BlueChoice HMO Open Access (CDH) Grandfathered/Small Group Non-ACA Benefit Summaries - Maryland

The following BlueFund and Compatible HSA & HRA Plans are BlueChoice HMO 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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MSGR BlueChoice HMO HSA (Combined Medical and Rx Deductible)

Rx Copay Options 1,2 & 6: $0/$25/$45 ; Option 3: 75% Member Coinsurance ; Options 4-5: $0/$45/$65


Options Features Medical Summary Rx Summary
Option 2 $2,000 Deductible CUT6953 Options listed above
Option 3 CORE $2,700 Deductible CUT6951 Options listed above
Option 4 $1,500 Deductible SUM1765 Options listed above
Option 5 $2,000 Deductible SUM1766 Options listed above
Option 6 $1,300 Deductible SUM1929 Options listed above

MSGR BlueChoice HMO (Combined Medical & Rx Deductible)

Options Features Medical Summary
Option 1 $1,200 Deductible SUM1934

MSGR BlueChoice HMO HRA (Combined Medical & Rx Deductible)

Options Features Medical Summary Rx Summary
Option 1 $1,500 Deductible CUT8401 $0/$25/$45
Option 2 $2,000 Deductible CUT8402 $0/$25/$45

MSGR BlueChoice HMO HRA (Separate Medical and Rx Deductibles)

Options Features Medical Summary Rx Summary
Option 3 CORE $2,500 Deductible CUT8403 75% Member Coinsurance

Non-MSGR 1-50 BlueChoice HMO HSA (Combined Medical & Rx Deductible)

Options Features Medical Summary Rx Summary
Option 2 $2,500 Deductible CUT7006 $0/$25/$45
Option 3 $4,000 Deductible CUT7007 $0/$25/$45
Option 6 $1,300 Deductible SUM1866 $0/$25/$45
Option 7 $1,500 Deductible SUM1920 $0/$25/$45

Non-MSGR BlueChoice HMO HRA (Combined Medical & Rx Deductible)

Options Features Medical Summary
Option 1 $1,200 Deductible SUM1890
Option 2 $2,500 Deductible CUT7006
Option 3 $4,000 Deductible CUT7007
Option 7 $1,500 Deductible SUM1920

Non-MSGR 1-50 BlueChoice HMO HRA (Separate Medical and Rx Deductibles)

Options Features Medical Summary
Option 1 $1,200 Deductible SUM1890
Option 2 $2,500 Deductible CUT7006
Option 3 $4,000 Deductible CUT7007

Non-MSGR 1-50 BlueChoice HMO (Combined Medical & Rx Deductible)

Options Features Medical Summary
Option 1 $1,200 Deductible SUM1942

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