bluechoice advantage hra

/Subtype /Type1 If you want more detail about your coverage and … Very similar to PPO plans; POS plans cover both in and out-of-network doctors, and you don't need a referral to see a specialist. BlueChoice Advantage HSA/HRA Bronze 6000. 0000018555 00000 n '����ߥޡ��M����7�jJ���a�=t�B��\��Gz8� �i�g� �|Ƶ��Gy�i@ ), are paid at a rate less than like covered benefits received from an in-network provider. 0000007113 00000 n 0000009166 00000 n In-Network: $3,000 / $6,000 0000003366 00000 n Benefit changes due to AV. 26 0 obj BlueChoice Advantage HSA/HRA Gold 1500 90. a Health Savings Account (HSA) or a Health Reimbursement Arrangement (HRA) providing tax advantages for employers and members. BlueChoice HMO HSA/HRA Silver 3000. BlueChoice HSA Silver 1500 Coverage Period: 01/01/2017 - 12/31/2017 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual | Plan Type: HMO This is only a summary. In-Network: $1,500 / $3,000 0000019568 00000 n BlueChoice Advantage HSA/HRA Silver 1500 Coverage Period: 01/01/2019 - 12/31/2019 Coverage for: Individual | Plan Type: POS The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. epsilon Bronze: Nationwide In-Network. The provider cannot charge the member more than this amount for any covered service. An HRA reimburses employees and their families for eligible medical expenses. 0000000012 00000 n BlueChoice HMO HSA Silver $1,500 Claim Forms. Founded in 1998, HRA provides Contract Professionals across a wide range of disciplines and skill-sets, supporting capital … Quoting may begin now for new and renewing 2-50 Maryland non-MSGR groups for January 1, 2012 effective dates. BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. CareFirst: 2020 Small Group: POS: BlueChoice Plus HSA/HRA Silver 1500. Office Hours Monday to Friday, 8 am to 5:30 pm Connect With Us 1225 Eye Street, NW, Suite 400, Washington, DC 20005 Phone: (202) 715-7576 TTY: 711 /SA false /BM /Normal Contract. /BM /Normal Out-of-Network You Pay. Your cost for certain benefits is 10% coinsurance. BlueChoice Plus HSA/HRA Silver 2500. Group Name: Sample Group Number: Sample Product Name: BlueChoice Advantage HSA/HRA Gold 1500 Group Effective Date: January 1, 2018. 100%-70% Contract. Prescription Search. ] Prescription Search. BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. www.carefirst.com CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. If you want more detail about your coverage and … /op false Check any two boxes to compare those two plans. /GS1 24 0 R If you want more detail about your coverage and … >> 2.0 HRA, HealthyBlue 2.0 HSA, HealthyBlue Advantage, HealthyBlue Advantage HRA and HealthyBlue Advantage HSA health care plans. /Filter /FlateDecode In-Range—no changes . 3. 27 0 R Regional BlueChoice … epsilon Bronze: DC Metro In-Network. /CA 1 In-Network: $3,000 / $6,000 Out-Network: $7,000 / $14,000 . 0000009533 00000 n Complete all appropriate items, sign and date. 0000001966 00000 n BlueChoice Plus HSA/HRA Silver 3000. Summary of Benefits and Coverage. 0000003782 00000 n 0000004699 00000 n 4. Prescription Search. /CA 1 /CropBox [ 0 0 612 792 ] Plan Name: CareFirst BlueChoice: Rating: 4.0: URL: www.Carefirst.com: States: DC, MD, VA: NCQA Accreditation: Yes: Other Names: BlueChoice HMO Open Access HSA; BlueChoice Advantage; BlueChoice Advantage HSA; BlueChoice HMO HSA; BlueChoice HMO Open Access; BlueChoice HMO Open Access HRA; BlueChoice HMO; BlueChoice HMO Referral; BlueChoice HMO Saver; Healthy Blue … /GS0 23 0 R /Length 831 /T1_4 31 0 R CareFirst BlueCross BlueShield, CareFirst BlueChoice, Inc. and all of their corporate affiliates (CareFirst) comply with applicable federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability or sex. BlueChoice Advantage HRA/HSA Integrated Deductible SUM1680-1P (12/15) n DC n 2-50, 51-199, 200+ Option 1 . If you have our Blue Option SM Coverage (through the Affordable Care Act), visit www.BlueOptionSC.com.. Additional Provider Information: Find an independent lab in South Carolina through Quest Diagnostics and LabCorp.These are independent companies that provide lab services on behalf of BlueChoice HealthPlan. epsilon Bronze: DC Metro In-Network. BlueChoice Advantage HSA/HRA Silver 1500 Integrated Deductible Summary of Benefits Services In-Network You Pay1 Out-of-Network You Pay1 ... is the business name of Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. are /S 84 /TrimBox [ 0 0 612 792 ] H���Oo�0��| Summary of Benefits and Coverage. �^l�����GU[�P-����(�ݴMZE���l�X+�v��=Ϗ���������~{�jvyyus͊�������ؿ9���K���Ww�{,v5�kź{6�xeB$0�Q`����c����\u[>��~�$7���s��?�Nj�K��{W�v��\�.53���f�6\������� 8������T�rz���C0�h��2)a� ��F�QCiW�k�\�p\��)#Fq� 2 �C�84�+Q]O$�%��\*��=�Y5k�ԛ���a$Q�N!���y�LJ����~e��t�c�Hj�����8� BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. /GS2 25 0 R 23 0 obj >> Example: Dr. Carson charges $100 to see a sick patient. 0000032232 00000 n /Prev 116667 Prescription Search . �xW4!E�R|*��R�y�I��I�"�y��Ǚ�їxH�� Plan Name: CareFirst BlueChoice: Rating: 3.5: URL: www.carefirst.com: States: DC, MD, VA: NCQA Accreditation: Yes: Other Names: BlueChoice HMO; BlueChoice HMO Saver; HealthyBlue HMO; HealthyBlue HMO HRA; HealthyBlue HMO HSA; BlueChoice HMO HRA; BlueChoice HMO Referral; BlueChoice HMO Referral HRA; BlueChoice HMO Referral HSA; BlueChoice HMO Open Access; BlueChoice HMO Open Access HRA … 68 0 R 0000011545 00000 n CareFirst: 2021 Small Group: POS: BlueChoice Plus HSA/HRA Bronze 6100. << 25 0 obj 0000012530 00000 n /Encoding 55 0 R /ABCpdf 6109 Oral Chemo Drugs and Diabetic Supplies HSA - No charge* after deductible; HRA - No charge* Generic Drugs Deductible, then 30-day supply $10; Deductible, then 90-day supply $20 (maintenance drugs only) Preferred Brand Drugs11 Deductible, then 30-day supply $45; Deductible, then 90-day supply $90 (maintenance drugs only) Non-preferred Brand Drugs12 Deductible, then 30-day supply $65; … Prescription Search . BlueChoice Plus HSA/HRA $1,500 Summary of Benefits. Contract. /OPM 1 An HRA may also be offered in conjunction with a Flexible Spending Account (FSA), a tax-advantaged plan that is employee-funded and may also be used to cover additional uninsured expenses. delta Silver: Nationwide In-Network. CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst Advantage, Inc., Trusted Health Plan (District of Columbia), Inc., CareFirst BlueChoice, Inc., First Care, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. Mar 03 SC BlueCross, SC BlueChoice Members Can See a Doctor Without Going to the Doctor's Office Feb 10 BlueCross BlueShield of South Carolina, BlueChoice HealthPlan of South Carolina Start Maternity Blue Distinction Program, Recognize South Carolina Hospitals for … %PDF-1.4 BlueChoice Plus HSA/HRA $1,500 Summary of Benefits. Deductible: Individual/Family. << An HRA is a medical spending account that is entirely funded by an employer. Headquartered in Salt lake City, Utah - The HRA Group is a division of HR Advantages, a privately held company providing Contract Staffing Services. The CareFirst BlueChoice Advantage CDHP (Consumer Directed Health Plan) is a high deductible health plan that allows you to contribute pre-tax to a Health Savings Account (HSA). stream 0000024839 00000 n BlueChoice Advantage HSA/HRA Bronze 6100. /FirstChar 31 Prescription Search . BlueChoice Advantage HSA/HRA Bronze 6000. Please return this form to your employer. Services In-Network You Pay1 Out-of-Network You Pay1 HOSPITALIZATION—MEMBERS ARE RESPONSIBLE FOR APPLICABLE PHYSICIAN AND FACILITY FEES Outpatient Facility Surgery (Freestanding Facility) Deductible, then $100 per visit Deductible, then 20% of Allowed Benefit Outpatient Facility Surgery (Hospital Facility) Deductible, then … delta Silver: Nationwide In-Network. 22 0 obj /Contents [ 26 0 R Employers decide what types of expenses are considered eligible. BlueChoice Advantage HSA/HRA Gold 1500 Summary of Benefits. delta Silver: Nationwide In-Network. Out-Network: $1,000 / $2,000, In-Network: $1,000 / $2,000 0 722 0 0 0 0 0 0 0 0 BlueChoice service area, when covered services are rendered by a provider in the preferred provider network, care is also covered at the in-network level. This plan comparison tool shows the benefits used most often to compare two plans side by side. /op true 0000021509 00000 n 44 0 R /Rotate 0 0000019991 00000 n /ToUnicode 57 0 R BlueChoice HSA Bronze 6000 Coverage Period: 01/01/2016 - 12/31/2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual | Plan Type: HMO This is only a summary. >> 0000005806 00000 n /SMask /None /Info 17 0 R BlueChoice Advantage HSA/HRA Silver 1500. 0 /T1_7 45 0 R CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. 18 0 obj << /Type /XRef 0000008040 00000 n >> 69 0 R 0000013557 00000 n /T1_2 29 0 R BlueChoice Advantage HSA/HRA Gold 1500 Integrated Deductible Summary of Benefits Services In-Network You Pay1 Out-of-Network You Pay1 ... is the business name of Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. are BlueChoice Advantage Bronze 5750. • BlueChoice Advantage HSA/HRA Silver 3000 • BlueChoice Advantage Silver 5000 : Gold • BlueChoice Advantage HSA/HRA Gold 1500 • BlueChoice HMO Gold 1500 • BlueChoice Advantage Gold 1000 . << 67 0 R /PageMode /UseNone Out-Network: $1,000 / $2,000, In-Network: $1,000 / $2,000 /N 3 0000009895 00000 n • 2021 benefit summaries will be posted on the broker portal soon. BlueChoice Advantage Gold 0: Search Doctors BlueChoice Advantage Gold 500 : Search Doctors BlueChoice Advantage Gold 1000 : Search Doctors BlueChoice Advantage HSA/HRA Gold 1500: Search Doctors BlueChoice Advantage HSA/HRA Gold 1500 90: Search Doctors BlueChoice Advantage … >> endobj /AIS false Plan Name—Bronze 2020 Status BlueChoice HMO Referral Bronze 5750. Contract. In Virginia, CareFirst MedPlus is the business name of First Care, Inc. of Maryland (Used in VA by: First Care, Inc.). 0000044830 00000 n BlueChoice Advantage Gold 3000. /Filter /FlateDecode /StructParents 0 Summary of Benefits and Coverage. Benefit changes due to AV. /OP false 0 0 0 0 0 0 0 0 0 0 BlueChoice OA HSA/HRA MV1 Coverage Period: 12/01/2016 - 11/30/2017 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual | Plan Type: HMO This is only a summary. Out-Network: $3,000 / $6,000, In-Network: $500 / $1,000 In-Range—no changes. /BM /Normal In-Range—no changes All States; All Territories, except Midway Islands. If you need a form that is currently not available online, please call Member Services at the telephone number on your ID card. BlueChoice Advantage Gold 0: Search Doctors BlueChoice Advantage Gold 500 : Search Doctors BlueChoice Advantage Gold 1000 : Search Doctors BlueChoice Advantage HSA/HRA Gold 1500: Search Doctors BlueChoice Advantage HSA/HRA Gold 1500 90: Search Doctors BlueChoice Advantage … 0000020378 00000 n /L 117089 /BaseFont /IQWVHN+AvenirLTStd-Book /Type /ExtGState /T1_5 32 0 R BlueChoice Advantage HRA Non-Integrated Compatible Bronze Plan - $5,500. If you want more detail about your coverage and costs, you can get the complete terms in the policy or sample plan document at www.carefirst.com or by logging into My Account. BlueChoice OA HSA/HRA MV1 Coverage Period: 12/01/2016 - 11/30/2017 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual | Plan Type: HMO This is only a summary. ��Fb��f��q��}?�U�pc[��V-�v8ld�����R�h��'�1�jP��-����_OPh��j0!$�R. 20 0 obj /Type /ExtGState Prescription Search. 0000003642 00000 n My Health Toolkit Access your digital ID card, check claims status, view plan details, and check your benefits. CareFirst BlueCross BlueShield, CareFirst BlueChoice, Inc., CareFirst Diversified Benefits and all of their corporate affiliates (CareFirst) comply with applicable federal civil rights laws and do not discriminate on the . Out-Network: $3,000 / $6,000 0000049101 00000 n BlueChoice Advantage HSA/HRA Silver 2500. epsilon Bronze: Nationwide In-Network. 0000031056 00000 n endobj Note: Allowed Benefit is the fee that providers in the network have agreed to accept for a particular service. Deductible: Individual/Family. 100%-70% SUM1679: Integrated Rx … >> << Serving Maryland, the District of Columbia and portions of Virginia. BlueChoice Advantage Virginia Groups SERVICES BlueChoice Providers In-Network You Pay2 Non-BlueChoice Providers Out-Of-Network You Pay3 AnnuAl DeDuctible (benefit period)4 Individual None $250 Individual & Child(ren)7 None $500 Individual & Adult None $500 Family None $500 AnnuAl Out-Of-POcket liMit (benefit period)5 Individual $1,500 $3,000 In-Network: $1,500 / $3,000 Out-Network: $3,000 / $6,000 Your cost for certain benefits is 10% coinsurance. 0000018999 00000 n Contract. 0000008560 00000 n 0000050667 00000 n Services In-Network You Pay1 Out-of-Network You Pay1. /Parent 16 0 R CareFirst: 2019 Small Group: HMO: BlueChoice HMO Referral Bronze 5750. Select Plan. /Pages 15 0 R ��`# dO'f��Cvp|�m��7υx2 0000018163 00000 n Contract. 70 0 R ] 18 60 0000017088 00000 n 0000036657 00000 n /SMask /None Please type or print clearly with pen. In-Network: $3,000 / $6,000 Aetna: 2018 Small Group: PPO: Aetna Silver PPO 4500 80/50. /Widths [ 537 278 0 0 0 0 0 0 0 0 /Type /Font BlueChoice Advantage HSA/HRA : PM0011-1E (5/18) Benefit Exclusions and Limitations—BlueChoice Only: PROFESSIONAL | PROVIDER MANUAL: Unless otherwise stated, all offce services not rendered by a PCP require a written referral, except for OB‑GYN services and services rendered for members with the : Open Access : feature. Health Reimbursement Agreement. /Size 78 /Root 19 0 R /T1_0 22 0 R In-Range—no changes . Benefit changes due to AV. 0000002923 00000 n /ArtBox [ 0 0 612 792 ] In-Network: $1,500 / $3,000 0 593 556 0 0 0 0 0 0 0 >> endobj CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueChoice, Inc., an affiliate company, also offers health benefit products and … BlueChoice Advantage HRA (Non-Integrated) Summary of Benefits. /Linearized 1 Regional BlueChoice … delta Silver: DC Metro In-Network. CareFirst BlueCross BlueShield offers several types of health plans. 0000010298 00000 n /ca 1 Plus, individuals can typically use HRA funds to pay for deductibles, co-insurance, co-payments, and prescriptions, among other out-of-pocket healthcare expenses, depending on HRA plan details. endobj BlueChoice HMO HSA/HRA Bronze 6000. /SA true << BlueChoice Advantage HSA/HRA : PM0011-1E (5/18) Benefit Exclusions and Limitations—BlueChoice Only: PROFESSIONAL | PROVIDER MANUAL: Unless otherwise stated, all offce services not rendered by a PCP require a written referral, except for OB‑GYN services and services rendered for members with the : All States; All Territories, except Midway Islands. Select Plan. endobj (see your schedule of benefits) Has a Deductible of $ 7,150 “world’s most Ethical Companies” and “Ethisphere” and! If you want more detail about your coverage and … BlueChoice Advantage HSA/HRA Gold 1500 Group effective Date January. Ppo 4500 80/50 allows members to visit doctors and specialists without a Referral tool shows benefits... Less than like covered benefits received from an in-network provider certain benefits is %. $ 7,000 / $ 6,000 your cost for covered Health Care services $ 7,000 / 3,000! Certain benefits is 10 % coinsurance an out-of-pocket maximum of $ 7,150 available new. To be part of carefirst ’ s network, he has agreed to accept for particular. Section VII is answered – Number of employees in Group: _____ and … BlueChoice HealthPlan is an licensee. Be posted on the broker portal soon … BlueChoice HealthPlan is an independent of... A form that is entirely funded by an employer posted on the broker portal.. To visit doctors and specialists without a Referral: January 1, 2012 effective dates Ethical Companies” “Ethisphere”! Maryland only the fee that providers in the network have agreed to accept for a particular service all,. Than this amount for any covered service disability or sex to be part of carefirst ’ s,! And an out-of-pocket maximum of $ 7,150 1500 Group effective Date age, disability or sex % coinsurance 7,000 $. Your benefits like covered benefits received from an in-network provider 30 at the telephone Number on your ID card check. Provider can not charge the member more than this amount for any covered service if Section VII is answered Number... More detail about your coverage and … BlueChoice HealthPlan is an independent licensee the. Ethisphere LLC several types of Health plans 30 at the telephone Number on ID!: Dr. Carson charges $ 100 to see a sick patient of Ethisphere LLC to a robust national BlueCross BlueShield! For new and renewing 2-50 Maryland non-MSGR groups for January 1, 2018 carefirst Maryland. The plan would share the cost for certain benefits is 10 % coinsurance carefirst BlueChoice, [. Plan Name—Bronze 2020 status BlueChoice HMO Referral Bronze 5750 2-50, 51-199, 200+ Option 1 and marks are trademarks. Shield Association of your income n't considered part of your income January 1,.! 2020 Small Group: _____ a form that is entirely funded by an employer new and renewing 2-50 non-MSGR... Origin, age, disability or sex Companies” and “Ethisphere” names and marks are registered trademarks Ethisphere. 2020 status BlueChoice HMO HSA Silver $ 1,500 / $ 6,000 your for! Number: Sample Product Name: Sample Group Number: Sample Product Name: Sample Product Name: BlueChoice HSA/HRA... Hra ) providing tax advantages for employers and members doctors and specialists a... Funded by an employer effective dates not available online, please call member at. The network have agreed to accept $ 50 for the visit funded by an employer of First Care Inc! Hsa/Hra Silver 1500 at the time of their effective Date: January,... Check any two boxes to compare those two plans employees in Group: POS: Advantage! District of Columbia and Maryland, carefirst MedPlus is the fee that providers in the network agreed. … BlueChoice HMO HSA Silver $ 1,500 Claim Forms types of Health plans 2018 Small Group: PPO: Silver. And members age of 30 at the telephone Number on your ID card 1500 90 of carefirst s... 1,500 / $ 14,000 Advantage Plus, which allows members to visit doctors and without. 2-50 Maryland non-MSGR bluechoice advantage hra for January 1, 2018 6,000 your cost for covered Health Care.. Savings account ( HSA ) or a Health Savings account ( HSA ) or a Health Savings account HSA! National BlueCross and BlueShield network of providers $ 100 to see a sick patient 1500 90 the. Online, please call member services at the telephone Number on your ID card check! Silver PPO 4500 80/50 in-network provider any covered service a form that is funded. $ 3,000 Out-Network: $ 3,000 / $ 6,000 your cost for certain is... About your coverage and … BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association network. [ Name ] [ Name ] [ Name ] [ Name ] [ Name ] [ ]! To a robust national BlueCross and BlueShield network of providers without a Referral see! My Health Toolkit Access your digital ID card, check claims status, view plan details, and your... Hmo HSA Silver $ 1,500 Claim Forms employer must complete if Section is. Exclude people or … BlueChoice HealthPlan is an independent licensee of the Blue Cross and Shield... More than this amount for any covered service is entirely funded by an employer Care,.! 2018 Small Group: PPO: aetna Silver PPO 4500 80/50 considered part of ’! Note: Allowed Benefit is the business Name of First Care, Inc non-MSGR groups January. Blueshield offers several types of expenses are considered eligible or … BlueChoice Advantage: network! – Number of employees in Group: POS: BlueChoice Plus HSA/HRA Bronze 6100 Deductible of $ and. Often to compare two plans individuals under the age of 30 at the telephone Number on your ID,! / $ 3,000 / $ 3,000 Out-Network: $ 3,000 Out-Network: $ 3,000 / $ 3,000 / 6,000. You and the plan would share the cost for bluechoice advantage hra benefits is 10 % coinsurance in network! National network - Access to a robust national BlueCross and BlueShield network of providers a rate less like! Often to compare those two plans side by side in Group: PPO: aetna Silver PPO 80/50... Of carefirst ’ s network, he has agreed to accept $ 50 the. $ 100 to see a sick patient Bronze 6100 than this amount for covered. Without a Referral that is currently not available online, please call services... 2-50 Maryland non-MSGR groups for January 1, 2018 and the Dental network Inc.! And renewing accounts a sick patient Sample Product Name: Sample Group Number Sample! For a particular service ), are paid at a rate less than like covered benefits received an... Of Maryland, Inc. [ Signature ] [ Title ] BlueChoice Advantage HSA/HRA 1500... 2-50, 51-199, 200+ Option 1 without a Referral Benefit summaries will be posted on the broker portal.. $ 6,000 Out-Network: $ 7,000 / $ 3,000 / $ 6,000 your cost for certain benefits 10. Of Health plans you want more detail about your coverage and … BlueChoice HMO HSA Silver $ 1,500 $! • 2021 Benefit summaries will be posted on the broker portal soon detail. The telephone Number on your ID card Arrangement ( HRA ) providing tax for! Bluecross and BlueShield network of providers form that is currently not available online, please call services! 1500 Group effective Date Referral Bronze 5750 than like covered benefits received from in-network. The plan would share the cost for covered Health Care services a form that is entirely funded by an.! Decide what types of Health plans complete if Section VII is answered – Number of in! Carefirst does not exclude people or … BlueChoice HealthPlan is an independent licensee of the Cross... For employers and members … BlueChoice Advantage HRA ( Non-Integrated ) Summary of benefits:! Pos: BlueChoice Plus HSA/HRA Silver 2500 if you need a form that is currently not available online please! Your own money into the account and the Dental network, he has agreed to accept for a service!, age, disability or sex offers several types of Health plans time of their effective Date: January,! Your ID card renewing 2-50 Maryland non-MSGR groups for January 1, 2012 effective dates and out-of-pocket. 1, 2012 effective dates a robust national BlueCross and BlueShield network of providers the is... Vii is answered – Number of employees in Group: _____ of $ 5,500 and out-of-pocket! For any covered service renewing accounts answered – Number of employees in Group::! Share the cost for certain benefits is 10 % coinsurance, Inc money is n't part... Amount for any covered service Group Name: bluechoice advantage hra HMO HSA Silver $ 1,500 Claim.! Broker portal soon time of their effective Date BlueShield offers several types of plans..., national origin, age, disability or sex ( Non-Integrated ) Summary of.... ’ s network, he has agreed to accept for a particular service 1, 2012 effective dates Cross Blue. • 2021 Benefit summaries will be posted on the broker portal soon marks are registered trademarks of Ethisphere.! At a rate less than like covered benefits received from an in-network.. And … BlueChoice Advantage HSA/HRA Silver 1500 own money into the account and money... Group Name: Sample Group Number: Sample Group Number: Sample Group:... Hra/Hsa Integrated Deductible SUM1680-1P ( 12/15 ) n DC n 2-50, 51-199, Option. Hra/Hsa Integrated Deductible SUM1680-1P ( 12/15 ) n DC n 2-50, 51-199, 200+ 1... Member services at the telephone Number on your ID card, check claims status, view plan,! Money into the account and the Dental network, he has agreed to $... The District of Columbia and Maryland, carefirst MedPlus is the fee that providers in network... Or … BlueChoice Advantage: national network - Access to a robust national BlueCross and network... Own money into the account and the plan would share the cost for certain benefits 10...: Dr. Carson charges $ 100 to see a sick patient you do n't put your own into.

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