BluePreferred PPO
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.

BluePreferred PPO

Plan Name Rx Plan Type Integration Status Medical Summary

BluePreferred PPO Platinum Zero Med Ded 25 Dent Ded SE ON/OFF SHOP

$10/20%/40%/50% (up to $100)/50% (up to $150)

Standard

Integrated OOP ONLY

 SUM7977

SUM7977-SPA

BluePreferred PPO Platinum 0 Med Ded 25 Dent Ded

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

Standard

Integrated OOP ONLY

 SUM7978

SUM7978-SPA

BluePreferred PPO Platinum 500 Med Ded 25 Dent Ded

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

Standard

Integrated OOP ONLY

 SUM7979

SUM7979-SPA

BluePreferred PPO 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

 SUM7980

SUM7980-SPA

BluePreferred PPO 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

 SUM7981

SUM7981-SPA

BluePreferred PPO Gold 1500 Ded ON/OFF SHOP

D,$15/D,20%/D,40%/D,50% (up to $100)/D,50% (up to $150)

HRA

Fully Integrated

 SUM7982

SUM7982-SPA

BluePreferred PPO Silver 2200 Med Ded 250 Drug Ded 25 Dent Ded

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

HRA

Rx DEDUCTIBLE W/INTEGRATED OOP

 SUM7983

SUM7983-SPA

BluePreferred PPO 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

 SUM7984

SUM7984-SPA

BluePreferred PPO HSA/HRA Silver 3050 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

 SUM7985

SUM7985-SPA