WAL-MART PHARMACY 10-2703
Accepted Insurance Health Plans for NPI 1720005986
Pharmacy - Community/Retail Pharmacy in Florence, SC

NPI Status: Active since July 16, 2006

Contact Information

2014 S IRBY ST
FLORENCE, SC
ZIP 29505
Phone: (843) 292-0307

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  1. Aetna CVS Health
  2. Ambetter from Absolute Total Care
  3. Ambetter from Arizona Complete Health
  4. Ambetter from Arkansas Health & Wellness
  5. Ambetter from Home State Health
  6. Ambetter from Louisiana Healthcare Connections
  7. Ambetter from Magnolia Health
  8. Ambetter from Meridian
  9. Ambetter from Nebraska Total Care
  10. Ambetter from NH Healthy Families
  11. Ambetter from Sunflower Health Plan
  12. Ambetter from Superior HealthPlan
  13. Ambetter Health
  14. Ambetter Health of Delaware
  15. Ambetter of Alabama
  16. Ambetter of Illinois
  17. Ambetter of North Carolina
  18. Ambetter of Oklahoma
  19. Ambetter of Tennessee
  20. Antidote Health Plan of Arizona, Inc.
  21. Antidote Health Plan of Ohio, Inc.
  22. Avera Health Plans
  23. AvMed
  24. BannerAetna
  25. Baylor Scott and White Health Plan
  26. Blue Cross and Blue Shield of Alabama
  27. Blue Cross and Blue Shield of Illinois
  28. Blue Cross and Blue Shield of Kansas City
  29. Blue Cross and Blue Shield of Montana
  30. Blue Cross and Blue Shield of Nebraska
  31. Blue Cross and Blue Shield of Oklahoma
  32. Blue Cross and Blue Shield of Texas
  33. Blue Cross Blue Shield of North Dakota
  34. Blue Cross Blue Shield of Wyoming
  35. BlueCross BlueShield of Tennessee
  36. Chorus Community Health Plans
  37. CHRISTUS Health Plan
  38. Common Ground Healthcare Cooperative
  39. Dean Health Plan
  40. Florida Blue (BlueCross BlueShield FL)
  41. Florida Blue HMO (a BlueCross BlueShield FL company)
  42. HealthPartners
  43. Highmark Blue Cross Blue Shield Delaware
  44. Highmark Blue Cross Blue Shield West Virginia
  45. Humana
  46. Medica
  47. MedMutual
  48. Moda Health Plan, Inc.
  49. Oscar Health Insurance
  50. Oscar Health Plan of North Carolina, Inc
  51. Oscar Health Plan, Inc.
  52. Oscar Insurance Company
  53. Oscar Insurance Company of Florida
  54. Oscar Insurance Corporation of Ohio
  55. Primewell Health Services of Mississippi
  56. Priority Health
  57. Sanford Health Plan
  58. SummaCare
  59. UnitedHealthcare
  60. University of Michigan Health Plan
  61. WellCare of North Carolina

Accepted Health Plans and Insurance Coverage

List of insurance companies accepted by WAL-MART PHARMACY 10-2703. 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 + 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 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 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 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 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 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 96992IN0060010 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 + Adult Dental + Vision EPO 48161MO0200040 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 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 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 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 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 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 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 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 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: $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 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 + 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 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 + 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 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 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 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 + 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 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 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 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 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 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 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: 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: $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 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 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 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 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 + 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 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 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 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 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
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?
Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx HMO 68445AZ0600010 No
Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx HMO 68445AZ0600011 No
Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx HMO 68445AZ0610010 No
Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx HMO 68445AZ0610011 No
Bronze Standard HMO 68445AZ0590010 No
Catastrophic Standard HMO 68445AZ0590050 No
Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx HMO 68445AZ0600030 No
Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx HMO 68445AZ0600031 No
Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx HMO 68445AZ0610030 No
Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx HMO 68445AZ0610031 No
Gold Standard HMO 68445AZ0590030 No
Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx HMO 68445AZ0600020 No
Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx HMO 68445AZ0600021 No
Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx HMO 68445AZ0610020 No
Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx HMO 68445AZ0610021 No
Silver Standard HMO 68445AZ0590020 No
Plan Name Plan Type Plan ID Dental Only Plan?
Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx HMO 31981OH0020010 No
Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx HMO 31981OH0020011 No
Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx HMO 31981OH0030010 No
Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx HMO 31981OH0030011 No
Bronze Standard HMO 31981OH0010010 No
Catastrophic Standard HMO 31981OH0010050 No
Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx HMO 31981OH0020030 No
Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx HMO 31981OH0020031 No
Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx HMO 31981OH0030030 No
Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx HMO 31981OH0030031 No
Gold Standard HMO 31981OH0010030 No
Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx HMO 31981OH0020020 No
Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx HMO 31981OH0020021 No
Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx HMO 31981OH0030020 No
Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx HMO 31981OH0030021 No
Silver Standard HMO 31981OH0010020 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?
BannerAetna Bronze 2 HSA: No PCP required + 98point6 virtual care 24/7 HMO 23435AZ0040001 No
BannerAetna Bronze 4: No PCP required + $0 PCP + free 98.6 virtual care 24/7 + Adult Dental + Vision HMO 23435AZ0040022 No
BannerAetna Bronze 4: No PCP required + $0 PCP + free 98point6 virtual care 24/7 HMO 23435AZ0040016 No
BannerAetna Bronze S: No PCP required + free 98point6 virtual care 24/7 HMO 23435AZ0040011 No
BannerAetna Gold 10: No PCP required + $0 PCP + free 98.6 virtual care 24/7 + Adult Dental + Vision HMO 23435AZ0040023 No
BannerAetna Gold 10: No PCP required + $0 PCP + free 98point6 virtual care 24/7 HMO 23435AZ0040028 No
BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 HMO 23435AZ0040017 No
BannerAetna Gold 3: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision HMO 23435AZ0040024 No
BannerAetna Gold S: No PCP required + free 98point6 virtual care 24/7 HMO 23435AZ0040012 No
BannerAetna Silver 10: No PCP required + $0 PCP + free 98.6 virtual care 24/7 + Adult Dental +Vision HMO 23435AZ0040025 No
BannerAetna Silver 4: No PCP required + free 98point6 virtual care 24/7 HMO 23435AZ0040014 No
BannerAetna Silver 4: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision HMO 23435AZ0040026 No
BannerAetna Silver 5: No PCP required + free 98point6 virtual care 24/7 HMO 23435AZ0040019 No
BannerAetna Silver S: No PCP required + free 98point6 virtual care 24/7 HMO 23435AZ0040015 No
BannerAetna Silver S: No PCP required + free 98point6 virtual care 24/7 + Adult Dental + Vision HMO 23435AZ0040027 No
Plan Name Plan Type Plan ID Dental Only Plan?
BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) HMO 40788TX0460001 No
BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) HMO 40788TX0460001 No
BSW Elite Gold HMO 004 (Two free PCP visits, $0 Pediatric PCP visits) HMO 40788TX0460004 No
BSW Elite Gold HMO 004 (Two free PCP visits, $0 Pediatric PCP visits) HMO 40788TX0460004 No
BSW Elite Gold HMO 012 HMO 40788TX0460012 No
BSW Elite Gold HMO 012 HMO 40788TX0460012 No
BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) HMO 40788TX0460003 No
BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) HMO 40788TX0460003 No
BSW Prime Silver HMO 008 (Two free PCP visits, $0 Pediatric PCP visit) HMO 40788TX0460008 No
BSW Prime Silver HMO 008 (Two free PCP visits, $0 Pediatric PCP visit) HMO 40788TX0460008 No
BSW Prime Silver HMO 005 HMO 40788TX0460005 No
BSW Prime Silver HMO 005 HMO 40788TX0460005 No
BSW Savers Bronze HMO H S A 006 HMO 40788TX0460006 No
BSW Savers Bronze HMO H S A 006 HMO 40788TX0460006 No
BSW Vital Bronze HMO 007 (CMS Standardized Plan with $0 Pediatric PCP copay) HMO 40788TX0460007 No
BSW Vital Bronze HMO 007 (CMS Standardized Plan with $0 Pediatric PCP copay) HMO 40788TX0460007 No
BSW Vital Bronze HMO 009 (One free PCP visit, $0 Pediatric PCP visit) HMO 40788TX0460009 No
BSW Vital Bronze HMO 009 (One free PCP visit, $0 Pediatric PCP visit) HMO 40788TX0460009 No
Plan Name Plan Type Plan ID Dental Only Plan?
Blue Cross Select Gold PPO 46944AL0650001 No
Blue Cross Select Silver PPO 46944AL0660001 No
Blue HSA Bronze PPO 46944AL0560001 No
Blue Protect PPO 46944AL0470001 No
Blue Saver Bronze PPO 46944AL0460001 No
Blue Saver Silver EPO EPO 46944AL0710001 No
Blue Standardized Bronze PPO 46944AL0750001 No
Blue Standardized Gold PPO 46944AL0720001 No
Blue Standardized Silver PPO 46944AL0730001 No
Blue Standardized Silver EPO EPO 46944AL0740001 No
Blue Value Gold PPO 46944AL0370001 No
Blue Value Silver PPO 46944AL0410001 No
Blue Access Gold for Business PPO 46944AL0340001 No
Blue Choice Platinum for Business PPO 46944AL0280001 No
Blue HSA Silver for Business PPO 46944AL0680001 No
Blue Saver Bronze for Business PPO 46944AL0430001 No
Blue Saver Gold for Business PPO 46944AL0760001 No
Blue Secure Gold for Business PPO 46944AL0670001 No
Blue Secure Silver for Business PPO 46944AL0380001 No
Plan Name Plan Type Plan ID Dental Only Plan?
Blue Choice Preferred Bronze PPO? 201 PPO 36096IL0990127 No
Blue Choice Preferred Bronze PPO? 201 PPO 36096IL0990188 No
Blue Choice Preferred Bronze PPO? 201 PPO 36096IL0990189 No
Blue Choice Preferred Bronze PPO? 201 PPO 36096IL0990190 No
Blue Choice Preferred Bronze PPO? 201 PPO 36096IL0990191 No
Blue Choice Preferred Bronze PPO? 201 PPO 36096IL0990192 No
Blue Choice Preferred Bronze PPO? 201 PPO 36096IL0990193 No
Blue Choice Preferred Bronze PPO? 201 PPO 36096IL0990194 No
Blue Choice Preferred Bronze PPO? 201 PPO 36096IL0990195 No
Blue Choice Preferred Bronze PPO? 201 PPO 36096IL0990196 No
Blue Choice Preferred Bronze PPO? 201 PPO 36096IL0990197 No
Blue Choice Preferred Bronze PPO? 201 PPO 36096IL0990198 No
Blue Choice Preferred Bronze PPO? 201 PPO 36096IL0990199 No
Blue Choice Preferred Bronze PPO? 701 PPO 36096IL0990265 No
Blue Choice Preferred Bronze PPO? 701 PPO 36096IL0990267 No
Blue Choice Preferred Bronze PPO? 701 PPO 36096IL0990268 No
Blue Choice Preferred Bronze PPO? 701 PPO 36096IL0990269 No
Blue Choice Preferred Bronze PPO? 701 PPO 36096IL0990270 No
Blue Choice Preferred Bronze PPO? 701 PPO 36096IL0990271 No
Blue Choice Preferred Bronze PPO? 701 PPO 36096IL0990272 No
Blue Choice Preferred Bronze PPO? 701 PPO 36096IL0990273 No
Blue Choice Preferred Bronze PPO? 701 PPO 36096IL0990274 No
Blue Choice Preferred Bronze PPO? 701 PPO 36096IL0990275 No
Blue Choice Preferred Bronze PPO? 701 PPO 36096IL0990276 No
Blue Choice Preferred Bronze PPO? 701 PPO 36096IL0990277 No
Blue Choice Preferred Bronze PPO? 701 PPO 36096IL0990278 No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays PPO 36096IL0990306 No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays PPO 36096IL0990332 No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays PPO 36096IL0990333 No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays PPO 36096IL0990334 No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays PPO 36096IL0990335 No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays PPO 36096IL0990336 No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays PPO 36096IL0990337 No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays PPO 36096IL0990338 No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays PPO 36096IL0990339 No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays PPO 36096IL0990340 No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays PPO 36096IL0990341 No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays PPO 36096IL0990342 No
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays PPO 36096IL0990343 No
Blue Choice Preferred Gold PPO? 204 PPO 36096IL0990122 No
Blue Choice Preferred Gold PPO? 204 PPO 36096IL0990128 No
Blue Choice Preferred Gold PPO? 204 PPO 36096IL0990129 No
Blue Choice Preferred Gold PPO? 204 PPO 36096IL0990130 No
Blue Choice Preferred Gold PPO? 204 PPO 36096IL0990131 No
Blue Choice Preferred Gold PPO? 204 PPO 36096IL0990132 No
Blue Choice Preferred Gold PPO? 204 PPO 36096IL0990133 No
Blue Choice Preferred Gold PPO? 204 PPO 36096IL0990134 No
Blue Choice Preferred Gold PPO? 204 PPO 36096IL0990135 No
Blue Choice Preferred Gold PPO? 204 PPO 36096IL0990136 No
Blue Choice Preferred Gold PPO? 204 PPO 36096IL0990137 No
Blue Choice Preferred Gold PPO? 204 PPO 36096IL0990138 No
Blue Choice Preferred Gold PPO? 204 PPO 36096IL0990139 No
Blue Choice Preferred Gold PPO? Standard - Rx Copays PPO 36096IL0990279 No
Blue Choice Preferred Gold PPO? Standard - Rx Copays PPO 36096IL0990282 No
Blue Choice Preferred Gold PPO? Standard - Rx Copays PPO 36096IL0990283 No
Blue Choice Preferred Gold PPO? Standard - Rx Copays PPO 36096IL0990284 No
Blue Choice Preferred Gold PPO? Standard - Rx Copays PPO 36096IL0990285 No
Blue Choice Preferred Gold PPO? Standard - Rx Copays PPO 36096IL0990286 No
Blue Choice Preferred Gold PPO? Standard - Rx Copays PPO 36096IL0990287 No
Blue Choice Preferred Gold PPO? Standard - Rx Copays PPO 36096IL0990288 No
Blue Choice Preferred Gold PPO? Standard - Rx Copays PPO 36096IL0990289 No
Blue Choice Preferred Gold PPO? Standard - Rx Copays PPO 36096IL0990290 No
Blue Choice Preferred Gold PPO? Standard - Rx Copays PPO 36096IL0990291 No
Blue Choice Preferred Gold PPO? Standard - Rx Copays PPO 36096IL0990292 No
Blue Choice Preferred Gold PPO? Standard - Rx Copays PPO 36096IL0990293 No
Blue Choice Preferred Security PPO? 200 PPO 36096IL0990126 No
Blue Choice Preferred Security PPO? 200 PPO 36096IL0990176 No
Blue Choice Preferred Security PPO? 200 PPO 36096IL0990177 No
Blue Choice Preferred Security PPO? 200 PPO 36096IL0990178 No
Blue Choice Preferred Security PPO? 200 PPO 36096IL0990179 No
Blue Choice Preferred Security PPO? 200 PPO 36096IL0990180 No
Blue Choice Preferred Security PPO? 200 PPO 36096IL0990181 No
Blue Choice Preferred Security PPO? 200 PPO 36096IL0990182 No
Blue Choice Preferred Security PPO? 200 PPO 36096IL0990183 No
Blue Choice Preferred Security PPO? 200 PPO 36096IL0990184 No
Blue Choice Preferred Security PPO? 200 PPO 36096IL0990185 No
Blue Choice Preferred Security PPO? 200 PPO 36096IL0990186 No
Blue Choice Preferred Security PPO? 200 PPO 36096IL0990187 No
Blue Choice Preferred Silver PPO? 203 PPO 36096IL0990123 No
Blue Choice Preferred Silver PPO? 203 PPO 36096IL0990140 No
Blue Choice Preferred Silver PPO? 203 PPO 36096IL0990141 No
Blue Choice Preferred Silver PPO? 203 PPO 36096IL0990142 No
Blue Choice Preferred Silver PPO? 203 PPO 36096IL0990143 No
Blue Choice Preferred Silver PPO? 203 PPO 36096IL0990144 No
Blue Choice Preferred Silver PPO? 203 PPO 36096IL0990145 No
Blue Choice Preferred Silver PPO? 203 PPO 36096IL0990146 No
Blue Choice Preferred Silver PPO? 203 PPO 36096IL0990147 No
Blue Choice Preferred Silver PPO? 203 PPO 36096IL0990148 No
Blue Choice Preferred Silver PPO? 203 PPO 36096IL0990149 No
Blue Choice Preferred Silver PPO? 203 PPO 36096IL0990150 No
Blue Choice Preferred Silver PPO? 203 PPO 36096IL0990151 No
Blue Choice Preferred Silver PPO? 801 PPO 36096IL0990361 No
Blue Choice Preferred Silver PPO? 801 PPO 36096IL0990362 No
Blue Choice Preferred Silver PPO? 801 PPO 36096IL0990363 No
Blue Choice Preferred Silver PPO? 801 PPO 36096IL0990364 No
Blue Choice Preferred Silver PPO? 801 PPO 36096IL0990365 No
Blue Choice Preferred Silver PPO? 801 PPO 36096IL0990366 No
Blue Choice Preferred Silver PPO? 801 PPO 36096IL0990367 No
Blue Choice Preferred Silver PPO? 801 PPO 36096IL0990368 No
Blue Choice Preferred Silver PPO? 801 PPO 36096IL0990369 No
Blue Choice Preferred Silver PPO? 801 PPO 36096IL0990370 No
Blue Choice Preferred Silver PPO? 801 PPO 36096IL0990371 No
Blue Choice Preferred Silver PPO? 801 PPO 36096IL0990372 No
Blue Choice Preferred Silver PPO? 801 PPO 36096IL0990373 No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays PPO 36096IL0990280 No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays PPO 36096IL0990294 No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays PPO 36096IL0990295 No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays PPO 36096IL0990296 No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays PPO 36096IL0990297 No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays PPO 36096IL0990298 No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays PPO 36096IL0990299 No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays PPO 36096IL0990300 No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays PPO 36096IL0990344 No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays PPO 36096IL0990345 No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays PPO 36096IL0990346 No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays PPO 36096IL0990347 No
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays PPO 36096IL0990348 No
Blue Precision Bronze HMO? 205 HMO 36096IL0810083 No
Blue Precision Bronze HMO? 205 HMO 36096IL0810108 No
Blue Precision Bronze HMO? 205 HMO 36096IL0810109 No
Blue Precision Bronze HMO? 205 HMO 36096IL0810110 No
Blue Precision Bronze HMO? 205 HMO 36096IL0810111 No
Blue Precision Bronze HMO? 205 HMO 36096IL0810112 No
Blue Precision Bronze HMO? 701 HMO 36096IL0810123 No
Blue Precision Bronze HMO? 701 HMO 36096IL0810134 No
Blue Precision Bronze HMO? 701 HMO 36096IL0810135 No
Blue Precision Bronze HMO? 701 HMO 36096IL0810136 No
Blue Precision Bronze HMO? 701 HMO 36096IL0810137 No
Blue Precision Bronze HMO? 701 HMO 36096IL0810138 No
Blue Precision Bronze HMO? Standard - Select Rx Copays HMO 36096IL0810172 No
Blue Precision Bronze HMO? Standard - Select Rx Copays HMO 36096IL0810173 No
Blue Precision Bronze HMO? Standard - Select Rx Copays HMO 36096IL0810174 No
Blue Precision Bronze HMO? Standard - Select Rx Copays HMO 36096IL0810175 No
Blue Precision Bronze HMO? Standard - Select Rx Copays HMO 36096IL0810176 No
Blue Precision Bronze HMO? Standard - Select Rx Copays HMO 36096IL0810177 No
Blue Precision Gold HMO? 207 HMO 36096IL0810080 No
Blue Precision Gold HMO? 207 HMO 36096IL0810090 No
Blue Precision Gold HMO? 207 HMO 36096IL0810091 No
Blue Precision Gold HMO? 207 HMO 36096IL0810092 No
Blue Precision Gold HMO? 207 HMO 36096IL0810093 No
Blue Precision Gold HMO? 207 HMO 36096IL0810094 No
Blue Precision Gold HMO? 703 HMO 36096IL0810121 No
Blue Precision Gold HMO? 703 HMO 36096IL0810124 No
Blue Precision Gold HMO? 703 HMO 36096IL0810125 No
Blue Precision Gold HMO? 703 HMO 36096IL0810126 No
Blue Precision Gold HMO? 703 HMO 36096IL0810127 No
Blue Precision Gold HMO? 703 HMO 36096IL0810128 No
Blue Precision Gold HMO? Standard - Rx Copays HMO 36096IL0810139 No
Blue Precision Gold HMO? Standard - Rx Copays HMO 36096IL0810142 No
Blue Precision Gold HMO? Standard - Rx Copays HMO 36096IL0810143 No
Blue Precision Gold HMO? Standard - Rx Copays HMO 36096IL0810144 No
Blue Precision Gold HMO? Standard - Rx Copays HMO 36096IL0810145 No
Blue Precision Gold HMO? Standard - Rx Copays HMO 36096IL0810146 No
Blue Precision Silver HMO? 206 HMO 36096IL0810081 No
Blue Precision Silver HMO? 206 HMO 36096IL0810096 No
Blue Precision Silver HMO? 206 HMO 36096IL0810097 No
Blue Precision Silver HMO? 206 HMO 36096IL0810098 No
Blue Precision Silver HMO? 206 HMO 36096IL0810099 No
Blue Precision Silver HMO? 206 HMO 36096IL0810100 No
Blue Precision Silver HMO? 704 HMO 36096IL0810122 No
Blue Precision Silver HMO? 704 HMO 36096IL0810129 No
Blue Precision Silver HMO? 704 HMO 36096IL0810130 No
Blue Precision Silver HMO? 704 HMO 36096IL0810131 No
Blue Precision Silver HMO? 704 HMO 36096IL0810132 No
Blue Precision Silver HMO? 704 HMO 36096IL0810133 No
Blue Precision Silver HMO? Standard - Select Rx Copays HMO 36096IL0810140 No
Blue Precision Silver HMO? Standard - Select Rx Copays HMO 36096IL0810147 No
Blue Precision Silver HMO? Standard - Select Rx Copays HMO 36096IL0810148 No
Blue Precision Silver HMO? Standard - Select Rx Copays HMO 36096IL0810149 No
Blue Precision Silver HMO? Standard - Select Rx Copays HMO 36096IL0810150 No
Blue Precision Silver HMO? Standard - Select Rx Copays HMO 36096IL0810151 No
BlueCare Direct Bronze? Standard - Select Rx Copays with Advocate HMO 36096IL0810195 No
BlueCare Direct Bronze? Standard - Select Rx Copays with Advocate HMO 36096IL0810212 No
BlueCare Direct Bronze? Standard - Select Rx Copays with Advocate HMO 36096IL0810213 No
BlueCare Direct Gold? Standard - Rx Copays with Advocate HMO 36096IL0810193 No
BlueCare Direct Gold? Standard - Rx Copays with Advocate HMO 36096IL0810208 No
BlueCare Direct Gold? Standard - Rx Copays with Advocate HMO 36096IL0810209 No
BlueCare Direct Silver? Standard - Select Rx Copays with Advocate HMO 36096IL0810194 No
BlueCare Direct Silver? Standard - Select Rx Copays with Advocate HMO 36096IL0810210 No
BlueCare Direct Silver? Standard - Select Rx Copays with Advocate HMO 36096IL0810211 No
Plan Name Plan Type Plan ID Dental Only Plan?
Blue KC Catastrophic BlueSelect EPO EPO 34762MO0590023 No
Blue KC Catastrophic BlueSelect EPO EPO 94248KS0560012 No
Blue KC Choice Bronze 2 BlueSelect EPO with Spira Care EPO 34762MO0590014 No
Blue KC Choice Bronze 2 BlueSelect EPO with Spira Care EPO 94248KS0560008 No
Blue KC Choice Silver 1 BlueSelect EPO with Spira Care EPO 34762MO0590004 No
Blue KC Choice Silver 1 BlueSelect EPO with Spira Care EPO 94248KS0560004 No
Blue KC Choice Silver BlueSelect Plus EPO with Spira Care EPO 34762MO0590002 No
Blue KC Choice Silver BlueSelect Plus EPO with Spira Care EPO 94248KS0560002 No
Blue KC Community Silver Preferred-Care Blue EPO EPO 34762MO0590009 No
Blue KC First Bronze Preferred-Care Blue EPO EPO 34762MO0590010 No
Blue KC Saver Bronze Preferred-Care Blue EPO EPO 34762MO0590003 No
Blue KC Saver Bronze Preferred-Care Blue EPO EPO 94248KS0560009 No
Blue KC Standard Bronze BlueSelect EPO EPO 34762MO0590018 No
Blue KC Standard Bronze BlueSelect EPO EPO 94248KS0560015 No
Blue KC Standard Bronze Preferred-Care Blue EPO EPO 34762MO0590020 No
Blue KC Standard Gold Preferred-Care Blue EPO EPO 34762MO0590013 No
Blue KC Standard Gold Preferred-Care Blue EPO EPO 94248KS0560007 No
Blue KC Standard Silver BlueSelect EPO EPO 34762MO0590022 No
Blue KC Standard Silver BlueSelect EPO EPO 94248KS0560014 No
Blue KC Standard Silver Preferred-Care Blue EPO EPO 34762MO0590019 No
Plan Name Plan Type Plan ID Dental Only Plan?
Blue Focus Bronze POS? 205 POS 30751MT0670003 No
Blue Focus Bronze POS? 205 POS 30751MT0670012 No
Blue Focus Bronze POS? 205 POS 30751MT0670013 No
Blue Focus Bronze POS? 705 POS 30751MT0670006 No
Blue Focus Bronze POS? 705 POS 30751MT0670016 No
Blue Focus Bronze POS? 705 POS 30751MT0670017 No
Blue Focus Bronze POS? Standard POS 30751MT0670009 No
Blue Focus Bronze POS? Standard POS 30751MT0670018 No
Blue Focus Bronze POS? Standard POS 30751MT0670019 No
Blue Focus Gold POS? 207 POS 30751MT0670001 No
Blue Focus Gold POS? 207 POS 30751MT0670020 No
Blue Focus Gold POS? 207 POS 30751MT0670021 No
Blue Focus Gold POS? Standard POS 30751MT0670007 No
Blue Focus Gold POS? Standard POS 30751MT0670022 No
Blue Focus Gold POS? Standard POS 30751MT0670023 No
Blue Focus Silver POS? 206 POS 30751MT0670002 No
Blue Focus Silver POS? 206 POS 30751MT0670024 No
Blue Focus Silver POS? 206 POS 30751MT0670025 No
Blue Focus Silver POS? Standard POS 30751MT0670008 No
Blue Focus Silver POS? Standard POS 30751MT0670028 No
Blue Focus Silver POS? Standard POS 30751MT0670029 No
Blue Preferred Bronze PPO? 201 PPO 30751MT0550040 No
Blue Preferred Bronze PPO? 201 PPO 30751MT0550049 No
Blue Preferred Bronze PPO? 201 PPO 30751MT0550050 No
Blue Preferred Bronze PPO? 201 PPO 30751MT0550051 No
Blue Preferred Bronze PPO? 202 PPO 30751MT0550041 No
Blue Preferred Bronze PPO? 202 PPO 30751MT0550052 No
Blue Preferred Bronze PPO? 202 PPO 30751MT0550053 No
Blue Preferred Bronze PPO? 202 PPO 30751MT0550054 No
Blue Preferred Bronze PPO? Standard PPO 30751MT0550092 No
Blue Preferred Bronze PPO? Standard PPO 30751MT0550093 No
Blue Preferred Bronze PPO? Standard PPO 30751MT0550100 No
Blue Preferred Bronze PPO? Standard PPO 30751MT0550101 No
Blue Preferred Gold PPO? 204 PPO 30751MT0550038 No
Blue Preferred Gold PPO? 204 PPO 30751MT0550043 No
Blue Preferred Gold PPO? 204 PPO 30751MT0550044 No
Blue Preferred Gold PPO? 204 PPO 30751MT0550045 No
Blue Preferred Gold PPO? Standard PPO 30751MT0550086 No
Blue Preferred Gold PPO? Standard PPO 30751MT0550089 No
Blue Preferred Gold PPO? Standard PPO 30751MT0550094 No
Blue Preferred Gold PPO? Standard PPO 30751MT0550095 No
Blue Preferred Security PPO? 200 PPO 30751MT0550042 No
Blue Preferred Security PPO? 200 PPO 30751MT0550055 No
Blue Preferred Security PPO? 200 PPO 30751MT0550056 No
Blue Preferred Security PPO? 200 PPO 30751MT0550057 No
Blue Preferred Silver PPO? 203 PPO 30751MT0550039 No
Blue Preferred Silver PPO? 203 PPO 30751MT0550046 No
Blue Preferred Silver PPO? 203 PPO 30751MT0550047 No
Blue Preferred Silver PPO? 203 PPO 30751MT0550048 No
Blue Preferred Silver PPO? 308 PPO 30751MT0550061 No
Blue Preferred Silver PPO? 308 PPO 30751MT0550071 No
Blue Preferred Silver PPO? 308 PPO 30751MT0550072 No
Blue Preferred Silver PPO? 308 PPO 30751MT0550073 No
Blue Preferred Silver PPO? Standard PPO 30751MT0550087 No
Blue Preferred Silver PPO? Standard PPO 30751MT0550090 No
Blue Preferred Silver PPO? Standard PPO 30751MT0550096 No
Blue Preferred Silver PPO? Standard PPO 30751MT0550097 No
Plan Name Plan Type Plan ID Dental Only Plan?
HeartlandBlue Bronze 0% Coinsurance after Deductible NEtwork Blue EPO 29678NE1450002 No
HeartlandBlue Bronze 0% Coinsurance after Deductible NEtwork Blue PPO PPO 29678NE1510002 No
HeartlandBlue Bronze 5000 Blueprint Health w/ Adult Vision EPO 29678NE1560014 No
HeartlandBlue Bronze 5000 Blueprint Health w/ Adult Vision EPO 29678NE1570014 No
HeartlandBlue Bronze 5000 Blueprint Health w/ Adult Vision EPO 29678NE1580014 No
HeartlandBlue Bronze 5000 Premier Select BlueChoice w/ Adult Vision EPO 29678NE1530014 No
HeartlandBlue Bronze 5000 Premier Select BlueChoice w/ Adult Vision EPO 29678NE1540014 No
HeartlandBlue Bronze 5000 Premier Select BlueChoice w/ Adult Vision EPO 29678NE1550014 No
HeartlandBlue Bronze HSA 6500 Blueprint Health EPO 29678NE1480001 No
HeartlandBlue Bronze HSA 6500 Blueprint Health EPO 29678NE1490001 No
HeartlandBlue Bronze HSA 6500 Blueprint Health EPO 29678NE1500001 No
HeartlandBlue Bronze HSA 6500 NEtwork Blue EPO 29678NE1450001 No
HeartlandBlue Bronze HSA 6500 NEtwork Blue PPO PPO 29678NE1510001 No
HeartlandBlue Bronze HSA 6500 Premier Select BlueChoice EPO 29678NE1460001 No
HeartlandBlue Bronze HSA 6500 Premier Select BlueChoice EPO 29678NE1470001 No
HeartlandBlue Bronze HSA 6500 Premier Select BlueChoice EPO 29678NE1520001 No
HeartlandBlue Bronze Standard 7500 Blueprint Health EPO 29678NE1480006 No
HeartlandBlue Bronze Standard 7500 Blueprint Health EPO 29678NE1490006 No
HeartlandBlue Bronze Standard 7500 Blueprint Health EPO 29678NE1500006 No
HeartlandBlue Bronze Standard 7500 NEtwork Blue EPO 29678NE1450006 No
HeartlandBlue Bronze Standard 7500 NEtwork Blue PPO PPO 29678NE1510006 No
HeartlandBlue Bronze Standard 7500 Premier Select BlueChoice EPO 29678NE1460006 No
HeartlandBlue Bronze Standard 7500 Premier Select BlueChoice EPO 29678NE1470006 No
HeartlandBlue Bronze Standard 7500 Premier Select BlueChoice EPO 29678NE1520006 No
HeartlandBlue Gold $0 Deductible NEtwork Blue EPO 29678NE1450012 No
HeartlandBlue Gold $0 Deductible NEtwork Blue PPO PPO 29678NE1510012 No
HeartlandBlue Gold $0 PCP Visit 1500 NEtwork Blue EPO 29678NE1450011 No
HeartlandBlue Gold $0 PCP Visit 1500 NEtwork Blue PPO PPO 29678NE1510011 No
HeartlandBlue Gold Standard 1500 Blueprint Health EPO 29678NE1480013 No
HeartlandBlue Gold Standard 1500 Blueprint Health EPO 29678NE1490013 No
HeartlandBlue Gold Standard 1500 Blueprint Health EPO 29678NE1500013 No
HeartlandBlue Gold Standard 1500 NEtwork Blue EPO 29678NE1450013 No
HeartlandBlue Gold Standard 1500 NEtwork Blue PPO PPO 29678NE1510013 No
HeartlandBlue Gold Standard 1500 Premier Select BlueChoice EPO 29678NE1460013 No
HeartlandBlue Gold Standard 1500 Premier Select BlueChoice EPO 29678NE1470013 No
HeartlandBlue Gold Standard 1500 Premier Select BlueChoice EPO 29678NE1520013 No
HeartlandBlue Silver $0 Mental Health Visit 6000 NEtwork Blue EPO 29678NE1450009 No
HeartlandBlue Silver $0 Mental Health Visit 6000 NEtwork Blue PPO PPO 29678NE1510009 No
HeartlandBlue Silver $0 PCP Visit 4500 NEtwork Blue EPO 29678NE1450008 No
HeartlandBlue Silver $0 PCP Visit 4500 NEtwork Blue PPO PPO 29678NE1510008 No
HeartlandBlue Silver Standard 5000 Blueprint Health EPO 29678NE1480010 No
HeartlandBlue Silver Standard 5000 Blueprint Health EPO 29678NE1490010 No
HeartlandBlue Silver Standard 5000 Blueprint Health EPO 29678NE1500010 No
HeartlandBlue Silver Standard 5000 NEtwork Blue EPO 29678NE1450010 No
HeartlandBlue Silver Standard 5000 NEtwork Blue PPO PPO 29678NE1510010 No
HeartlandBlue Silver Standard 5000 Premier Select BlueChoice EPO 29678NE1460010 No
HeartlandBlue Silver Standard 5000 Premier Select BlueChoice EPO 29678NE1470010 No
HeartlandBlue Silver Standard 5000 Premier Select BlueChoice EPO 29678NE1520010 No
Plan Name Plan Type Plan ID Dental Only Plan?
Blue Advantage Bronze PPO? 202 PPO 87571OK0350070 No
Blue Advantage Bronze PPO? 202 PPO 87571OK0350091 No
Blue Advantage Bronze PPO? 202 PPO 87571OK0350092 No
Blue Advantage Bronze PPO? 202 PPO 87571OK0350093 No
Blue Advantage Bronze PPO? 202 PPO 87571OK0350094 No
Blue Advantage Bronze PPO? 203 PPO 87571OK0350068 No
Blue Advantage Bronze PPO? 203 PPO 87571OK0350083 No
Blue Advantage Bronze PPO? 203 PPO 87571OK0350084 No
Blue Advantage Bronze PPO? 203 PPO 87571OK0350085 No
Blue Advantage Bronze PPO? 203 PPO 87571OK0350086 No
Blue Advantage Bronze PPO? Standard PPO 87571OK0350176 No
Blue Advantage Bronze PPO? Standard PPO 87571OK0350219 No
Blue Advantage Bronze PPO? Standard PPO 87571OK0350220 No
Blue Advantage Bronze PPO? Standard PPO 87571OK0350221 No
Blue Advantage Bronze PPO? Standard PPO 87571OK0350222 No
Blue Advantage Gold PPO? 309 PPO 87571OK0350097 No
Blue Advantage Gold PPO? 309 PPO 87571OK0350106 No
Blue Advantage Gold PPO? 309 PPO 87571OK0350107 No
Blue Advantage Gold PPO? 309 PPO 87571OK0350108 No
Blue Advantage Gold PPO? 309 PPO 87571OK0350109 No
Blue Advantage Gold PPO? 604 PPO 87571OK0350118 No
Blue Advantage Gold PPO? 604 PPO 87571OK0350127 No
Blue Advantage Gold PPO? 604 PPO 87571OK0350128 No
Blue Advantage Gold PPO? 604 PPO 87571OK0350129 No
Blue Advantage Gold PPO? 604 PPO 87571OK0350130 No
Blue Advantage Gold PPO? Standard PPO 87571OK0350178 No
Blue Advantage Gold PPO? Standard PPO 87571OK0350227 No
Blue Advantage Gold PPO? Standard PPO 87571OK0350228 No
Blue Advantage Gold PPO? Standard PPO 87571OK0350229 No
Blue Advantage Gold PPO? Standard PPO 87571OK0350230 No
Blue Advantage Silver PPO? 204 PPO 87571OK0350069 No
Blue Advantage Silver PPO? 204 PPO 87571OK0350087 No
Blue Advantage Silver PPO? 204 PPO 87571OK0350088 No
Blue Advantage Silver PPO? 204 PPO 87571OK0350089 No
Blue Advantage Silver PPO? 204 PPO 87571OK0350090 No
Blue Advantage Silver PPO? 501 PPO 87571OK0350115 No
Blue Advantage Silver PPO? Standard PPO 87571OK0350177 No
Blue Advantage Silver PPO? Standard PPO 87571OK0350223 No
Blue Advantage Silver PPO? Standard PPO 87571OK0350224 No
Blue Advantage Silver PPO? Standard PPO 87571OK0350225 No
Blue Advantage Silver PPO? Standard PPO 87571OK0350226 No
Blue Preferred Bronze PPO? Standard PPO 87571OK0350173 No
Blue Preferred Bronze PPO? Standard PPO 87571OK0350191 No
Blue Preferred Bronze PPO? Standard PPO 87571OK0350192 No
Blue Preferred Bronze PPO? Standard PPO 87571OK0350193 No
Blue Preferred Bronze PPO? Standard PPO 87571OK0350194 No
Blue Preferred Gold PPO? Standard PPO 87571OK0350171 No
Blue Preferred Gold PPO? Standard PPO 87571OK0350199 No
Blue Preferred Gold PPO? Standard PPO 87571OK0350200 No
Blue Preferred Gold PPO? Standard PPO 87571OK0350201 No
Blue Preferred Gold PPO? Standard PPO 87571OK0350202 No
Blue Preferred Security PPO? 200 PPO 87571OK0350165 No
Blue Preferred Security PPO? 200 PPO 87571OK0350203 No
Blue Preferred Security PPO? 200 PPO 87571OK0350204 No
Blue Preferred Security PPO? 200 PPO 87571OK0350205 No
Blue Preferred Security PPO? 200 PPO 87571OK0350206 No
Blue Preferred Silver PPO? Standard PPO 87571OK0350172 No
Blue Preferred Silver PPO? Standard PPO 87571OK0350215 No
Blue Preferred Silver PPO? Standard PPO 87571OK0350216 No
Blue Preferred Silver PPO? Standard PPO 87571OK0350217 No
Blue Preferred Silver PPO? Standard PPO 87571OK0350218 No
MyBlue Gold HMO? 704 HMO 87571OK0510057 No
MyBlue Gold HMO? 704 HMO 87571OK0510060 No
MyBlue Gold HMO? 804 HMO 87571OK0510071 No
MyBlue Gold HMO? 804 HMO 87571OK0510073 No
MyBlue Gold HMO? Standard HMO 87571OK0510063 No
MyBlue Gold HMO? Standard HMO 87571OK0510066 No
MyBlue Silver HMO? 705 HMO 87571OK0510058 No
MyBlue Silver HMO? 705 HMO 87571OK0510061 No
MyBlue Silver HMO? 803 HMO 87571OK0510070 No
MyBlue Silver HMO? 803 HMO 87571OK0510072 No
MyBlue Silver HMO? Standard HMO 87571OK0510064 No
MyBlue Silver HMO? Standard HMO 87571OK0510067 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?
CHRISTUS Bronze HMO 98780LA0150001 No
CHRISTUS Bronze HMO 98780LA0150002 No
CHRISTUS Bronze HMO 98780LA0150003 No
CHRISTUS Bronze Essential HMO 98780LA0040001 No
CHRISTUS Bronze Essential HMO 98780LA0040002 No
CHRISTUS Bronze Essential HMO 98780LA0040003 No
CHRISTUS Bronze Essential Plus HMO 98780LA0160001 No
CHRISTUS Bronze Essential Plus HMO 98780LA0160002 No
CHRISTUS Bronze Essential Plus HMO 98780LA0160003 No
CHRISTUS Bronze Plus HMO 98780LA0170001 No
CHRISTUS Bronze Plus HMO 98780LA0170002 No
CHRISTUS Bronze Plus HMO 98780LA0170003 No
CHRISTUS Gold HMO 98780LA0200001 No
CHRISTUS Gold HMO 98780LA0200002 No
CHRISTUS Gold HMO 98780LA0200003 No
CHRISTUS Gold Essential HMO 98780LA0030001 No
CHRISTUS Gold Essential HMO 98780LA0030002 No
CHRISTUS Gold Essential HMO 98780LA0030003 No
CHRISTUS Gold Essential Plus HMO 98780LA0090001 No
CHRISTUS Gold Essential Plus HMO 98780LA0090002 No
CHRISTUS Gold Essential Plus HMO 98780LA0090003 No
CHRISTUS Gold Plus HMO 98780LA0210001 No
CHRISTUS Gold Plus HMO 98780LA0210002 No
CHRISTUS Gold Plus HMO 98780LA0210003 No
CHRISTUS Silver HMO 98780LA0010001 No
CHRISTUS Silver HMO 98780LA0010002 No
CHRISTUS Silver HMO 98780LA0010003 No
CHRISTUS Silver Essential HMO 98780LA0080001 No
CHRISTUS Silver Essential HMO 98780LA0080002 No
CHRISTUS Silver Essential HMO 98780LA0080003 No
CHRISTUS Silver Essential Plus HMO 98780LA0180001 No
CHRISTUS Silver Essential Plus HMO 98780LA0180002 No
CHRISTUS Silver Essential Plus HMO 98780LA0180003 No
CHRISTUS Silver Plus HMO 98780LA0190001 No
CHRISTUS Silver Plus HMO 98780LA0190002 No
CHRISTUS Silver Plus HMO 98780LA0190003 No
CHRISTUS Standard Expanded Bronze HMO 98780LA0140001 No
CHRISTUS Standard Expanded Bronze HMO 98780LA0140002 No
CHRISTUS Standard Expanded Bronze HMO 98780LA0140003 No
CHRISTUS Standard Gold HMO 98780LA0130001 No
CHRISTUS Standard Gold HMO 98780LA0130002 No
CHRISTUS Standard Gold HMO 98780LA0130003 No
CHRISTUS Standard Silver HMO 98780LA0120001 No
CHRISTUS Standard Silver HMO 98780LA0120002 No
CHRISTUS Standard Silver HMO 98780LA0120003 No
Plan Name Plan Type Plan ID Dental Only Plan?
CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network EPO 87416WI0030003 No
CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network (Vision Exam) EPO 87416WI0060023 No
CGHC Bronze $9200 ($40 PCP Copay) - Envision Network EPO 87416WI0030027 No
CGHC Bronze $9200 ($40 PCP Copay) - Envision Network (Vision Exam) EPO 87416WI0060015 No
CGHC Bronze Standard $7500 - Envision Network EPO 87416WI0030041 No
CGHC Catastrophic $9200 - Envision Network EPO 87416WI0030026 No
CGHC Gold $0 Ded - Envision Network EPO 87416WI0030005 No
CGHC Gold $0 Ded - Envision Network (Vision Exam) EPO 87416WI0060025 No
CGHC Gold $3000 - Envision Network EPO 87416WI0030017 No
CGHC Gold $3000 - Envision Network (Vision Exam) EPO 87416WI0060006 No
CGHC Gold Standard $1500 - Envision Network EPO 87416WI0030043 No
CGHC Silver $4200 Ded / $5000 Rx Ded - Envision Network EPO 87416WI0030023 No
CGHC Silver $4200 Ded / $5000 Rx Ded - Envision Network (Vision Exam) EPO 87416WI0060012 No
CGHC Silver $4700 Ded / $6000 Rx Ded - Envision Network EPO 87416WI0030047 No
CGHC Silver $4700 Ded / $6000 Rx Ded - Envision Network (Vision Exam) EPO 87416WI0060011 No
CGHC Silver Standard $5000 - Envision Network EPO 87416WI0030042 No
Plan Name Plan Type Plan ID Dental Only Plan?
Dean Bronze $0 Copay PCP Visits HMO 38345WI0010183 No
Dean Bronze Share HMO 38345WI0010186 No
Dean Catastrophic HMO 38345WI0010063 No
Dean Expanded Bronze Standard HMO 38345WI0010164 No
Dean Focus Bronze $0 Copay PCP Visits EPO 38345WI0080073 No
Dean Focus Bronze Share EPO 38345WI0080076 No
Dean Focus Catastrophic EPO 38345WI0080064 No
Dean Focus Expanded Bronze Standard EPO 38345WI0080070 No
Dean Focus Gold HSA EPO 38345WI0080063 No
Dean Focus Gold Share EPO 38345WI0080074 No
Dean Focus Gold Standard EPO 38345WI0080068 No
Dean Focus Silver $0 Copay PCP Visits EPO 38345WI0080072 No
Dean Focus Silver Share EPO 38345WI0080075 No
Dean Focus Silver Standard EPO 38345WI0080069 No
Dean Gold HSA HMO 38345WI0010158 No
Dean Gold Share HMO 38345WI0010184 No
Dean Gold Standard HMO 38345WI0010162 No
Dean Silver $0 Copay PCP Visits HMO 38345WI0010182 No
Dean Silver Share HMO 38345WI0010185 No
Dean Silver Standard HMO 38345WI0010163 No
Prevea360 Bronze HSA HMO 38345WI0240009 No
Prevea360 Bronze Share HMO 38345WI0240022 No
Prevea360 Catastrophic HMO 38345WI0240010 No
Prevea360 Expanded Bronze Standard HMO 38345WI0240017 No
Prevea360 Gold HSA HMO 38345WI0240011 No
Prevea360 Gold Share HMO 38345WI0240020 No
Prevea360 Gold Standard HMO 38345WI0240015 No
Prevea360 Silver $0 Copay PCP Visits HMO 38345WI0240019 No
Prevea360 Silver Share HMO 38345WI0240021 No
Prevea360 Silver Standard HMO 38345WI0240016 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?
Atlas $1,000 Gold PPO 20173WI0130020 No
Atlas $1,500 Standard Gold PPO 20173WI0130040 No
Atlas $2,650 Plus Silver PPO 20173WI0130021 No
Atlas $3,500 HSA Silver PPO 20173WI0130026 No
Atlas $5,000 Standard Silver PPO 20173WI0130041 No
Atlas $6,500 Plus Bronze PPO 20173WI0130023 No
Atlas $7,500 Standard Bronze PPO 20173WI0130042 No
Atlas $8,200 HSA Bronze PPO 20173WI0130027 No
Atlas $9,200 Catastrophic PPO 20173WI0130025 No
Robin Oak $1,000 Gold PPO 20173WI0130001 No
Robin Oak $1,500 Standard Gold PPO 20173WI0130011 No
Robin Select $2,800 Plus Silver PPO 20173WI0130033 No
Robin Select $3,500 HSA Silver PPO 20173WI0130037 No
Robin Select $5,000 Standard Silver PPO 20173WI0130034 No
Robin Select $6,500 Plus Bronze PPO 20173WI0130035 No
Robin Select $7,500 Standard Bronze PPO 20173WI0130036 No
Robin Select $8,200 HSA Bronze PPO 20173WI0130038 No
Robin Select $9,200 Catastrophic PPO 20173WI0130039 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?
Humana Dental Smart Choice PPO 44965LA0590001 Yes
Humana Dental Smart Choice PPO 62294MI0420001 Yes
Humana Dental Smart Choice PPO 91604WI0490002 Yes
Humana Dental Smart Choice PPO 97596OH0580003 Yes
Humana Dental Smart Choice - High PPO 15980FL0160004 Yes
Humana Dental Smart Choice - High PPO 23468OK0200002 Yes
Humana Dental Smart Choice - High PPO 31358HI0010002 Yes
Humana Dental Smart Choice - High PPO 32237NC0290002 Yes
Humana Dental Smart Choice - High PPO 44580AL0380003 Yes
Humana Dental Smart Choice - High PPO 48963MS0510003 Yes
Humana Dental Smart Choice - High PPO 63141TX0760002 Yes
Humana Dental Smart Choice - High PPO 66105AZ0620003 Yes
Humana Dental Smart Choice - High PPO 82120TN0630005 Yes
Humana Dental Smart Choice - High PPO 99791IN0540002 Yes
Humana Dental Smart Choice - Lite PPO 15980FL0160005 Yes
Humana Dental Smart Choice - Lite PPO 30613MO0560002 Yes
Humana Dental Smart Choice - Lite PPO 32237NC0290003 Yes
Humana Dental Smart Choice - Lite PPO 44580AL0380004 Yes
Humana Dental Smart Choice - Lite PPO 63141TX0760003 Yes
Humana Dental Smart Choice - Lite PPO 82120TN0630006 Yes
Humana Dental Smart Choice - Low PPO 15980FL0160003 Yes
Humana Dental Smart Choice - Low PPO 23468OK0200001 Yes
Humana Dental Smart Choice - Low PPO 30613MO0560001 Yes
Humana Dental Smart Choice - Low PPO 32237NC0290001 Yes
Humana Dental Smart Choice - Low PPO 44580AL0380001 Yes
Humana Dental Smart Choice - Low PPO 48963MS0510002 Yes
Humana Dental Smart Choice - Low PPO 63141TX0760001 Yes
Humana Dental Smart Choice - Low PPO 66105AZ0620002 Yes
Humana Dental Smart Choice - Low PPO 82120TN0630004 Yes
Humana Dental Smart Choice - Low PPO 99791IN0540001 Yes
Humana Dental Smart Choice Basic PPO 46958UT0470002 Yes
Plan Name Plan Type Plan ID Dental Only Plan?
Select by Medica Bronze $0 Copay PCP Visits EPO 39520KS0040041 No
Select by Medica Bronze Share EPO 39520KS0040029 No
Select by Medica Expanded Bronze Standard EPO 39520KS0040073 No
Select by Medica Gold $0 Copay PCP Visits EPO 39520KS0040045 No
Select by Medica Gold Share EPO 39520KS0040075 No
Select by Medica Gold Standard EPO 39520KS0040055 No
Select by Medica Silver $0 Copay PCP Visits EPO 39520KS0040074 No
Select by Medica Silver Share EPO 39520KS0040076 No
Select by Medica Silver Standard EPO 39520KS0040057 No
WellFirst by Medica Bronze $0 Copay PCP Visits EPO 47840MO0010021 No
WellFirst by Medica Bronze Share EPO 47840MO0010022 No
WellFirst by Medica Catastrophic EPO 47840MO0010010 No
WellFirst by Medica Expanded Bronze Standard EPO 47840MO0010017 No
WellFirst by Medica Gold $0 Copay PCP Visits EPO 47840MO0010019 No
WellFirst by Medica Gold Copay Plus EPO 47840MO0010001 No
WellFirst by Medica Gold Standard EPO 47840MO0010015 No
WellFirst by Medica Silver $0 Copay PCP Visits EPO 47840MO0010020 No
WellFirst by Medica Silver Copay Plus EPO 47840MO0010002 No
WellFirst by Medica Silver Standard EPO 47840MO0010016 No
Plan Name Plan Type Plan ID Dental Only Plan?
Bronze $8,300 w/ Virtual & Wellness ON-EX HMO 99969OH0080499 No
Bronze HSA $7,300 ON-EX HMO 99969OH0080498 No
Bronze Standard w/ Virtual & Wellness HMO 99969OH0080500 No
Bronze Standard w/ Virtual & Wellness (CLE-Care) HMO 99969OH0080506 No
Gold $1250 w/ Virtual & Wellness ON-EX HMO 99969OH0080543 No
Gold $500 w/ Virtual & Wellness ON-EX HMO 99969OH0080542 No
Gold Standard w/ Virtual & Wellness HMO 99969OH0080492 No
Gold Standard w/ Virtual & Wellness (CLE-CARE) HMO 99969OH0080504 No
Silver $5000 w/ Virtual & Wellness ON-EX HMO 99969OH0080544 No
Silver Standard w/ Virtual & Wellness HMO 99969OH0080496 No
Silver Standard w/ Virtual & Wellness (CLE-Care) HMO 99969OH0080505 No
SilverSelect w/ Virtual & Wellness ON-EX HMO 99969OH0080495 No
Young Adult Essentials ON-EX HMO 99969OH0080503 No
Plan Name Plan Type Plan ID Dental Only Plan?
Moda Health Affinity Bronze 7750 EPO 39424OR1680005 No
Moda Health Affinity Bronze 9000 EPO 39424OR1660002 No
Moda Health Affinity Bronze HDHP 7500 EPO 39424OR1680007 No
Moda Health Affinity Gold 1000 EPO 39424OR1700001 No
Moda Health Affinity Gold 1500 EPO 39424OR1680008 No
Moda Health Affinity Gold 250 EPO 39424OR1690001 No
Moda Health Affinity Silver 3000 EPO 39424OR1690003 No
Moda Health Affinity Silver 3400 EPO 39424OR1680002 No
Moda Health Affinity Silver 4500 EPO 39424OR1680004 No
Moda Health Affinity Silver 6000 EPO 39424OR1660001 No
Moda Health Oregon Standard Bronze Affinity EPO 39424OR1670003 No
Moda Health Oregon Standard Gold Affinity EPO 39424OR1670001 No
Moda Health Oregon Standard Silver Affinity EPO 39424OR1670002 No
Moda Pioneer Alaska Standard Bronze PPO 73836AK0960001 No
Moda Pioneer Alaska Standard Gold PPO 73836AK0940001 No
Moda Pioneer Alaska Standard Silver PPO 73836AK0950001 No
Moda Pioneer Bronze 6500 PPO 73836AK0930003 No
Moda Pioneer Bronze HDHP 5500 PPO 73836AK0970002 No
Moda Pioneer Gold 1500 PPO 73836AK0930001 No
Moda Pioneer Silver 4500 PPO 73836AK0930002 No
Moda Select Bronze 8700 ($0 Virtual Urgent Care through CirrusMD) EPO 17933TX0010006 No
Moda Select Bronze HDHP 7500 EPO 17933TX0010007 No
Moda Select Gold 1000 ($0 Virtual Urgent Care through CirrusMD) EPO 17933TX0010001 No
Moda Select Gold 1800 ($0 Virtual Urgent Care through CirrusMD) EPO 17933TX0010002 No
Moda Select Silver 3500 ($0 Virtual Urgent Care through CirrusMD) EPO 17933TX0010003 No
Moda Select Silver 4800 ($0 Virtual Urgent Care through CirrusMD) EPO 17933TX0010004 No
Moda Select Silver 6400 ($0 Virtual Urgent Care through CirrusMD) EPO 17933TX0010005 No
Moda Select Texas Standard Bronze EPO 17933TX0010010 No
Moda Select Texas Standard Gold EPO 17933TX0010009 No
Moda Select Texas Standard Silver EPO 17933TX0010008 No
Plan Name Plan Type Plan ID Dental Only Plan?
Bronze Classic 4700 (Select) HMO 29341OH0100024 No
Bronze Classic PCP Saver (Select) HMO 29341OH0100002 No
Bronze Classic Standard (Select) HMO 29341OH0100050 No
Gold Classic (Select) HMO 29341OH0100013 No
Gold Classic Standard (Select) HMO 29341OH0100053 No
Gold Elite Saver Plus (Select) HMO 29341OH0100035 No
Secure (Select) HMO 29341OH0100011 No
Silver Classic Standard (Select) HMO 29341OH0100052 No
Silver Elite Saver Plus (Select) HMO 29341OH0100030 No
Silver Simple Chronic Care CKM (Select) HMO 29341OH0100060 No
Silver Simple PCP Saver (Select) HMO 29341OH0100025 No
Plan Name Plan Type Plan ID Dental Only Plan?
Bronze Classic 4700 HMO 69803NC0010024 No
Bronze Classic 4700 | with Atrium Health HMO 69803NC0010061 No
Bronze Classic Standard HMO 69803NC0010050 No
Bronze Classic Standard | with Atrium Health HMO 69803NC0010055 No
Bronze Elite + PCP Saver Plus HMO 69803NC0010005 No
Bronze Elite + PCP Saver Plus | with Atrium Health HMO 69803NC0010062 No
Gold Classic Standard HMO 69803NC0010053 No
Gold Classic Standard | with Atrium Health HMO 69803NC0010057 No
Gold Elite Saver Plus HMO 69803NC0010035 No
Gold Elite Saver Plus | with Atrium Health HMO 69803NC0010066 No
Secure HMO 69803NC0010011 No
Secure | with Atrium Health HMO 69803NC0010060 No
Silver Classic HMO 69803NC0010006 No
Silver Classic | with Atrium Health HMO 69803NC0010063 No
Silver Classic Standard HMO 69803NC0010052 No
Silver Classic Standard | with Atrium Health HMO 69803NC0010056 No
Silver Simple Diabetes HMO 69803NC0010045 No
Silver Simple Diabetes | with Atrium Health HMO 69803NC0010064 No
Silver Simple PCP Saver HMO 69803NC0010025 No
Silver Simple PCP Saver | with Atrium Health HMO 69803NC0010065 No
Plan Name Plan Type Plan ID Dental Only Plan?
Bronze Classic 4700 HMO 13877AZ0070024 No
Bronze Classic 4700 (Select) HMO 11574IL0020024 No
Bronze Classic PCP Saver Plus Rx Copay (Select) HMO 11574IL0020021 No
Bronze Classic Standard HMO 13877AZ0070050 No
Bronze Classic Standard (Choice) HMO 11574IL0010050 No
Bronze Classic Standard (Select) HMO 11574IL0020050 No
Bronze Elite + PCP Saver Plus HMO 13877AZ0070005 No
Gold Classic HMO 13877AZ0070013 No
Gold Classic Standard HMO 13877AZ0070053 No
Gold Classic Standard (Choice) HMO 11574IL0010053 No
Gold Classic Standard (Select) HMO 11574IL0020053 No
Secure HMO 13877AZ0070011 No
Secure (Choice) HMO 11574IL0010011 No
Silver Classic Standard HMO 13877AZ0070052 No
Silver Classic Standard (Choice) HMO 11574IL0010052 No
Silver Classic Standard (Select) HMO 11574IL0020052 No
Silver Elite Saver Plus HMO 13877AZ0070030 No
Silver Elite Saver Plus Rx Copay (Select) HMO 11574IL0020030 No
Silver Simple Chronic Care CKM HMO 13877AZ0070060 No
Silver Simple Diabetes (Choice) HMO 11574IL0010045 No
Silver Simple Diabetes (Select) HMO 11574IL0020060 No
Silver Simple PCP Saver HMO 13877AZ0070025 No
Silver Simple PCP Saver (Select) HMO 11574IL0020025 No
Silver Simple Specialist Saver with COPD HMO 13877AZ0070008 No
Plan Name Plan Type Plan ID Dental Only Plan?
Bronze Classic EPO 57424NE0010003 No
Bronze Classic 4700 EPO 23552TN0020024 No
Bronze Classic 4700 EPO 43490KS0010024 No
Bronze Classic 4700 EPO 45819IA0010060 No
Bronze Classic 4700 EPO 69512MO0010024 No
Bronze Classic 4700 EPO 77739MI0070024 No
Bronze Classic 4700 PPO 91908OK0010024 No
Bronze Classic 4700 | MercyOne EPO 45819IA0010024 No
Bronze Classic Standard EPO 23552TN0020050 No
Bronze Classic Standard EPO 43490KS0010050 No
Bronze Classic Standard EPO 45819IA0010065 No
Bronze Classic Standard EPO 57424NE0010050 No
Bronze Classic Standard EPO 69512MO0010050 No
Bronze Classic Standard EPO 77739MI0070050 No
Bronze Classic Standard PPO 91908OK0010050 No
Bronze Classic Standard | MercyOne EPO 45819IA0010050 No
Bronze Elite + PCP Saver EPO 43490KS0010005 No
Bronze Elite + PCP Saver Plus EPO 23552TN0020005 No
Bronze Elite + PCP Saver Plus EPO 45819IA0010056 No
Bronze Elite + PCP Saver Plus EPO 57424NE0010005 No
Bronze Elite + PCP Saver Plus EPO 69512MO0010005 No
Bronze Elite + PCP Saver Plus EPO 77739MI0070005 No
Bronze Elite + PCP Saver Plus PPO 91908OK0010005 No
Bronze Elite + PCP Saver Plus | MercyOne EPO 45819IA0010005 No
Gold Classic EPO 23552TN0020013 No
Gold Classic Standard EPO 23552TN0020053 No
Gold Classic Standard EPO 43490KS0010053 No
Gold Classic Standard EPO 45819IA0010067 No
Gold Classic Standard EPO 57424NE0010053 No
Gold Classic Standard EPO 69512MO0010053 No
Gold Classic Standard EPO 77739MI0070053 No
Gold Classic Standard PPO 91908OK0010053 No
Gold Classic Standard | MercyOne EPO 45819IA0010053 No
Gold Elite EPO 23552TN0020036 No
Gold Elite EPO 45819IA0010063 No
Gold Elite EPO 57424NE0010036 No
Gold Elite | MercyOne EPO 45819IA0010036 No
Gold Elite Saver Plus EPO 77739MI0070035 No
Secure EPO 23552TN0020011 No
Secure EPO 43490KS0010011 No
Secure EPO 45819IA0010058 No
Secure EPO 57424NE0010011 No
Secure EPO 69512MO0010011 No
Secure EPO 77739MI0070011 No
Secure PPO 91908OK0010011 No
Secure | MercyOne EPO 45819IA0010011 No
Silver Classic EPO 23552TN0020006 No
Silver Classic EPO 43490KS0010006 No
Silver Classic EPO 45819IA0010057 No
Silver Classic EPO 57424NE0010006 No
Silver Classic EPO 77739MI0070006 No
Silver Classic | MercyOne EPO 45819IA0010006 No
Silver Classic Standard EPO 23552TN0020052 No
Silver Classic Standard EPO 43490KS0010052 No
Silver Classic Standard EPO 45819IA0010066 No
Silver Classic Standard EPO 57424NE0010052 No
Silver Classic Standard EPO 69512MO0010052 No
Silver Classic Standard EPO 77739MI0070052 No
Silver Classic Standard PPO 91908OK0010052 No
Silver Classic Standard | MercyOne EPO 45819IA0010052 No
Silver Elite Saver Plus EPO 69512MO0010030 No
Silver Elite Saver Plus PPO 91908OK0010030 No
Silver Simple Breathe Easy with Enhanced COPD Benefits EPO 23552TN0020056 No
Silver Simple Breathe Easy with Enhanced COPD Benefits PPO 91908OK0010055 No
Silver Simple Diabetes EPO 23552TN0020055 No
Silver Simple Diabetes EPO 43490KS0010045 No
Silver Simple Diabetes EPO 45819IA0010064 No
Silver Simple Diabetes EPO 57424NE0010045 No
Silver Simple Diabetes EPO 69512MO0010045 No
Silver Simple Diabetes PPO 91908OK0010045 No
Silver Simple Diabetes | MercyOne EPO 45819IA0010045 No
Silver Simple PCP Saver EPO 23552TN0020025 No
Silver Simple PCP Saver EPO 43490KS0010025 No
Silver Simple PCP Saver EPO 45819IA0010061 No
Silver Simple PCP Saver EPO 57424NE0010025 No
Silver Simple PCP Saver EPO 69512MO0010025 No
Silver Simple PCP Saver EPO 77739MI0070025 No
Silver Simple PCP Saver PPO 91908OK0010025 No
Silver Simple PCP Saver | MercyOne EPO 45819IA0010025 No
Plan Name Plan Type Plan ID Dental Only Plan?
Bronze Classic 4700 EPO 40572FL0070024 No
Bronze Classic 4700 EPO 40572FL0200024 No
Bronze Classic Standard EPO 40572FL0070050 No
Bronze Classic Standard EPO 40572FL0200050 No
Bronze Elite + PCP Saver Plus EPO 40572FL0070005 No
Bronze Elite + PCP Saver Plus EPO 40572FL0200005 No
Gold Classic Standard EPO 40572FL0070053 No
Gold Classic Standard EPO 40572FL0200053 No
Gold Elite EPO 40572FL0070036 No
Gold Elite Saver Plus EPO 40572FL0070035 No
Secure EPO 40572FL0070011 No
Secure EPO 40572FL0200011 No
Silver Classic Standard EPO 40572FL0070052 No
Silver Classic Standard EPO 40572FL0200052 No
Silver Elite EPO 40572FL0070016 No
Silver Elite EPO 40572FL0200016 No
Silver Simple Chronic Care CKM EPO 40572FL0070060 No
Silver Simple Chronic Care CKM EPO 40572FL0200060 No
Silver Simple Diabetes EPO 40572FL0070061 No
Silver Simple Diabetes EPO 40572FL0200061 No
Silver Simple PCP Saver EPO 40572FL0070025 No
Silver Simple PCP Saver EPO 40572FL0200025 No
Plan Name Plan Type Plan ID Dental Only Plan?
Bronze Classic PCP Saver HMO 45845OH0100002 No
Bronze Classic Standard HMO 45845OH0100050 No
Bronze Simple HSA HMO 45845OH0100014 No
Gold Classic Standard HMO 45845OH0100053 No
Gold Elite HMO 45845OH0100036 No
Gold Elite Saver Plus HMO 45845OH0100035 No
Secure HMO 45845OH0100011 No
Silver Classic Standard HMO 45845OH0100052 No
Silver Elite Saver Plus HMO 45845OH0100030 No
Silver Simple Chronic Care CKM HMO 45845OH0100060 No
Silver Simple Diabetes HMO 45845OH0100045 No
Silver Simple PCP Saver HMO 45845OH0100025 No
Plan Name Plan Type Plan ID Dental Only Plan?
Essential Bronze 6500 POS 14624MS0010001 No
Essential Gold 1500 POS 14624MS0010002 No
Freedom Silver 4000 POS 14624MS0010004 No
Savings Bronze 7700 POS 14624MS0010006 No
Standard Bronze 7500 POS 14624MS0010009 No
Standard Gold 1500 POS 14624MS0010007 No
Standard Silver 5000 POS 14624MS0010008 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?
Sanford Individual Simplicity $1,750 PPO 31195SD0110001 No
Sanford Individual Simplicity $1,750 PPO 89364ND0120001 No
Sanford Individual Simplicity $3,500 PPO 31195SD0110003 No
Sanford Individual Simplicity $3,500 PPO 89364ND0120003 No
Sanford Individual Simplicity $4,750 PPO 31195SD0110005 No
Sanford Individual Simplicity $4,750 PPO 89364ND0120005 No
Sanford Individual Simplicity $6,000 PPO 31195SD0110007 No
Sanford Individual Simplicity $6,000 PPO 89364ND0120007 No
Sanford Individual Simplicity $7,100 HSA Qualified PPO 31195SD0110006 No
Sanford Individual Simplicity $7,100 HSA Qualified PPO 89364ND0120006 No
Sanford Individual Simplicity $9,200 PPO 31195SD0110009 No
Sanford Individual Simplicity $9,200 PPO 89364ND0120009 No
Sanford Individual Simplicity Standardized $1,500 PPO 31195SD0110018 No
Sanford Individual Simplicity Standardized $1,500 PPO 89364ND0120018 No
Sanford Individual Simplicity Standardized $5,000 PPO 31195SD0110017 No
Sanford Individual Simplicity Standardized $5,000 PPO 89364ND0120017 No
Sanford Individual Simplicity Standardized $7,500 PPO 31195SD0110016 No
Sanford Individual Simplicity Standardized $7,500 PPO 89364ND0120016 No
Sanford Individual TRUE $1,750 HMO 31195SD0080018 No
Sanford Individual TRUE $1,750 HMO 89364ND0090018 No
Sanford Individual TRUE $3,500 HMO 31195SD0080008 No
Sanford Individual TRUE $3,500 HMO 89364ND0090008 No
Sanford Individual TRUE $4,750 HMO 31195SD0080016 No
Sanford Individual TRUE $4,750 HMO 89364ND0090016 No
Sanford Individual TRUE $6,000 HMO 31195SD0080007 No
Sanford Individual TRUE $6,000 HMO 89364ND0090007 No
Sanford Individual TRUE $7,100 HSA Qualified HMO 31195SD0080009 No
Sanford Individual TRUE $7,100 HSA Qualified HMO 89364ND0090009 No
Sanford Individual TRUE $9,200 HMO 31195SD0080015 No
Sanford Individual TRUE $9,200 HMO 89364ND0090015 No
Sanford Individual TRUE Standardized $1,500 HMO 31195SD0080028 No
Sanford Individual TRUE Standardized $1,500 HMO 89364ND0090028 No
Sanford Individual TRUE Standardized $5,000 HMO 31195SD0080027 No
Sanford Individual TRUE Standardized $5,000 HMO 89364ND0090027 No
Sanford Individual TRUE Standardized $7,500 HMO 31195SD0080026 No
Sanford Individual TRUE Standardized $7,500 HMO 89364ND0090026 No
Plan Name Plan Type Plan ID Dental Only Plan?
SummaCare Bronze 8000 HMO 52664OH1530023 No
SummaCare Bronze 9200 with 3 Free PCP Visits HMO 52664OH1530022 No
SummaCare Gold 2000 with 3 Free PCP Visits HMO 52664OH1530026 No
SummaCare Silver 5000 1000 Rx with 3 Free PCP Visits HMO 52664OH1530025 No
SummaCare Silver 7000 with 3 Free PCP Visits HMO 52664OH1530030 No
SummaCare Standard Bronze HMO 52664OH1530032 No
SummaCare Standard Gold HMO 52664OH1530036 No
SummaCare Standard Silver HMO 52664OH1530035 No
Plan Name Plan Type Plan ID Dental Only Plan?
UHC Bronze Copay Focus $0 Indiv Med Ded HMO 33764SC0030012 No
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) HMO 40220TX0080031 No
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) HMO 40702AZ0060034 No
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) HMO 68398FL0030045 No
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) EPO 69461AL0110020 No
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) EPO 69842LA0240024 No
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) EPO 94968KS0090015 No
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) EPO 95426MO0410019 No
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) HMO 33931OH0030035 No
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) HMO 45480OK0050035 No
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) HMO 54332NC0030033 No
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) HMO 80180WI0100004 No
UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) HMO 97560MS0030028 No
UHC Bronze Copay Focus (No Referrals) EPO 69443TN0140028 No
UHC Bronze Copay Focus (No Referrals) HMO 42529IL0070023 No
UHC Bronze Copay Focus (No Referrals) HMO 71667MI0010039 No
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) HMO 40702AZ0070005 No
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) EPO 94968KS0100004 No
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) HMO 33931OH0070004 No
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) HMO 80180WI0110003 No
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) HMO 97560MS0080006 No
UHC Bronze Copay Focus+ $0 Indiv Med Ded (Dental + Vision) HMO 33764SC0040002 No
UHC Bronze Copay Focus+ (Dental + Vision, No Referrals) EPO 69443TN0180003 No
UHC Bronze Standard HMO 33764SC0030008 No
UHC Bronze Standard HMO 40220TX0080015 No
UHC Bronze Standard HMO 40702AZ0060019 No
UHC Bronze Standard HMO 68398FL0030042 No
UHC Bronze Standard (No Referrals) EPO 69443TN0140025 No
UHC Bronze Standard (No Referrals) EPO 69461AL0110018 No
UHC Bronze Standard (No Referrals) EPO 69842LA0240018 No
UHC Bronze Standard (No Referrals) EPO 94968KS0090013 No
UHC Bronze Standard (No Referrals) EPO 95426MO0410013 No
UHC Bronze Standard (No Referrals) HMO 33931OH0030026 No
UHC Bronze Standard (No Referrals) HMO 42529IL0070021 No
UHC Bronze Standard (No Referrals) HMO 45480OK0050030 No
UHC Bronze Standard (No Referrals) HMO 54332NC0030030 No
UHC Bronze Standard (No Referrals) HMO 71667MI0010030 No
UHC Bronze Standard (No Referrals) HMO 80180WI0100001 No
UHC Bronze Standard (No Referrals) HMO 97560MS0030025 No
UHC Bronze Standard+ (Dental + Vision, No Referrals) HMO 33931OH0070005 No
UHC Bronze Value HMO 33764SC0030009 No
UHC Bronze Value ($0 Virtual Urgent Care) HMO 40702AZ0060033 No
UHC Bronze Value ($0 Virtual Urgent Care) HMO 68398FL0030041 No
UHC Bronze Value ($0 Virtual Urgent Care, $3 Tier 2 Rx) HMO 40220TX0080010 No
UHC Bronze Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) EPO 95426MO0410011 No
UHC Bronze Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) HMO 54332NC0030032 No
UHC Bronze Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) HMO 97560MS0030023 No
UHC Bronze Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) EPO 69461AL0110007 No
UHC Bronze Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) EPO 94968KS0090011 No
UHC Bronze Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) HMO 45480OK0050017 No
UHC Bronze Value ($5 Tier 2 Rx, No Referrals) EPO 69842LA0240008 No
UHC Bronze Value ($5 Tier 2 Rx, No Referrals) HMO 33931OH0030034 No
UHC Bronze Value (No Referrals) EPO 69443TN0140007 No
UHC Bronze Value (No Referrals) HMO 71667MI0010012 No
UHC Bronze Value (Rx Copay, No Referrals) HMO 42529IL0070018 No
UHC Bronze Value HSA (No Referrals) HMO 80180WI0100003 No
UHC Bronze Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) HMO 40220TX0090003 No
UHC Bronze Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) EPO 95426MO0420003 No
UHC Bronze Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) HMO 54332NC0060003 No
UHC Bronze Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) HMO 97560MS0080005 No
UHC Bronze Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) EPO 69461AL0120003 No
UHC Bronze Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) EPO 69842LA0250004 No
UHC Bronze Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) EPO 94968KS0100003 No
UHC Bronze Value+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) HMO 45480OK0110003 No
UHC Bronze Value+ ($0 Virtual Urgent Care, Dental + Vision) HMO 40702AZ0070004 No
UHC Bronze Value+ ($0 Virtual Urgent Care, Dental + Vision) HMO 68398FL0060003 No
UHC Bronze Value+ ($5 Tier 2 Rx, Dental + Vision, No Referrals) HMO 33931OH0070003 No
UHC Bronze Value+ (Dental + Vision, No Referrals) HMO 71667MI0050003 No
UHC Bronze Value+ (Rx Copay, Dental + Vision, No Referrals) HMO 42529IL0080003 No
UHC Gold Advantage HMO 33764SC0030001 No
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx) HMO 68398FL0030057 No
UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) HMO 54332NC0030015 No
UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) HMO 40220TX0080028 No
UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) HMO 40702AZ0060046 No
UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) EPO 69461AL0110025 No
UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) EPO 94968KS0090019 No
UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) EPO 95426MO0410020 No
UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) HMO 80180WI0100002 No
UHC Gold Advantage ($0 Virtual Urgent Care, No Referrals) HMO 45480OK0050038 No
UHC Gold Advantage ($3 Tier 2 Rx, No Referrals) HMO 33931OH0030042 No
UHC Gold Advantage ($5 Tier 2 Rx, No Referrals) EPO 69842LA0240025 No
UHC Gold Advantage (No Referrals) EPO 69443TN0140031 No
UHC Gold Advantage (No Referrals) HMO 42529IL0070029 No
UHC Gold Advantage (No Referrals) HMO 71667MI0010024 No
UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) HMO 68398FL0060001 No
UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) HMO 54332NC0060002 No
UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) HMO 40220TX0090002 No
UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) HMO 40702AZ0070010 No
UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) EPO 69461AL0120002 No
UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) EPO 94968KS0100001 No
UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) EPO 95426MO0420001 No
UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) HMO 80180WI0110002 No
UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) EPO 69842LA0250002 No
UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) HMO 45480OK0110001 No
UHC Gold Advantage+ ($3 Tier 2 Rx, Dental + Vision, No Referrals) HMO 33931OH0070002 No
UHC Gold Advantage+ (Dental + Vision) HMO 33764SC0040001 No
UHC Gold Advantage+ (Dental + Vision, No Referrals) EPO 69443TN0180002 No
UHC Gold Advantage+ (Dental + Vision, No Referrals) HMO 42529IL0080005 No
UHC Gold Advantage+ (Dental + Vision, No Referrals) HMO 71667MI0050002 No
UHC Gold Copay Focus $0 Indiv Med Ded HMO 33764SC0030003 No
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) HMO 97560MS0030032 No
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) HMO 40702AZ0060047 No
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) HMO 68398FL0030034 No
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, $0 Insulin, No Referrals) EPO 69842LA0240023 No
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) EPO 69461AL0110023 No
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) EPO 94968KS0090018 No
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) EPO 95426MO0410018 No
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) HMO 33931OH0030032 No
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) HMO 54332NC0030035 No
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) HMO 80180WI0100012 No
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) HMO 45480OK0050034 No
UHC Gold Copay Focus (No Referrals) EPO 69443TN0140030 No
UHC Gold Copay Focus (No Referrals) HMO 42529IL0070027 No
UHC Gold Copay Focus (No Referrals) HMO 71667MI0010042 No
UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) HMO 97560MS0080003 No
UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) EPO 94968KS0100006 No
UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) HMO 33931OH0070008 No
UHC Gold Standard HMO 33764SC0030002 No
UHC Gold Standard HMO 40220TX0080024 No
UHC Gold Standard HMO 40702AZ0060016 No
UHC Gold Standard HMO 68398FL0030036 No
UHC Gold Standard $0 Indiv Ded ($0 Virtual Urgent Care) HMO 40220TX0080013 No
UHC Gold Standard (No Referrals) EPO 69443TN0140016 No
UHC Gold Standard (No Referrals) EPO 69461AL0110010 No
UHC Gold Standard (No Referrals) EPO 69842LA0240012 No
UHC Gold Standard (No Referrals) EPO 94968KS0090003 No
UHC Gold Standard (No Referrals) EPO 95426MO0410009 No
UHC Gold Standard (No Referrals) HMO 33931OH0030014 No
UHC Gold Standard (No Referrals) HMO 45480OK0050028 No
UHC Gold Standard (No Referrals) HMO 54332NC0030022 No
UHC Gold Standard (No Referrals) HMO 71667MI0010026 No
UHC Gold Standard (No Referrals) HMO 80180WI0100010 No
UHC Gold Standard (No Referrals) HMO 97560MS0030014 No
UHC Gold Standard (Rx Copay, No Referrals) HMO 42529IL0070012 No
UHC Gold Standard+ (Dental + Vision, No Referrals) HMO 33931OH0070009 No
UHC Gold Value ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) HMO 97560MS0030031 No
UHC Gold Value+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) HMO 97560MS0080004 No
UHC Kelsey-Seybold Bronze Copay Focus HMO 40220TX0080032 No
UHC Kelsey-Seybold Gold Copay Focus ($5 Tier 2 Rx) HMO 40220TX0080034 No
UHC Kelsey-Seybold Silver Copay Focus HMO 40220TX0080033 No
UHC Silver Advantage HMO 33764SC0030007 No
UHC Silver Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx) HMO 68398FL0030048 No
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) HMO 40220TX0080026 No
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) HMO 40702AZ0060038 No
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) EPO 94968KS0090016 No
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) EPO 95426MO0410016 No
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) HMO 33931OH0030031 No
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) HMO 54332NC0030034 No
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) HMO 80180WI0100009 No
UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) HMO 97560MS0030029 No
UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) HMO 45480OK0050037 No
UHC Silver Advantage (No Referrals) EPO 69443TN0140029 No
UHC Silver Advantage (No Referrals) HMO 71667MI0010041 No
UHC Silver Advantage (Rx Copay, No Referrals) HMO 42529IL0070025 No
UHC Silver Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) HMO 68398FL0060002 No
UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) HMO 40220TX0090001 No
UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) HMO 40702AZ0070006 No
UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) EPO 94968KS0100002 No
UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) EPO 95426MO0420002 No
UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) HMO 33931OH0070001 No
UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) HMO 54332NC0060001 No
UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) HMO 80180WI0110001 No
UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) HMO 97560MS0080001 No
UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) HMO 45480OK0110002 No
UHC Silver Advantage+ (Dental + Vision) HMO 33764SC0040003 No
UHC Silver Advantage+ (Dental + Vision, No Referrals) EPO 69443TN0180001 No
UHC Silver Advantage+ (Dental + Vision, No Referrals) HMO 71667MI0050001 No
UHC Silver Advantage+ (Rx Copay, Dental + Vision, No Referrals) HMO 42529IL0080001 No
UHC Silver Copay Focus $0 Indiv Med Ded HMO 33764SC0030006 No
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) HMO 40702AZ0060041 No
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) EPO 69461AL0110013 No
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) EPO 69842LA0240022 No
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) EPO 95426MO0410006 No
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) HMO 33931OH0030030 No
UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) HMO 97560MS0030018 No
UHC Silver Copay Focus (No Referrals) EPO 69443TN0140020 No
UHC Silver Copay Focus (No Referrals) HMO 42529IL0070013 No
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) HMO 40702AZ0070008 No
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) EPO 69461AL0120005 No
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) EPO 69842LA0250003 No
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) HMO 33931OH0070007 No
UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) HMO 97560MS0080002 No
UHC Silver Standard EPO 69842LA0240017 No
UHC Silver Standard HMO 33764SC0030004 No
UHC Silver Standard HMO 40220TX0080020 No
UHC Silver Standard HMO 40702AZ0060018 No
UHC Silver Standard HMO 68398FL0030040 No
UHC Silver Standard (No Referrals) EPO 69443TN0140021 No
UHC Silver Standard (No Referrals) EPO 69461AL0110014 No
UHC Silver Standard (No Referrals) EPO 94968KS0090008 No
UHC Silver Standard (No Referrals) EPO 95426MO0410008 No
UHC Silver Standard (No Referrals) HMO 33931OH0030021 No
UHC Silver Standard (No Referrals) HMO 42529IL0070017 No
UHC Silver Standard (No Referrals) HMO 45480OK0050029 No
UHC Silver Standard (No Referrals) HMO 54332NC0030027 No
UHC Silver Standard (No Referrals) HMO 71667MI0010028 No
UHC Silver Standard (No Referrals) HMO 80180WI0100005 No
UHC Silver Standard (No Referrals) HMO 97560MS0030021 No
UHC Silver Standard+ (Dental + Vision) HMO 68398FL0060005 No
UHC Silver Standard+ (Dental + Vision, No Referrals) EPO 95426MO0420004 No
UHC Silver Standard+ (Dental + Vision, No Referrals) HMO 33931OH0070006 No
UHC Silver Standard+ (Dental + Vision, No Referrals) HMO 42529IL0080004 No
UHC Silver Value ($0 Virtual Urgent Care, $2 Tier 2 Rx, No Referrals) EPO 69461AL0110004 No
UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx) HMO 40220TX0080025 No
UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx) HMO 68398FL0030046 No
UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) EPO 69842LA0240014 No
UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) EPO 94968KS0090004 No
UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) HMO 45480OK0050036 No
UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) HMO 54332NC0030020 No
UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) HMO 80180WI0100008 No
UHC Silver Value (No Referrals) HMO 71667MI0010033 No
UHC Silver Value+ ($0 Virtual Urgent Care, $2 Tier 2 Rx, Dental + Vision, No Referrals) EPO 69461AL0120004 No
UHC Silver Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) HMO 40220TX0090004 No
UHC Silver Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) HMO 68398FL0060004 No
UHC Silver Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) EPO 69842LA0250005 No
UHC Silver Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) EPO 94968KS0100005 No
UHC Silver Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) HMO 45480OK0110004 No
UHC Silver Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) HMO 54332NC0060004 No
UHC Silver Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) HMO 80180WI0110004 No
UHC Silver Value+ (Dental + Vision, No Referrals) HMO 71667MI0050004 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