BlueChoice Plus
Small Group Off-SHOP - Virginia

Benefit summaries are now available for the health plans listed below. Please check the site frequently for summary updates.

Please note: Not all services and procedures are covered by your benefits contract. Benefit summaries are for comparison purposes only and does not create rights not given through the benefit plan.

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

BlueChoice Plus

Plan Name Rx Plan Type Integration Status Medical Summary

BlueChoice Plus Platinum 0 Ded

$10/$45/$65/50% (up to $100)/50% (up to $150)

Standard

Integrated OOP only

 SUM7969

SUM7969-SPA

BlueChoice Plus Platinum 500 Med Ded 25 Dent Ded

$0/$45/$65/50% to $100/50% to $150

Standard

Integrated OOP only

 SUM7970

SUM7970-SPA

BlueChoice Plus Gold 800 Med Ded 250 Drug Ded 25 Dent Ded

$15/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150)

Standard

Rx DEDUCTIBLE W/INTEGRATED OOP

 SUM7971

SUM7971-SPA

BlueChoice Plus Gold 1000 Med Ded 250 Drug Ded 25 Dent Ded

$15/D,$45/D,$70/D,50% (up to $100)/D,50% (up to $150)

HRA

Rx DEDUCTIBLE W/INTEGRATED OOP

 SUM7972

SUM7972-SPA

BlueChoice Plus HSA/HRA Silver 2800 Med Ded 25 Dent Ded

D,$15/D,$50/D,$70/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

 SUM7973

SUM7973-SPA

BlueChoice Plus HSA/HRA Silver 3350 Med Ded 25 Dent Ded

D,$15/D,$50/D,$70/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

 SUM7974

SUM7974-SPA

BlueChoice Plus HSA/HRA Silver 3600 Med Ded 25 Dent Ded

D,$15/D,$50/D,$70/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

 SUM7975

SUM7975-SPA

BlueChoice Plus HSA/HRA Bronze 6100 Ded

D,$15/D,$45/D,$75/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

 SUM7976

SUM7976-SPA