BlueChoice Opt-Out Plus Open Access (CDH) Grandfathered/Small Group Non-ACA Benefit Summaries - District of Columbia

The following BlueFund and Compatible HSA & HRA Plans are BlueChoice Opt-Out Plus Open Access based. Whether you choose an option as a BlueFund or Compatible plan, there is no difference in cost.


NOTE: BlueFund Plans integrate with our fund administrator. Compatible Plans do not integrate with a CareFirst fund administrator.

Employers can consult with a CareFirst account executive to explore other plan options that fit their organization's benefit needs.

HSA plans require a combined medical and Rx plan.

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DC 1-50 BlueChoice Opt-Out Plus HSA (Combined Medical & Rx Deductible)

OptionsFeaturesMedical SummaryRx Summary
Option 2 In: $2,500 Ded; 100% |
Out: $3,750 Ded; 80%		 CUT6974 $0/$25/$45
Option 3 In: $4,000 Ded; 100% |
Out: $6,000 Ded; 80%		 CUT6975 $0/$25/$45
Option 6 In: $1,300 Ded; 100% |
Out: $2,000 Ded; 80%		 SUM1913 $0/$25/$45

DC 1-50 BlueChoice Opt-Out Plus HRA (Combined Medical & Rx Deductible)

OptionsFeaturesMedical Summary
Option 1 In: $1,200 Ded; 100% |
Out: $1,800 Ded; 80%		 SUM1922
Option 2 In: $2,500 Ded; 100% |
Out: $3,750 Ded; 80%		 CUT6974
Option 3 In: $4,000 Ded; 100% |
Out: $6,000 Ded; 80%		 CUT6975

DC 1-50 BlueChoice Opt-Out Plus HRA (Separate Medical and Rx Deductibles)

OptionsFeaturesMedical Summary
Option 1 In: $1,200 Ded; 100% |
Out: $1,800 Ded; 80%		 SUM1922
Option 2 In: $2,500 Ded; 100% |
Out: $3,750 Ded; 80%		 CUT6974
Option 3 In: $4,000 Ded; 100% |
Out: $6,000 Ded; 80%		 CUT6975

DC 1-50 BlueChoice Opt-Out Plus (Combined Medical & Rx Deductible)

OptionsFeaturesMedical Summary
Option 1 In: $1,200 Ded; 100% |
Out: $1,800 Ded; 80%		 SUM1955

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