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HealthyBlue HMO - Small Group Off-SHOP Applications - Virginia
HealthyBlue HMO (including HSA/HRA)
| Group Size | Group Subscriber Enrollment Form | Group Contract Application | Point of Enrollment |
|---|---|---|---|
| 2-50 | SUM4232 (for plans effective between 1/1/19 and 12/31/23) | VA/GRPAPP/HCR (1/23) (HMO) | VA/GRPAPP/HCR (1/23) (POE) |