BlueChoice HMO
Small Group On-SHOP - District of Columbia

Benefit summaries are now available for the health plans listed below. Please check the site frequently for summary updates.

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

BlueChoice HMO

Plan Name Rx Plan Type Integration Status Medical Summary
BlueChoice HMO Platinum 0 $10/$45/$65/50% to $100/50% to $150 Non-Integrated SUM6225
BlueChoice HMO Standard Platinum $0 $5/$15/$25/ $100/$100 Non-Integrated SUM6226
BlueChoice HMO Standard Gold $500 $15/$50/$70/$150/$150 Non-Integrated SUM6227
BlueChoice HMO HSA Standard Bronze $6,350 20%/20%/20%/20% to $150/20% to $150 HSA, HRA, or HDHP Integrated SUM6228
BlueChoice HMO Standard Bronze $7,500 $25/$75/$100/$150/$150 Non-Integrated SUM6229
BlueChoice HMO Gold 800 $10/$45/$65/50% to $100/50% to $150 Non-Integrated SUM6230
BlueChoice HMO Gold 1500 $10/$45/$65/50% to $100/50% to $150 HRA Non-Integrated SUM6231
BlueChoice HMO Gold 3000 Virtual Connect $10/$40/$70/$100/$150 HRA Non-Integrated SUM6232
BlueChoice HMO Silver 1900 $10/$45/$65/50% to $100/50% to $150 HRA Non-Integrated SUM6233
BlueChoice HMO Standard Silver $4,850 $20/$50/$70/$150/$150 Non-Integrated SUM6234
BlueChoice HMO Silver 6500 $15/$45/$65/$100/$150 HRA Non-Integrated SUM6235
BlueChoice HMO Value Bronze 6000 $20/$50/$70/$100/$150 HRA Integrated SUM6236
BlueChoice HMO HSA/HRA Gold 1500 $10/$45/$65/50% to $100/50% to $150 HSA, HRA or HDHP Integrated SUM6237
BlueChoice HMO HSA/HRA Gold 1500 90 $10/$45/$65/$100/$150 HSA, HRA or HDHP Integrated SUM6238
BlueChoice HMO HSA/HRA Silver 1600 $15/$45/$65/50% to $100/50% to $150 HSA, HRA or HDHP Integrated SUM6239
BlueChoice HMO HSA/HRA Silver 2000 $10/$45/$65/50% to $100/50% to $150 HSA, HRA or HDHP Integrated SUM6240
BlueChoice HMO HSA/HRA Silver 2400 70 $10/$45/$65/$100/$150 HSA, HRA or HDHP Integrated SUM6241
BlueChoice HMO HSA/HRA Silver 3000 $10/$45/$65/50% to $100/50% to $150 HSA, HRA or HDHP Integrated SUM6242
BlueChoice HMO HSA/HRA Silver 3000 70 $10/$45/$65/$100/$150 HSA, HRA or HDHP Integrated SUM6243
BlueChoice HMO HSA/HRA Bronze 6100 $10/$45/$65/50% to $100/50% to $150 HSA, HRA or HDHP Integrated SUM6244
BlueChoice HMO HSA/HRA Bronze 6500 90 $10/$45/$65/$100/$150 HSA, HRA or HDHP Integrated SUM6245