BlueNet® EPO

Large Group (51 + total employees)

Small Group (2-50 total employees)

Large Group (51 + total employees)
Grandfathered (GFD) Plans — for groups that renewed after implementation of the ACA on 9/23/2010 Non-Grandfathered (UGF) Plans — for new or existing groups that enrolled or renewed after implementation of the ACA on 9/23/2010
BlueNet 250/2000 Option A (LG/GFD)  BlueNet 250/2000 Option A (LG/UGF) 
BlueNet 250/2000 Option B (LG/GFD)  BlueNet 250/2000 Option B (LG/UGF) 
BlueNet 250/2000 Option C (LG/GFD)  BlueNet 250/2000 Option C (LG/UGF) 
BlueNet 250/2000 Option D (LG/GFD)  BlueNet 250/2000 Option D (LG/UGF) 
BlueNet 500/2000 Option A (LG/GFD)  BlueNet 500/2000 Option A (LG/UGF) 
BlueNet 500/2000 Option B (LG/GFD)  BlueNet 500/2000 Option B (LG/UGF) 
BlueNet 500/2000 Option C (LG/GFD)  BlueNet 500/2000 Option C (LG/UGF) 
BlueNet 500/2000 Option D (LG/GFD)  BlueNet 500/2000 Option D (LG/UGF) 
BlueNet 750/2000 Option A (LG/GFD)  BlueNet 750/2000 Option A (LG/UGF) 
BlueNet 750/2000 Option B (LG/GFD)  BlueNet 750/2000 Option B (LG/UGF) 
BlueNet 750/2000 Option C (LG/GFD)  BlueNet 750/2000 Option C (LG/UGF) 
BlueNet 750/2000 Option D (LG/GFD)  BlueNet 750/2000 Option D (LG/UGF) 
BlueNet 1000/5000 Option A (LG/GFD)  BlueNet 1000/5000 Option A (LG/UGF) 
BlueNet 1000/5000 Option B (LG/GFD)  BlueNet 1000/5000 Option B (LG/UGF) 
BlueNet 1000/5000 Option C (LG/GFD)  BlueNet 1000/5000 Option C (LG/UGF) 
BlueNet 1000/5000 Option D (LG/GFD)  BlueNet 1000/5000 Option D (LG/UGF) 
BlueNet 2000/7000 Option A (LG/GFD)  BlueNet 2000/7000 Option A (LG/UGF) 
BlueNet 2000/7000 Option B (LG/GFD)  BlueNet 2000/7000 Option B (LG/UGF) 
BlueNet 2000/7000 Option C (LG/GFD)  BlueNet 2000/7000 Option C (LG/UGF) 
BlueNet 2000/7000 Option D (LG/GFD)  BlueNet 2000/7000 Option D (LG/UGF) 
BlueNet 5000/10000 Option A (LG/GFD)  BlueNet 5000/10000 Option A (LG/UGF) 
BlueNet 5000/10000 Option B (LG/GFD)  BlueNet 5000/10000 Option B (LG/UGF) 
BlueNet 5000/10000 Option C (LG/GFD)  BlueNet 5000/10000 Option C (LG/UGF) 
BlueNet 5000/10000 Option D (LG/GFD)  BlueNet 5000/10000 Option D (LG/UGF) 

Small Group (2-50 total employees)
Grandfathered (GFD) Plans — for groups that renewed after implementation of the ACA on 9/23/2010 Non-Grandfathered (UGF) Plans — for new or existing groups that enrolled or renewed after implementation of the ACA on 9/23/2010
BlueNet 250/2000 Option A (SG/GFD)  BlueNet 250/2000 Option A (SG/UGF) 
BlueNet 250/2000 Option B (SG/GFD)  BlueNet 250/2000 Option B (SG/UGF) 
BlueNet 250/2000 Option C (SG/GFD)  BlueNet 250/2000 Option C (SG/UGF) 
BlueNet 250/2000 Option D (SG/GFD)  BlueNet 250/2000 Option D (SG/UGF) 
BlueNet 500/2000 Option A (SG/GFD)  BlueNet 500/2000 Option A (SG/UGF) 
BlueNet 500/2000 Option B (SG/GFD)  BlueNet 500/2000 Option B (SG/UGF) 
BlueNet 500/2000 Option C (SG/GFD)  BlueNet 500/2000 Option C (SG/UGF) 
BlueNet 500/2000 Option D (SG/GFD)  BlueNet 500/2000 Option D (SG/UGF) 
BlueNet 750/2000 Option A (SG/GFD)  BlueNet 750/2000 Option A (SG/UGF) 
BlueNet 750/2000 Option B (SG/GFD)  BlueNet 750/2000 Option B (SG/UGF) 
BlueNet 750/2000 Option C (SG/GFD)  BlueNet 750/2000 Option C (SG/UGF) 
BlueNet 750/2000 Option D (SG/GFD)  BlueNet 750/2000 Option D (SG/UGF) 
BlueNet 1000/5000 Option A (SG/GFD)  BlueNet 1000/5000 Option A (SG/UGF) 
BlueNet 1000/5000 Option B (SG/GFD)  BlueNet 1000/5000 Option B (SG/UGF) 
BlueNet 1000/5000 Option C (SG/GFD)  BlueNet 1000/5000 Option C (SG/UGF) 
BlueNet 1000/5000 Option D (SG/GFD)  BlueNet 1000/5000 Option D (SG/UGF) 
BlueNet 2000/7000 Option A (SG/GFD)  BlueNet 2000/7000 Option A (SG/UGF) 
BlueNet 2000/7000 Option B (SG/GFD)  BlueNet 2000/7000 Option B (SG/UGF) 
BlueNet 2000/7000 Option C (SG/GFD)  BlueNet 2000/7000 Option C (SG/UGF) 
BlueNet 2000/7000 Option D (SG/GFD)  BlueNet 2000/7000 Option D (SG/UGF) 
BlueNet 5000/10000 Option A (SG/GFD)  BlueNet 5000/10000 Option A (SG/UGF) 
BlueNet 5000/10000 Option B (SG/GFD)  BlueNet 5000/10000 Option B (SG/UGF) 
BlueNet 5000/10000 Option C (SG/GFD)  BlueNet 5000/10000 Option C (SG/UGF) 
BlueNet 5000/10000 Option D (SG/GFD)  BlueNet 5000/10000 Option D (SG/UGF)