BlueChoice HMO HSA/HRA
Mid / Large Group Benefit Summaries - District of Columbia

The following Consumer Driven Health Plan integrated fund administrator and Compatible HSA & HRA Plans are BlueChoice HMO-based. Whether you choose an option as a Consumer Driven Health Plan integrated fund administrator or Compatible plan, there is no difference in cost.


NOTE: All HSA and HRA plans may be offered through our Consumer Driven Health Plan integrated fund administrator or Compatible. Compatible funds do not integrate with CareFirst's fund administrator.

Employers can consult with a CareFirst account executive to explore other plan options that fit their organization's benefit needs.

HSA plans require a combined medical and Rx plan.

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Options Features Medical Summary Rx Summary
Option 4 Copay $10/20 $1,650 Ded. SUM4647 Integrated Rx Options
Option 5 Copay $0/0 $2,000 Ded. SUM5781 Integrated Rx Options
Option 8 Copay $20/40 $1,650 Ded. SUM4644 Integrated Rx Options
Option 9 Copay $0/5 $2,500 Ded. SUM4645 Integrated Rx Options



All plans are fully insured. Please consult with your CareFirst sales representative for information about self-insured options.

Options Features Medical Summary Rx Summary
BlueChoice HMO HSA/HRA
Option MV 1		 $4,000 Deductible SUM4650 Integrated Minimum Value (MV) Rx Options
BlueChoice HMO HSA/HRA
Option MV 3		 $3,300 Deductible SUM5098 Integrated Minimum Value (MV) Rx Options
BlueChoice HMO HSA/HRA
Option MV 4		 $5,000 Deductible SUM5099 Integrated Minimum Value (MV) Rx Options
BlueChoice HMO HSA/HRA
Option MV 5 		$7,000 Deductible SUM6894 Integrated Minimum Value (MV) Rx Options
BlueChoice HMO HSA/HRA
Option MV 6 		$3,300 Deductible SUM6897 Integrated Minimum Value (MV) Rx Options

All plans are fully insured. Please consult with your CareFirst sales representative for information about self-insured options.

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