BlueChoice HMO
Small Group On-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 HMO

Plan Name Rx Plan Type Integration Status Medical Summary

BlueChoice HMO Gold 1900 Med Ded 25 Dent Ded ON/OFF SHOP

D,$10/D,45%/D,70%/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

SUM7958

SUM7958-SPA

BlueChoice HMO HSA/HRA Silver 3150 Med Ded 25 Dent Ded ON/OFF SHOP

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

HSA/HRA/HDHP

Fully Integrated

SUM7961

SUM7961-SPA