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 Essential Platinum 0

$5/$15/$25/$100/$100

Standard

Integrated OOP only

 SUM6998

BlueChoice HMO Essential Gold 500

$15/$50/$70/$150/$150

Standard

Integrated OOP only

 SUM6999

BlueChoice HMO Essential Silver 4850

$20/D,$50/D,$70/D,$100/D,$150

Standard

RX Deductible with Integrated OOP

 SUM7006

BlueChoice HMO HSA Bronze 6350

D,20%/D,20%/D,20%/D,20% ($150 max)/D,20% ($150 max)

HSA

Fully Integrated

 SUM7000

BlueChoice HMO Essential Bronze 7500

$25/D,$75/D,$100/D,$150/D,$150

Standard

RX Deductible with Integrated OOP

 SUM7001

BlueChoice HMO Platinum 0 Ded

$10/$45/$65/50% (up to $100)/50% (up to $150)

Standard

Integrated OOP only

 SUM6997

BlueChoice HMO Gold 800 Ded

$10/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150)

Standard

RX Deductible with Integrated OOP

 SUM7002

BlueChoice HMO Gold 1500 Ded

$10/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150)

HRA

RX Deductible with Integrated OOP

 SUM7003

BlueChoice HMO Gold 3000 Ded

$10/D,$40/D,$70/D,$100/D,$150

HRA

RX Deductible with Integrated OOP

 SUM7004

BlueChoice HMO Silver 1900 Ded

$15/D,$50/D,$75/D,50% (up to $100)/D,50% (up to $150)

HRA

RX Deductible with Integrated OOP

 SUM7005

BlueChoice HMO Silver 6500 Ded

$15/D,$45/D,$75/D,$100/D,$150

HRA

RX Deductible with Integrated OOP

 SUM7007

BlueChoice HMO Bronze 6000 Ded

D,$20/D,$50/D,$70/D,$100/D,$150

HRA

Fully Integrated

 SUM7008

BlueChoice HMO HSA/HRA Gold 1700 Ded

D,$10/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

 SUM7009

BlueChoice HMO HSA/HRA Silver 1950 Ded

D,$15/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

 SUM7010

BlueChoice HMO HSA/HRA Silver 2500 Ded

D,$10/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

 SUM7011

BlueChoice HMO HSA/HRA Silver 3400 Ded

D,$10/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

 SUM7012

BlueChoice HMO HSA/HRA Bronze 6100 Ded

D,$15/D,$45/D,$75/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

 SUM7013