INFUSION WORX, LLC
Accepted Insurance Health Plans for NPI 1679335053
Home Infusion in Schaumburg, IL
NPI Status: Active since January 30, 2024
Contact Information
165 COMMERCE DR STE 101
SCHAUMBURG, IL
ZIP 60173
Phone: (224) 532-5058
Fax: (224) 534-5504
- Aetna CVS Health
- Ambetter from Absolute Total Care
- Ambetter from Arizona Complete Health
- Ambetter from Arkansas Health & Wellness
- Ambetter from Home State Health
- Ambetter from Louisiana Healthcare Connections
- Ambetter from Magnolia Health
- Ambetter from Meridian
- Ambetter from Nebraska Total Care
- Ambetter from NH Healthy Families
- Ambetter from Sunflower Health Plan
- Ambetter from Superior HealthPlan
- Ambetter Health
- Ambetter Health of Delaware
- Ambetter of Alabama
- Ambetter of Illinois
- Ambetter of North Carolina
- Ambetter of Oklahoma
- Ambetter of Tennessee
- Avera Health Plans
- AvMed
- BannerAetna
- Blue Cross and Blue Shield of Texas
- Blue Cross Blue Shield of North Dakota
- Blue Cross Blue Shield of Wyoming
- BlueCross BlueShield of Tennessee
- Chorus Community Health Plans
- Cigna Healthcare
- Florida Blue (BlueCross BlueShield FL)
- Florida Blue HMO (a BlueCross BlueShield FL company)
- Highmark Blue Cross Blue Shield Delaware
- Highmark Blue Cross Blue Shield West Virginia
- Priority Health
- UnitedHealthcare
- University of Michigan Health Plan
- WellCare of North Carolina
Accepted Health Plans and Insurance Coverage
List of insurance companies accepted by INFUSION WORX, LLC. Use our filterable tables to quickly find the details of your health plan, including: Plan Name, Plan Type and Plan ID. Search this page to find if your specific insurance is accepted. Please verify directly with the provider to make sure your healthplan is currently accepted.
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Bronze 1 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay | HMO | 99129IL0120001 | No |
| Bronze 2 Advanced HSA: Aetna network + CVS Health Virtual Primary Care | EPO | 48161MO0200003 | No |
| Bronze 2 Advanced HSA: Aetna network + CVS Health Virtual Primary Care | EPO | 48161MO0200003 | No |
| Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care | EPO | 84600KS0130001 | No |
| Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care | EPO | 84600KS0130001 | No |
| Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care | HMO | 38927UT0380001 | No |
| Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care | HMO | 38927UT0380001 | No |
| Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care | HMO | 61671NC0100001 | No |
| Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care | HMO | 84867OH0100001 | No |
| Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care | HMO | 84867OH0100001 | No |
| Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care | HMO | 96992IN0060001 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160054 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160054 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060002 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130002 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130002 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100016 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100002 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 99129IL0120012 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | EPO | 84600KS0130010 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | EPO | 84600KS0130010 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 18628FL0160060 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 61671NC0100022 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 61671NC0100022 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 84867OH0100010 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 84867OH0100010 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 96992IN0060010 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 96992IN0060010 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 99129IL0120032 | No |
| Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 99129IL0120032 | No |
| Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200028 | No |
| Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200028 | No |
| Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision | EPO | 48161MO0200040 | No |
| Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision | EPO | 48161MO0200040 | No |
| Bronze 4 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380002 | No |
| Bronze 4 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380002 | No |
| Bronze S: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200016 | No |
| Bronze S: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200016 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160022 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060003 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060003 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130003 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380003 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380003 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100006 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100006 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100003 | No |
| Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 99129IL0120003 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160061 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060011 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060011 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130011 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130011 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100023 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100023 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100011 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100011 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 99129IL0120033 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 99129IL0120033 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | EPO | 84600KS0130012 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | EPO | 84600KS0130012 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 18628FL0160062 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 61671NC0100024 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 61671NC0100024 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 84867OH0100012 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 84867OH0100012 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 96992IN0060012 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 96992IN0060012 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 99129IL0120034 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 99129IL0120034 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision | HMO | 58840TX0110147 | No |
| Gold 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision | HMO | 58840TX0110147 | No |
| Gold 10 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380010 | No |
| Gold 10 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380010 | No |
| Gold 10: $0 PCP at Aetna network & MinuteClinic Primary Care + $0 CVS Health Virtual Care | HMO | 58840TX0130001 | No |
| Gold 10: $0 PCP at Aetna network & MinuteClinic Primary Care + $0 CVS Health Virtual Care | HMO | 58840TX0130001 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160055 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060004 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060004 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130004 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380004 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100017 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100004 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100004 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay | HMO | 99129IL0120017 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay | HMO | 99129IL0120017 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision | EPO | 84600KS0130013 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision | EPO | 84600KS0130013 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 18628FL0160063 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 61671NC0100025 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 61671NC0100025 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 96992IN0060013 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 96992IN0060013 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision + Rx Copay | HMO | 99129IL0120035 | No |
| Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision + Rx Copay | HMO | 99129IL0120035 | No |
| Gold 3 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 | HMO | 58840TX0110075 | No |
| Gold 3 Advanced: Aetna network + $0 walk-in clinic + Adult Dental + Vision | HMO | 58840TX0110149 | No |
| Gold 3 Advanced: Aetna network + $0 walk-in clinic + Adult Dental + Vision | HMO | 58840TX0110149 | No |
| Gold 4 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 | HMO | 58840TX0110085 | No |
| Gold 4 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 | HMO | 58840TX0110085 | No |
| Gold S: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200019 | No |
| Gold S: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200019 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160030 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160030 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060005 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130005 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380005 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380005 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100007 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 67190DE0100008 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100005 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100005 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay | HMO | 99129IL0120005 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay | PPO | 72547IL0170005 | No |
| Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay | PPO | 72547IL0170005 | No |
| Gold S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 | HMO | 58840TX0110033 | No |
| Gold S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 | HMO | 58840TX0110033 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160064 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060014 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060014 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130014 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130014 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100026 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100026 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100013 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100013 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 99129IL0120036 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 99129IL0120036 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | EPO | 84600KS0130015 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | EPO | 84600KS0130015 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 18628FL0160065 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 61671NC0100027 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 61671NC0100027 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 84867OH0100014 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 84867OH0100014 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 96992IN0060015 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 96992IN0060015 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 99129IL0120037 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision | HMO | 99129IL0120037 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 | HMO | 58840TX0110151 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 | HMO | 58840TX0110151 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision | HMO | 58840TX0110152 | No |
| Silver 10 Advanced: $0 PCP + Aetna network + $0 walk-in clinic + Adult Dental + Vision | HMO | 58840TX0110152 | No |
| Silver 10 Advanced: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200044 | No |
| Silver 10 Advanced: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200044 | No |
| Silver 10 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision | EPO | 48161MO0200045 | No |
| Silver 10 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision | EPO | 48161MO0200045 | No |
| Silver 10: $0 PCP at Aetna network & MinuteClinic Primary Care + $0 CVS Health Virtual Care | HMO | 58840TX0130002 | No |
| Silver 10: $0 PCP at Aetna network & MinuteClinic Primary Care + $0 CVS Health Virtual Care | HMO | 58840TX0130002 | No |
| Silver 5 Advanced: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200015 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160029 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060006 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130006 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130006 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380006 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100019 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100019 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100006 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay | HMO | 99129IL0120006 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision + Rx Copay | HMO | 99129IL0120038 | No |
| Silver 5 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision + Rx Copay | HMO | 99129IL0120038 | No |
| Silver 5 Advanced: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 | HMO | 58840TX0110103 | No |
| Silver 6 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380008 | No |
| Silver 6 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380008 | No |
| Silver S: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200025 | No |
| Silver S: Aetna network + $0 CVS Health Virtual Primary Care | EPO | 48161MO0200025 | No |
| Silver S: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental+Vision | EPO | 48161MO0200046 | No |
| Silver S: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental+Vision | EPO | 48161MO0200046 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 18628FL0160009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 | HMO | 96992IN0060009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision | HMO | 18628FL0160067 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision | HMO | 96992IN0060016 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision | HMO | 96992IN0060016 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | EPO | 84600KS0130009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 38927UT0380009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 61671NC0100009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 67190DE0100009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 84867OH0100009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 99129IL0120009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | HMO | 99129IL0120009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care | PPO | 72547IL0170009 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision | EPO | 84600KS0130016 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision | EPO | 84600KS0130016 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision | HMO | 61671NC0100028 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision | HMO | 61671NC0100028 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision | HMO | 84867OH0100015 | No |
| Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Adult Dental+Vision | HMO | 84867OH0100015 | No |
| Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 | HMO | 58840TX0110055 | No |
| Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision | HMO | 58840TX0110154 | No |
| Silver S: Aetna network + $0 walk-in clinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision | HMO | 58840TX0110154 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Clear Silver | HMO | 79222SC0010023 | No |
| Elite Bronze | HMO | 79222SC0010022 | No |
| Elite Bronze + Vision + Adult Dental | HMO | 79222SC0020022 | No |
| Elite Gold | HMO | 79222SC0010029 | No |
| Elite Gold + Vision + Adult Dental | HMO | 79222SC0020030 | No |
| Everyday Bronze | HMO | 79222SC0010011 | No |
| Everyday Bronze + Vision + Adult Dental | HMO | 79222SC0020011 | No |
| Everyday Gold | HMO | 79222SC0010026 | No |
| Everyday Gold + Vision + Adult Dental | HMO | 79222SC0020026 | No |
| Focused Silver | HMO | 79222SC0010025 | No |
| Focused Silver + Vision + Adult Dental | HMO | 79222SC0020025 | No |
| Standard Expanded Bronze | HMO | 79222SC0010031 | No |
| Standard Expanded Bronze + Vision + Adult Dental | HMO | 79222SC0020031 | No |
| Standard Gold | HMO | 79222SC0010033 | No |
| Standard Gold + Vision + Adult Dental | HMO | 79222SC0020033 | No |
| Standard Silver | HMO | 79222SC0010032 | No |
| Standard Silver + Vision + Adult Dental | HMO | 79222SC0020032 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Choice Bronze HSA | HMO | 91450AZ0080037 | No |
| Choice Bronze HSA + Vision + Adult Dental | HMO | 91450AZ0180037 | No |
| Clear Silver | HMO | 91450AZ0080097 | No |
| Complete Gold | HMO | 91450AZ0080059 | No |
| Complete Gold + Vision + Adult Dental | HMO | 91450AZ0180059 | No |
| Complete Silver | HMO | 91450AZ0080044 | No |
| Complete Silver + Vision + Adult Dental | HMO | 91450AZ0180044 | No |
| Elite Gold | HMO | 91450AZ0080113 | No |
| Elite Gold + Vision + Adult Dental | HMO | 91450AZ0180113 | No |
| Everyday Bronze | HMO | 91450AZ0080119 | No |
| Everyday Bronze + Vision + Adult Dental | HMO | 91450AZ0180119 | No |
| Standard Expanded Bronze | HMO | 91450AZ0080122 | No |
| Standard Expanded Bronze + Vision + Adult Dental | HMO | 91450AZ0180104 | No |
| Standard Gold | HMO | 91450AZ0080124 | No |
| Standard Gold + Vision + Adult Dental | HMO | 91450AZ0180106 | No |
| Standard Silver | HMO | 91450AZ0080123 | No |
| Standard Silver + Vision + Adult Dental | HMO | 91450AZ0180105 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Choice Bronze HSA (QualChoice) | POS | 70525AR0070285 | No |
| Complete Gold | PPO | 62141AR0080014 | No |
| Complete Gold + Vision + Adult Dental | PPO | 62141AR0100014 | No |
| Complete Silver (QualChoice) | POS | 70525AR0070001 | No |
| Connected Silver | PPO | 62141AR0080007 | No |
| Connected Silver (QualChoice) | POS | 70525AR0070261 | No |
| Connected Silver (QualChoiceLife) | PPO | 37903AR0070025 | No |
| Connected Silver + Vision + Adult Dental | PPO | 62141AR0100007 | No |
| Elite Bronze | PPO | 62141AR0080026 | No |
| Elite Bronze + Vision + Adult Dental | PPO | 62141AR0100026 | No |
| Elite Gold (QualChoice) | POS | 70525AR0070268 | No |
| Elite Gold (QualChoiceLife) | PPO | 37903AR0070031 | No |
| Everyday Bronze | PPO | 62141AR0080017 | No |
| Everyday Bronze + Vision + Adult Dental | PPO | 62141AR0100017 | No |
| Everyday Gold | PPO | 62141AR0080030 | No |
| Everyday Gold + Vision + Adult Dental | PPO | 62141AR0100030 | No |
| Everyday Silver (QualChoiceLife) | PPO | 37903AR0070001 | No |
| Focused Silver | PPO | 62141AR0080029 | No |
| Focused Silver + Vision + Adult Dental | PPO | 62141AR0100032 | No |
| Standard Expanded Bronze | PPO | 62141AR0080032 | No |
| Standard Expanded Bronze (QualChoice) | POS | 70525AR0070287 | No |
| Standard Expanded Bronze + Vision + Adult Dental | PPO | 62141AR0100033 | No |
| Standard Gold | PPO | 62141AR0080034 | No |
| Standard Gold (QualChoice) | POS | 70525AR0070289 | No |
| Standard Gold (QualChoiceLife) | PPO | 37903AR0070034 | No |
| Standard Gold + Vision + Adult Dental | PPO | 62141AR0100035 | No |
| Standard Silver | PPO | 62141AR0080033 | No |
| Standard Silver (QualChoice) | POS | 70525AR0070288 | No |
| Standard Silver (QualChoiceLife) | PPO | 37903AR0070033 | No |
| Standard Silver + Vision + Adult Dental | PPO | 62141AR0100034 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Complete Gold | EPO | 99723MO0090016 | No |
| Complete Gold + Vision + Adult Dental | EPO | 99723MO0110010 | No |
| Complete Silver | EPO | 99723MO0090011 | No |
| Complete Silver + Vision + Adult Dental | EPO | 99723MO0110013 | No |
| Elite Bronze | EPO | 99723MO0090053 | No |
| Elite Bronze + Vision + Adult Dental | EPO | 99723MO0110053 | No |
| Everyday Bronze | EPO | 99723MO0090018 | No |
| Everyday Bronze + Vision + Adult Dental | EPO | 99723MO0110009 | No |
| Everyday Gold | EPO | 99723MO0090063 | No |
| Everyday Gold + Vision + Adult Dental | EPO | 99723MO0110063 | No |
| Premier Silver | EPO | 99723MO0090004 | No |
| Premier Silver + Vision + Adult Dental | EPO | 99723MO0110014 | No |
| Standard Expanded Bronze | EPO | 99723MO0090069 | No |
| Standard Expanded Bronze + Vision + Adult Dental | EPO | 99723MO0110070 | No |
| Standard Gold | EPO | 99723MO0090071 | No |
| Standard Gold + Vision + Adult Dental | EPO | 99723MO0110072 | No |
| Standard Silver | EPO | 99723MO0090070 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Complete Gold | EPO | 90787LA0010006 | No |
| Complete Gold + Vision + Adult Dental | EPO | 90787LA0020005 | No |
| Elite Bronze | EPO | 90787LA0010002 | No |
| Elite Bronze + Vision + Adult Dental | EPO | 90787LA0020002 | No |
| Elite Gold | EPO | 90787LA0010008 | No |
| Elite Gold + Vision + Adult Dental | EPO | 90787LA0020008 | No |
| Elite Silver | EPO | 90787LA0010012 | No |
| Elite Silver + Vision + Adult Dental | EPO | 90787LA0020012 | No |
| Everyday Bronze | EPO | 90787LA0010001 | No |
| Everyday Bronze + Vision + Adult Dental | EPO | 90787LA0020001 | No |
| Focused Silver | EPO | 90787LA0010005 | No |
| Focused Silver + Vision + Adult Dental | EPO | 90787LA0020004 | No |
| Standard Expanded Bronze | EPO | 90787LA0010009 | No |
| Standard Expanded Bronze + Vision + Adult Dental | EPO | 90787LA0020009 | No |
| Standard Gold | EPO | 90787LA0010011 | No |
| Standard Gold + Vision + Adult Dental | EPO | 90787LA0020011 | No |
| Standard Silver | EPO | 90787LA0010010 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Choice Bronze HSA | HMO | 90714MS0010052 | No |
| Choice Bronze HSA + Vision + Adult Dental | HMO | 90714MS0030052 | No |
| Complete Gold | HMO | 90714MS0010019 | No |
| Complete Gold + Vision + Adult Dental | HMO | 90714MS0030019 | No |
| Complete Silver | HMO | 90714MS0010011 | No |
| Complete Silver + Vision + Adult Dental | HMO | 90714MS0030026 | No |
| Everyday Bronze | HMO | 90714MS0010016 | No |
| Everyday Bronze + Vision + Adult Dental | HMO | 90714MS0030010 | No |
| Everyday Gold | HMO | 90714MS0010060 | No |
| Everyday Gold + Vision + Adult Dental | HMO | 90714MS0030060 | No |
| Focused Silver | HMO | 90714MS0010059 | No |
| Focused Silver + Vision + Adult Dental | HMO | 90714MS0030059 | No |
| Standard Expanded Bronze | HMO | 90714MS0010063 | No |
| Standard Expanded Bronze + Vision + Adult Dental | HMO | 90714MS0030064 | No |
| Standard Gold | HMO | 90714MS0010065 | No |
| Standard Gold + Vision + Adult Dental | HMO | 90714MS0030066 | No |
| Standard Silver | HMO | 90714MS0010064 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Clear Silver | HMO | 58594MI0030017 | No |
| Elite Bronze | HMO | 58594MI0030016 | No |
| Elite Bronze + Vision + Adult Dental | HMO | 58594MI0040016 | No |
| Elite Gold | HMO | 58594MI0030021 | No |
| Elite Gold + Vision + Adult Dental | HMO | 58594MI0040023 | No |
| Everyday Bronze | HMO | 58594MI0030013 | No |
| Everyday Bronze + Vision + Adult Dental | HMO | 58594MI0040013 | No |
| Everyday Gold | HMO | 58594MI0030020 | No |
| Everyday Gold + Vision + Adult Dental | HMO | 58594MI0040020 | No |
| Focused Silver | HMO | 58594MI0030019 | No |
| Focused Silver + Vision + Adult Dental | HMO | 58594MI0040019 | No |
| Standard Expanded Bronze | HMO | 58594MI0030023 | No |
| Standard Expanded Bronze + Vision + Adult Dental | HMO | 58594MI0040024 | No |
| Standard Gold | HMO | 58594MI0030025 | No |
| Standard Gold + Vision + Adult Dental | HMO | 58594MI0040026 | No |
| Standard Silver | HMO | 58594MI0030024 | No |
| Standard Silver + Vision + Adult Dental | HMO | 58594MI0040025 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Choice Bronze HSA | HMO | 26289NE0020002 | No |
| Choice Bronze HSA + Vision + Adult Dental | HMO | 26289NE0030002 | No |
| Clear Gold | HMO | 26289NE0020050 | No |
| Clear Gold + Vision + Adult Dental | HMO | 26289NE0030044 | No |
| Complete Silver | HMO | 26289NE0020008 | No |
| Complete Silver + Vision + Adult Dental | HMO | 26289NE0030008 | No |
| Elite Bronze | HMO | 26289NE0020007 | No |
| Elite Bronze + Vision + Adult Dental | HMO | 26289NE0030007 | No |
| Elite Gold | HMO | 26289NE0020036 | No |
| Elite Gold + Vision + Adult Dental | HMO | 26289NE0030036 | No |
| Focused Silver | HMO | 26289NE0020048 | No |
| Focused Silver + Vision + Adult Dental | HMO | 26289NE0030042 | No |
| Standard Expanded Bronze | HMO | 26289NE0020039 | No |
| Standard Expanded Bronze + Vision + Adult Dental | HMO | 26289NE0030015 | No |
| Standard Gold | HMO | 26289NE0020041 | No |
| Standard Gold + Vision + Adult Dental | HMO | 26289NE0030017 | No |
| Standard Silver | HMO | 26289NE0020040 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Choice Bronze HSA | EPO | 75841NH0090006 | No |
| Choice Bronze HSA + Vision + Adult Dental | EPO | 75841NH0100002 | No |
| Clear Silver | EPO | 75841NH0090013 | No |
| Clear Silver + Vision + Adult Dental | EPO | 75841NH0100010 | No |
| Complete Gold | EPO | 75841NH0090005 | No |
| Complete Gold + Vision + Adult Dental | EPO | 75841NH0100009 | No |
| Complete Silver | EPO | 75841NH0090011 | No |
| Complete Silver + Vision + Adult Dental | EPO | 75841NH0100011 | No |
| Elite Bronze | EPO | 75841NH0090021 | No |
| Elite Bronze + Vision + Adult Dental | EPO | 75841NH0100021 | No |
| Everyday Gold | EPO | 75841NH0090026 | No |
| Everyday Gold + Vision + Adult Dental | EPO | 75841NH0100026 | No |
| Standard Expanded Bronze | EPO | 75841NH0090028 | No |
| Standard Expanded Bronze + Vision + Adult Dental | EPO | 75841NH0100029 | No |
| Standard Gold | EPO | 75841NH0090030 | No |
| Standard Gold + Vision + Adult Dental | EPO | 75841NH0100031 | No |
| Standard Silver | EPO | 75841NH0090029 | No |
| Standard Silver + Vision + Adult Dental | EPO | 75841NH0100030 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Clear Silver | EPO | 34368KS0110049 | No |
| Elite Bronze | EPO | 34368KS0110047 | No |
| Elite Bronze + Vision + Adult Dental | EPO | 34368KS0120047 | No |
| Elite Gold | EPO | 34368KS0110066 | No |
| Elite Gold + Vision + Adult Dental | EPO | 34368KS0120068 | No |
| Everyday Bronze | EPO | 34368KS0110043 | No |
| Everyday Bronze + Vision + Adult Dental | EPO | 34368KS0120043 | No |
| Everyday Gold | EPO | 34368KS0110033 | No |
| Everyday Gold + Vision + Adult Dental | EPO | 34368KS0120033 | No |
| Focused Silver | EPO | 34368KS0110053 | No |
| Focused Silver + Vision + Adult Dental | EPO | 34368KS0120053 | No |
| Standard Expanded Bronze | EPO | 34368KS0110068 | No |
| Standard Expanded Bronze + Vision + Adult Dental | EPO | 34368KS0120069 | No |
| Standard Gold | EPO | 34368KS0110070 | No |
| Standard Gold + Vision + Adult Dental | EPO | 34368KS0120071 | No |
| Standard Silver | EPO | 34368KS0110069 | No |
| Standard Silver + Vision + Adult Dental | EPO | 34368KS0120070 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Clear VALUE Silver | HMO | 87226TX0060007 | No |
| Clear VALUE Silver | HMO | 87226TX0070007 | No |
| Clear VALUE Silver | HMO | 87226TX0080007 | No |
| Clear VALUE Silver | HMO | 87226TX0100007 | No |
| Complete Gold | EPO | 29418TX0140064 | No |
| Complete Gold + Vision + Adult Dental | EPO | 29418TX0160020 | No |
| Complete Silver | EPO | 29418TX0140019 | No |
| Complete Silver + Vision + Adult Dental | EPO | 29418TX0160038 | No |
| Complete VALUE Gold | HMO | 87226TX0060013 | No |
| Complete VALUE Gold | HMO | 87226TX0070013 | No |
| Complete VALUE Gold | HMO | 87226TX0080013 | No |
| Complete VALUE Gold | HMO | 87226TX0100013 | No |
| Everyday Gold | EPO | 29418TX0140102 | No |
| Everyday Gold + Vision + Adult Dental | EPO | 29418TX0160102 | No |
| Focused Silver | EPO | 29418TX0140100 | No |
| Focused Silver + Vision + Adult Dental | EPO | 29418TX0160100 | No |
| Focused VALUE Silver | HMO | 87226TX0060009 | No |
| Focused VALUE Silver | HMO | 87226TX0070009 | No |
| Focused VALUE Silver | HMO | 87226TX0080009 | No |
| Focused VALUE Silver | HMO | 87226TX0100009 | No |
| Focused VALUE Silver + Vision + Adult Dental | HMO | 87226TX0120001 | No |
| Focused VALUE Silver + Vision + Adult Dental | HMO | 87226TX0130003 | No |
| Focused VALUE Silver + Vision + Adult Dental | HMO | 87226TX0140003 | No |
| Focused VALUE Silver + Vision + Adult Dental | HMO | 87226TX0150001 | No |
| Standard Gold | EPO | 29418TX0140109 | No |
| Standard Gold + Vision + Adult Dental | EPO | 29418TX0160052 | No |
| Standard Gold VALUE | HMO | 87226TX0060012 | No |
| Standard Gold VALUE | HMO | 87226TX0070012 | No |
| Standard Gold VALUE | HMO | 87226TX0080012 | No |
| Standard Gold VALUE | HMO | 87226TX0100012 | No |
| Standard Silver | EPO | 29418TX0140108 | No |
| Standard Silver VALUE | HMO | 87226TX0060011 | No |
| Standard Silver VALUE | HMO | 87226TX0070011 | No |
| Standard Silver VALUE | HMO | 87226TX0080011 | No |
| Standard Silver VALUE | HMO | 87226TX0100011 | No |
| Standard Silver VALUE + Vision + Adult Dental | HMO | 87226TX0120005 | No |
| Standard Silver VALUE + Vision + Adult Dental | HMO | 87226TX0130002 | No |
| Standard Silver VALUE + Vision + Adult Dental | HMO | 87226TX0140004 | No |
| Standard Silver VALUE + Vision + Adult Dental | HMO | 87226TX0150003 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Choice Bronze HSA | HMO | 35065IN0040002 | No |
| Choice Bronze HSA | HMO | 41047OH0010045 | No |
| Choice Bronze HSA + Vision + Adult Dental | HMO | 35065IN0050002 | No |
| Choice Bronze HSA + Vision + Adult Dental | HMO | 41047OH0030045 | No |
| Clear Gold | HMO | 41047OH0010067 | No |
| Clear Gold + Vision + Adult Dental | HMO | 41047OH0030071 | No |
| Clear Silver | HMO | 35065IN0040003 | No |
| Clear Silver | HMO | 41047OH0010061 | No |
| Complete Gold | HMO | 35065IN0040004 | No |
| Complete Gold | HMO | 41047OH0010041 | No |
| Complete Gold | HMO | 48286IA0010015 | No |
| Complete Gold | HMO | 49004FL0010011 | No |
| Complete Gold | HMO | 49004FL0010025 | No |
| Complete Gold + Vision + Adult Dental | HMO | 35065IN0050003 | No |
| Complete Gold + Vision + Adult Dental | HMO | 41047OH0030041 | No |
| Complete Gold + Vision + Adult Dental | HMO | 48286IA0020015 | No |
| Complete Gold + Vision + Adult Dental | HMO | 49004FL0020010 | No |
| Complete Gold + Vision + Adult Dental | HMO | 49004FL0020021 | No |
| Complete Silver | HMO | 41047OH0010025 | No |
| Complete Silver + Vision + Adult Dental | HMO | 41047OH0030025 | No |
| Complete VALUE Gold | HMO | 86382FL0050010 | No |
| Complete VALUE Silver | HMO | 86382FL0050006 | No |
| Elite Bronze | HMO | 48286IA0010013 | No |
| Elite Bronze | HMO | 49004FL0010004 | No |
| Elite Bronze | HMO | 49004FL0010017 | No |
| Elite Bronze + Vision + Adult Dental | HMO | 48286IA0020013 | No |
| Elite Bronze + Vision + Adult Dental | HMO | 49004FL0020004 | No |
| Elite Bronze + Vision + Adult Dental | HMO | 49004FL0020015 | No |
| Elite Gold | HMO | 35065IN0040007 | No |
| Elite Gold + Vision + Adult Dental | HMO | 35065IN0050006 | No |
| Elite Silver | HMO | 48286IA0010022 | No |
| Elite Silver | HMO | 49004FL0010008 | No |
| Elite Silver | HMO | 49004FL0010020 | No |
| Elite Silver + Vision + Adult Dental | HMO | 48286IA0020021 | No |
| Elite Silver + Vision + Adult Dental | HMO | 49004FL0020007 | No |
| Elite Silver + Vision + Adult Dental | HMO | 49004FL0020017 | No |
| Elite VALUE Bronze | HMO | 86382FL0050005 | No |
| Enhanced Diabetes Care Silver with $0 Drug Options | HMO | 49004FL0010009 | No |
| Enhanced Diabetes Care Silver with $0 Drug Options | HMO | 49004FL0010023 | No |
| Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental | HMO | 49004FL0020008 | No |
| Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental | HMO | 49004FL0020020 | No |
| Everyday Bronze | HMO | 35065IN0040008 | No |
| Everyday Bronze | HMO | 41047OH0010057 | No |
| Everyday Bronze | HMO | 48286IA0010012 | No |
| Everyday Bronze | HMO | 49004FL0010002 | No |
| Everyday Bronze | HMO | 49004FL0010015 | No |
| Everyday Bronze + Vision + Adult Dental | HMO | 35065IN0050007 | No |
| Everyday Bronze + Vision + Adult Dental | HMO | 41047OH0030057 | No |
| Everyday Bronze + Vision + Adult Dental | HMO | 48286IA0020012 | No |
| Everyday Bronze + Vision + Adult Dental | HMO | 49004FL0020002 | No |
| Everyday Bronze + Vision + Adult Dental | HMO | 49004FL0020013 | No |
| Everyday Gold | HMO | 48286IA0010016 | No |
| Everyday Gold | HMO | 49004FL0010010 | No |
| Everyday Gold | HMO | 49004FL0010026 | No |
| Everyday Gold + Vision + Adult Dental | HMO | 48286IA0020016 | No |
| Everyday Gold + Vision + Adult Dental | HMO | 49004FL0020009 | No |
| Everyday Gold + Vision + Adult Dental | HMO | 49004FL0020022 | No |
| Focused Silver | HMO | 35065IN0040010 | No |
| Focused Silver | HMO | 48286IA0010019 | No |
| Focused Silver | HMO | 49004FL0010007 | No |
| Focused Silver | HMO | 49004FL0010021 | No |
| Focused Silver + Vision + Adult Dental | HMO | 35065IN0050009 | No |
| Focused Silver + Vision + Adult Dental | HMO | 48286IA0020019 | No |
| Focused Silver + Vision + Adult Dental | HMO | 49004FL0020006 | No |
| Focused Silver + Vision + Adult Dental | HMO | 49004FL0020018 | No |
| Focused VALUE Silver | HMO | 86382FL0050009 | No |
| Standard Expanded Bronze | HMO | 35065IN0040012 | No |
| Standard Expanded Bronze | HMO | 41047OH0010069 | No |
| Standard Expanded Bronze | HMO | 48286IA0010014 | No |
| Standard Expanded Bronze | HMO | 49004FL0010001 | No |
| Standard Expanded Bronze | HMO | 49004FL0010018 | No |
| Standard Expanded Bronze + Vision + Adult Dental | HMO | 35065IN0050011 | No |
| Standard Expanded Bronze + Vision + Adult Dental | HMO | 41047OH0030072 | No |
| Standard Expanded Bronze + Vision + Adult Dental | HMO | 48286IA0020014 | No |
| Standard Expanded Bronze + Vision + Adult Dental | HMO | 49004FL0020001 | No |
| Standard Expanded Bronze + Vision + Adult Dental | HMO | 49004FL0020016 | No |
| Standard Expanded Bronze VALUE | HMO | 86382FL0050017 | No |
| Standard Gold | HMO | 35065IN0040013 | No |
| Standard Gold | HMO | 41047OH0010071 | No |
| Standard Gold | HMO | 48286IA0010017 | No |
| Standard Gold | HMO | 49004FL0010013 | No |
| Standard Gold | HMO | 49004FL0010028 | No |
| Standard Gold + Vision + Adult Dental | HMO | 35065IN0050012 | No |
| Standard Gold + Vision + Adult Dental | HMO | 41047OH0030074 | No |
| Standard Gold + Vision + Adult Dental | HMO | 48286IA0020017 | No |
| Standard Gold + Vision + Adult Dental | HMO | 49004FL0020012 | No |
| Standard Gold + Vision + Adult Dental | HMO | 49004FL0020024 | No |
| Standard Gold VALUE | HMO | 86382FL0050019 | No |
| Standard Silver | HMO | 35065IN0040001 | No |
| Standard Silver | HMO | 41047OH0010070 | No |
| Standard Silver | HMO | 48286IA0010020 | No |
| Standard Silver | HMO | 49004FL0010006 | No |
| Standard Silver | HMO | 49004FL0010024 | No |
| Standard Silver + Vision + Adult Dental | HMO | 35065IN0050001 | No |
| Standard Silver + Vision + Adult Dental | HMO | 41047OH0030073 | No |
| Standard Silver VALUE | HMO | 86382FL0050018 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Clear Gold | EPO | 64004DE0090011 | No |
| Clear Gold + Vision + Adult Dental | EPO | 64004DE0100011 | No |
| Complete Gold | EPO | 64004DE0090009 | No |
| Complete Gold + Vision + Adult Dental | EPO | 64004DE0100009 | No |
| Elite Silver | EPO | 64004DE0090013 | No |
| Elite Silver + Vision + Adult Dental | EPO | 64004DE0100013 | No |
| Everyday Bronze | EPO | 64004DE0090002 | No |
| Everyday Bronze + Vision + Adult Dental | EPO | 64004DE0100002 | No |
| Focused Silver | EPO | 64004DE0090007 | No |
| Focused Silver + Vision + Adult Dental | EPO | 64004DE0100007 | No |
| Premier Bronze HSA | EPO | 64004DE0090001 | No |
| Premier Bronze HSA + Vision + Adult Dental | EPO | 64004DE0100001 | No |
| Standard Expanded Bronze | EPO | 64004DE0090004 | No |
| Standard Expanded Bronze + Vision + Adult Dental | EPO | 64004DE0100004 | No |
| Standard Gold | EPO | 64004DE0090012 | No |
| Standard Gold + Vision + Adult Dental | EPO | 64004DE0100012 | No |
| Standard Silver | EPO | 64004DE0090008 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Complete Gold | EPO | 53932AL0100015 | No |
| Complete Gold + Vision + Adult Dental | EPO | 53932AL0110010 | No |
| Elite Bronze | EPO | 53932AL0100014 | No |
| Elite Bronze + Vision + Adult Dental | EPO | 53932AL0110014 | No |
| Elite Gold | EPO | 53932AL0100016 | No |
| Elite Gold + Vision + Adult Dental | EPO | 53932AL0110015 | No |
| Elite Silver | EPO | 53932AL0100017 | No |
| Elite Silver + Vision + Adult Dental | EPO | 53932AL0110016 | No |
| Everyday Bronze | EPO | 53932AL0100003 | No |
| Everyday Bronze + Vision + Adult Dental | EPO | 53932AL0110003 | No |
| Focused Silver | EPO | 53932AL0100005 | No |
| Focused Silver + Vision + Adult Dental | EPO | 53932AL0110005 | No |
| Standard Expanded Bronze | EPO | 53932AL0100011 | No |
| Standard Expanded Bronze + Vision + Adult Dental | EPO | 53932AL0110011 | No |
| Standard Gold | EPO | 53932AL0100013 | No |
| Standard Gold + Vision + Adult Dental | EPO | 53932AL0110013 | No |
| Standard Silver | EPO | 53932AL0100012 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Central Bronze | HMO | 27833IL0140069 | No |
| Central Bronze + Vision + Adult Dental | HMO | 27833IL0150069 | No |
| Central Gold | HMO | 27833IL0140071 | No |
| Central Gold + Vision + Adult Dental | HMO | 27833IL0150071 | No |
| Clear Silver | HMO | 27833IL0140061 | No |
| Everyday Bronze | HMO | 27833IL0140016 | No |
| Everyday Bronze + Vision + Adult Dental | HMO | 27833IL0150016 | No |
| Everyday Gold | HMO | 27833IL0140064 | No |
| Everyday Gold + Vision + Adult Dental | HMO | 27833IL0150059 | No |
| Focused Silver | HMO | 27833IL0140063 | No |
| Focused Silver + Vision + Adult Dental | HMO | 27833IL0150058 | No |
| Standard Expanded Bronze | HMO | 27833IL0140073 | No |
| Standard Expanded Bronze + Vision + Adult Dental | HMO | 27833IL0150072 | No |
| Standard Gold | HMO | 27833IL0140075 | No |
| Standard Gold + Vision + Adult Dental | HMO | 27833IL0150074 | No |
| Standard Silver | HMO | 27833IL0140074 | No |
| Standard Silver + Vision + Adult Dental | HMO | 27833IL0150073 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Clear Silver with $0 Insulin Options | HMO | 77264NC0010037 | No |
| Complete Gold | HMO | 77264NC0010007 | No |
| Complete Gold + Vision + Adult Dental | HMO | 77264NC0020007 | No |
| Complete Gold with Atrium Health | HMO | 77264NC0010056 | No |
| Complete Gold with Atrium Health + Vision + Adult Dental | HMO | 77264NC0020053 | No |
| Complete Silver with Atrium Health | HMO | 77264NC0010051 | No |
| Complete Silver with Atrium Health + Vision + Adult Dental | HMO | 77264NC0020048 | No |
| Elite Bronze | HMO | 77264NC0010036 | No |
| Elite Bronze + Vision + Adult Dental | HMO | 77264NC0020036 | No |
| Elite Bronze with Atrium Health | HMO | 77264NC0010050 | No |
| Elite Bronze with Atrium Health + Vision + Adult Dental | HMO | 77264NC0020047 | No |
| Everyday Bronze | HMO | 77264NC0010028 | No |
| Everyday Bronze + Vision + Adult Dental | HMO | 77264NC0020028 | No |
| Everyday Bronze with Atrium Health | HMO | 77264NC0010049 | No |
| Everyday Bronze with Atrium Health + Vision + Adult Dental | HMO | 77264NC0020046 | No |
| Focused Silver | HMO | 77264NC0010039 | No |
| Focused Silver + Vision + Adult Dental | HMO | 77264NC0020039 | No |
| Focused Silver with Atrium Health | HMO | 77264NC0010054 | No |
| Focused Silver with Atrium Health + Vision + Adult Dental | HMO | 77264NC0020051 | No |
| Standard Expanded Bronze | HMO | 77264NC0010044 | No |
| Standard Expanded Bronze + Vision + Adult Dental | HMO | 77264NC0020055 | No |
| Standard Expanded Bronze with Atrium Health | HMO | 77264NC0010059 | No |
| Standard Expanded Bronze with Atrium Health + Vision + Adult Dental | HMO | 77264NC0020058 | No |
| Standard Gold | HMO | 77264NC0010046 | No |
| Standard Gold + Vision + Adult Dental | HMO | 77264NC0020057 | No |
| Standard Gold with Atrium Health | HMO | 77264NC0010061 | No |
| Standard Gold with Atrium Health + Vision + Adult Dental | HMO | 77264NC0020060 | No |
| Standard Silver | HMO | 77264NC0010045 | No |
| Standard Silver + Vision + Adult Dental | HMO | 77264NC0020056 | No |
| Standard Silver with Atrium Health | HMO | 77264NC0010060 | No |
| Standard Silver with Atrium Health + Vision + Adult Dental | HMO | 77264NC0020059 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Elite Bronze | PPO | 62505OK0120006 | No |
| Elite Bronze + Vision + Adult Dental | PPO | 62505OK0130006 | No |
| Elite Gold | PPO | 62505OK0120016 | No |
| Elite Gold + Vision + Adult Dental | PPO | 62505OK0130017 | No |
| Everyday Bronze | PPO | 62505OK0120002 | No |
| Everyday Bronze + Vision + Adult Dental | PPO | 62505OK0130002 | No |
| Everyday Gold | PPO | 62505OK0120014 | No |
| Everyday Gold + Vision + Adult Dental | PPO | 62505OK0130014 | No |
| Focused Silver | PPO | 62505OK0120012 | No |
| Focused Silver + Vision + Adult Dental | PPO | 62505OK0130012 | No |
| Standard Expanded Bronze | PPO | 62505OK0120019 | No |
| Standard Expanded Bronze + Vision + Adult Dental | PPO | 62505OK0130019 | No |
| Standard Gold | PPO | 62505OK0120021 | No |
| Standard Gold + Vision + Adult Dental | PPO | 62505OK0130021 | No |
| Standard Silver | PPO | 62505OK0120020 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Clear Silver | EPO | 70111TN0110027 | No |
| Elite Bronze | EPO | 70111TN0110026 | No |
| Elite Bronze + Vision + Adult Dental | EPO | 70111TN0120026 | No |
| Elite Gold | EPO | 70111TN0110031 | No |
| Elite Gold + Vision + Adult Dental | EPO | 70111TN0120034 | No |
| Enhanced Diabetes Care Silver with $0 Drug Options | EPO | 70111TN0110018 | No |
| Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental | EPO | 70111TN0120001 | No |
| Everyday Bronze | EPO | 70111TN0110023 | No |
| Everyday Bronze + Vision + Adult Dental | EPO | 70111TN0120023 | No |
| Everyday Gold | EPO | 70111TN0110030 | No |
| Everyday Gold + Vision + Adult Dental | EPO | 70111TN0120030 | No |
| Focused Silver | EPO | 70111TN0110029 | No |
| Focused Silver + Vision + Adult Dental | EPO | 70111TN0120029 | No |
| Standard Expanded Bronze | EPO | 70111TN0110033 | No |
| Standard Expanded Bronze + Vision + Adult Dental | EPO | 70111TN0120035 | No |
| Standard Gold | EPO | 70111TN0110035 | No |
| Standard Gold + Vision + Adult Dental | EPO | 70111TN0120037 | No |
| Standard Silver | EPO | 70111TN0110034 | No |
| Standard Silver + Vision + Adult Dental | EPO | 70111TN0120036 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Avera $1800 | PPO | 60536SD0020064 | No |
| Avera $1800 | PPO | 60536SD0020065 | No |
| Avera $2000 | PPO | 60536SD0020007 | No |
| Avera $2000 | PPO | 60536SD0020041 | No |
| Avera $4000 | PPO | 60536SD0020022 | No |
| Avera $4000 | PPO | 60536SD0020043 | No |
| Avera $4500 | PPO | 60536SD0020039 | No |
| Avera $4500 | PPO | 60536SD0020045 | No |
| Avera $6000 | PPO | 60536SD0020023 | No |
| Avera $6000 | PPO | 60536SD0020046 | No |
| Avera $7500 HSA Eligible HDHP | PPO | 60536SD0020024 | No |
| Avera $7500 HSA Eligible HDHP | PPO | 60536SD0020047 | No |
| Avera $9200 | PPO | 60536SD0020018 | No |
| Avera $9200 | PPO | 60536SD0020050 | No |
| Avera Standard $1500 | PPO | 60536SD0020051 | No |
| Avera Standard $1500 | PPO | 60536SD0020057 | No |
| Avera Standard $5000 | PPO | 60536SD0020052 | No |
| Avera Standard $5000 | PPO | 60536SD0020058 | No |
| Avera Standard $7500 | PPO | 60536SD0020066 | No |
| Avera Standard $7500 | PPO | 60536SD0020067 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| AvMed Entrust Bronze 600 (2025) | HMO | 19898FL0340006 | No |
| AvMed Entrust Bronze 600 (2025) | HMO | 19898FL0340016 | No |
| AvMed Entrust Bronze 600 (2025) | HMO | 19898FL0340026 | No |
| AvMed Entrust Bronze 600 (2025) | HMO | 19898FL0340036 | No |
| AvMed Entrust Bronze 600 (2025) | HMO | 19898FL0340046 | No |
| AvMed Entrust Bronze 650 (2025) | HMO | 19898FL0340007 | No |
| AvMed Entrust Bronze 650 (2025) | HMO | 19898FL0340017 | No |
| AvMed Entrust Bronze 650 (2025) | HMO | 19898FL0340027 | No |
| AvMed Entrust Bronze 650 (2025) | HMO | 19898FL0340037 | No |
| AvMed Entrust Bronze 650 (2025) | HMO | 19898FL0340047 | No |
| AvMed Entrust Expanded Bronze Standard (2025) | HMO | 19898FL0340091 | No |
| AvMed Entrust Expanded Bronze Standard (2025) | HMO | 19898FL0340092 | No |
| AvMed Entrust Expanded Bronze Standard (2025) | HMO | 19898FL0340093 | No |
| AvMed Entrust Expanded Bronze Standard (2025) | HMO | 19898FL0340094 | No |
| AvMed Entrust Expanded Bronze Standard (2025) | HMO | 19898FL0340095 | No |
| AvMed Entrust Gold 125 (2025) | HMO | 19898FL0340001 | No |
| AvMed Entrust Gold 125 (2025) | HMO | 19898FL0340011 | No |
| AvMed Entrust Gold 125 (2025) | HMO | 19898FL0340021 | No |
| AvMed Entrust Gold 125 (2025) | HMO | 19898FL0340031 | No |
| AvMed Entrust Gold 125 (2025) | HMO | 19898FL0340041 | No |
| AvMed Entrust Gold 125 Dental+Vision (2025) | HMO | 19898FL0350001 | No |
| AvMed Entrust Gold 125 Dental+Vision (2025) | HMO | 19898FL0350011 | No |
| AvMed Entrust Gold 125 Dental+Vision (2025) | HMO | 19898FL0350021 | No |
| AvMed Entrust Gold 125 Dental+Vision (2025) | HMO | 19898FL0350031 | No |
| AvMed Entrust Gold 125 Dental+Vision (2025) | HMO | 19898FL0350041 | No |
| AvMed Entrust Gold Standard (2025) | HMO | 19898FL0340071 | No |
| AvMed Entrust Gold Standard (2025) | HMO | 19898FL0340072 | No |
| AvMed Entrust Gold Standard (2025) | HMO | 19898FL0340073 | No |
| AvMed Entrust Gold Standard (2025) | HMO | 19898FL0340074 | No |
| AvMed Entrust Gold Standard (2025) | HMO | 19898FL0340075 | No |
| AvMed Entrust Platinum 25 (2025) | HMO | 19898FL0340020 | No |
| AvMed Entrust Platinum 25 (2025) | HMO | 19898FL0340061 | No |
| AvMed Entrust Platinum 25 (2025) | HMO | 19898FL0340064 | No |
| AvMed Entrust Platinum 25 Dental+Vision (2025) | HMO | 19898FL0350020 | No |
| AvMed Entrust Platinum 25 Dental+Vision (2025) | HMO | 19898FL0350061 | No |
| AvMed Entrust Platinum 25 Dental+Vision (2025) | HMO | 19898FL0350064 | No |
| AvMed Entrust Platinum Standard (2025) | HMO | 19898FL0340062 | No |
| AvMed Entrust Platinum Standard (2025) | HMO | 19898FL0340063 | No |
| AvMed Entrust Platinum Standard (2025) | HMO | 19898FL0340065 | No |
| AvMed Entrust Silver 350 (2025) | HMO | 19898FL0340003 | No |
| AvMed Entrust Silver 350 (2025) | HMO | 19898FL0340013 | No |
| AvMed Entrust Silver 350 (2025) | HMO | 19898FL0340023 | No |
| AvMed Entrust Silver 350 (2025) | HMO | 19898FL0340033 | No |
| AvMed Entrust Silver 350 (2025) | HMO | 19898FL0340043 | No |
| AvMed Entrust Silver 350 Dental+Vision (2025) | HMO | 19898FL0350003 | No |
| AvMed Entrust Silver 350 Dental+Vision (2025) | HMO | 19898FL0350013 | No |
| AvMed Entrust Silver 350 Dental+Vision (2025) | HMO | 19898FL0350023 | No |
| AvMed Entrust Silver 350 Dental+Vision (2025) | HMO | 19898FL0350033 | No |
| AvMed Entrust Silver 350 Dental+Vision (2025) | HMO | 19898FL0350043 | No |
| AvMed Entrust Silver 550 (2025) | HMO | 19898FL0340005 | No |
| AvMed Entrust Silver 550 (2025) | HMO | 19898FL0340015 | No |
| AvMed Entrust Silver 550 (2025) | HMO | 19898FL0340025 | No |
| AvMed Entrust Silver 550 (2025) | HMO | 19898FL0340035 | No |
| AvMed Entrust Silver 550 (2025) | HMO | 19898FL0340045 | No |
| AvMed Entrust Silver 550 Dental+Vision (2025) | HMO | 19898FL0350005 | No |
| AvMed Entrust Silver 550 Dental+Vision (2025) | HMO | 19898FL0350015 | No |
| AvMed Entrust Silver 550 Dental+Vision (2025) | HMO | 19898FL0350025 | No |
| AvMed Entrust Silver 550 Dental+Vision (2025) | HMO | 19898FL0350035 | No |
| AvMed Entrust Silver 550 Dental+Vision (2025) | HMO | 19898FL0350045 | No |
| AvMed Entrust Silver Standard (2025) | HMO | 19898FL0340081 | No |
| AvMed Entrust Silver Standard (2025) | HMO | 19898FL0340082 | No |
| AvMed Entrust Silver Standard (2025) | HMO | 19898FL0340083 | No |
| AvMed Entrust Silver Standard (2025) | HMO | 19898FL0340084 | No |
| AvMed Entrust Silver Standard (2025) | HMO | 19898FL0340085 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460554 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460705 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460706 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460707 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460708 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460709 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460710 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460711 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460712 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460713 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460714 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460715 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460716 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460717 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460718 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460719 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460721 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460722 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460723 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460724 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460725 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460726 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460727 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460728 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0460869 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0461073 | No |
| Blue Advantage Bronze HMO? 204 | HMO | 33602TX0461074 | No |
| Blue Advantage Bronze HMO? 301 | HMO | 33602TX0460782 | No |
| Blue Advantage Bronze HMO? 301 | HMO | 33602TX0460783 | No |
| Blue Advantage Bronze HMO? 301 | HMO | 33602TX0460787 | No |
| Blue Advantage Bronze HMO? 301 | HMO | 33602TX0460792 | No |
| Blue Advantage Bronze HMO? 301 | HMO | 33602TX0460793 | No |
| Blue Advantage Bronze HMO? 301 | HMO | 33602TX0460794 | No |
| Blue Advantage Bronze HMO? 301 | HMO | 33602TX0460795 | No |
| Blue Advantage Bronze HMO? 301 | HMO | 33602TX0460797 | No |
| Blue Advantage Bronze HMO? 301 | HMO | 33602TX0460799 | No |
| Blue Advantage Bronze HMO? 301 | HMO | 33602TX0460801 | No |
| Blue Advantage Bronze HMO? 301 | HMO | 33602TX0460802 | No |
| Blue Advantage Bronze HMO? 301 | HMO | 33602TX0460803 | No |
| Blue Advantage Bronze HMO? 301 | HMO | 33602TX0460804 | No |
| Blue Advantage Bronze HMO? 301 | HMO | 33602TX0460806 | No |
| Blue Advantage Bronze HMO? 301 | HMO | 33602TX0460871 | No |
| Blue Advantage Bronze HMO? 301 | HMO | 33602TX0461076 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461033 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461034 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461035 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461036 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461037 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461038 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461039 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461040 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461041 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461042 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461043 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461044 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461045 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461046 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461047 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461048 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461049 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461050 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461051 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461052 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461053 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461054 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461055 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461056 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461057 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461058 | No |
| Blue Advantage Bronze HMO? Standard | HMO | 33602TX0461079 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460548 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460555 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460556 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460557 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460558 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460559 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460560 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460561 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460562 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460563 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460564 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460565 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460566 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460567 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460568 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460569 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460571 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460572 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460573 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460574 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460575 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460576 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460577 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460578 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0460863 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0461061 | No |
| Blue Advantage Gold HMO? 206 | HMO | 33602TX0461062 | No |
| Blue Advantage Gold HMO? 603 | HMO | 33602TX0460809 | No |
| Blue Advantage Gold HMO? 603 | HMO | 33602TX0460814 | No |
| Blue Advantage Gold HMO? 603 | HMO | 33602TX0460819 | No |
| Blue Advantage Gold HMO? 603 | HMO | 33602TX0460820 | No |
| Blue Advantage Gold HMO? 603 | HMO | 33602TX0460821 | No |
| Blue Advantage Gold HMO? 603 | HMO | 33602TX0460822 | No |
| Blue Advantage Gold HMO? 603 | HMO | 33602TX0460824 | No |
| Blue Advantage Gold HMO? 603 | HMO | 33602TX0460826 | No |
| Blue Advantage Gold HMO? 603 | HMO | 33602TX0460828 | No |
| Blue Advantage Gold HMO? 603 | HMO | 33602TX0460829 | No |
| Blue Advantage Gold HMO? 603 | HMO | 33602TX0460830 | No |
| Blue Advantage Gold HMO? 603 | HMO | 33602TX0460831 | No |
| Blue Advantage Gold HMO? 603 | HMO | 33602TX0460833 | No |
| Blue Advantage Gold HMO? 603 | HMO | 33602TX0460860 | No |
| Blue Advantage Gold HMO? 603 | HMO | 33602TX0460865 | No |
| Blue Advantage Gold HMO? 603 | HMO | 33602TX0461066 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460925 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460928 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460929 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460930 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460931 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460932 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460933 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460934 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460935 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460936 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460937 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460938 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460939 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460940 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460941 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460942 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460943 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460944 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460945 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460946 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460947 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460948 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460949 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460950 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460951 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460952 | No |
| Blue Advantage Gold HMO? Standard | HMO | 33602TX0460953 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870002 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870038 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870039 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870040 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870041 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870042 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870043 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870044 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870045 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870046 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870047 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870048 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870049 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870050 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870051 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870052 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870053 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870054 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870055 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870056 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870057 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870058 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870059 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870060 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870061 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870062 | No |
| Blue Advantage Plus Bronze? 303 | POS | 33602TX0870063 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870003 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870064 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870065 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870066 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870067 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870068 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870069 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870070 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870071 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870072 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870073 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870074 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870075 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870076 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870077 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870078 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870079 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870080 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870081 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870082 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870083 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870084 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870085 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870086 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870087 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870088 | No |
| Blue Advantage Plus Bronze? 305 | POS | 33602TX0870089 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870004 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870090 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870091 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870092 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870093 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870094 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870095 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870096 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870097 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870098 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870099 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870100 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870101 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870102 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870103 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870104 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870105 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870106 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870107 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870108 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870109 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870110 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870111 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870112 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870113 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870114 | No |
| Blue Advantage Plus Bronze? Standard | POS | 33602TX0870115 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870005 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870116 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870117 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870118 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870119 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870120 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870121 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870122 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870123 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870124 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870125 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870126 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870127 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870128 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870129 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870130 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870131 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870132 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870133 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870134 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870135 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870136 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870137 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870138 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870139 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870140 | No |
| Blue Advantage Plus Gold? 203 | POS | 33602TX0870141 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870011 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870272 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870273 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870274 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870275 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870276 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870277 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870278 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870279 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870280 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870281 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870282 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870283 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870284 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870285 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870286 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870287 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870288 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870289 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870290 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870291 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870292 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870293 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870294 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870295 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870296 | No |
| Blue Advantage Plus Gold? 803 | POS | 33602TX0870297 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870006 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870142 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870143 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870144 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870145 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870146 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870147 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870148 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870149 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870150 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870151 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870152 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870153 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870154 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870155 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870156 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870157 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870158 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870159 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870160 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870161 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870162 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870163 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870164 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870165 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870166 | No |
| Blue Advantage Plus Gold? Standard | POS | 33602TX0870167 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870007 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870168 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870169 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870170 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870171 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870172 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870173 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870174 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870175 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870176 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870177 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870178 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870179 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870180 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870181 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870182 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870183 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870184 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870185 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870186 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870187 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870188 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870189 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870190 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870191 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870192 | No |
| Blue Advantage Plus Silver? 202 | POS | 33602TX0870193 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870009 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870220 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870221 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870222 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870223 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870224 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870225 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870226 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870227 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870228 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870229 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870230 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870231 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870232 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870233 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870234 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870235 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870236 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870237 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870238 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870239 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870240 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870241 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870242 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870243 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870244 | No |
| Blue Advantage Plus Silver? 605 | POS | 33602TX0870245 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870010 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870246 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870247 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870248 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870249 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870250 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870251 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870252 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870253 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870254 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870255 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870256 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870257 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870258 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870259 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870260 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870261 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870262 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870263 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870264 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870265 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870266 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870267 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870268 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870269 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870270 | No |
| Blue Advantage Plus Silver? Standard | POS | 33602TX0870271 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460552 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460655 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460656 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460657 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460658 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460659 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460660 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460661 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460662 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460663 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460664 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460665 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460666 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460667 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460668 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460669 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460671 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460672 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460673 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460674 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460675 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460676 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460677 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460678 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0460872 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0461077 | No |
| Blue Advantage Security HMO? 200 | HMO | 33602TX0461078 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460553 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460680 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460681 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460682 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460683 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460684 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460685 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460686 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460687 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460688 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460689 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460690 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460691 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460692 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460693 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460694 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460696 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460697 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460698 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460699 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460700 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460701 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460702 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460703 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0460867 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0461069 | No |
| Blue Advantage Silver HMO? 205 | HMO | 33602TX0461070 | No |
| Blue Advantage Silver HMO? 801 | HMO | 33602TX0461083 | No |
| Blue Advantage Silver HMO? 801 | HMO | 33602TX0461090 | No |
| Blue Advantage Silver HMO? 801 | HMO | 33602TX0461094 | No |
| Blue Advantage Silver HMO? 801 | HMO | 33602TX0461099 | No |
| Blue Advantage Silver HMO? 801 | HMO | 33602TX0461100 | No |
| Blue Advantage Silver HMO? 801 | HMO | 33602TX0461101 | No |
| Blue Advantage Silver HMO? 801 | HMO | 33602TX0461102 | No |
| Blue Advantage Silver HMO? 801 | HMO | 33602TX0461104 | No |
| Blue Advantage Silver HMO? 801 | HMO | 33602TX0461105 | No |
| Blue Advantage Silver HMO? 801 | HMO | 33602TX0461107 | No |
| Blue Advantage Silver HMO? 801 | HMO | 33602TX0461108 | No |
| Blue Advantage Silver HMO? 801 | HMO | 33602TX0461109 | No |
| Blue Advantage Silver HMO? 801 | HMO | 33602TX0461110 | No |
| Blue Advantage Silver HMO? 801 | HMO | 33602TX0461112 | No |
| Blue Advantage Silver HMO? 801 | HMO | 33602TX0461114 | No |
| Blue Advantage Silver HMO? 801 | HMO | 33602TX0461115 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460926 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460954 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460955 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460956 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460957 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460958 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460959 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460960 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460961 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460962 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460963 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460964 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460965 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460966 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460967 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460968 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460969 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460970 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460971 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460972 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460973 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460974 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460975 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460976 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460977 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460978 | No |
| Blue Advantage Silver HMO? Standard | HMO | 33602TX0460979 | No |
| MyBlue Health Bronze? 402 | HMO | 33602TX0461080 | No |
| MyBlue Health Bronze? 402 | HMO | 33602TX0461116 | No |
| MyBlue Health Bronze? 402 | HMO | 33602TX0461117 | No |
| MyBlue Health Bronze? 402 | HMO | 33602TX0461118 | No |
| MyBlue Health Bronze? 402 | HMO | 33602TX0461119 | No |
| MyBlue Health Bronze? 402 | HMO | 33602TX0461120 | No |
| MyBlue Health Bronze? 402 | HMO | 33602TX0461121 | No |
| MyBlue Health Bronze? 402 | HMO | 33602TX0461122 | No |
| MyBlue Health Bronze? 402 | HMO | 33602TX0461179 | No |
| MyBlue Health Bronze? 402 | HMO | 33602TX0461196 | No |
| MyBlue Health Bronze? 402 | HMO | 33602TX0461197 | No |
| MyBlue Health Bronze? Standard | HMO | 33602TX0461087 | No |
| MyBlue Health Bronze? Standard | HMO | 33602TX0461159 | No |
| MyBlue Health Bronze? Standard | HMO | 33602TX0461160 | No |
| MyBlue Health Bronze? Standard | HMO | 33602TX0461161 | No |
| MyBlue Health Bronze? Standard | HMO | 33602TX0461163 | No |
| MyBlue Health Bronze? Standard | HMO | 33602TX0461164 | No |
| MyBlue Health Bronze? Standard | HMO | 33602TX0461185 | No |
| MyBlue Health Bronze? Standard | HMO | 33602TX0461198 | No |
| MyBlue Health Bronze? Standard | HMO | 33602TX0461199 | No |
| MyBlue Health Gold? 403 | HMO | 33602TX0461081 | No |
| MyBlue Health Gold? 403 | HMO | 33602TX0461123 | No |
| MyBlue Health Gold? 403 | HMO | 33602TX0461124 | No |
| MyBlue Health Gold? 403 | HMO | 33602TX0461125 | No |
| MyBlue Health Gold? 403 | HMO | 33602TX0461126 | No |
| MyBlue Health Gold? 403 | HMO | 33602TX0461127 | No |
| MyBlue Health Gold? 403 | HMO | 33602TX0461128 | No |
| MyBlue Health Gold? 403 | HMO | 33602TX0461129 | No |
| MyBlue Health Gold? 403 | HMO | 33602TX0461180 | No |
| MyBlue Health Gold? 403 | HMO | 33602TX0461200 | No |
| MyBlue Health Gold? 403 | HMO | 33602TX0461201 | No |
| MyBlue Health Gold? Standard | HMO | 33602TX0461088 | No |
| MyBlue Health Gold? Standard | HMO | 33602TX0461166 | No |
| MyBlue Health Gold? Standard | HMO | 33602TX0461167 | No |
| MyBlue Health Gold? Standard | HMO | 33602TX0461168 | No |
| MyBlue Health Gold? Standard | HMO | 33602TX0461170 | No |
| MyBlue Health Gold? Standard | HMO | 33602TX0461171 | No |
| MyBlue Health Gold? Standard | HMO | 33602TX0461186 | No |
| MyBlue Health Gold? Standard | HMO | 33602TX0461202 | No |
| MyBlue Health Gold? Standard | HMO | 33602TX0461203 | No |
| MyBlue Health Silver? 405 | HMO | 33602TX0461082 | No |
| MyBlue Health Silver? 405 | HMO | 33602TX0461130 | No |
| MyBlue Health Silver? 405 | HMO | 33602TX0461131 | No |
| MyBlue Health Silver? 405 | HMO | 33602TX0461132 | No |
| MyBlue Health Silver? 405 | HMO | 33602TX0461133 | No |
| MyBlue Health Silver? 405 | HMO | 33602TX0461134 | No |
| MyBlue Health Silver? 405 | HMO | 33602TX0461135 | No |
| MyBlue Health Silver? 405 | HMO | 33602TX0461136 | No |
| MyBlue Health Silver? 405 | HMO | 33602TX0461181 | No |
| MyBlue Health Silver? 405 | HMO | 33602TX0461204 | No |
| MyBlue Health Silver? 405 | HMO | 33602TX0461205 | No |
| MyBlue Health Silver? Standard | HMO | 33602TX0461089 | No |
| MyBlue Health Silver? Standard | HMO | 33602TX0461173 | No |
| MyBlue Health Silver? Standard | HMO | 33602TX0461174 | No |
| MyBlue Health Silver? Standard | HMO | 33602TX0461175 | No |
| MyBlue Health Silver? Standard | HMO | 33602TX0461177 | No |
| MyBlue Health Silver? Standard | HMO | 33602TX0461178 | No |
| MyBlue Health Silver? Standard | HMO | 33602TX0461187 | No |
| MyBlue Health Silver? Standard | HMO | 33602TX0461208 | No |
| MyBlue Health Silver? Standard | HMO | 33602TX0461209 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| BlueCare Gold $25 PCP Copay ($5 Value Based Drug List) | PPO | 37160ND2410005 | No |
| BlueCare Silver $45 PCP Copay ($5 Value Based Drug List) | PPO | 37160ND2410002 | No |
| BlueDirect Bronze 100 HSA Eligible ($7500 Deductible / $5 Preventive Drug List) | PPO | 37160ND2410020 | No |
| BlueDirect Gold 90 HSA Eligible ($2600 Deductible / $5 Preventive Drug List) | PPO | 37160ND2410022 | No |
| BlueDirect Silver 80 HSA Eligible ($3500 Deductible / $5 Preventive Drug List) | PPO | 37160ND2410014 | No |
| BlueEssential Catastrophic 100 $9200 Deductible | PPO | 37160ND2410021 | No |
| BlueValue Bronze $50 PCP Copay (Standardized plan) | PPO | 37160ND2410028 | No |
| BlueValue Gold $30 PCP Copay (Standardized plan) | PPO | 37160ND2410026 | No |
| BlueValue Silver $40 PCP Copay (Standardized plan) | PPO | 37160ND2410027 | No |
| DakotaBlue Altru Gold ($5 Value Based Drug List) | PPO | 37160ND2480001 | No |
| DakotaBlue Altru Silver ($5 Value Based Drug List) | PPO | 37160ND2480003 | No |
| DakotaBlue Trinity Gold ($5 Value Based Drug List) | PPO | 37160ND2480009 | No |
| DakotaBlue Trinity Silver ($5 Value Based Drug List) | PPO | 37160ND2480010 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| BlueSelect Bronze Basic | PPO | 11269WY0070026 | No |
| BlueSelect Bronze Core | PPO | 11269WY0070004 | No |
| BlueSelect Expanded Bronze Standard without Kid's Dental | PPO | 11269WY0170020 | No |
| BlueSelect Gold Core | PPO | 11269WY0070025 | No |
| BlueSelect Gold HealthPlus | PPO | 11269WY0070013 | No |
| BlueSelect Gold Standard without Kid's Dental | PPO | 11269WY0170017 | No |
| BlueSelect Silver Classic | PPO | 11269WY0070014 | No |
| BlueSelect Silver Classic without Kid's Dental | PPO | 11269WY0170016 | No |
| BlueSelect Silver HealthPlus | PPO | 11269WY0070016 | No |
| BlueSelect Silver HealthPlus without Kid's Dental | PPO | 11269WY0170021 | No |
| BlueSelect Silver Standard without Kid's Dental | PPO | 11269WY0170018 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| BlueCross B07E HSA | EPO | 14002TN0400285 | No |
| BlueCross B07E HSA | EPO | 14002TN0400300 | No |
| BlueCross B07E HSA | EPO | 14002TN0400301 | No |
| BlueCross B07E HSA | EPO | 14002TN0400302 | No |
| BlueCross B07S HSA | EPO | 14002TN0400001 | No |
| BlueCross B07S HSA | EPO | 14002TN0400005 | No |
| BlueCross B15E $0 virtual care from Teladoc Health � | EPO | 14002TN0400239 | No |
| BlueCross B15E $0 virtual care from Teladoc Health � | EPO | 14002TN0400240 | No |
| BlueCross B15E $0 virtual care from Teladoc Health � | EPO | 14002TN0400287 | No |
| BlueCross B15E $0 virtual care from Teladoc Health � | EPO | 14002TN0400303 | No |
| BlueCross B15E $0 virtual care from Teladoc Health � | EPO | 14002TN0400304 | No |
| BlueCross B15E $0 virtual care from Teladoc Health � | EPO | 14002TN0400305 | No |
| BlueCross B15S $0 virtual care from Teladoc Health � | EPO | 14002TN0400091 | No |
| BlueCross B15S $0 virtual care from Teladoc Health � | EPO | 14002TN0400097 | No |
| BlueCross B16E $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400253 | No |
| BlueCross B16E $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400254 | No |
| BlueCross B16E $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400288 | No |
| BlueCross B16E $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400306 | No |
| BlueCross B16E $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400307 | No |
| BlueCross B16E $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400308 | No |
| BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400241 | No |
| BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400242 | No |
| BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400243 | No |
| BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400244 | No |
| BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400245 | No |
| BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400246 | No |
| BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400247 | No |
| BlueCross B16S $50 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400248 | No |
| BlueCross B17E $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400311 | No |
| BlueCross B17E $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400312 | No |
| BlueCross B17E $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400313 | No |
| BlueCross B17E $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400314 | No |
| BlueCross B17E $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400315 | No |
| BlueCross B17E $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400316 | No |
| BlueCross B17S $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400309 | No |
| BlueCross B17S $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400310 | No |
| BlueCross G06E $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400295 | No |
| BlueCross G06E $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400353 | No |
| BlueCross G06E $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400354 | No |
| BlueCross G06E $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400355 | No |
| BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400200 | No |
| BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400201 | No |
| BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400202 | No |
| BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400203 | No |
| BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400204 | No |
| BlueCross G06S $35 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400205 | No |
| BlueCross G08E $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400234 | No |
| BlueCross G08E $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400235 | No |
| BlueCross G08E $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400297 | No |
| BlueCross G08E $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400356 | No |
| BlueCross G08E $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400357 | No |
| BlueCross G08E $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400358 | No |
| BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400222 | No |
| BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400223 | No |
| BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400224 | No |
| BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400225 | No |
| BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400226 | No |
| BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400227 | No |
| BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400228 | No |
| BlueCross G08S $30 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400229 | No |
| BlueCross S25E $55 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400255 | No |
| BlueCross S25E $55 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400256 | No |
| BlueCross S25E $55 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400292 | No |
| BlueCross S25E $55 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400328 | No |
| BlueCross S25E $55 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400329 | No |
| BlueCross S25E $55 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400330 | No |
| BlueCross S25S $55 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400188 | No |
| BlueCross S25S $55 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400194 | No |
| BlueCross S26E $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400269 | No |
| BlueCross S26E $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400270 | No |
| BlueCross S26E $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400293 | No |
| BlueCross S26E $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400331 | No |
| BlueCross S26E $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400332 | No |
| BlueCross S26E $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400333 | No |
| BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400257 | No |
| BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400258 | No |
| BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400259 | No |
| BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400260 | No |
| BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400261 | No |
| BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400262 | No |
| BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400263 | No |
| BlueCross S26S $40 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400264 | No |
| BlueCross S27E $60 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400294 | No |
| BlueCross S27E $60 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400334 | No |
| BlueCross S27E $60 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400335 | No |
| BlueCross S27E $60 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400336 | No |
| BlueCross S27S $60 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400271 | No |
| BlueCross S27S $60 PCP Copay + $0 virtual care from Teladoc Health � | EPO | 14002TN0400277 | No |
| BlueCross S29E $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400339 | No |
| BlueCross S29E $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400340 | No |
| BlueCross S29E $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400341 | No |
| BlueCross S29E $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400342 | No |
| BlueCross S29S $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400337 | No |
| BlueCross S29S $60 PCP Copay + $0 virtual care from Teladoc Health � + Adult Dental | EPO | 14002TN0400338 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Chorus Bronze Complete | EPO | 14630WI0010010 | No |
| Chorus Bronze HDHP | EPO | 14630WI0010005 | No |
| Chorus Catastrophic | EPO | 14630WI0010008 | No |
| Chorus Core Bronze | EPO | 14630WI0010015 | No |
| Chorus Core Gold | EPO | 14630WI0010014 | No |
| Chorus Core Silver | EPO | 14630WI0010013 | No |
| Chorus Gold | EPO | 14630WI0010004 | No |
| Chorus Silver | EPO | 14630WI0010003 | No |
| Chorus Silver Select | EPO | 14630WI0010007 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Connect Bronze 2000 Indiv Med Deductible | HMO | 53882IL0040009 | No |
| Connect Bronze 5000 Indiv Med Deductible - Rx Copay | HMO | 53882IL0040002 | No |
| Connect Bronze CMS Standard | HMO | 53882IL0040044 | No |
| Connect Gold CMS Standard - Rx Copay | HMO | 53882IL0040048 | No |
| Connect Silver 3000 Indiv Med Deductible - Rx Copay | HMO | 53882IL0040006 | No |
| Connect Silver CMS Standard | HMO | 53882IL0040046 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) | PPO | 16842FL0260010 | No |
| BlueOptions Bronze 24J01-04 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) | PPO | 16842FL0260004 | No |
| BlueOptions Bronze 24J01-06 ($0 Virtual PCP Visits / Rewards) | PPO | 16842FL0260006 | No |
| BlueOptions Bronze 24J01-17 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) | PPO | 16842FL0260017 | No |
| BlueOptions Bronze 24J01-18S (Multilingual Available / Rewards) | PPO | 16842FL0260018 | No |
| BlueOptions Gold 24J01-09 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) | PPO | 16842FL0260009 | No |
| BlueOptions Gold 24J01-12 ($0 Virtual PCP Visits / $15 Labs / Rewards) | PPO | 16842FL0260012 | No |
| BlueOptions Gold 24J01-20S ($30 PCP Visits / Multilingual Available / Rewards) | PPO | 16842FL0260020 | No |
| BlueOptions Platinum 24J01-05 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) | PPO | 16842FL0260005 | No |
| BlueOptions Platinum 24J01-08 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) | PPO | 16842FL0260008 | No |
| BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) | PPO | 16842FL0260021 | No |
| BlueOptions Silver 24J01-03 ($0 Virtual PCP Visits / $0 Labs / Rewards) | PPO | 16842FL0260003 | No |
| BlueOptions Silver 24J01-07 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) | PPO | 16842FL0260007 | No |
| BlueOptions Silver 24J01-19S ($40 PCP Visits / Multilingual Available / Rewards) | PPO | 16842FL0260019 | No |
| BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx) | EPO | 16842FL0120078 | No |
| BlueSelect Bronze 1449 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) | EPO | 16842FL0120068 | No |
| BlueSelect Bronze 2139 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) | EPO | 16842FL0120091 | No |
| BlueSelect Bronze 2139E ($0 Virtual PCP Visits / $50 PCP Visits / Adult Dental & Vision / Rewards) | EPO | 16842FL0320014 | No |
| BlueSelect Bronze 2139V ($0 Virtual PCP Visits / $50 PCP Visits / Adult Vision / Rewards) | EPO | 16842FL0310014 | No |
| BlueSelect Bronze 2342S ($50 PCP Visits / Multilingual Available / Rewards) | EPO | 16842FL0120093 | No |
| BlueSelect Bronze 24L01-01 ($0 Virtual PCP Visits / Rewards) | EPO | 16842FL0120001 | No |
| BlueSelect Gold 1535 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) | EPO | 16842FL0120076 | No |
| BlueSelect Gold 1535V ($0 Virtual PCP Visits / $15 PCP Visits / Adult Vision / Rewards) | EPO | 16842FL0310001 | No |
| BlueSelect Gold 1835 ($0 Virtual PCP Visits / $15 Labs / Rewards) | EPO | 16842FL0120086 | No |
| BlueSelect Gold 2344S ($30 PCP Visits / Multilingual Available / Rewards) | EPO | 16842FL0120095 | No |
| BlueSelect Platinum 1451 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) | EPO | 16842FL0120062 | No |
| BlueSelect Platinum 1457 ($0 Deductible / $0 Virtual PCP Visits / $10 PCP Visits / Rewards) | EPO | 16842FL0120070 | No |
| BlueSelect Platinum 2345S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) | EPO | 16842FL0120096 | No |
| BlueSelect Silver 1443 ($0 Virtual PCP Visits / $0 Labs / Rewards) | EPO | 16842FL0120072 | No |
| BlueSelect Silver 1443E ($0 Virtual PCP Visits / $0 Labs / Adult Dental & Vision / Rewards) | EPO | 16842FL0320004 | No |
| BlueSelect Silver 1443V ($0 Virtual PCP Visits / $0 Labs / Adult Vision / Rewards) | EPO | 16842FL0310004 | No |
| BlueSelect Silver 1456 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) | EPO | 16842FL0120033 | No |
| BlueSelect Silver 2343S ($40 PCP Visits / Multilingual Available / Rewards) | EPO | 16842FL0120094 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) | POS | 30252FL0140009 | No |
| BlueCare Bronze 24K01-03 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) | POS | 30252FL0140003 | No |
| BlueCare Bronze 24K01-05 ($0 Virtual PCP Visits / Rewards) | POS | 30252FL0140005 | No |
| BlueCare Bronze 24K01-25 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) | POS | 30252FL0140025 | No |
| BlueCare Bronze 24K01-31S (Multilingual Available / Rewards) | POS | 30252FL0140031 | No |
| BlueCare Bronze 24K02-17 ($0 Virtual PCP Visits / 3 PCP Visits for $0 then $55 / Rewards) | POS | 30252FL0140017 | No |
| BlueCare Bronze 24K02-18 ($0 Virtual PCP Visits / Rewards) | POS | 30252FL0140018 | No |
| BlueCare Bronze 24K02-23 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) | POS | 30252FL0140023 | No |
| BlueCare Bronze 24K02-26S (Multilingual Available / Rewards) | POS | 30252FL0140026 | No |
| BlueCare Gold 24K01-08 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) | POS | 30252FL0140008 | No |
| BlueCare Gold 24K01-10 ($0 Virtual PCP Visits / $15 Labs / Rewards) | POS | 30252FL0140010 | No |
| BlueCare Gold 24K01-33S ($30 PCP Visits / Multilingual Available/ Rewards) | POS | 30252FL0140033 | No |
| BlueCare Gold 24K02-20 ($0 Virtual PCP Visits / $15 PCP Visits / Rewards) | POS | 30252FL0140020 | No |
| BlueCare Gold 24K02-28S ($30 PCP Visits / Multilingual Available / Rewards) | POS | 30252FL0140028 | No |
| BlueCare Platinum 24K01-04 ($0 Virtual PCP Visits / $0 Labs / $15 PCP Visits / Rewards) | POS | 30252FL0140004 | No |
| BlueCare Platinum 24K01-07 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) | POS | 30252FL0140007 | No |
| BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) | POS | 30252FL0140034 | No |
| BlueCare Platinum 24K02-15 ($0 Virtual PCP Visits / $0 Labs / $10 PCP Visits / Rewards) | POS | 30252FL0140015 | No |
| BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Multilingual Available / Rewards) | POS | 30252FL0140029 | No |
| BlueCare Silver 24K01-02 ($0 Virtual PCP Visits / $0 Labs / Rewards) | POS | 30252FL0140002 | No |
| BlueCare Silver 24K01-06 ($0 Virtual PCP Visits / $50 PCP Visits / Rewards) | POS | 30252FL0140006 | No |
| BlueCare Silver 24K01-32S ($40 PCP Visits / Multilingual Available / Rewards) | POS | 30252FL0140032 | No |
| BlueCare Silver 24K02-21 ($0 Virtual PCP Visits / $0 Labs / Rewards) | POS | 30252FL0140021 | No |
| BlueCare Silver 24K02-27S ($40 PCP Visits / Multilingual Available / Rewards) | POS | 30252FL0140027 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| my Blue Access Major Events PPO Catastrophic 9200 - 3 Free PCP Visits | PPO | 76168DE0690013 | No |
| my Blue Access PPO Bronze 3800 | PPO | 76168DE0690001 | No |
| my Blue Access PPO Bronze 3800 + Adult Dental and Vision | PPO | 76168DE0700001 | No |
| my Blue Access PPO Bronze 7400 HSA - Custom Drug Benefit | PPO | 76168DE0710001 | No |
| my Blue Access PPO Bronze 8900 | PPO | 76168DE0690008 | No |
| my Blue Access PPO Gold 0 | PPO | 76168DE0690004 | No |
| my Blue Access PPO Gold 0 + Adult Dental and Vision | PPO | 76168DE0700004 | No |
| my Blue Access PPO Gold 1700 HSA | PPO | 76168DE0710003 | No |
| my Blue Access PPO Premier Gold 0 | PPO | 76168DE0730001 | No |
| my Blue Access PPO Premier Gold 0 + Adult Dental and Vision | PPO | 76168DE0740002 | No |
| my Blue Access PPO Premier Platinum 0 | PPO | 76168DE0730003 | No |
| my Blue Access PPO Premier Platinum 0 + Adult Dental and Vision | PPO | 76168DE0740004 | No |
| my Blue Access PPO Silver 7000 | PPO | 76168DE0690007 | No |
| my Blue Access PPO Standard Bronze 7500 | PPO | 76168DE0690012 | No |
| my Blue Access PPO Standard Gold 1500 | PPO | 76168DE0690010 | No |
| my Blue Access PPO Standard Platinum 0 | PPO | 76168DE0690011 | No |
| my Blue Access PPO Standard Silver 5000 | PPO | 76168DE0690009 | No |
| my Blue Access PPO Standard Silver 5000 + Adult Dental and Vision | PPO | 76168DE0700006 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| my Blue Access WV Major Events PPO Catastrophic 9200 - 3 Free PCP Visits | PPO | 31274WV0560010 | No |
| my Blue Access WV PPO Bronze 3800 | PPO | 31274WV0560001 | No |
| my Blue Access WV PPO Bronze 3800 + Adult Dental and Vision | PPO | 31274WV0570001 | No |
| my Blue Access WV PPO Bronze 7400 HSA - Custom Drug Benefit | PPO | 31274WV0580001 | No |
| my Blue Access WV PPO Bronze 8900 | PPO | 31274WV0560006 | No |
| my Blue Access WV PPO Gold 0 | PPO | 31274WV0560005 | No |
| my Blue Access WV PPO Gold 0 + Adult Dental and Vision | PPO | 31274WV0570003 | No |
| my Blue Access WV PPO Gold 1700 HSA | PPO | 31274WV0580002 | No |
| my Blue Access WV PPO Premier Gold 0 | PPO | 31274WV0590002 | No |
| my Blue Access WV PPO Premier Gold 0 + Adult Dental and Vision | PPO | 31274WV0600002 | No |
| my Blue Access WV PPO Silver 7000 | PPO | 31274WV0560003 | No |
| my Blue Access WV PPO Standard Bronze 7500 | PPO | 31274WV0560007 | No |
| my Blue Access WV PPO Standard Gold 1500 | PPO | 31274WV0560009 | No |
| my Blue Access WV PPO Standard Silver 5000 | PPO | 31274WV0560008 | No |
| my Blue Access WV PPO Standard Silver 5000 + Adult Dental and Vision | PPO | 31274WV0570004 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| MyPriority Balanced Silver | HMO | 29698MI0541020 | No |
| MyPriority Balanced Silver Bronson Healthcare Partners | HMO | 29698MI0541022 | No |
| MyPriority Balanced Silver Corewell Health West Michigan Network | HMO | 29698MI0541021 | No |
| MyPriority Balanced Silver Corewell Health West Michigan Network (Allegan, Barry) | HMO | 29698MI0541037 | No |
| MyPriority Balanced Silver Southeast Michigan Network | HMO | 29698MI0541023 | No |
| MyPriority Balanced Silver Trinity Health East Network | HMO | 29698MI0541025 | No |
| MyPriority Enhanced Gold Bronson Healthcare Partners | HMO | 29698MI0540596 | No |
| MyPriority Enhanced Gold Corewell Health West Michigan Network | HMO | 29698MI0540595 | No |
| MyPriority Enhanced Gold Corewell Health West Michigan Network (Allegan, Barry) | HMO | 29698MI0540742 | No |
| MyPriority Enhanced Gold Southeast Michigan Network | HMO | 29698MI0540597 | No |
| MyPriority Enhanced Gold Trinity Health East Network | HMO | 29698MI0540599 | No |
| MyPriority Premier Silver | HMO | 29698MI0541060 | No |
| MyPriority Premier Silver Bronson Healthcare Partners | HMO | 29698MI0541062 | No |
| MyPriority Premier Silver Corewell Health West Michigan Network | HMO | 29698MI0541061 | No |
| MyPriority Premier Silver Corewell Health West Michigan Network (Allegan, Barry) | HMO | 29698MI0541039 | No |
| MyPriority Premier Silver Southeast Michigan Network | HMO | 29698MI0541063 | No |
| MyPriority Premier Silver Trinity Health East Network | HMO | 29698MI0541065 | No |
| MyPriority Standard Bronze | HMO | 29698MI0541100 | No |
| MyPriority Standard Bronze - Bronson Healthcare Partners | HMO | 29698MI0541102 | No |
| MyPriority Standard Bronze - Corewell Health West Michigan Network | HMO | 29698MI0541101 | No |
| MyPriority Standard Bronze - Corewell Health West Michigan Network (Allegan, Barry) | HMO | 29698MI0541143 | No |
| MyPriority Standard Bronze - Southeast Michigan Network | HMO | 29698MI0541103 | No |
| MyPriority Standard Bronze - Travel | HMO | 29698MI0541106 | No |
| MyPriority Standard Bronze - Trinity Health East Network | HMO | 29698MI0541105 | No |
| MyPriority Standard Gold | HMO | 29698MI0541120 | No |
| MyPriority Standard Gold Bronson Healthcare Partners | HMO | 29698MI0541122 | No |
| MyPriority Standard Gold Corewell Health West Michigan Network | HMO | 29698MI0541121 | No |
| MyPriority Standard Gold Corewell Health West Michigan Network (Allegan, Barry) | HMO | 29698MI0541145 | No |
| MyPriority Standard Gold Southeast Michigan Network | HMO | 29698MI0541123 | No |
| MyPriority Standard Gold Trinity Health East Network | HMO | 29698MI0541125 | No |
| MyPriority Standard Silver | HMO | 29698MI0541110 | No |
| MyPriority Standard Silver - Bronson Healthcare Partners | HMO | 29698MI0541112 | No |
| MyPriority Standard Silver - Corewell Health West Michigan Network | HMO | 29698MI0541111 | No |
| MyPriority Standard Silver - Corewell Health West Michigan Network (Allegan, Barry) | HMO | 29698MI0541144 | No |
| MyPriority Standard Silver - Southeast Michigan Network | HMO | 29698MI0541113 | No |
| MyPriority Standard Silver - Travel | HMO | 29698MI0541116 | No |
| MyPriority Standard Silver - Trinity Health East Network | HMO | 29698MI0541115 | No |
| MyPriority Value Bronze | HMO | 29698MI0541010 | No |
| MyPriority Value Bronze Bronson Healthcare Partners | HMO | 29698MI0541012 | No |
| MyPriority Value Bronze Corewell Health West Michigan Network | HMO | 29698MI0541011 | No |
| MyPriority Value Bronze Corewell Health West Michigan Network (Allegan, Barry) | HMO | 29698MI0541036 | No |
| MyPriority Value Bronze HSA | HMO | 29698MI0541000 | No |
| MyPriority Value Bronze HSA Bronson Healthcare Partners | HMO | 29698MI0541002 | No |
| MyPriority Value Bronze HSA Corewell Health West Michigan Network | HMO | 29698MI0541001 | No |
| MyPriority Value Bronze HSA Corewell Health West Michigan Network (Allegan, Barry) | HMO | 29698MI0541035 | No |
| MyPriority Value Bronze HSA Southeast Michigan Network | HMO | 29698MI0541003 | No |
| MyPriority Value Bronze HSA Trinity Health East Network | HMO | 29698MI0541005 | No |
| MyPriority Value Bronze Southeast Michigan Network | HMO | 29698MI0541013 | No |
| MyPriority Value Bronze Trinity Health East Network | HMO | 29698MI0541015 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| UHC Bronze Copay Focus (No Referrals) | HMO | 42529IL0070023 | No |
| UHC Bronze Standard (No Referrals) | HMO | 42529IL0070021 | No |
| UHC Bronze Value (Rx Copay, No Referrals) | HMO | 42529IL0070018 | No |
| UHC Bronze Value+ (Rx Copay, Dental + Vision, No Referrals) | HMO | 42529IL0080003 | No |
| UHC Gold Advantage (No Referrals) | HMO | 42529IL0070029 | No |
| UHC Gold Advantage+ (Dental + Vision, No Referrals) | HMO | 42529IL0080005 | No |
| UHC Gold Copay Focus (No Referrals) | HMO | 42529IL0070027 | No |
| UHC Gold Standard (Rx Copay, No Referrals) | HMO | 42529IL0070012 | No |
| UHC Silver Advantage (Rx Copay, No Referrals) | HMO | 42529IL0070025 | No |
| UHC Silver Advantage+ (Rx Copay, Dental + Vision, No Referrals) | HMO | 42529IL0080001 | No |
| UHC Silver Copay Focus (No Referrals) | HMO | 42529IL0070013 | No |
| UHC Silver Standard (No Referrals) | HMO | 42529IL0070017 | No |
| UHC Silver Standard+ (Dental + Vision, No Referrals) | HMO | 42529IL0080004 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| University of Michigan Health Plan HMO Exclusive Bronze | HMO | 60829MI0190030 | No |
| University of Michigan Health Plan HMO Exclusive Bronze HSA | HMO | 60829MI0220002 | No |
| University of Michigan Health Plan HMO Exclusive Bronze Standard | HMO | 60829MI0190034 | No |
| University of Michigan Health Plan HMO Exclusive Catastrophic | HMO | 60829MI0190026 | No |
| University of Michigan Health Plan HMO Exclusive Gold Classic | HMO | 60829MI0190009 | No |
| University of Michigan Health Plan HMO Exclusive Gold Select | HMO | 60829MI0190016 | No |
| University of Michigan Health Plan HMO Exclusive Gold Standard | HMO | 60829MI0190032 | No |
| University of Michigan Health Plan HMO Exclusive Silver | HMO | 60829MI0190017 | No |
| University of Michigan Health Plan HMO Exclusive Silver Select Plus | HMO | 60829MI0190020 | No |
| University of Michigan Health Plan HMO Exclusive Silver Standard | HMO | 60829MI0190033 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Standard Expanded Bronze WellCare | PPO | 44007NC0120004 | No |
| Standard Gold WellCare | PPO | 44007NC0120006 | No |
| Standard Silver WellCare | PPO | 44007NC0120005 | No |