Only showing plans with an end date of 2/1/2021 or greater
Plans List for CAF - Pay attention to START and END dates.
Showing 400 plans
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27211-BlueDental Traditional (ACA Compliant) Plan 1
27212-BlueDental Preferred (ACA Compliant) Plan 1
AreaflavMetalPNDescriptionProductCPIDSHOP Click For StartEnd
DCDN/A 5201BlueDental Basic (Std Fee) DEN5201 N/A Benefits 7/1/201512/31/2021
DCDN/A 5238BlueDental Plus Plan 1 ORTHO (90 Fee) DEN5238 N/A Benefits 7/1/201512/31/2021
DCDN/A 5236BlueDental Plus Plan 1 ORTHO (Std Fee) DEN5236 N/A Benefits 7/1/201512/31/2021
DCDN/A 5237BlueDental Plus Plan 1 (90 Fee) DEN5237 N/A Benefits 7/1/201512/31/2021
DCDN/A 5235BlueDental Plus Plan 1 (Std Fee) DEN5235 N/A Benefits 7/1/201512/31/2021
DCDN/A 5242BlueDental Plus Plan 2 ORTHO (90 Fee) DEN5242 N/A Benefits 7/1/201512/31/2021
DCDN/A 5240BlueDental Plus Plan 2 ORTHO (Std Fee) DEN5240 N/A Benefits 7/1/201512/31/2021
DCDN/A 5241BlueDental Plus Plan 2 (90 Fee) DEN5241 N/A Benefits 7/1/201512/31/2021
DCDN/A 5239BlueDental Plus Plan 2 (Std Fee) DEN5239 N/A Benefits 7/1/201512/31/2021
DCDN/A 5246BlueDental Plus Plan 3 ORTHO (90 Fee) DEN5246 N/A Benefits 7/1/201512/31/2021
DCDN/A 5244BlueDental Plus Plan 3 ORTHO (Std Fee) DEN5244 N/A Benefits 7/1/201512/31/2021
DCDN/A 5245BlueDental Plus Plan 3 (90 Fee) DEN5245 N/A Benefits 7/1/201512/31/2021
DCDN/A 5243BlueDental Plus Plan 3 (Std Fee) DEN5243 N/A Benefits 7/1/201512/31/2021
DCDN/A 5250BlueDental Plus Plan 4 ORTHO (90 Fee) DEN5250 N/A Benefits 7/1/201512/31/2021
DCDN/A 5248BlueDental Plus Plan 4 ORTHO (Std Fee) DEN5248 N/A Benefits 7/1/201512/31/2021
DCDN/A 5249BlueDental Plus Plan 4 (90 Fee) DEN5249 N/A Benefits 7/1/201512/31/2021
DCDN/A 5247BlueDental Plus Plan 4 (Std Fee) DEN5247 N/A Benefits 7/1/201512/31/2021
DCDN/A 5254BlueDental Plus Plan 5 ORTHO (90 Fee) DEN5254 N/A Benefits 7/1/201512/31/2021
DCDN/A 5252BlueDental Plus Plan 5 ORTHO (Std Fee) DEN5252 N/A Benefits 7/1/201512/31/2021
DCDN/A 5253BlueDental Plus Plan 5 (90 Fee) DEN5253 N/A Benefits 7/1/201512/31/2021
DCDN/A 5251BlueDental Plus Plan 5 (Std Fee) DEN5251 N/A Benefits 7/1/201512/31/2021
DCDN/A 5258BlueDental Plus Plan 6 ORTHO (90 Fee) DEN5258 N/A Benefits 7/1/201512/31/2021
DCDN/A 5256BlueDental Plus Plan 6 ORTHO (Std Fee) DEN5256 N/A Benefits 7/1/201512/31/2021
DCDN/A 5257BlueDental Plus Plan 6 (90 Fee) DEN5257 N/A Benefits 7/1/201512/31/2021
DCDN/A 5255BlueDental Plus Plan 6 (Std Fee) DEN5255 N/A Benefits 7/1/201512/31/2021
DCDN/A 5262BlueDental Plus Plan 7 ORTHO (90 Fee) DEN5262 N/A Benefits 7/1/201512/31/2021
DCDN/A 5260BlueDental Plus Plan 7 ORTHO (Std Fee) DEN5260 N/A Benefits 7/1/201512/31/2021
DCDN/A 5261BlueDental Plus Plan 7 (90 Fee) DEN5261 N/A Benefits 7/1/201512/31/2021
DCDN/A 5259BlueDental Plus Plan 7 (Std Fee) DEN5259 N/A Benefits 7/1/201512/31/2021
DCDN/A 5266BlueDental Plus Plan 8 ORTHO (90 Fee) DEN5266 N/A Benefits 7/1/201512/31/2021
DCDN/A 5264BlueDental Plus Plan 8 ORTHO (Std Fee) DEN5264 N/A Benefits 7/1/201512/31/2021
DCDN/A 5265BlueDental Plus Plan 8 (90 Fee) DEN5265 N/A Benefits 7/1/201512/31/2021
DCDN/A 5263BlueDental Plus Plan 8 (Std Fee) DEN5263 N/A Benefits 7/1/201512/31/2021
DCDN/A 5420Preferred Dental PPO Option 1 DEN5420 N/A Benefits 1/1/201712/31/2021
DCDN/A 5421Preferred Dental PPO Option 2 DEN5421 N/A Benefits 1/1/201712/31/2021
DCDN/A 5422Preferred Dental PPO Option 3 DEN5422 N/A Benefits 1/1/201712/31/2021
DCDN/A 5423Preferred Dental PPO Option 4 DEN5423 N/A Benefits 1/1/201712/31/2021
DCDN/A 5424Preferred Dental PPO Plan 1 ORTHO DEN5424 N/A Benefits 1/1/201712/31/2021
DCDN/A 5425Preferred Dental PPO Plan 2 ORTHO DEN5425 N/A Benefits 1/1/201712/31/2021
DCDN/A 5426Preferred Dental PPO Plan 3 ORTHO DEN5426 N/A Benefits 1/1/201712/31/2021
DCDN/A 5427Preferred Dental PPO Plan 4 ORTHO DEN5427 N/A Benefits 1/1/201712/31/2021
DCDN/A 5433Traditional Dental Plan 1 DEN5433 N/A Benefits 1/1/201712/31/2021
DCDN/A 5428Traditional Dental Plan 1 ORTHO DEN5428 N/A Benefits 1/1/201712/31/2021
DCDN/A 5434Traditional Dental Plan 2 DEN5434 N/A Benefits 1/1/201712/31/2021
DCDN/A 5429Traditional Dental Plan 2 ORTHO DEN5429 N/A Benefits 1/1/201712/31/2021
DCDN/A 5435Traditional Dental Plan 3 DEN5435 N/A Benefits 1/1/201712/31/2021
DCDN/A 5430Traditional Dental Plan 3 ORTHO DEN5430 N/A Benefits 1/1/201712/31/2021
DCDN/A 5431Traditional Dental Plan 4 DEN5431 N/A Benefits 1/1/201712/31/2021
DCDN/A 5432Traditional Dental Plan 4 ORTHO DEN5432 N/A Benefits 1/1/201712/31/2021
DCMBronze 27018BLUECHOICE ADVANTAGE POS BRONZE $6,000 (HSA/HRA) POS100035907 ON-SHOP Benefits 1/1/202112/31/2021
DCMBronze 27017BLUECHOICE ADVANTAGE POS BRONZE $6,100 (HSA/HRA) POS100035889 ON-SHOP Benefits 1/1/202112/31/2021
DCMBronze 27095BLUECHOICE HMO 90 BRONZE $6,500 (HSA/HRA) HMO100035927 ON-SHOP Benefits 1/1/202112/31/2021
DCMBronze 27092BLUECHOICE HMO BRONZE $6,000 (HSA/HRA) HMO100035933 ON-SHOP Benefits 1/1/202112/31/2021
DCMBronze 27094BLUECHOICE HMO BRONZE $6,100 (HSA/HRA) HMO100035916 ON-SHOP Benefits 1/1/202112/31/2021
DCMBronze 27055BLUECHOICE HMO REFERRAL BRONZE $8,250 (HSA/HRA) HMO100035938 ON-SHOP Benefits 1/1/202112/31/2021
DCMBronze 27177BLUECHOICE PLUS POS BRONZE $6,100 (HSA/HRA) POS100035946 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27020BLUECHOICE ADVANTAGE POS 90 GOLD $1,500 (HSA/HRA) POS100035901 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27046BLUECHOICE ADVANTAGE POS GOLD $0 (Rx Ded $0) POS100035908 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27035BLUECHOICE ADVANTAGE POS GOLD $1,000 (Rx Ded $250) POS100035883 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27021BLUECHOICE ADVANTAGE POS GOLD $1,500 (HSA/HRA) POS100035893 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27036BLUECHOICE ADVANTAGE POS GOLD $3,000 (Rx Ded $250) POS100035898 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27047BLUECHOICE ADVANTAGE POS GOLD $500 (Rx Ded $250) POS100035884 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27098BLUECHOICE HMO 90 GOLD $1,500 (HSA/HRA) HMO100035925 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27099BLUECHOICE HMO GOLD $1,500 (HSA/HRA) HMO100035921 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27127BLUECHOICE HMO GOLD $1,500 (Rx Ded $250) HMO100035909 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27128BLUECHOICE HMO GOLD $3,000 (Rx Ded $250) HMO100035924 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27063BLUECHOICE HMO GOLD $500 (Rx Ded $250) HMO100035910 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27115BLUECHOICE HMO REFERRAL GOLD $0 (Rx Ded $0) HMO100035936 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27116BLUECHOICE HMO REFERRAL GOLD $500 (Rx Ded $250) HMO100035935 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27183BLUECHOICE PLUS POS GOLD $1,000 (Rx Ded $250) POS100035944 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27185BLUECHOICE PLUS POS GOLD $500 (Rx Ded $250) POS100035945 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27144BLUEPREFERRED PPO 90/70 GOLD $1,000 (HRA) PPO100035878 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27156BLUEPREFERRED PPO GOLD $1,000 (Rx Ded $250) PPO100035868 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27157BLUEPREFERRED PPO GOLD $1,500 (Rx Ded $250) PPO100035877 ON-SHOP Benefits 1/1/202112/31/2021
DCMGold 27165BLUEPREFERRED PPO GOLD $500 (Rx Ded $250) PPO100035869 ON-SHOP Benefits 1/1/202112/31/2021
DCMPlatinum 27049BLUECHOICE ADVANTAGE POS PLATINUM $0 (Rx Ded $0) POS100035885 ON-SHOP Benefits 1/1/202112/31/2021
DCMPlatinum 27064BLUECHOICE HMO PLATINUM $0 (Rx Ded $0) HMO100035911 ON-SHOP Benefits 1/1/202112/31/2021
DCMPlatinum 27117BLUECHOICE HMO REFERRAL PLATINUM $0 (Rx Ded $0) HMO100035934 ON-SHOP Benefits 1/1/202112/31/2021
DCMPlatinum 27171BLUECHOICE PLUS POS OPTOUT PLATINUM $0 (Rx Ded $0) POS100035950 ON-SHOP Benefits 1/1/202112/31/2021
DCMPlatinum 27167BLUEPREFERRED PPO PLATINUM $0 (Rx Ded $0) PPO100035874 ON-SHOP Benefits 1/1/202112/31/2021
DCMPlatinum 27168BLUEPREFERRED PPO PLATINUM $500 (Rx Ded $0) PPO100035875 ON-SHOP Benefits 1/1/202112/31/2021
DCMPlatinum 27189HEALTHYBLUE ADVANTAGE POS PLATINUM $500 (Rx Ded $0) POS100035888 ON-SHOP Benefits 1/1/202112/31/2021
DCMPlatinum 27187HEALTHYBLUE PLUS POS PLATINUM $500 (Rx Ded $0) POS100035943 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27025BLUECHOICE ADVANTAGE POS 70 SILVER $2,100 (HSA/HRA) POS100035903 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27026BLUECHOICE ADVANTAGE POS 70 SILVER $3,000 (HSA/HRA) POS100035905 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27022BLUECHOICE ADVANTAGE POS SILVER $1,500 (HSA/HRA) POS100035886 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27023BLUECHOICE ADVANTAGE POS SILVER $1,500 (HSA/HRA) POS100035896 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27024BLUECHOICE ADVANTAGE POS SILVER $2,000 (HSA/HRA) POS100035899 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27027BLUECHOICE ADVANTAGE POS SILVER $3,000 (HSA/HRA) POS100035891 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27037BLUECHOICE ADVANTAGE POS SILVER $4,000 (Rx Ded $400) POS100035895 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27038BLUECHOICE ADVANTAGE POS SILVER $5,000 (Rx Ded $450) POS100035897 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27103BLUECHOICE HMO 70 SILVER $2,100 (HSA/HRA) HMO100035929 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27107BLUECHOICE HMO 70 SILVER $3,000 (HSA/HRA) HMO100035931 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27058BLUECHOICE HMO REFERRAL SILVER $4,000 (Rx Ded $400) HMO100035937 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27101BLUECHOICE HMO SILVER $1,500 (HSA/HRA) HMO100035912 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27130BLUECHOICE HMO SILVER $1,500 (Rx Ded $250) HMO100035920 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27102BLUECHOICE HMO SILVER $2,000 (HSA/HRA) HMO100035914 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27108BLUECHOICE HMO SILVER $3,000 (HSA/HRA) HMO100035918 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27131BLUECHOICE HMO SILVER $5,000 (Rx Ded $450) HMO100035923 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27179BLUECHOICE PLUS POS SILVER $1,500 (HSA/HRA) POS100035939 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27180BLUECHOICE PLUS POS SILVER $2,500 (HSA/HRA) POS100035948 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27178BLUECHOICE PLUS POS SILVER $3,000 (HSA/HRA) POS100035941 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27148BLUEPREFERRED PPO 70 SILVER $2,100 (HSA/HRA) PPO100035881 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27150BLUEPREFERRED PPO 80/60 SILVER $2,400 (HSA/HRA) PPO100035879 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27145BLUEPREFERRED PPO SILVER $1,500 (HSA/HRA) PPO100035880 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27146BLUEPREFERRED PPO SILVER $1,500 (HSA/HRA) PPO100035870 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27158BLUEPREFERRED PPO SILVER $1,500 (Rx Ded $250) PPO100035876 ON-SHOP Benefits 1/1/202112/31/2021
DCMSilver 27147BLUEPREFERRED PPO SILVER $2,000 (HSA/HRA) PPO100035872 ON-SHOP Benefits 1/1/202112/31/2021
DCVNone 5625BlueVision Plus Option 1 (FS/ER) VIS5625 N/A Benefits 1/1/201512/31/2021
DCVNone 5627BlueVision Plus Option 2 (FS/ER) VIS5627 N/A Benefits 1/1/201512/31/2021
DCVNone 5629BlueVision Plus Option 3 (FS/ER) VIS5629 N/A Benefits 1/1/201512/31/2021
DCVNone 5631BlueVision Plus Option 4 (FS/ER) VIS5631 N/A Benefits 1/1/201512/31/2021
DCVNone 5633BlueVision Plus Option A (FS/ER) Increased Allowances VIS5633 N/A Benefits 1/1/201512/31/2021
DCVNone 5635BlueVision Plus Option A (FS/VL) Increased Allowances VIS5635 N/A Benefits 1/1/201512/31/2021
DCVNone 5637BlueVision Plus Option B (FS/ER) Increased Allowances VIS5637 N/A Benefits 1/1/201512/31/2021
DCVNone 5639BlueVision Plus Option B (FS/VL) Increased Allowances VIS5639 N/A Benefits 1/1/201512/31/2021
DCVNone 5641BlueVision Plus Option C (FS/ER) Increased Allowances VIS5641 N/A Benefits 1/1/201512/31/2021
DCVNone 5643BlueVision Plus Option C (FS/VL) Increased Allowances VIS5643 N/A Benefits 1/1/201512/31/2021
DCVNone 5645BlueVision Plus Option D (FS/ER) Increased Allowances VIS5645 N/A Benefits 1/1/201512/31/2021
DCVNone 5647BlueVision Plus Option D (FS/VL) Increased Allowances VIS5647 N/A Benefits 1/1/201512/31/2021
MDDN/A 5200BlueDental Basic (Std Fee) DEN5200 N/A Benefits 7/1/201512/31/2021
MDDN/A 5206BlueDental Plus Plan 1 ORTHO (90 Fee) DEN5206 N/A Benefits 7/1/201512/31/2021
MDDN/A 5204BlueDental Plus Plan 1 ORTHO (Std Fee) DEN5204 N/A Benefits 7/1/201512/31/2021
MDDN/A 5205BlueDental Plus Plan 1 (90 Fee) DEN5205 N/A Benefits 7/1/201512/31/2021
MDDN/A 5203BlueDental Plus Plan 1 (Std Fee) DEN5203 N/A Benefits 7/1/201512/31/2021
MDDN/A 5210BlueDental Plus Plan 2 ORTHO (90 Fee) DEN5210 N/A Benefits 7/1/201512/31/2021
MDDN/A 5208BlueDental Plus Plan 2 ORTHO (Std Fee) DEN5208 N/A Benefits 7/1/201512/31/2021
MDDN/A 5209BlueDental Plus Plan 2 (90 Fee) DEN5209 N/A Benefits 7/1/201512/31/2021
MDDN/A 5207BlueDental Plus Plan 2 (Std Fee) DEN5207 N/A Benefits 7/1/201512/31/2021
MDDN/A 5214BlueDental Plus Plan 3 ORTHO (90 Fee) DEN5214 N/A Benefits 7/1/201512/31/2021
MDDN/A 5212BlueDental Plus Plan 3 ORTHO (Std Fee) DEN5212 N/A Benefits 7/1/201512/31/2021
MDDN/A 5213BlueDental Plus Plan 3 (90 Fee) DEN5213 N/A Benefits 7/1/201512/31/2021
MDDN/A 5211BlueDental Plus Plan 3 (Std Fee) DEN5211 N/A Benefits 7/1/201512/31/2021
MDDN/A 5218BlueDental Plus Plan 4 ORTHO (90 Fee) DEN5218 N/A Benefits 7/1/201512/31/2021
MDDN/A 5216BlueDental Plus Plan 4 ORTHO (Std Fee) DEN5216 N/A Benefits 7/1/201512/31/2021
MDDN/A 5217BlueDental Plus Plan 4 (90 Fee) DEN5217 N/A Benefits 7/1/201512/31/2021
MDDN/A 5215BlueDental Plus Plan 4 (Std Fee) DEN5215 N/A Benefits 7/1/201512/31/2021
MDDN/A 5222BlueDental Plus Plan 5 ORTHO (90 Fee) DEN5222 N/A Benefits 7/1/201512/31/2021
MDDN/A 5220BlueDental Plus Plan 5 ORTHO (Std Fee) DEN5220 N/A Benefits 7/1/201512/31/2021
MDDN/A 5221BlueDental Plus Plan 5 (90 Fee) DEN5221 N/A Benefits 7/1/201512/31/2021
MDDN/A 5219BlueDental Plus Plan 5 (Std Fee) DEN5219 N/A Benefits 7/1/201512/31/2021
MDDN/A 5226BlueDental Plus Plan 6 ORTHO (90 Fee) DEN5226 N/A Benefits 7/1/201512/31/2021
MDDN/A 5224BlueDental Plus Plan 6 ORTHO (Std Fee) DEN5224 N/A Benefits 7/1/201512/31/2021
MDDN/A 5225BlueDental Plus Plan 6 (90 Fee) DEN5225 N/A Benefits 7/1/201512/31/2021
MDDN/A 5223BlueDental Plus Plan 6 (Std Fee) DEN5223 N/A Benefits 7/1/201512/31/2021
MDDN/A 5230BlueDental Plus Plan 7 ORTHO (90 Fee) DEN5230 N/A Benefits 7/1/201512/31/2021
MDDN/A 5228BlueDental Plus Plan 7 ORTHO (Std Fee) DEN5228 N/A Benefits 7/1/201512/31/2021
MDDN/A 5229BlueDental Plus Plan 7 (90 Fee) DEN5229 N/A Benefits 7/1/201512/31/2021
MDDN/A 5227BlueDental Plus Plan 7 (Std Fee) DEN5227 N/A Benefits 7/1/201512/31/2021
MDDN/A 5234BlueDental Plus Plan 8 ORTHO (90 Fee) DEN5234 N/A Benefits 7/1/201512/31/2021
MDDN/A 5232BlueDental Plus Plan 8 ORTHO (Std Fee) DEN5232 N/A Benefits 7/1/201512/31/2021
MDDN/A 5233BlueDental Plus Plan 8 (90 Fee) DEN5233 N/A Benefits 7/1/201512/31/2021
MDDN/A 5231BlueDental Plus Plan 8 (Std Fee) DEN5231 N/A Benefits 7/1/201512/31/2021
MDDN/A 5404Preferred Dental PPO Plan 1 DEN5404 N/A Benefits 1/1/201712/31/2021
MDDN/A 5408Preferred Dental PPO Plan 1 ORTHO DEN5408 N/A Benefits 1/1/201712/31/2021
MDDN/A 5405Preferred Dental PPO Plan 2 DEN5405 N/A Benefits 1/1/201712/31/2021
MDDN/A 5409Preferred Dental PPO Plan 2 ORTHO DEN5409 N/A Benefits 1/1/201712/31/2021
MDDN/A 5406Preferred Dental PPO Plan 3 DEN5406 N/A Benefits 1/1/201712/31/2021
MDDN/A 5410Preferred Dental PPO Plan 3 ORTHO DEN5410 N/A Benefits 1/1/201712/31/2021
MDDN/A 5407Preferred Dental PPO Plan 4 DEN5407 N/A Benefits 1/1/201712/31/2021
MDDN/A 5411Preferred Dental PPO Plan 4 ORTHO DEN5411 N/A Benefits 1/1/201712/31/2021
MDDN/A 5417Traditional Dental Plan 1 DEN5417 N/A Benefits 1/1/201712/31/2021
MDDN/A 5412Traditional Dental Plan 1 ORTHO DEN5412 N/A Benefits 1/1/201712/31/2021
MDDN/A 5418Traditional Dental Plan 2 DEN5418 N/A Benefits 1/1/201712/31/2021
MDDN/A 5413Traditional Dental Plan 2 ORTHO DEN5413 N/A Benefits 1/1/201712/31/2021
MDDN/A 5419Traditional Dental Plan 3 DEN5419 N/A Benefits 1/1/201712/31/2021
MDDN/A 5414Traditional Dental Plan 3 ORTHO DEN5414 N/A Benefits 1/1/201712/31/2021
MDDN/A 5415Traditional Dental Plan 4 DEN5415 N/A Benefits 1/1/201712/31/2021
MDDN/A 5416Traditional Dental Plan 4 ORTHO DEN5416 N/A Benefits 1/1/201712/31/2021
MDMBronze 27001BLUECHOICE ADVANTAGE POS BRONZE $6,000 POS100035634 OFF-SHOP Benefits 1/1/202112/31/2021
MDMBronze 27016BLUECHOICE ADVANTAGE POS BRONZE $6,100 (HSA/HRA) POS100035510 ON-SHOP Benefits 1/1/202112/31/2021
MDMBronze 27193BLUECHOICE ADVANTAGE POS BRONZE $6,100 (HSA/HRA) POS100035519 OFF-SHOP Benefits 1/1/202112/31/2021
MDMBronze 27070BLUECHOICE HMO 90 BRONZE $6,500 (HSA/HRA) HMO100035654 OFF-SHOP Benefits 1/1/202112/31/2021
MDMBronze 27091BLUECHOICE HMO BRONZE $6,000 HMO100035709 ON-SHOP Benefits 1/1/202112/31/2021
MDMBronze 27066BLUECHOICE HMO BRONZE $6,000 (HRA) HMO100035707 OFF-SHOP Benefits 1/1/202112/31/2021
MDMBronze 27068BLUECHOICE HMO BRONZE $6,100 (HSA/HRA) HMO100035652 OFF-SHOP Benefits 1/1/202112/31/2021
MDMBronze 27093BLUECHOICE HMO BRONZE $6,100 (HSA/HRA) HMO100035648 ON-SHOP Benefits 1/1/202112/31/2021
MDMBronze 27050BLUECHOICE HMO REFERRAL BRONZE $6,200 (HSA/HRA) HMO100035639 OFF-SHOP Benefits 1/1/202112/31/2021
MDMBronze 27053BLUECHOICE HMO REFERRAL BRONZE $6,200 (HSA/HRA) HMO100035637 ON-SHOP Benefits 1/1/202112/31/2021
MDMBronze 27054BLUECHOICE HMO REFERRAL BRONZE $8,250 HMO100035713 ON-SHOP Benefits 1/1/202112/31/2021
MDMBronze 27052BLUECHOICE HMO REFERRAL BRONZE $8,250 (HRA) HMO100035715 OFF-SHOP Benefits 1/1/202112/31/2021
MDMBronze 27173BLUECHOICE PLUS POS BRONZE $6,100 (HSA/HRA) POS100035732 OFF-SHOP Benefits 1/1/202112/31/2021
MDMBronze 27207BLUEPREFERRED PPO BRONZE $6,200 (HSA/HRA) PPO100035825 ON-SHOP Benefits 1/1/202112/31/2021
MDMBronze 27132BLUEPREFERRED PPO BRONZE $6,200 (HSA/HRA) PPO100035787 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27003BLUECHOICE ADVANTAGE POS 90 GOLD $1,500 (HSA/HRA) POS100035587 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27040BLUECHOICE ADVANTAGE POS GOLD $0 (Rx Ded $0) POS100035630 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27034BLUECHOICE ADVANTAGE POS GOLD $1,000 (Rx Ded $250) POS100035576 ON-SHOP Benefits 1/1/202112/31/2021
MDMGold 27029BLUECHOICE ADVANTAGE POS GOLD $1,000 (Rx Ded $250) POS100035578 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27019BLUECHOICE ADVANTAGE POS GOLD $1,500 (HSA/HRA) POS100035544 ON-SHOP Benefits 1/1/202112/31/2021
MDMGold 27196BLUECHOICE ADVANTAGE POS GOLD $1,500 (HSA/HRA) POS100035551 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27194BLUECHOICE ADVANTAGE POS GOLD $3,000 (Rx Ded $250) POS100035573 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27042BLUECHOICE ADVANTAGE POS GOLD $500 (Rx Ded $250) POS100035593 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27075BLUECHOICE HMO 90 GOLD $1,500 (HSA/HRA) HMO100035693 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27097BLUECHOICE HMO GOLD $1,000 HMO100035699 ON-SHOP Benefits 1/1/202112/31/2021
MDMGold 27072BLUECHOICE HMO GOLD $1,000 (HRA) HMO100035696 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27077BLUECHOICE HMO GOLD $1,500 (HSA/HRA) HMO100035689 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27126BLUECHOICE HMO GOLD $1,500 (Rx Ded $250) HMO100035723 ON-SHOP Benefits 1/1/202112/31/2021
MDMGold 27119BLUECHOICE HMO GOLD $1,500 (Rx Ded $250) HMO100035724 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27120BLUECHOICE HMO GOLD $3,000 (Rx Ded $250) HMO100035721 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27060BLUECHOICE HMO GOLD $500 (Rx Ded $250) HMO100035646 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27110BLUECHOICE HMO REFERRAL GOLD $0 (Rx Ded $0) HMO100035710 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27112BLUECHOICE HMO REFERRAL GOLD $500 (Rx Ded $250) HMO100035711 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27182BLUECHOICE PLUS POS GOLD $1,000 (Rx Ded $250) POS100035774 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27197BLUECHOICE PLUS POS GOLD $500 (Rx Ded $250) POS100035778 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27204BLUEPREFERRED PPO 90/70 GOLD $1,000 PPO100035852 ON-SHOP Benefits 1/1/202112/31/2021
MDMGold 27206BLUEPREFERRED PPO 90/70 GOLD $1,000 (HRA) PPO100035853 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27201BLUEPREFERRED PPO GOLD $1,000 (Rx Ded $250) PPO100035860 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27153BLUEPREFERRED PPO GOLD $1,500 (Rx Ded $250) PPO100035821 OFF-SHOP Benefits 1/1/202112/31/2021
MDMGold 27160BLUEPREFERRED PPO GOLD $500 (Rx Ded $250) PPO100035822 OFF-SHOP Benefits 1/1/202112/31/2021
MDMPlatinum 27190BLUECHOICE ADVANTAGE POS PLATINUM $0 (Rx Ded $0) POS100035596 OFF-SHOP Benefits 1/1/202112/31/2021
MDMPlatinum 27062BLUECHOICE HMO PLATINUM $0 (Rx Ded $0) HMO100035647 OFF-SHOP Benefits 1/1/202112/31/2021
MDMPlatinum 27114BLUECHOICE HMO REFERRAL PLATINUM $0 (Rx Ded $0) HMO100035712 OFF-SHOP Benefits 1/1/202112/31/2021
MDMPlatinum 27170BLUECHOICE PLUS POS OPTOUT PLATINUM $0 (Rx Ded $0) POS100035731 OFF-SHOP Benefits 1/1/202112/31/2021
MDMPlatinum 27202BLUEPREFERRED PPO PLATINUM $0 (Rx Ded $0) PPO100035866 OFF-SHOP Benefits 1/1/202112/31/2021
MDMPlatinum 27203BLUEPREFERRED PPO PLATINUM $500 (Rx Ded $0) PPO100035867 OFF-SHOP Benefits 1/1/202112/31/2021
MDMPlatinum 27209HEALTHYBLUE ADVANTAGE POS PLATINUM $500 (Rx Ded $0) POS100035628 OFF-SHOP Benefits 1/1/202112/31/2021
MDMPlatinum 27210HEALTHYBLUE PLUS POS PLATINUM $500 (Rx Ded $0) POS100035781 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27011BLUECHOICE ADVANTAGE POS 70 SILVER $2,100 (HSA/HRA) POS100035619 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27013BLUECHOICE ADVANTAGE POS 70 SILVER $3,000 (HSA/HRA) POS100035599 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27006BLUECHOICE ADVANTAGE POS SILVER $1,500 (HSA/HRA) POS100035535 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27008BLUECHOICE ADVANTAGE POS SILVER $2,000 (HSA/HRA) POS100035610 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27015BLUECHOICE ADVANTAGE POS SILVER $3,000 (HSA/HRA) POS100035526 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27191BLUECHOICE ADVANTAGE POS SILVER $3,000 (HSA/HRA) POS100035521 ON-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27195BLUECHOICE ADVANTAGE POS SILVER $4,000 (Rx Ded $400) POS100035567 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27192BLUECHOICE ADVANTAGE POS SILVER $5,000 (Rx Ded $450) POS100035555 ON-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27032BLUECHOICE ADVANTAGE POS SILVER $5,000 (Rx Ded $450) POS100035557 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27083BLUECHOICE HMO 70 SILVER $2,100 (HSA/HRA) HMO100035675 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27088BLUECHOICE HMO 70 SILVER $3,000 (HSA/HRA) HMO100035668 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27057BLUECHOICE HMO REFERRAL SILVER $4,000 (Rx Ded $400) HMO100035644 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27079BLUECHOICE HMO SILVER $1,500 (HSA/HRA) HMO100035701 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27100BLUECHOICE HMO SILVER $1,500 (HSA/HRA) HMO100035700 ON-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27124BLUECHOICE HMO SILVER $1,500 (Rx Ded $250) HMO100035718 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27081BLUECHOICE HMO SILVER $2,000 (HSA/HRA) HMO100035674 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27085BLUECHOICE HMO SILVER $2,400 (HSA/HRA) HMO100035681 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27105BLUECHOICE HMO SILVER $2,400 (HSA/HRA) HMO100035685 ON-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27106BLUECHOICE HMO SILVER $3,000 (HSA/HRA) HMO100035659 ON-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27090BLUECHOICE HMO SILVER $3,000 (HSA/HRA) HMO100035662 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27122BLUECHOICE HMO SILVER $5,000 (Rx Ded $450) HMO100035729 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27129BLUECHOICE HMO SILVER $5,000 (Rx Ded $450) HMO100035727 ON-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27200BLUECHOICE PLUS POS SILVER $1,500 (HSA/HRA) POS100035759 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27198BLUECHOICE PLUS POS SILVER $2,500 (HSA/HRA) POS100035770 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27199BLUECHOICE PLUS POS SILVER $3,000 (HSA/HRA) POS100035747 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27139BLUEPREFERRED PPO 70 SILVER $2,100 (HSA/HRA) PPO100035804 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27141BLUEPREFERRED PPO 80/60 SILVER $2,400 (HSA/HRA) PPO100035795 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27208BLUEPREFERRED PPO 80/60 SILVER $2,400 (HSA/HRA) PPO100035836 ON-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27136BLUEPREFERRED PPO SILVER $1,500 (HSA/HRA) PPO100035789 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27155BLUEPREFERRED PPO SILVER $1,500 (Rx Ded $250) PPO100035815 OFF-SHOP Benefits 1/1/202112/31/2021
MDMSilver 27205BLUEPREFERRED PPO SILVER $2,000 (HSA/HRA) PPO100035845 OFF-SHOP Benefits 1/1/202112/31/2021
MDVNone 5601BlueVision Plus Option 1 (FS/ER) VIS5601 N/A Benefits 1/1/201512/31/2021
MDVNone 5603BlueVision Plus Option 2 (FS/ER) VIS5603 N/A Benefits 1/1/201512/31/2021
MDVNone 5605BlueVision Plus Option 3 (FS/ER) VIS5605 N/A Benefits 1/1/201512/31/2021
MDVNone 5607BlueVision Plus Option 4 (FS/ER) VIS5607 N/A Benefits 1/1/201512/31/2021
MDVNone 5609BlueVision Plus Option A (FS/ER) Increased Allowances VIS5609 N/A Benefits 1/1/201512/31/2021
MDVNone 5611BlueVision Plus Option A (FS/VL) Increased Allowances VIS5611 N/A Benefits 1/1/201512/31/2021
MDVNone 5613BlueVision Plus Option B (FS/ER) Increased Allowances VIS5613 N/A Benefits 1/1/201512/31/2021
MDVNone 5615BlueVision Plus Option B (FS/VL) Increased Allowances VIS5615 N/A Benefits 1/1/201512/31/2021
MDVNone 5617BlueVision Plus Option C (FS/ER) Increased Allowances VIS5617 N/A Benefits 1/1/201512/31/2021
MDVNone 5619BlueVision Plus Option C (FS/VL) Increased Allowances VIS5619 N/A Benefits 1/1/201512/31/2021
MDVNone 5621BlueVision Plus Option D (FS/ER) Increased Allowances VIS5621 N/A Benefits 1/1/201512/31/2021
MDVNone 5623BlueVision Plus Option D (FS/VL) Increased Allowances VIS5623 N/A Benefits 1/1/201512/31/2021
VADN/A 5202BlueDental Basic (Std Fee) DEN5202 N/A Benefits 7/1/201512/31/2021
VADN/A 5270BlueDental Plus Plan 1 ORTHO (90 Fee) DEN5270 N/A Benefits 7/1/201512/31/2021
VADN/A 5268BlueDental Plus Plan 1 ORTHO (Std Fee) DEN5268 N/A Benefits 7/1/201512/31/2021
VADN/A 5269BlueDental Plus Plan 1 (90 Fee) DEN5269 N/A Benefits 7/1/201512/31/2021
VADN/A 5267BlueDental Plus Plan 1 (Std Fee) DEN5267 N/A Benefits 7/1/201512/31/2021
VADN/A 5274BlueDental Plus Plan 2 ORTHO (90 Fee) DEN5274 N/A Benefits 7/1/201512/31/2021
VADN/A 5272BlueDental Plus Plan 2 ORTHO (Std Fee) DEN5272 N/A Benefits 7/1/201512/31/2021
VADN/A 5273BlueDental Plus Plan 2 (90 Fee) DEN5273 N/A Benefits 7/1/201512/31/2021
VADN/A 5271BlueDental Plus Plan 2 (Std Fee) DEN5271 N/A Benefits 7/1/201512/31/2021
VADN/A 5278BlueDental Plus Plan 3 ORTHO (90 Fee) DEN5278 N/A Benefits 7/1/201512/31/2021
VADN/A 5276BlueDental Plus Plan 3 ORTHO (Std Fee) DEN5276 N/A Benefits 7/1/201512/31/2021
VADN/A 5277BlueDental Plus Plan 3 (90 Fee) DEN5277 N/A Benefits 7/1/201512/31/2021
VADN/A 5275BlueDental Plus Plan 3 (Std Fee) DEN5275 N/A Benefits 7/1/201512/31/2021
VADN/A 5282BlueDental Plus Plan 4 ORTHO (90 Fee) DEN5282 N/A Benefits 7/1/201512/31/2021
VADN/A 5280BlueDental Plus Plan 4 ORTHO (Std Fee) DEN5280 N/A Benefits 7/1/201512/31/2021
VADN/A 5281BlueDental Plus Plan 4 (90 Fee) DEN5281 N/A Benefits 7/1/201512/31/2021
VADN/A 5279BlueDental Plus Plan 4 (Std Fee) DEN5279 N/A Benefits 7/1/201512/31/2021
VADN/A 5286BlueDental Plus Plan 5 ORTHO (90 Fee) DEN5286 N/A Benefits 7/1/201512/31/2021
VADN/A 5284BlueDental Plus Plan 5 ORTHO (Std Fee) DEN5284 N/A Benefits 7/1/201512/31/2021
VADN/A 5285BlueDental Plus Plan 5 (90 Fee) DEN5285 N/A Benefits 7/1/201512/31/2021
VADN/A 5283BlueDental Plus Plan 5 (Std Fee) DEN5283 N/A Benefits 7/1/201512/31/2021
VADN/A 5290BlueDental Plus Plan 6 ORTHO (90 Fee) DEN5290 N/A Benefits 7/1/201512/31/2021
VADN/A 5288BlueDental Plus Plan 6 ORTHO (Std Fee) DEN5288 N/A Benefits 7/1/201512/31/2021
VADN/A 5289BlueDental Plus Plan 6 (90 Fee) DEN5289 N/A Benefits 7/1/201512/31/2021
VADN/A 5287BlueDental Plus Plan 6 (Std Fee) DEN5287 N/A Benefits 7/1/201512/31/2021
VADN/A 5294BlueDental Plus Plan 7 ORTHO (90 Fee) DEN5294 N/A Benefits 7/1/201512/31/2021
VADN/A 5292BlueDental Plus Plan 7 ORTHO (Std Fee) DEN5292 N/A Benefits 7/1/201512/31/2021
VADN/A 5293BlueDental Plus Plan 7 (90 Fee) DEN5293 N/A Benefits 7/1/201512/31/2021
VADN/A 5291BlueDental Plus Plan 7 (Std Fee) DEN5291 N/A Benefits 7/1/201512/31/2021
VADN/A 5298BlueDental Plus Plan 8 ORTHO (90 Fee) DEN5298 N/A Benefits 7/1/201512/31/2021
VADN/A 5296BlueDental Plus Plan 8 ORTHO (Std Fee) DEN5296 N/A Benefits 7/1/201512/31/2021
VADN/A 5297BlueDental Plus Plan 8 (90 Fee) DEN5297 N/A Benefits 7/1/201512/31/2021
VADN/A 5295BlueDental Plus Plan 8 (Std Fee) DEN5295 N/A Benefits 7/1/201512/31/2021
VADN/A 5436Preferred Dental PPO Plan 1 DEN5436 N/A Benefits 1/1/201712/31/2021
VADN/A 5440Preferred Dental PPO Plan 1 ORTHO DEN5440 N/A Benefits 1/1/201712/31/2021
VADN/A 5437Preferred Dental PPO Plan 2 DEN5437 N/A Benefits 1/1/201712/31/2021
VADN/A 5441Preferred Dental PPO Plan 2 ORTHO DEN5441 N/A Benefits 1/1/201712/31/2021
VADN/A 5438Preferred Dental PPO Plan 3 DEN5438 N/A Benefits 1/1/201712/31/2021
VADN/A 5442Preferred Dental PPO Plan 3 ORTHO DEN5442 N/A Benefits 1/1/201712/31/2021
VADN/A 5439Preferred Dental PPO Plan 4 DEN5439 N/A Benefits 1/1/201712/31/2021
VADN/A 5443Preferred Dental PPO Plan 4 ORTHO DEN5443 N/A Benefits 1/1/201712/31/2021
VADN/A 5448Traditional Dental Plan 1 DEN5448 N/A Benefits 1/1/201712/31/2021
VADN/A 5444Traditional Dental Plan 1 ORTHO DEN5444 N/A Benefits 1/1/201712/31/2021
VADN/A 5449Traditional Dental Plan 2 DEN5449 N/A Benefits 1/1/201712/31/2021
VADN/A 5445Traditional Dental Plan 2 ORTHO DEN5445 N/A Benefits 1/1/201712/31/2021
VADN/A 5450Traditional Dental Plan 3 DEN5450 N/A Benefits 1/1/201712/31/2021
VADN/A 5446Traditional Dental Plan 3 ORTHO DEN5446 N/A Benefits 1/1/201712/31/2021
VADN/A 5451Traditional Dental Plan 4 DEN5451 N/A Benefits 1/1/201712/31/2021
VADN/A 5447Traditional Dental Plan 4 ORTHO DEN5447 N/A Benefits 1/1/201712/31/2021
VAMBronze 27000BLUECHOICE ADVANTAGE POS BRONZE $6,000 (HRA) POS100035423 OFF-SHOP Benefits 1/1/202112/31/2021
VAMBronze 27002BLUECHOICE ADVANTAGE POS BRONZE $6,100 (HSA/HRA) POS100035152 OFF-SHOP Benefits 1/1/202112/31/2021
VAMBronze 27069BLUECHOICE HMO 90 BRONZE $6,500 (HSA/HRA) HMO100035234 OFF-SHOP Benefits 1/1/202112/31/2021
VAMBronze 27065BLUECHOICE HMO BRONZE $6,000 (HRA) HMO100035425 OFF-SHOP Benefits 1/1/202112/31/2021
VAMBronze 27067BLUECHOICE HMO BRONZE $6,100 (HSA/HRA) HMO100035232 OFF-SHOP Benefits 1/1/202112/31/2021
VAMBronze 27051BLUECHOICE HMO REFERRAL BRONZE $8,250 (HRA) HMO100035284 OFF-SHOP Benefits 1/1/202112/31/2021
VAMBronze 27172BLUECHOICE PLUS POS BRONZE $6,100 (HSA/HRA) POS100035297 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27004BLUECHOICE ADVANTAGE POS 90 GOLD $1,500 (HSA/HRA) POS100035163 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27039BLUECHOICE ADVANTAGE POS GOLD $0 (Rx Ded $0) POS100035208 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27028BLUECHOICE ADVANTAGE POS GOLD $1,000 (Rx Ded $250) POS100035195 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27005BLUECHOICE ADVANTAGE POS GOLD $1,500 (HSA/HRA) POS100035160 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27030BLUECHOICE ADVANTAGE POS GOLD $3,000 (Rx Ded $250) POS100035199 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27041BLUECHOICE ADVANTAGE POS GOLD $500 (Rx Ded $250) POS100035200 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27074BLUECHOICE HMO 90 GOLD $1,500 (HSA/HRA) HMO100035245 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27096BLUECHOICE HMO GOLD $1,000 HMO100035216 ON-SHOP Benefits 1/1/202112/31/2021
VAMGold 27071BLUECHOICE HMO GOLD $1,000 (HRA) HMO100035218 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27073BLUECHOICE HMO GOLD $1,000 SE HMO100035220 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27076BLUECHOICE HMO GOLD $1,500 (HSA/HRA) HMO100035238 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27118BLUECHOICE HMO GOLD $1,500 (Rx Ded $250) HMO100035274 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27121BLUECHOICE HMO GOLD $3,000 (Rx Ded $250) HMO100035276 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27059BLUECHOICE HMO GOLD $500 (Rx Ded $250) HMO100035279 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27109BLUECHOICE HMO REFERRAL GOLD $0 (Rx Ded $0) HMO100035289 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27111BLUECHOICE HMO REFERRAL GOLD $500 (Rx Ded $250) HMO100035285 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27181BLUECHOICE PLUS POS GOLD $1,000 (Rx Ded $250) POS100035319 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27184BLUECHOICE PLUS POS GOLD $500 (Rx Ded $250) POS100035369 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27143BLUEPREFERRED PPO 90/70 GOLD $1,000 PPO100035321 ON-SHOP Benefits 1/1/202112/31/2021
VAMGold 27133BLUEPREFERRED PPO 90/70 GOLD $1,000 (HRA) PPO100035323 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27134BLUEPREFERRED PPO 90/70 GOLD $1,000 SE (HRA) PPO100035327 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27151BLUEPREFERRED PPO GOLD $1,000 (Rx Ded $250) PPO100035357 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27152BLUEPREFERRED PPO GOLD $1,500 (Rx Ded $250) PPO100035361 OFF-SHOP Benefits 1/1/202112/31/2021
VAMGold 27159BLUEPREFERRED PPO GOLD $500 (Rx Ded $250) PPO100035363 OFF-SHOP Benefits 1/1/202112/31/2021
VAMPlatinum 27043BLUECHOICE ADVANTAGE POS 90/70 PLATINUM $0 (Rx Ded $0) POS100035192 OFF-SHOP Benefits 1/1/202112/31/2021
VAMPlatinum 27048BLUECHOICE ADVANTAGE POS 90/70 PLATINUM $0 (Rx Ded $0) POS100035191 ON-SHOP Benefits 1/1/202112/31/2021
VAMPlatinum 27045BLUECHOICE ADVANTAGE POS 90/70 PLATINUM SE $0 (Rx Ded $0) POS100035193 OFF-SHOP Benefits 1/1/202112/31/2021
VAMPlatinum 27044BLUECHOICE ADVANTAGE POS PLATINUM $0 (Rx Ded $0) POS100035201 OFF-SHOP Benefits 1/1/202112/31/2021
VAMPlatinum 27061BLUECHOICE HMO PLATINUM $0 (Rx Ded $0) HMO100035280 OFF-SHOP Benefits 1/1/202112/31/2021
VAMPlatinum 27113BLUECHOICE HMO REFERRAL PLATINUM $0 (Rx Ded $0) HMO100035290 OFF-SHOP Benefits 1/1/202112/31/2021
VAMPlatinum 27169BLUECHOICE PLUS POS OPTOUT PLATINUM $0 (Rx Ded $0) POS100035320 OFF-SHOP Benefits 1/1/202112/31/2021
VAMPlatinum 27166BLUEPREFERRED PPO 100/80 PLATINUM $0 (Rx Ded $0) PPO100035339 ON-SHOP Benefits 1/1/202112/31/2021
VAMPlatinum 27161BLUEPREFERRED PPO 100/80 PLATINUM $0 (Rx Ded $0) PPO100035340 OFF-SHOP Benefits 1/1/202112/31/2021
VAMPlatinum 27164BLUEPREFERRED PPO 100/80 PLATINUM SE $0 (Rx Ded $0) PPO100035341 OFF-SHOP Benefits 1/1/202112/31/2021
VAMPlatinum 27162BLUEPREFERRED PPO PLATINUM $0 (Rx Ded $0) PPO100035364 OFF-SHOP Benefits 1/1/202112/31/2021
VAMPlatinum 27163BLUEPREFERRED PPO PLATINUM $500 (Rx Ded $0) PPO100035365 OFF-SHOP Benefits 1/1/202112/31/2021
VAMPlatinum 27188HEALTHYBLUE ADVANTAGE POS PLATINUM $500 (Rx Ded $0) POS100035367 OFF-SHOP Benefits 1/1/202112/31/2021
VAMPlatinum 27186HEALTHYBLUE PLUS POS PLATINUM $500 (Rx Ded $0) POS100035368 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27010BLUECHOICE ADVANTAGE POS 70 SILVER $2,100 (HSA/HRA) POS100035176 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27012BLUECHOICE ADVANTAGE POS 70 SILVER $3,000 (HSA/HRA) POS100035187 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27007BLUECHOICE ADVANTAGE POS SILVER $1,500 (HSA/HRA) POS100035166 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27009BLUECHOICE ADVANTAGE POS SILVER $2,000 (HSA/HRA) POS100035171 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27014BLUECHOICE ADVANTAGE POS SILVER $3,000 (HSA/HRA) POS100035184 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27031BLUECHOICE ADVANTAGE POS SILVER $4,000 (Rx Ded $400) POS100035203 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27033BLUECHOICE ADVANTAGE POS SILVER $5,000 (Rx Ded $450) POS100035205 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27082BLUECHOICE HMO 70 SILVER $2,100 (HSA/HRA) HMO100035260 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27087BLUECHOICE HMO 70 SILVER $3,000 (HSA/HRA) HMO100035268 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27056BLUECHOICE HMO REFERRAL SILVER $4,000 (Rx Ded $400) HMO100035288 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27078BLUECHOICE HMO SILVER $1,500 (HSA/HRA) HMO100035252 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27123BLUECHOICE HMO SILVER $1,500 (Rx Ded $250) HMO100035291 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27080BLUECHOICE HMO SILVER $2,000 (HSA/HRA) HMO100035257 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27084BLUECHOICE HMO SILVER $2,400 (HSA/HRA) HMO100035214 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27104BLUECHOICE HMO SILVER $2,400 (HSA/HRA) HMO100035210 ON-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27086BLUECHOICE HMO SILVER $2,400 SE (HSA/HRA) HMO100035225 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27089BLUECHOICE HMO SILVER $3,000 (HSA/HRA) HMO100035265 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27125BLUECHOICE HMO SILVER $5,000 (Rx Ded $450) HMO100035295 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27174BLUECHOICE PLUS POS SILVER $1,500 (HSA/HRA) POS100035303 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27175BLUECHOICE PLUS POS SILVER $2,500 (HSA/HRA) POS100035309 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27176BLUECHOICE PLUS POS SILVER $3,000 (HSA/HRA) POS100035312 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27138BLUEPREFERRED PPO 70 SILVER $2,100 (HSA/HRA) PPO100035353 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27140BLUEPREFERRED PPO 80/60 SILVER $2,400 (HSA/HRA) PPO100035331 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27149BLUEPREFERRED PPO 80/60 SILVER $2,400 (HSA/HRA) PPO100035328 ON-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27142BLUEPREFERRED PPO 80/60 SILVER $2,400 SE (HSA/HRA) PPO100035336 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27135BLUEPREFERRED PPO SILVER $1,500 (HSA/HRA) PPO100035346 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27154BLUEPREFERRED PPO SILVER $1,500 (Rx Ded $250) PPO100035366 OFF-SHOP Benefits 1/1/202112/31/2021
VAMSilver 27137BLUEPREFERRED PPO SILVER $2,000 (HSA/HRA) PPO100035347 OFF-SHOP Benefits 1/1/202112/31/2021
VAVNone 5649BlueVision Plus Option 1 (FS/ER) VIS5649 N/A Benefits 1/1/201512/31/2021
VAVNone 5651BlueVision Plus Option 2 (FS/ER) VIS5651 N/A Benefits 1/1/201512/31/2021
VAVNone 5653BlueVision Plus Option 3 (FS/ER) VIS5653 N/A Benefits 1/1/201512/31/2021
VAVNone 5655BlueVision Plus Option 4 (FS/ER) VIS5655 N/A Benefits 1/1/201512/31/2021
VAVNone 5657BlueVision Plus Option A (FS/ER) Increased Allowances VIS5657 N/A Benefits 1/1/201512/31/2021
VAVNone 5659BlueVision Plus Option A (FS/VL) Increased Allowances VIS5659 N/A Benefits 1/1/201512/31/2021
VAVNone 5661BlueVision Plus Option B (FS/ER) Increased Allowances VIS5661 N/A Benefits 1/1/201512/31/2021
VAVNone 5663BlueVision Plus Option B (FS/VL) Increased Allowances VIS5663 N/A Benefits 1/1/201512/31/2021
VAVNone 5665BlueVision Plus Option C (FS/ER) Increased Allowances VIS5665 N/A Benefits 1/1/201512/31/2021
VAVNone 5667BlueVision Plus Option C (FS/VL) Increased Allowances VIS5667 N/A Benefits 1/1/201512/31/2021
VAVNone 5669BlueVision Plus Option D (FS/ER) Increased Allowances VIS5669 N/A Benefits 1/1/201512/31/2021
VAVNone 5671BlueVision Plus Option D (FS/VL) Increased Allowances VIS5671 N/A Benefits 1/1/201512/31/2021
DCDN/A 5335BlueDental EPO DEN5335 N/A Benefits 6/1/20197/31/2021
DCDN/A 5336BlueDental EPO w/Ortho DEN5336 N/A Benefits 6/1/20197/31/2021
MDDN/A 5333BlueDental EPO DEN5333 N/A Benefits 6/1/20197/31/2021
MDDN/A 5334BlueDental EPO w/Ortho DEN5334 N/A Benefits 6/1/20197/31/2021
VADN/A 5337BlueDental EPO DEN5337 N/A Benefits 6/1/20197/31/2021
VADN/A 5338BlueDental EPO w/Ortho DEN5338 N/A Benefits 6/1/20197/31/2021
TAMcopy
Only ANT will show CPID
Replacement rules for description field
Word in DescReplaced with
ANTHEM
AETNA
EVERGREEN
KP
HEALTHKEEPERSHK
BLUEPREFERREDBP
BLUECHOICE PLUSBCP
BLUECHOICEBCH
HEALTHYBLUEHB
ADVANTAGEAdv
BLUEFUNDBF
COMPATIBLEComp


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