BlueChoice Advantage (HRA and HSA/HRA)
Mid / Large Group Benefit Summaries - Virginia

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

Spanish benefit summaries are available upon request. Please contact your CareFirst sales representative for more information.

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

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BlueChoice Advantage HSA/HRA Combined Rx Summary of Plan Options
Options Features Medical Summary Rx Summary
Option 1 In: $1,650 Ded. |
Out:
$3,300 Ded. 100%-70%
SUM1679 Integrated Rx Options
Option 2 In: $2,000 Ded. |
Out:
$4,000 Ded. 90%-60%
SUM1713 Integrated Rx Options
Option 12 In: $2,000 Ded. |
Out
:$4,000 Ded. 100%-60%
SUM5460 Integrated Rx Options
Option 14 In: $2,000 Ded. |
Out
:$4,000 Ded. 100%-80%
SUM5816 Integrated Rx Options
Option 3 In: $1,650 Ded. |
Out
:$3,300 Ded. 90%-70%
SUM4705 Integrated Rx Options
Option 4 In: $1,650 Ded. |
Out
: $3,300 Ded. 80%-60%
SUM4706 Integrated Rx Options
Option 5 In: $2,500 Ded.|
Out
$5,000 Ded. 100%-80%
SUM4707 Integrated Rx Options
Option 6 In: $1,650 Ded.|
Out
:$3,300 Ded. 100%-80%
SUM4708 Integrated Rx Options

All plans are fully insured. Please consult with your CareFirst sales representative for information about self-insured options.

Options Features Medical Summary Rx Summary
BlueChoice Advantage HSA/HRA
Option MV 1
$4,000 Deductible SUM2700 Integrated Minimum Value (MV) Rx Options
BlueChoice Advantage HSA/HRA
Option MV 2
$5,500 Deductible SUM3309 Integrated Minimum Value (MV) Rx Options
BlueChoice Advantage HSA/HRA
Option MV 3
$3,300 Deductible SUM5108 Integrated Minimum Value (MV) Rx Options
BlueChoice Advantage HSA/HRA
Option MV 4
$5,000 Deductible SUM5109 Integrated Minimum Value (MV) Rx Options
BlueChoice Advantage HSA/HRA
Option MV 5
$7,000 Deductible SUM6905 Integrated Minimum Value (MV) Rx Options
BlueChoice Advantage HSA/HRA
Option MV 6
$3,300 Deductible SUM6908 Integrated Minimum Value (MV) Rx Options

All plans are fully insured. Please consult with your CareFirst sales representative for information about self-insured options.

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