BluePreferred PPO
Small Group Off-SHOP - Virginia

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

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 Zero Med Ded 25 Dent Ded SE ON/OFF SHOP

$10/20%/40%/50% (up to $100)/50% (up to $150)

Standard

Integrated OOP ONLY

 SUM7085

BluePreferred PPO Platinum 0 Med Ded 25 Dent Ded

$10/$45/$65/50% (up to $100)/50% (up to $150)

Standard

Integrated OOP ONLY

 SUM7086

BluePreferred PPO Platinum 500 Med Ded 25 Dent Ded

$10/$45/$65/50% (up to $100)/50% (up to $150)

Standard

Integrated OOP ONLY

 SUM7087

BluePreferred PPO Gold 800 Med Ded 250 Drug Ded 25 Dent Ded

$10/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150)

Standard

Rx DEDUCTIBLE W/INTEGRATED OOP

 SUM7088

BluePreferred PPO Gold 1000 Med Ded 250 Drug Ded 25 Dent Ded

$10/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150)

HRA

Rx DEDUCTIBLE W/INTEGRATED OOP

 SUM7089

BluePreferred PPO Gold 1250 Ded SE ON/OFF SHOP

D,$15/D,20%/D,40%/D,50% (up to $100)/D,50% (up to $150)

HRA

Fully Integrated

 SUM7090

BluePreferred PPO Silver 1900 Med Ded 250 Drug Ded 25 Dent Ded

$15/D,$50/D,$75/D,50% (up to $100)/D,50% (up to $150)

HRA

Rx DEDUCTIBLE W/INTEGRATED OOP

 SUM7093

BluePreferred PPO Gold 1500 Med Ded 250 Drug Ded 25 Dent Ded

$10/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150)

HRA

Rx DEDUCTIBLE W/INTEGRATED OOP

 SUM7092

BluePreferred PPO HSA/HRA Silver 1950 Med Ded 25 Dent Ded

D,$15/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

 SUM7094

BluePreferred PPO HSA/HRA Silver 2500 Med Ded 25 Dent Ded

D,$10/D,$45/D,$65/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

 SUM7095

BluePreferred PPO HSA/HRA Silver 2900 Med Ded 25 Dent Ded SE ON/OFF SHOP

D,$10/D,20%/D,40%/D,50% (up to $100)/D,50% (up to $150)

HSA/HRA/HDHP

Fully Integrated

 SUM7096