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Vision - Virginia

CareFirst Vision

Group SizeGroup Subscriber Enrollment FormGroup Contract Application
2-50 Renewing
(Grandfathered/Non-ACA)

BlueVision Plus
CUT5150 N/A
2-50
(New & Renewing Groups)

BlueVision Plus
SUM2031 VA/GRPAPP/HCR (1/14) (D-V Only) (for plans effective prior to 12/31/18)

VA/GRPAPP/HCR (1/19) (D-V Only) (for plans effective between 1/1/19 and 4/30/19)

VA/GHMSI/DN-VS ONLY/GCA (11/18) (for plans effective 5/1/19 and after)
51+ Groups
(New & Returning Groups)

BlueVision Plus
SUM2710 VA/GHMSI/GCA/LG (1/14) (BP, HB(PPO), & DN-VS Only) (for plans effective prior to 5/1/19)

VA/GHMSI/DN-VS ONLY/GCA (11/18) (for plans effective 5/1/19 and after)