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

 SUM7555

SUM7555-SPA

BluePreferred PPO Platinum 0 Med Ded 25 Dent Ded

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

Standard

Integrated OOP ONLY

 SUM7556

SUM7556-SPA

BluePreferred PPO Platinum 500 Med Ded 25 Dent Ded

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

Standard

Integrated OOP ONLY

 SUM7557

SUM7557-SPA

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

 SUM7558

SUM7558-SPA

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

 SUM7559

SUM7559-SPA

BluePreferred PPO Gold 1400 Ded SE ON/OFF SHOP

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

HRA

Fully Integrated

 SUM7561

SUM7561-SPA

BluePreferred PPO Silver 2000 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

 SUM7563

SUM7563-SPA

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

 SUM7562

SUM7562-SPA

BluePreferred PPO HSA/HRA Silver 2300 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

 SUM7564

SUM7564-SPA

BluePreferred PPO HSA/HRA Silver 2650 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

 SUM7565

SUM7565-SPA

BluePreferred PPO HSA/HRA Silver 3000 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

 SUM7566

SUM7566-SPA