BluePreferred (CDH) Grandfathered/Small Group Non-ACA Benefit Summaries - District of Columbia
The following BlueFund and Compatible HSA & HRA Plans are BluePreferred 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.
Rx Copay (Options 1-4, 6-7): $0/$25/$45; $10/$25/$45
Rx Copay (Options 8-9): $0/$25/$45
Options | Features | Medical Summary | Rx Summary |
---|---|---|---|
Option 3 | In: $2,000 Ded; 100% | Out: $4,000 Ded; 80% |
CUT6754 | Options listed above |
Option 4 | In: $2,700 Ded; 100% | Out: $5,400 Ded; 80% |
CUT6755 | Options listed above |
Option 6 | In: $1,300 Ded; 100% | Out: $2,600 Ded; 80% |
SUM1914 | Options listed above |
Option 7 | In: $1,300 Ded; 90% | Out: $2,600 Ded; 70% |
SUM1917 | Options listed above |
Option 8 | In: $1,500 Ded; 100% | Out: $3,000 Ded; 80% |
SUM1915 | Options listed above |
Option 9 | In: $1,500 Ded; 90% | Out: $3,000 Ded; 70% |
SUM1918 | Options listed above |
Rx Copay (All Options): $10/$25/$45, $0/$25/$45
Options | Features | Medical Summary | Rx Summary |
---|---|---|---|
Option 1 | In: $1,000 Ded; 100% | Out: $2,000 Ded; 80% |
CUT6747 | Options listed above |
Option 2 | In: $1,000 Ded; 90% | Out: $2,000 Ded; 70% |
CUT6748 | Options listed above |
Option 3 | In: $2,000 Ded; 100% | Out: $4,000 Ded; 80% |
CUT6749 | Options listed above |
Option 4 | In: $3,000 Ded; 100% | Out: $6,000 Ded; 80% |
CUT6750 | Options listed above |
Option 5 | In: $5,000 Ded; 100% | Out: $10,000 Ded; 80% |
CUT6751 | Options listed above |
Option 8 | In: $1,500 Ded; 100% | Out: $3,000 Ded; 80% |
SUM1916 | Options listed above |
Option 9 | In: $1,500 Ded; 90% | Out: $3,000 Ded; 70% |
SUM1919 | Options listed above |
Options | Features | Medical Summary |
---|---|---|
Option 1 | In: $1,000 Ded; 100% | Out: $2,000 Ded; 80% |
CUT6742 |
Option 2 | In: $1,000 Ded; 90% | Out: $2,000 Ded; 70% |
CUT6743 |
Option 3 | In: $2,000 Ded; 100% | Out: $4,000 Ded; 80% |
CUT6744 |
Option 4 | In: $3,000 Ded; 100% | Out: $6,000 Ded; 80% |
CUT6745 |
Option 5 | In: $5,000 Ded; 100% | Out: $10,000 Ded; 80% |
CUT6746 |