Fee)	DEN	5249	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5247	BlueDental Plus Plan 4 (Std Fee)	DEN	5247	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5254	BlueDental Plus Plan 5 ORTHO (90 Fee)	DEN	5254	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5252	BlueDental Plus Plan 5 ORTHO (Std Fee)	DEN	5252	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5253	BlueDental Plus Plan 5 (90 Fee)	DEN	5253	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5251	BlueDental Plus Plan 5 (Std Fee)	DEN	5251	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5258	BlueDental Plus Plan 6 ORTHO (90 Fee)	DEN	5258	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5256	BlueDental Plus Plan 6 ORTHO (Std Fee)	DEN	5256	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5257	BlueDental Plus Plan 6 (90 Fee)	DEN	5257	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5255	BlueDental Plus Plan 6 (Std Fee)	DEN	5255	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5262	BlueDental Plus Plan 7 ORTHO (90 Fee)	DEN	5262	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5260	BlueDental Plus Plan 7 ORTHO (Std Fee)	DEN	5260	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5261	BlueDental Plus Plan 7 (90 Fee)	DEN	5261	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5259	BlueDental Plus Plan 7 (Std Fee)	DEN	5259	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5266	BlueDental Plus Plan 8 ORTHO (90 Fee)	DEN	5266	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5264	BlueDental Plus Plan 8 ORTHO (Std Fee)	DEN	5264	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5265	BlueDental Plus Plan 8 (90 Fee)	DEN	5265	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5263	BlueDental Plus Plan 8 (Std Fee)	DEN	5263	N/A	Benefits	7/1/2015	12/31/2020
DC	D	N/A	5420	Preferred Dental PPO Option 1	DEN	5420	N/A	Benefits	1/1/2017	12/31/2020
DC	D	N/A	5421	Preferred Dental PPO Option 2	DEN	5421	N/A	Benefits	1/1/2017	12/31/2020
DC	D	N/A	5422	Preferred Dental PPO Option 3	DEN	5422	N/A	Benefits	1/1/2017	12/31/2020
DC	D	N/A	5423	Preferred Dental PPO Option 4	DEN	5423	N/A	Benefits	1/1/2017	12/31/2020
DC	D	N/A	5424	Preferred Dental PPO Plan 1 ORTHO	DEN	5424	N/A	Benefits	1/1/2017	12/31/2020
DC	D	N/A	5425	Preferred Dental PPO Plan 2 ORTHO	DEN	5425	N/A	Benefits	1/1/2017	12/31/2020
DC	D	N/A	5426	Preferred Dental PPO Plan 3 ORTHO	DEN	5426	N/A	Benefits	1/1/2017	12/31/2020
DC	D	N/A	5427	Preferred Dental PPO Plan 4 ORTHO	DEN	5427	N/A	Benefits	1/1/2017	12/31/2020
DC	D	N/A	5433	Traditional Dental Plan 1	DEN	5433	N/A	Benefits	1/1/2017	12/31/2020
DC	D	N/A	5428	Traditional Dental Plan 1 ORTHO	DEN	5428	N/A	Benefits	1/1/2017	12/31/2020
DC	D	N/A	5434	Traditional Dental Plan 2	DEN	5434	N/A	Benefits	1/1/2017	12/31/2020
DC	D	N/A	5429	Traditional Dental Plan 2 ORTHO	DEN	5429	N/A	Benefits	1/1/2017	12/31/2020
DC	D	N/A	5435	Traditional Dental Plan 3	DEN	5435	N/A	Benefits	1/1/2017	12/31/2020
DC	D	N/A	5430	Traditional Dental Plan 3 ORTHO	DEN	5430	N/A	Benefits	1/1/2017	12/31/2020
DC	D	N/A	5431	Traditional Dental Plan 4	DEN	5431	N/A	Benefits	1/1/2017	12/31/2020
DC	D	N/A	5432	Traditional Dental Plan 4 ORTHO	DEN	5432	N/A	Benefits	1/1/2017	12/31/2020
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
DC	V	None	5625	BlueVision Plus Option 1 (FS/ER)	VIS	5625	N/A	Benefits	1/1/2015	12/31/2020
DC	V	None	5627	BlueVision Plus Option 2 (FS/ER)	VIS	5627	N/A	Benefits	1/1/2015	12/31/2020
DC	V	None	5629	BlueVision Plus Option 3 (FS/ER)	VIS	5629	N/A	Benefits	1/1/2015	12/31/2020
DC	V	None	5631	BlueVision Plus Option 4 (FS/ER)	VIS	5631	N/A	Benefits	1/1/2015	12/31/2020
DC	V	None	5633	BlueVision Plus Option A (FS/ER) Increased Allowances	VIS	5633	N/A	Benefits	1/1/2015	12/31/2020
DC	V	None	5635	BlueVision Plus Option A (FS/VL) Increased Allowances	VIS	5635	N/A	Benefits	1/1/2015	12/31/2020
DC	V	None	5637	BlueVision Plus Option B (FS/ER) Increased Allowances	VIS	5637	N/A	Benefits	1/1/2015	12/31/2020
DC	V	None	5639	BlueVision Plus Option B (FS/VL) Increased Allowances	VIS	5639	N/A	Benefits	1/1/2015	12/31/2020
DC	V	None	5641	BlueVision Plus Option C (FS/ER) Increased Allowances	VIS	5641	N/A	Benefits	1/1/2015	12/31/2020
DC	V	None	5643	BlueVision Plus Option C (FS/VL) Increased Allowances	VIS	5643	N/A	Benefits	1/1/2015	12/31/2020
DC	V	None	5645	BlueVision Plus Option D (FS/ER) Increased Allowances	VIS	5645	N/A	Benefits	1/1/2015	12/31/2020
DC	V	None	5647	BlueVision Plus Option D (FS/VL) Increased Allowances	VIS	5647	N/A	Benefits	1/1/2015	12/31/2020
MD	D	N/A	5200	BlueDental Basic (Std Fee)	DEN	5200	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5333	BlueDental EPO	DEN	5333	N/A	Benefits	6/1/2019	12/31/2020
MD	D	N/A	5334	BlueDental EPO w/Ortho	DEN	5334	N/A	Benefits	6/1/2019	12/31/2020
MD	D	N/A	5206	BlueDental Plus Plan 1 ORTHO (90 Fee)	DEN	5206	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5204	BlueDental Plus Plan 1 ORTHO (Std Fee)	DEN	5204	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5205	BlueDental Plus Plan 1 (90 Fee)	DEN	5205	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5203	BlueDental Plus Plan 1 (Std Fee)	DEN	5203	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5210	BlueDental Plus Plan 2 ORTHO (90 Fee)	DEN	5210	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5208	BlueDental Plus Plan 2 ORTHO (Std Fee)	DEN	5208	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5209	BlueDental Plus Plan 2 (90 Fee)	DEN	5209	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5207	BlueDental Plus Plan 2 (Std Fee)	DEN	5207	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5214	BlueDental Plus Plan 3 ORTHO (90 Fee)	DEN	5214	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5212	BlueDental Plus Plan 3 ORTHO (Std Fee)	DEN	5212	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5213	BlueDental Plus Plan 3 (90 Fee)	DEN	5213	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5211	BlueDental Plus Plan 3 (Std Fee)	DEN	5211	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5218	BlueDental Plus Plan 4 ORTHO (90 Fee)	DEN	5218	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5216	BlueDental Plus Plan 4 ORTHO (Std Fee)	DEN	5216	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5217	BlueDental Plus Plan 4 (90 Fee)	DEN	5217	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5215	BlueDental Plus Plan 4 (Std Fee)	DEN	5215	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5222	BlueDental Plus Plan 5 ORTHO (90 Fee)	DEN	5222	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5220	BlueDental Plus Plan 5 ORTHO (Std Fee)	DEN	5220	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5221	BlueDental Plus Plan 5 (90 Fee)	DEN	5221	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5219	BlueDental Plus Plan 5 (Std Fee)	DEN	5219	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5226	BlueDental Plus Plan 6 ORTHO (90 Fee)	DEN	5226	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5224	BlueDental Plus Plan 6 ORTHO (Std Fee)	DEN	5224	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5225	BlueDental Plus Plan 6 (90 Fee)	DEN	5225	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5223	BlueDental Plus Plan 6 (Std Fee)	DEN	5223	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5230	BlueDental Plus Plan 7 ORTHO (90 Fee)	DEN	5230	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5228	BlueDental Plus Plan 7 ORTHO (Std Fee)	DEN	5228	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5229	BlueDental Plus Plan 7 (90 Fee)	DEN	5229	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5227	BlueDental Plus Plan 7 (Std Fee)	DEN	5227	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5234	BlueDental Plus Plan 8 ORTHO (90 Fee)	DEN	5234	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5232	BlueDental Plus Plan 8 ORTHO (Std Fee)	DEN	5232	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5233	BlueDental Plus Plan 8 (90 Fee)	DEN	5233	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5231	BlueDental Plus Plan 8 (Std Fee)	DEN	5231	N/A	Benefits	7/1/2015	12/31/2020
MD	D	N/A	5404	Preferred Dental PPO Plan 1	DEN	5404	N/A	Benefits	1/1/2017	12/31/2020
MD	D	N/A	5408	Preferred Dental PPO Plan 1 ORTHO	DEN	5408	N/A	Benefits	1/1/2017	12/31/2020
MD	D	N/A	5405	Preferred Dental PPO Plan 2	DEN	5405	N/A	Benefits	1/1/2017	12/31/2020
MD	D	N/A	5409	Preferred Dental PPO Plan 2 ORTHO	DEN	5409	N/A	Benefits	1/1/2017	12/31/2020
MD	D	N/A	5406	Preferred Dental PPO Plan 3	DEN	5406	N/A	Benefits	1/1/2017	12/31/2020
MD	D	N/A	5410	Preferred Dental PPO Plan 3 ORTHO	DEN	5410	N/A	Benefits	1/1/2017	12/31/2020
MD	D	N/A	5407	Preferred Dental PPO Plan 4	DEN	5407	N/A	Benefits	1/1/2017	12/31/2020
MD	D	N/A	5411	Preferred Dental PPO Plan 4 ORTHO	DEN	5411	N/A	Benefits	1/1/2017	12/31/2020
MD	D	N/A	5417	Traditional Dental Plan 1	DEN	5417	N/A	Benefits	1/1/2017	12/31/2020
MD	D	N/A	5412	Traditional Dental Plan 1 ORTHO	DEN	5412	N/A	Benefits	1/1/2017	12/31/2020
MD	D	N/A	5418	Traditional Dental Plan 2	DEN	5418	N/A	Benefits	1/1/2017	12/31/2020
MD	D	N/A	5413	Traditional Dental Plan 2 ORTHO	DEN	5413	N/A	Benefits	1/1/2017	12/31/2020
MD	D	N/A	5419	Traditional Dental Plan 3	DEN	5419	N/A	Benefits	1/1/2017	12/31/2020
MD	D	N/A	5414	Traditional Dental Plan 3 ORTHO	DEN	5414	N/A	Benefits	1/1/2017	12/31/2020
MD	D	N/A	5415	Traditional Dental Plan 4	DEN	5415	N/A	Benefits	1/1/2017	12/31/2020
MD	D	N/A	5416	Traditional Dental Plan 4 ORTHO	DEN	5416	N/A	Benefits	1/1/2017	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	26750	BluePreferred PPO HRA/HSA Bronze Plan - $5,500	PPO	100032593	ON-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	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
MD	V	None	5601	BlueVision Plus Option 1 (FS/ER)	VIS	5601	N/A	Benefits	1/1/2015	12/31/2020
MD	V	None	5603	BlueVision Plus Option 2 (FS/ER)	VIS	5603	N/A	Benefits	1/1/2015	12/31/2020
MD	V	None	5605	BlueVision Plus Option 3 (FS/ER)	VIS	5605	N/A	Benefits	1/1/2015	12/31/2020
MD	V	None	5607	BlueVision Plus Option 4 (FS/ER)	VIS	5607	N/A	Benefits	1/1/2015	12/31/2020
MD	V	None	5609	BlueVision Plus Option A (FS/ER) Increased Allowances	VIS	5609	N/A	Benefits	1/1/2015	12/31/2020
MD	V	None	5611	BlueVision Plus Option A (FS/VL) Increased Allowances	VIS	5611	N/A	Benefits	1/1/2015	12/31/2020
MD	V	None	5613	BlueVision Plus Option B (FS/ER) Increased Allowances	VIS	5613	N/A	Benefits	1/1/2015	12/31/2020
MD	V	None	5615	BlueVision Plus Option B (FS/VL) Increased Allowances	VIS	5615	N/A	Benefits	1/1/2015	12/31/2020
MD	V	None	5617	BlueVision Plus Option C (FS/ER) Increased Allowances	VIS	5617	N/A	Benefits	1/1/2015	12/31/2020
MD	V	None	5619	BlueVision Plus Option C (FS/VL) Increased Allowances	VIS	5619	N/A	Benefits	1/1/2015	12/31/2020
MD	V	None	5621	BlueVision Plus Option D (FS/ER) Increased Allowances	VIS	5621	N/A	Benefits	1/1/2015	12/31/2020
MD	V	None	5623	BlueVision Plus Option D (FS/VL) Increased Allowances	VIS	5623	N/A	Benefits	1/1/2015	12/31/2020
VA	D	N/A	5202	BlueDental Basic (Std Fee)	DEN	5202	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5337	BlueDental EPO	DEN	5337	N/A	Benefits	6/1/2019	12/31/2020
VA	D	N/A	5338	BlueDental EPO w/Ortho	DEN	5338	N/A	Benefits	6/1/2019	12/31/2020
VA	D	N/A	5270	BlueDental Plus Plan 1 ORTHO (90 Fee)	DEN	5270	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5268	BlueDental Plus Plan 1 ORTHO (Std Fee)	DEN	5268	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5269	BlueDental Plus Plan 1 (90 Fee)	DEN	5269	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5267	BlueDental Plus Plan 1 (Std Fee)	DEN	5267	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5274	BlueDental Plus Plan 2 ORTHO (90 Fee)	DEN	5274	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5272	BlueDental Plus Plan 2 ORTHO (Std Fee)	DEN	5272	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5273	BlueDental Plus Plan 2 (90 Fee)	DEN	5273	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5271	BlueDental Plus Plan 2 (Std Fee)	DEN	5271	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5278	BlueDental Plus Plan 3 ORTHO (90 Fee)	DEN	5278	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5276	BlueDental Plus Plan 3 ORTHO (Std Fee)	DEN	5276	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5277	BlueDental Plus Plan 3 (90 Fee)	DEN	5277	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5275	BlueDental Plus Plan 3 (Std Fee)	DEN	5275	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5282	BlueDental Plus Plan 4 ORTHO (90 Fee)	DEN	5282	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5280	BlueDental Plus Plan 4 ORTHO (Std Fee)	DEN	5280	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5281	BlueDental Plus Plan 4 (90 Fee)	DEN	5281	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5279	BlueDental Plus Plan 4 (Std Fee)	DEN	5279	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5286	BlueDental Plus Plan 5 ORTHO (90 Fee)	DEN	5286	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5284	BlueDental Plus Plan 5 ORTHO (Std Fee)	DEN	5284	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5285	BlueDental Plus Plan 5 (90 Fee)	DEN	5285	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5283	BlueDental Plus Plan 5 (Std Fee)	DEN	5283	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5290	BlueDental Plus Plan 6 ORTHO (90 Fee)	DEN	5290	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5288	BlueDental Plus Plan 6 ORTHO (Std Fee)	DEN	5288	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5289	BlueDental Plus Plan 6 (90 Fee)	DEN	5289	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5287	BlueDental Plus Plan 6 (Std Fee)	DEN	5287	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5294	BlueDental Plus Plan 7 ORTHO (90 Fee)	DEN	5294	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5292	BlueDental Plus Plan 7 ORTHO (Std Fee)	DEN	5292	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5293	BlueDental Plus Plan 7 (90 Fee)	DEN	5293	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5291	BlueDental Plus Plan 7 (Std Fee)	DEN	5291	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5298	BlueDental Plus Plan 8 ORTHO (90 Fee)	DEN	5298	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5296	BlueDental Plus Plan 8 ORTHO (Std Fee)	DEN	5296	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5297	BlueDental Plus Plan 8 (90 Fee)	DEN	5297	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5295	BlueDental Plus Plan 8 (Std Fee)	DEN	5295	N/A	Benefits	7/1/2015	12/31/2020
VA	D	N/A	5436	Preferred Dental PPO Plan 1	DEN	5436	N/A	Benefits	1/1/2017	12/31/2020
VA	D	N/A	5440	Preferred Dental PPO Plan 1 ORTHO	DEN	5440	N/A	Benefits	1/1/2017	12/31/2020
VA	D	N/A	5437	Preferred Dental PPO Plan 2	DEN	5437	N/A	Benefits	1/1/2017	12/31/2020
VA	D	N/A	5441	Preferred Dental PPO Plan 2 ORTHO	DEN	5441	N/A	Benefits	1/1/2017	12/31/2020
VA	D	N/A	5438	Preferred Dental PPO Plan 3	DEN	5438	N/A	Benefits	1/1/2017	12/31/2020
VA	D	N/A	5442	Preferred Dental PPO Plan 3 ORTHO	DEN	5442	N/A	Benefits	1/1/2017	12/31/2020
VA	D	N/A	5439	Preferred Dental PPO Plan 4	DEN	5439	N/A	Benefits	1/1/2017	12/31/2020
VA	D	N/A	5443	Preferred Dental PPO Plan 4 ORTHO	DEN	5443	N/A	Benefits	1/1/2017	12/31/2020
VA	D	N/A	5448	Traditional Dental Plan 1	DEN	5448	N/A	Benefits	1/1/2017	12/31/2020
VA	D	N/A	5444	Traditional Dental Plan 1 ORTHO	DEN	5444	N/A	Benefits	1/1/2017	12/31/2020
VA	D	N/A	5449	Traditional Dental Plan 2	DEN	5449	N/A	Benefits	1/1/2017	12/31/2020
VA	D	N/A	5445	Traditional Dental Plan 2 ORTHO	DEN	5445	N/A	Benefits	1/1/2017	12/31/2020
VA	D	N/A	5450	Traditional Dental Plan 3	DEN	5450	N/A	Benefits	1/1/2017	12/31/2020
VA	D	N/A	5446	Traditional Dental Plan 3 ORTHO	DEN	5446	N/A	Benefits	1/1/2017	12/31/2020
VA	D	N/A	5451	Traditional Dental Plan 4	DEN	5451	N/A	Benefits	1/1/2017	12/31/2020
VA	D	N/A	5447	Traditional Dental Plan 4 ORTHO	DEN	5447	N/A	Benefits	1/1/2017	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	26839	BlueChoice HMO HRA/HSA Silver Plan - $2,300	HMO	100032815	ON-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	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
VA	V	None	5649	BlueVision Plus Option 1 (FS/ER)	VIS	5649	N/A	Benefits	1/1/2015	12/31/2020
VA	V	None	5651	BlueVision Plus Option 2 (FS/ER)	VIS	5651	N/A	Benefits	1/1/2015	12/31/2020
VA	V	None	5653	BlueVision Plus Option 3 (FS/ER)	VIS	5653	N/A	Benefits	1/1/2015	12/31/2020
VA	V	None	5655	BlueVision Plus Option 4 (FS/ER)	VIS	5655	N/A	Benefits	1/1/2015	12/31/2020
VA	V	None	5657	BlueVision Plus Option A (FS/ER) Increased Allowances	VIS	5657	N/A	Benefits	1/1/2015	12/31/2020
VA	V	None	5659	BlueVision Plus Option A (FS/VL) Increased Allowances	VIS	5659	N/A	Benefits	1/1/2015	12/31/2020
VA	V	None	5661	BlueVision Plus Option B (FS/ER) Increased Allowances	VIS	5661	N/A	Benefits	1/1/2015	12/31/2020
VA	V	None	5663	BlueVision Plus Option B (FS/VL) Increased Allowances	VIS	5663	N/A	Benefits	1/1/2015	12/31/2020
VA	V	None	5665	BlueVision Plus Option C (FS/ER) Increased Allowances	VIS	5665	N/A	Benefits	1/1/2015	12/31/2020
VA	V	None	5667	BlueVision Plus Option C (FS/VL) Increased Allowances	VIS	5667	N/A	Benefits	1/1/2015	12/31/2020
VA	V	None	5669	BlueVision Plus Option D (FS/ER) Increased Allowances	VIS	5669	N/A	Benefits	1/1/2015	12/31/2020
VA	V	None	5671	BlueVision Plus Option D (FS/VL) Increased Allowances	VIS	5671	N/A	Benefits	1/1/2015	12/31/2020

Word in Desc	Replaced with
ANTHEM
AETNA
EVERGREEN
KP
HEALTHKEEPERS	HK
BLUEPREFERRED	BP
BLUECHOICE PLUS	BCP
BLUECHOICE	BCH
HEALTHYBLUE	HB
ADVANTAGE	Adv
BLUEFUND	BF
COMPATIBLE	Comp

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