2018
BlueEssential
For groups 2 to 50:
BlueEssential 2000
BlueEssential 3000
BlueEssential 5000
For groups 51 to 99:
BlueEssential 2000
BlueEssential 3000
BlueEssential 5000
BluePreferred
For groups 2 to 50:
BluePreferred 100 1500
BluePreferred 100 2500
BluePreferred 100 5000
BluePreferred 90 100
BluePreferred 90 250
BluePreferred 90 500
BluePreferred 80 250
BluePreferred 80 500
BluePreferred 80 1000
BluePreferred 80 2000
For groups 51 to 99:
BluePreferred 100 1500
BluePreferred 100 2500
BluePreferred 100 5000
BluePreferred 90 100
BluePreferred 90 250
BluePreferred 90 500
BluePreferred 80 250
BluePreferred 80 500
BluePreferred 80 1000
BluePreferred 80 2000
BlueSolutions
BlueSolutions 2500 2 to 50
BlueSolutions 5000 2 to 50
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BluePreferred Basic
For groups 2 to 50:
BluePreferred Basic 1500
BluePreferred Basic 2500
BluePreferred Basic 5000
BluePreferred Basic 10000
For groups 51 to 99:
BluePreferred Basic 1500
BluePreferred Basic 2500
BluePreferred Basic 5000
BluePreferred Basic 10000
BlueSelect
For groups 2 to 50:
BlueSelect Plan 10
BlueSelect Plan 20
For groups 51 to 99:
BlueSelect Plan 10
BlueSelect Plan 20
BluePreferred Saver
BluePreferred Saver 100 1500 2 to 99
BluePreferred Saver 100 2700 2 to 99
BluePreferred Saver 100 5000 2 to 99
BluePreferred Saver 80 1500 2 to 99
BluePreferred Saver 80 2700 2 to 99
BluePreferred No Copay
BluePreferred No Copay 100 2 to 99
BluePreferred No Copay 2000 2 to 99
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2019
BluePreferred PPO
BluePreferred 100 1500
BluePreferred 100 2500
BluePreferred 100 5000
BluePreferred 90 100
BluePreferred 90 250
BluePreferred 90 500
BluePreferred 80 250
BluePreferred 80 500
BluePreferred 80 1000
BluePreferred 80 2000
BlueSelect HMO
BlueSelect Plan 10
BlueSelect Plan 20
BluePreferred No Copay PPO
BluePreferred No Copay 100
BluePreferred No Copay 2000
BluePreferred PPO Saver
BluePreferred Saver 100 1500
BluePreferred Saver 100 2700
BluePreferred Saver 100 5000
BluePreferred Saver 80 1500
BluePreferred Saver 80 2700
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