Below is a list of actual policy documents for QHP small group coverage. These policies describe how the plans generally work and include eligible expenses, claim filing and appeals procedures, and coverage limitations and exceptions, among other things.
If you have questions, contact a customer service representative at 1-855-258-8471 for more information.
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Platinum Plans
Blue Preferred Platinum PPO Plans
Off Exchange
- SBC - Blue Preferred Platinum PPO 001 - ($750/$1500)
- SBC - Blue Preferred Platinum PPO 002 - ($250/$500)
Gold Plans
Blue Preferred Gold PPO Plans
Off Exchange
- SBC - Blue Preferred Gold PPO 005 - ($2000/$4000)
- SBC - Blue Preferred Gold PPO 007 - ($1000/$2000)
- SBC - Blue Preferred Gold PPO 008 - ($1000/$2000)
- SBC - Blue Preferred Gold PPO 010 - ($1500/$3000)
- SBC - Blue Preferred Gold PPO 011 - ($2000/$4000)
- SBC - Blue Preferred Gold PPO 012 - ($0/$0)
- SBC - Blue Preferred Gold PPO 023 - ($4000/$8000)
- SBC - Blue Preferred Gold PPO 024 - ($2600/$5200)
- SBC - Blue Preferred Gold PPO 025 - ($750/$1500)
- SBC - Blue Preferred Gold PPO 026 - ($1000/$2000)
On Exchange
Silver Plans
Blue Preferred Silver PPO Plans
Off Exchange
- SBC - Blue Preferred Silver PPO 014 - ($3000/$6000)
- SBC - Blue Preferred Silver PPO 017 - ($2000/$4000)
- SBC - Blue Preferred Silver PPO 020 - ($2250/$4500)
- SBC - Blue Preferred Silver PPO 022 - ($3500/$7000)
- SBC - Blue Preferred Silver PPO 027 - ($3500/$7000)
- SBC - Blue Preferred Silver PPO 028 - ($4500/$9000)
On Exchange
- SBC - Blue Preferred Silver PPO 014 - ($3000/$6000)
- SBC - Blue Preferred Silver PPO 020 - ($2250/$4500)
Bronze Plans
Blue Preferred Bronze PPO Plans
Off Exchange
- SBC - Blue Preferred Bronze PPO 018 - ($5000/$10000)
- SBC - Blue Preferred Bronze PPO 019 - ($6000/$12000)