Grandfathered Plans 2023
Summary of Benefits and Coverage (SBC)
The Summary of Benefits and Coverage (SBC) provides a concise description of what services your plan covers along with what you will pay for covered benefits.
Plans Download BluePreferred Copay 250BluePreferred Copay 500BluePreferred Copay 1000BluePreferred Copay 1500BluePreferred Copay 2500BluePreferred Copay 3500BluePreferred Copay 5000BluePreferred Copay 7500BluePreferred Copay 10000BluePreferred Copay Portability 500BluePreferred Copay Portability 1000BluePreferred Copay Portability 2500BluePreferred Copay Portability 5000Plans Download BluePreferred Basic 1500BluePreferred Basic 2500BluePreferred Basic 3500BluePreferred Basic 5000BluePreferred Basic 7500BluePreferred Basic 10000BluePreferredBasic Portability 10000Plans Download BluePreferred Saver 1500BluePreferred Saver 2800BluePreferred Saver 3500BluePreferred Saver 5000BluePreferred Saver Portability 2800BluePreferred Saver Portability 5000Plans Download BlueClassic 250BlueClassic 500BlueClassic 750BlueClassic 1250BlueClassic 2500BlueClassic 5000BlueClassic Portability 5000Plans Download ExecuCare 500ExecuCare 1000ExecuCare 1250ExecuCare 1500ExecuCare 2500ExecuCare 5000Plans Download BlueOptimum 250BlueOptimum 500BlueOptimum 1000BlueOptimum 2000BlueOptimum 3000BlueOptimum 5000BlueOptimum 7500BlueOptimum 10000Plans Download BlueValue 250BlueValue 500BlueValue 1000BlueValue 2000BlueValue 3000BlueValue 5000BlueValue 7500BlueValue 10000BlueValue Portability 2000Plans Download BlueEssential 1000BlueEssential 2000BlueEssential 3000BlueEssential 5000BlueEssential 7500BlueEssential 10000Plans Download BluePortfolio 1750BluePortfolio 3000BluePortfolio 5500
Benefit Books
| Documents | Download |
|---|---|
| BlueClassic | |
| BlueEssential | |
| BlueOptimum | |
| BluePortfolio | |
| BluePreferred Basic | |
| BluePreferred Copay | |
| BluePreferred Saver | |
| BlueValue | |
| ExecuCare |