BlueChoice HMO
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 HMO Summary of Plan Options
OptionsFeaturesMedical SummaryRx Summary
Option 3 Copay $10/20 $0 Ded. BRC6937 Non-Integrated Rx Options
Option 13 Copay $30/40 $0 Ded. BRC6957 Non-Integrated Rx Options
Option 14 Copay $20/30 $0 Ded. BRC6958 Non-Integrated Rx Options
Option B Copay $20/30 $500 Ded. BRC6960 Non-Integrated Rx Options
Option C Copay $30/40 $500 Ded. BRC6961 Non-Integrated Rx Options
Option F * Copay $30/40 $500 Ded. BRC6964 Non-Integrated Rx Options
Option G * Copay $20/30 $500 Ded. BRC6890 Non-Integrated Rx Options
Option H * Copay $20/30 $0 Ded. BRC6891 Non-Integrated Rx Options
Option I Copay $30/40 $500 Ded. BRC6892 Non-Integrated Rx Options
Option J Copay $30/40 $0 Ded. BRC6893 Non-Integrated Rx Options
Option L NEW 10% $1,000 Ded. SUM4709 Non-Integrated Rx Options
Option M NEW $20/20% $1,000 Ded. SUM4710 Non-Integrated Rx Options
Option N NEW Copay $20/40 $1,500 Ded. SUM4711 Non-Integrated Rx Options
Option O NEW Copay $20/40 $2,000 Ded. SUM4712 Non-Integrated Rx Options
Option P NEW Copay $10/20 $500 Ded. SUM4713 Non-Integrated Rx Options

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

* This plan is not actively marketed and is for existing groups only. Not available for new business.


BlueChoice HMO Smart Selections Summary of Plan Options
OptionsFeaturesMedical SummaryRx Summary
Option 1-S $0 Deductible SUM3310 Non-Integrated Rx Options
Option 2-S $500 Deductible SUM3311 Non-Integrated Rx Options
Option 3-S $1,000 Deductible SUM3312 Non-Integrated Rx Options
Option 4-S $2,000 Deductible SUM3313 Non-Integrated Rx Options
Option 5-S $1,500 Deductible SUM4102 Non-Integrated Rx Options
Option 6-S $3,000 Deductible SUM4103 Non-Integrated Rx Options

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

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