BlueChoice HMO
Small Group Off-SHOP - Maryland

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.

BlueChoice HMO

Plan Name Rx Plan Type Integration Status Medical Summary
BlueChoice HMO Platinum 0 Ded $10/$45/$65/50% (up to $100)/50% (up to $150)  Standard Integrated OOP only SUM7414

SUM7414-SPA
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 SUM7415

SUM7415-SPA
BlueChoice HMO Gold 1500 Ded ON/OFF SHOP $10/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150) HRA RX Deductible with Integrated OOP SUM7416

SUM7416-SPA
BlueChoice HMO Gold 3000 Ded $10/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150) HRA RX Deductible with Integrated OOP SUM7417

SUM7417-SPA
BlueChoice HMO Silver 2000 Ded $15/D,$50/D,$75/D,50% (up to $100)/D,50% (up to $150) HRA RX Deductible with Integrated OOP SUM7418

SUM7418-SPA
BlueChoice HMO Silver 6900 Ded ON/OFF SHOP $15/D,$45/D,$75/D,$100/D,$150 HRA RX Deductible with Integrated OOP SUM7419

SUM7419-SPA
BlueChoice HMO Bronze 6000 Ded ON/OFF SHOP $20/D,$50/D,$70/D,$100/D,$150 HRA Fully Integrated SUM7420

SUM7420-SPA
BlueChoice HMO HSA/HRA Gold 1800 Ded $10/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150) HSA/HRA/HDHP Fully Integrated SUM7421

SUM7421-SPA
BlueChoice HMO HSA/HRA Silver 2300 Ded ON/OFF SHOP $15/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150) HSA/HRA/HDHP Fully Integrated SUM7422

SUM7422-SPA
BlueChoice HMO HSA/HRA Silver 2650 Ded $10/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150) HSA/HRA/HDHP Fully Integrated SUM7423

SUM7423-SPA
BlueChoice HMO HSA/HRA Silver 3000 Ded ON/OFF SHOP D,$10/D,20%/D,40%/D,50% (up to $100)/D,50% (up to $150) HSA/HRA/HDHP Fully Integrated SUM7424

SUM7424-SPA
BlueChoice HMO HSA/HRA Silver 3400 Ded $10/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150) HSA/HRA/HDHP Fully Integrated SUM7425

SUM7425-SPA
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 SUM7426

SUM7426-SPA