HMO Blue® Traditional

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
HMO Blue Plan 5 (LG/GFD)  HMO Blue Plan 5 (LG/UGF) 
HMO Blue Plan 10 (LG/GFD)  HMO Blue Plan 10 (LG/UGF) 
HMO Blue Plan 15/250 (LG/GFD)  HMO Blue Plan 15/250 (LG/UGF) 
HMO Blue Plan 15/500 (LG/GFD)  HMO Blue Plan 15/500 (LG/UGF) 
HMO Blue Plan 20/500 (LG/GFD)  HMO Blue Plan 20/500 (LG/UGF) 
HMO Blue Plan 20/750 (LG/GFD)  HMO Blue Plan 20/750 (LG/UGF) 
HMO Blue Plan 25 (LG/GFD)  HMO Blue Plan 25 (LG/UGF) 
HMO Blue Plan 30 (LG/GFD)  HMO Blue Plan 30 (LG/UGF) 
HMO Blue Plan 35 (LG/GFD)  HMO Blue Plan 35 (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
HMO Blue Plan 5 (SG/GFD)  HMO Blue Plan 5 (SG/UGF) 
HMO Blue Plan 10 (SG/GFD)  HMO Blue Plan 10 (SG/UGF) 
HMO Blue Plan 15/250 (SG/GFD)  HMO Blue Plan 15/250 (SG/UGF) 
HMO Blue Plan 15/500 (SG/GFD)  HMO Blue Plan 15/500 (SG/UGF) 
HMO Blue Plan 20/750 (SG/GFD)  HMO Blue Plan 20/750 (SG/UGF) 
HMO Blue Plan 25 (SG/GFD)  HMO Blue Plan 25 (SG/UGF) 
HMO Blue Plan 30 (SG/GFD)  HMO Blue Plan 30 (SG/UGF) 
HMO Blue Plan 35 (SG/GFD)  HMO Blue Plan 35 (SG/UGF)