Below is a list of actual policy documents for QHP small group coverage. These policies describe how the plans work and include eligible expenses, claim filing and appeals procedures, and coverage limitations and exceptions, among other things.
If you have questions, contact a customer service representative at the number provided on the back of your ID card for more information.
Platinum Plans
Blue PPO Platinum Plans
Off Exchange
Blue PPO Platinum 111
Blue PPO Platinum 110
Blue Preferred Platinum EPO Plans
Off Exchange
Blue Preferred Platinum EPO 128
Blue Preferred Platinum EPO 127
Gold Plans
Blue PPO Gold Plans
Off Exchange
Blue PPO Gold 104
Blue PPO Gold 102
Blue PPO Gold 103
Blue PPO Gold 107
Blue PPO Standard Gold 107
Blue HMO Network Gold Plans
Off Exchange
Blue EPO Gold Plans
Off Exchange
Blue Preferred Gold EPO
Off Exchange
Blue Preferred Gold EPO 122
Blue Preferred Gold EPO 129
Blue Preferred Gold EPO 123
Blue Preferred EPO Standard Gold 130
Blue Preferred Gold EPO 130
Blue Preferred Gold EPO 128
Silver Plans
Blue PPO Silver Plans
Off Exchange
Blue PPO Silver 105 - A
Blue PPO Silver 106
Blue PPO Silver 108
Blue Preferred Silver EPO
Off Exchange
Blue Preferred Silver EPO 131
Blue Preferred Silver EPO 125
Blue Preferred Silver EPO 136
Blue HMO Network Silver Plans
Off Exchange
Blue Advantage Silver Plans
Off Exchange
Blue EPO Silver Plans
Off Exchange
Bronze Plans
Blue PPO Bronze Plans
Off Exchange
Blue PPO Bronze 101
Blue PPO Bronze 109