BluePreferred - Group and Member Applications - Maryland

Non-MSGR MD Groups: If a group chooses BlueChoice medical coverage (HealthyBlue, BlueChoice, BlueChoice Open Access, BlueChoice Opt-Out Open Access, or BlueChoice Opt-Out Plus Open Access ) and indemnity dental coverage (Traditional or Preferred), and elects to offer non-parallel enrollment for dental, the group will receive a GHMSI or CFMI Non-Ridered Dental contract. In this case, the group is required to sign two Group Contract Applications (BlueChoice & GHMSI or CFMI), unless the group selects a Point-of-Enrollment package, which only requires the signed Point-of-Enrollment Group Contract Application. In this situation, an employee must complete two subscriber Enrollment Forms (BlueChoice & GHMSI or CFMI).

MSGR MD Groups: If a group chooses BlueChoice medical coverage (HealthyBlue, BlueChoice, BlueChoice Open Access, BlueChoice Opt-Out Open Access, or BlueChoice Opt-Out Plus Open Access ) and indemnity dental coverage (Traditional or Preferred), and elects to offer non-parallel enrollment for dental, the group will receive a GHMSI or CFMI Non-Ridered Dental contract. In this case, the group is required to sign two Group Contract Applications (BlueChoice & GHMSI or CFMI) and an employee must complete two subscriber Enrollment Forms (BlueChoice & GHMSI or CFMI).

Note: MSGR BluePreferred/SPPP Plans that elect to cover Retirees and offer non-parallel (non-rider) Traditional/Preferred Dental and/or BlueVision Plus must complete two (2) CFMI or GHMSI Group Applications - (1) BluePreferred  Group Application, and (1) Dental/Vision Non-Parallel Enrollment Group Application. (Retirees are only allowed to enroll in an ancillary plan if they are enrolling in BluePreferred medical.)