Alabama Preferred Plan |
PPO |
28725AL0110002 |
Yes |
Alabama Preferred Plan (Pediatric Only) |
PPO |
28725AL0130002 |
Yes |
Alabama Preferred Plus Plan |
PPO |
28725AL0110001 |
Yes |
Alabama Preferred Plus Plan (Pediatric Only) |
PPO |
28725AL0130001 |
Yes |
Alabama Wellness Essentials Plan |
PPO |
28725AL0150001 |
Yes |
Florida Preferred Plan |
PPO |
48129FL0130004 |
Yes |
Florida Preferred Plan (Pediatric Only) |
PPO |
48129FL0150004 |
Yes |
Florida Preferred Plus Plan |
PPO |
48129FL0130003 |
Yes |
Florida Preferred Plus Plan (Pediatric Only) |
PPO |
48129FL0150003 |
Yes |
Florida Wellness Essentials Plan |
PPO |
48129FL0180001 |
Yes |
High PPO Dental Plan |
PPO |
28419LA0040001 |
Yes |
High PPO Dental Plan (Pediatric Only) |
PPO |
28419LA0050001 |
Yes |
Kansas Preferred Plan |
PPO |
95038KS0040003 |
Yes |
Kansas Preferred Plan (Pediatric Only) |
PPO |
95038KS0050002 |
Yes |
Kansas Wellness Essentials Plan |
PPO |
95038KS0070001 |
Yes |
Low PPO Dental Plan |
PPO |
28419LA0040002 |
Yes |
Low PPO Dental Plan (Pediatric Only) |
PPO |
28419LA0050002 |
Yes |
Mississippi Preferred Plan |
PPO |
84254MS0050003 |
Yes |
Mississippi Preferred Plan (Pediatric Only) |
PPO |
84254MS0060002 |
Yes |
Mississippi Wellness Essentials Plan |
PPO |
84254MS0090001 |
Yes |
Missouri Preferred Plan |
PPO |
35853MO0040004 |
Yes |
Missouri Preferred Plan (Pediatric Only) |
PPO |
35853MO0050004 |
Yes |
Missouri Preferred Plus Plan |
PPO |
35853MO0040003 |
Yes |
Missouri Preferred Plus Plan (Pediatric Only) |
PPO |
35853MO0050003 |
Yes |
Missouri Wellness Essentials Plan |
PPO |
35853MO0070001 |
Yes |
New Hampshire Preferred Plan |
PPO |
72953NH0040002 |
Yes |
New Hampshire Preferred Plan (Pediatric Only) |
PPO |
72953NH0060002 |
Yes |
New Hampshire Preferred Plus Plan |
PPO |
72953NH0040001 |
Yes |
New Hampshire Preferred Plus Plan (Pediatric Only) |
PPO |
72953NH0060001 |
Yes |
Oklahoma Preferred Plan |
PPO |
13711OK0040003 |
Yes |
Oklahoma Preferred Plan (Pediatric Only) |
PPO |
13711OK0050002 |
Yes |
Oklahoma Wellness Essentials (On Exchange) |
PPO |
13711OK0100001 |
Yes |
South Carolina Preferred Plan |
PPO |
97325SC0060004 |
Yes |
South Carolina Preferred Plan (Pediatric Only) |
PPO |
97325SC0070004 |
Yes |
South Carolina Preferred Plus Plan |
PPO |
97325SC0060003 |
Yes |
South Carolina Preferred Plus Plan (Pediatric Only) |
PPO |
97325SC0070003 |
Yes |
South Carolina Wellness Essentials Plan |
PPO |
97325SC0090001 |
Yes |
Texas Preferred Plan |
PPO |
40540TX0060005 |
Yes |
Texas Preferred Plan (Pediatric Only) |
PPO |
40540TX0070004 |
Yes |
Texas Preferred Plus Plan |
PPO |
40540TX0060003 |
Yes |
Texas Preferred Plus Plan (Pediatric Only) |
PPO |
40540TX0070003 |
Yes |
Texas Wellness Essentials Plan |
PPO |
40540TX0100001 |
Yes |
Utah Preferred Plan |
PPO |
87169UT0040004 |
Yes |
Utah Preferred Plan (Pediatric Only) |
PPO |
87169UT0050004 |
Yes |
Utah Preferred Plus Plan |
PPO |
87169UT0040003 |
Yes |
Utah Preferred Plus Plan (Pediatric Only) |
PPO |
87169UT0050003 |
Yes |
Wisconsin Preferred Plan |
PPO |
34210WI0040003 |
Yes |
Wisconsin Preferred Plan (Pediatric Only) |
PPO |
34210WI0050002 |
Yes |
Wisconsin Wellness Essentials |
PPO |
34210WI0070001 |
Yes |
Wyoming Preferred Plan |
PPO |
80132WY0040004 |
Yes |
Wyoming Preferred Plan (Pediatric Only) |
PPO |
80132WY0050004 |
Yes |
Wyoming Preferred Plus Plan |
PPO |
80132WY0040003 |
Yes |
Wyoming Preferred Plus Plan (Pediatric Only) |
PPO |
80132WY0050003 |
Yes |