BluePreferred PPO
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.

Please note: Not all services and procedures are covered by your benefits contract. Benefit summaries are for comparison purposes only and does not create rights not given through the benefit plan.

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

BluePreferred PPO

Plan Name Rx Plan Type Integration Status Medical Summary
BluePreferred PPO Platinum 0 $10/$45/$65/50% to $100/50% to $150   Non-Integrated SUM6258
BluePreferred PPO Standard Platinum $0 $5/$15/$25/ $100/$100   Non-Integrated SUM6259
BluePreferred PPO HSA Standard Bronze $6,350 20%/20%/20%/20% to $150/20% to $150 HSA, HRA, or HDHP  Integrated SUM6260
BluePreferred PPO Standard Bronze $7,500 $25/$75/$100/$150/$150   Non-Integrated SUM6261
BluePreferred PPO Platinum 500 $10/$45/$65/50% to $100/50% to $150   Non-Integrated SUM6262
BluePreferred PPO Standard Gold $500 $15/$50/$70/$150/$150   Non-Integrated SUM6263
BluePreferred PPO Gold 800 $10/$45/$65/50% to $100/50% to $150   Non-Integrated SUM6264
BluePreferred PPO Gold 1000 $10/$45/$65/50% to $100/50% to $150 HRA Non-Integrated SUM6265
BluePreferred PPO 1100 90%/70% $15/20%/40%/50% to $100/50% to $150 HRA Integrated SUM6266
BluePreferred PPO Gold 1500 $10/$45/$65/50% to $100/50% to $150 HRA Non-Integrated SUM6267
BluePreferred PPO Silver 1900 $10/$45/$65/50% to $100/50% to $150 HRA Non-Integrated SUM6268
BluePreferred PPO Standard Silver $4,850 $20/$50/$70/$150/$150   Non-Integrated SUM6269
BluePreferred PPO HSA/HRA Silver 1600 $15/$45/$65/50% to $100/50% to $150 HSA, HRA or HDHP Integrated SUM6270
BluePreferred PPO Silver 1600 BlueFund HSA $15/$45/$65/50% to $100/50% to $150 HSA Integrated SUM6274
BluePreferred PPO HSA/HRA Silver 2000 $10/$45/$65/50% to $100/50% to $150 HSA, HRA or HDHP Integrated SUM6271
BluePreferred PPO HSA/HRA Silver 2400 70 $10/$45/$65/$100/$150 HSA, HRA or HDHP Integrated SUM6272
BluePreferred PPO HSA/HRA Silver 2750 80%/60% $10/20%/40%/50% to $100/50% to $150 HSA, HRA or HDHP Integrated SUM6273