businessadvantage · • preventive dental, one exam every six months: $50 • preventive dental,...

Focus on life. Focus on health. Stay focused.

BusinessADVANTAGE2019 Employer Group Coverage (2-50)

You make tough decisions every day to keep your business

growing. Deciding whether to offer affordable health care

coverage to your employees doesn’t have to be one of them.

1

What Does it Mean to Be Blue®?At BlueChoice HealthPlan, we’ve worked for more than 30 years to establish good relationships with our

clients and members. We are more than just a name on an insurance card. We are your trusted companion

who understands your unique needs and bottom line.

What does it mean to be Blue? When you choose BlueChoice®, you can stay focused, knowing that we are

here to serve you and help you with your health care needs. Our goal is to help people get healthier and help

you manage your health care costs.

BusinessADVANTAGEBusinessADVANTAGE is an affordable and comprehensive series of health plans with options to suit

employers with 2−50 employees. We can work with you to determine which features and benefits best fit

your company and your employees. Our plans include a variety of programs for medical, health and disease

management. No matter what your health coverage objectives may be, we have you covered!

Enhanced Plan DesignsBlueChoice routinely reviews our benefit plans and enhances them to meet your needs. This year, we are

offering more plans to choose from! You can choose from several levels of products with multiple plan designs:

• 15 Gold plans

• 24 Silver plans

• 11 Bronze plans

• Six of these are qualified high-deductible health plans (HDHPs)

You can offer dual options in any combination from any of these plans down to two lives. All plans are health

reimbursement arrangement-compatible and six plans are health savings account-qualified.

Plan BasicsWhen you choose the plan design that’s best for your company, you can count on BlueChoice to deliver:

• Deductible and copayment amounts that help you manage your health care costs.

• Comprehensive mail-order and retail pharmacy benefits.

• Chiropractic care.

• Value-added services like routine vision, preventive dental, an employee assistance program, a discount

program and 24-hour video access to a certified physician.

2

The Benefits of BusinessADVANTAGEAll BusinessADVANTAGE plans are comprehensive, open-access plans. In addition to the great benefits listed here,

your employees get the comfort and convenience of seeing any doctor they choose within the network without

getting a referral. This also includes full access to our in-network providers worldwide.

Through our BlueCard® program, BusinessADVANTAGE members living or traveling outside of South Carolina

can locate participating doctors and hospitals nationwide. When members use a doctor or hospital through

BlueCard, they receive the highest level of benefits.

Comprehensive Office Visit Copayments (if applicable) — Office visit copayments are comprehensive and cover

all diagnostic and treatment services (including X-rays) provided at a medical office of a participating provider.

These services include preventive services, diagnostic procedures, therapeutic procedures, surgical procedures,

medical supplies, consultations and treatments. OB-GYN providers are considered primary care physicians,

excluding maternity care.

Preventive Services — Automatically includes routine health screenings, well-baby and well-child visits that in-network

doctors provide, with no dollar maximums. Routine preventive care is not covered out of network.

Routine Screening for Colonoscopy and Mammogram — Covered at 100 percent at in-network providers.

Specialist Visits — No referral necessary! Members can stay within our national network or seek medical care

outside the network. If they use professionals within our network, they’ll typically receive higher benefits.

Pediatric Vision — Children ages 0-18 are eligible for one routine eye exam and one pair of frames and lenses

from a designated selection per benefit period. We provide benefits for contact lenses when deemed medically

necessary. The Physicians Eye Network (PEN) provides vision services. PEN is an independent company that offers

a vision provider network on behalf of BlueChoice.

Tiered Prescription Drug Benefits — BusinessADVANTAGE has a six-tier drug plan. Each tier represents a

different copayment, deductible and/or coinsurance level, depending on which plan you choose. This allows your

employees more options for their treatments.

Please refer to the plan grids on pages 14-28 for benefit details.

3

Tiered Prescription Drug BenefitsBlueChoice offers pharmacy benefits programs that provide the highest level of clinical effectiveness and safety

for the lowest net spending. Our goal is to help our members get the appropriate drugs they need at the best

price. One way we do this is by developing and maintaining a covered drug list (CDL).

We continually evaluate our prescription drug formularies and drug management programs to ensure that quality

and costs are managed effectively. We work with a group of independent doctors and pharmacists to evaluate our

pharmacy programs and get their recommendations. This group also approves decisions about our CDL, specialty

drug list and drug management programs. They base their decisions on a drug’s effectiveness, safety and value.

To view the CDL, visit www.BlueChoiceSC.com, go to the Member Center, and select BusinessADVANTAGE.

Six-Tier Drug ProgramBlueChoice has a six-tier prescription drug plan. This program offers flexibility in drug treatments. The chart shows

the drugs that are typically in each tier.

MEMBER COST

DRUG TIER USUALLY INCLUDES

$ Tier 1 Lowest-cost prescription generic and some over-the-counter drugs

$$ Tier 2 Prescription generic and some over-the-counter drugs

$$$ Tier 3Brand-name drugs that don’t have a generic available. Also may include higher-priced generics that have more cost-effective options at lower tiers.

$$$$ Tier 4Brand-name drugs that have brand or generic options at lower tiers. Also may include higher-priced generics that have more cost-effective options at lower tiers.

$$$$$ Tier 5Specialty drugs that are more cost-effective than other specialty drugs that treat the same conditions. Also may include some non-specialty brand or generic drugs that have more cost-effective options at lower tiers.

$$$$$$ Tier 6Specialty drugs that have more cost-effective alternatives at Tier 5. Also, may include some non-specialty brand or generic drugs that have more cost-effective options at lower tiers.

4

Value-Added Benefits and ServicesAll BusinessADVANTAGE plans include value-added benefits. These benefits are non-essential and do not count

toward any maximum out-of-pocket (MOOP) expenses.

Adult Routine Vision CareAll plans include our routine adult vision coverage provided through PEN. The benefit covers one eye exam each

year and one pair of glasses from a designated selection or contact lenses every two years. For members outside

of the South Carolina service area, we allow $71 toward the routine eye exam and $120 toward the purchase of

eyewear. The member must file these claims.

Preventive Dental CareAll plans include a dental allowance for exams and cleanings for adults and children. This benefit covers these

amounts per benefit period for exams and cleanings by any South Carolina-licensed dentist:

• Preventive dental, one exam every six months: $50

• Preventive dental, one cleaning every six months: $50

Members can send a completed dental reimbursement form and the paid receipt to BlueChoice for reimbursement of

the allowed amount. If you would like to offer a comprehensive dental plan, you can choose one of our Blue Dental plans.

Employee Assistance Program (EAP)First Sun EAP provides a broad array of services designed to help people and encourage success at all levels

in an organization. Because First Sun is a separate company from BlueChoice, First Sun will be responsible for

all services related to the employee assistance program. By offering your employees the employee assistance

program, you can help to reduce the number of days employees miss, help to increase productivity and bring

out the best in your employees. These services are free to members and those in their households.

EAP services include, but are not limited to:

• Three free face-to-face sessions per person for individual, couples and family counseling

• Three free life-management services per person about topics like financial services, adoption assistance or elder

care resources

• Employer assistance with training, workplace services and on-site support

DiscountsAt BlueChoice, members can take advantage of great discount programs and special services! We offer these

services and discounts to our members in addition to, but not included in, the services and benefits covered

under a BlueChoice policy. Through our value-added services, members have access to special discounts or

benefits on services such as:

• Blue365®, a program offering nationwide discounts

• Weight-loss programs and centers

• Lasik services

• Fitness center discounts

• Natural BlueSM holistic health

• Bosley® hair restoration

5

FOCUSfwd Wellness Incentive ProgramSM

Enrolling in the FOCUSfwd Wellness Incentive Program gives your employees the chance to win gift cards and $5,000

cash! This interactive program helps members get out and stay healthy as they complete health-related activities.

These are sample activities that can be completed in each category:

Earn Entries for PrizesSome activities, such as those in the Connect category, can be earned only once. Other activities, such as those

in the Challenge category, can be completed many times during the year. The more activities you complete, the

more opportunities to win! Your entries will accumulate throughout the entire year to increase your chances of

winning during the year and one of the $5,000 GRAND PRIZE drawings in December.

The FACTS• This exclusively designed program was created by BlueChoice HealthPlan with YOU in mind!

• Available to ALL members (subscribers and spouses over 18) at no additional cost.

• Many wellness programs incentivize the sick and injured, excluding the majority of the

population — healthy members.

• Preventive health programs increase employee awareness of their health, which can lead to a decrease

in medical costs and claims.

1 If you previously registered for My Health Toolkit, you will earn 10 entries the first time you log in to the Wellness Incentive Program via My Health Toolkit. This program is only available to eligible subscribers and their spouses (age 18 and older). Be sure to check with your employer or call the Customer Service number located on the back of your member ID card to confirm whether this program is available to you.

2 Please note that Blue CareOnDemand service is only available to certain members. Be sure to check with your employer or call the Customer Service number located on the back of your member ID card to confirm whether this service is available to you.

3Excludes vision and dental.4You will earn three entries for the first completed health coaching call regarding any of the applicable Great Expectations for health programs.5The rewards will increase your taxable earnings and be subject to applicable taxes.

Connect• My Health Toolkit Registration1

• Blue CareOnDemandSM Registration2

• BlueChoice HealthPlan WireSM

Registration

Challenge• Monthly wellness education

with quiz

• Participate in quarterly challenges

Prevent• Wellness Exam3

• Personal Health Assessment

• Preventive Cancer Screenings

• Flu Shot

• Great Expectations for health programs4

Connect Prevent Challenge For FF Sales Sheet

Physical Activity Monthly Wellness Video

getFIT Challenge

For FF Sales Sheet

For FF Sales Sheet

getFIT Reach getFIT Stretch

These are used within the getFIT program under FOCUSfwd



getFIT Challenge

For FF Sales Sheet

For FF Sales Sheet





getFIT Challenge

For FF Sales Sheet

For FF Sales Sheet



We Will Award5:• Twenty $50 gift cards EACH WEEK• Fifteen $100 gift cards EACH MONTH

• Four $1,000 cash prizes EACH QUARTER• Three $5,000 cash prizes EACH YEAR!



getFIT Challenge

For FF Sales Sheet

For FF Sales Sheet





getFIT Challenge

For FF Sales Sheet

For FF Sales Sheet





getFIT Challenge

For FF Sales Sheet

For FF Sales Sheet



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My Health Toolkit®

To get answers specific to your plan, you can create a free account and log in to My Health Toolkit. My Health Toolkit is

a protected, secure and convenient way for you to access your personal information. With My Health Toolkit, you can:

• See if your claim has been paid.

• Access your digital ID card or request a new plastic card.

• See how much you’ve paid toward your deductible and maximum out-of-pocket costs.

• Take a personal health assessment.

• Find out how much a prescription drug costs.

• Visit the FOCUSfwd Wellness Incentive ProgramSM page.

• Send Member Services a secure email.

My Health Toolkit AppYou can use the My Health Toolkit app to:

• View and share your digital ID card

• Check the status of your claims

• Confirm coverage

• Find a doctor or hospital in network

• Update contact information

Current My Health Toolkit users can log in to the app with their existing username and

password. New My Health Toolkit users can register through the app.

Get the AppSearch for My Health Toolkit in the App Store or Google Play

to download the My Health Toolkit app.

BLUECHOICE HEALTHPLAN

ZCL00000000

www.BlueChoiceSC.com

JOHN DOE

ZCL00000000Member ID

PLANPLAN CODERxBINRxGRP

PPO380.04004336CHC

Health BenefitsPediatric VisionComprehensive Dental

BLUECHOICE HEALTHPLAN

ZCJ00000000

www.BlueOptionSC.com

JOHN DOE

ZCJ00000000Member ID

PLAN CODERxBINRxGRP

380.04004336CHC

Health Benefits

Blue Option Network

Out of State Only

7

Blue CareOnDemand — A Faster, Easier Way to See a Doctor All your employees need is a computer or smartphone device to see a doctor

anytime, anywhere. During a video visit, the doctor will ask questions, answer

questions, diagnose symptoms and, if appropriate, call in a prescription to a

local pharmacy.

What types of medical issues can doctors treat?• Cold and flu symptoms

• Bronchitis and other respiratory infections

• Sinus infections

• Pinkeye

• Ear infections

• Allergies

• Migraines

• Rashes and other skin irritations

• Urinary tract infections

And more!

Mental Health and Breastfeeding Support services are also available through Blue CareOnDemand.

When should members use video visits?• If they need to see a doctor, but can’t fit it into

their schedule

• If their doctor’s office is closed

• If they feel too sick to drive

• If they have children at home and don’t want to bring

them to a doctor’s office

• If they are on business travel and stuck in a hotel room

Get started now!There are two easy ways for your employees to use Blue CareOnDemand.

• From a computer, go to www.BlueCareOnDemandSC.com.

• From a mobile phone or tablet, download the Blue CareOnDemand app for an Apple or Android device.

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Great Expectations® for health Coaching ProgramsComprehensive health management is an integral part of the services we offer to our members. We use a 360°

approach in managing the health of our members. There are programs for all members that focus on the early

detection of illness and the prevention of disease.

Members with chronic conditions also receive more targeted educational information and contact with our staff

of highly trained health specialists. Those with intensive needs receive care coordination and the support of our

caring team of nurses.

Members can self-enroll by calling 855-838-5897 and selecting option 2.

CONDITION NAME DESCRIPTION

Adult ADHD

The Adult Attention Deficit Hyperactivity Disorder (ADHD) Program is a coaching program that assists members in developing a personalized plan for strategies to better manage their ADHD. The program assesses, empowers and educates members, providing them with tools to better understand ADHD and the best ways to manage it. Members are able to set their own goals and may also receive educational mailings, access to online resources and newsletters, as appropriate.

Asthma (adult and pediatric)

This Asthma Program is a coaching program that assists members in developing a personalized plan for strategies to better manage their asthma.

Back CareThis program helps members with back pain, which may be keeping them from completing daily tasks, being active or just fully enjoying life.

Bipolar Support

The Bipolar Support Program is a coaching program that assists members in developing a personalized plan for strategies to better manage their bipolar disorder. The program assesses, empowers and educates members, allowing them to identify and self-monitor their symptoms. Members are able to set their own goals for recovery and may also receive educational mailings, access to online resources and newsletters, as appropriate.

Case ManagementThis program is for members who have medical conditions like cancer, severe trauma, multiple chronic conditions, complex wounds, gastric bypass, hepatitis C, traumatic brain injury, transplants and neuro-muscular diseases.

Chronic Kidney Disease

This program is for members who are in the first three stages of chronic kidney disease. They will have high levels of creatinine, making them likely candidates for kidney dialysis or transplant. Members who are in stages 4 and 5 of chronic kidney disease will become eligible for the case management program.

Chronic Obstructive Pulmonary Disease (COPD)

A coaching program that assists members in developing a personalized plan for strategies to better manage their COPD.

Depression

The Depression Program is a coaching program that assists members in developing a personalized plan for strategies to better manage their anxiety and depression. The program assesses, empowers and educates members using evidence-based interventions for symptom monitoring. Members are able to set their own goals for recovery and may also receive educational mailings, access to online resources and newsletters, as appropriate.

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CONDITION NAME DESCRIPTIONDiabetes (adult and pediatric)

This is a coaching program that assists members in developing a personalized plan for strategies to better manage their diabetes.

Healthy and Active Kids and Teens (childhood obesity)

This program helps families address the problem of childhood obesity. It teaches children and their families how to eat healthy and about the importance of being active.

Heart DiseaseThis program teaches members about their heart disease. It is a coaching program that assists members in developing a personalized plan for strategies to better manage their heart disease.

Heart FailureThis program teaches members about heart failure. It is a coaching program that assists members in developing a personalized plan for strategies to better manage their heart failure.

High Blood PressureThis program teaches members about their high blood pressure. It assists members in developing a personalized plan for strategies to lower it.

High CholesterolThis program teaches members about their high cholesterol. It assists members in developing a personalized plan for strategies to lower it.

Maternity This program helps members take steps toward healthier pregnancies.

Metabolic Health

This program can help members improve their health and prevent conditions like heart disease or diabetes. Members with these conditions qualify for the Metabolic Health program:• A diagnosis of pre-diabetes• Glucose intolerance• Metabolic syndrome (associated with being overweight or obese)• Polycystic ovary disease• A history of gestational diabetes• Other conditions by physician referral

Migraine This program is for members who suffer from severe, recurrent headaches.

Moms Support Program

The Moms Support Program is a coaching program that assists moms across the child-bearing spectrum in developing a personalized plan for strategies to better manage their depression and anxiety at any stage, pre- or post-pregnancy. The program assesses, empowers and educates members, allowing them to identify and self-monitor their symptoms. Members are able to set their own goals for recovery and may also receive educational mailings, access to online resources and newsletters, as appropriate.

Recovery Support Program

The Recovery Support Program is a coaching program that assists members in determining a personalized plan for lifestyle modifications to better manage their recovery from addiction. The program educates members about evidence-based techniques for coping with urges to use drugs or drink alcohol. Members may receive educational mailings, access to online resources and newsletters, as appropriate.

Stress ManagementThis program can help members manage stress. It assists members in developing a personalized plan for strategies to manage and improve it.

Tobacco Cessation This program assists members in developing a personalized plan for strategies to quit tobacco use.

Weight Management This program assists members in developing a personalized plan for strategies to lose weight.

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Blue DentalSM

For Groups with 5-50 Employees

If you would like to offer a comprehensive dental plan to your employees, you can purchase one of our Blue

Dental plans. Blue Dental can offer your employees a whole-health approach to their dental care. By choosing

BlueChoice for both your medical and dental coverage, your covered employees get an integrated approach that

provides a complete picture of their overall health. Proper dental care can help your employees spot issues early

like diabetes, heart disease, osteoporosis, oral cancer and kidney disease.

Our comprehensive dental offerings allow you to choose a dental benefit design that fits the needs of you and

your employees. Plus, by offering your medical and dental through BlueChoice, administering your dental benefits

becomes easier!

Why Choose Blue Dental?Flexible plan designsChoose from our comprehensive dental plan options: Open Access or Select.

OrthodontiaFor employers with preferred pricing, orthodontia is available for children and adults up to age 19. Preferred

pricing is for employers that contribute at least 50 percent or more of the single premium and have a minimum

10 or more contracts or 50 percent participation, whichever is greater.

Easy to administerSingle-source placement consolidates billing, eligibility and enrollment through a single account team.

Comprehensive dental networksBlue Dental gives your covered employees access to one of the industry’s largest national dental PPO networks.

Your covered employees can choose from more than 2,400 access points in South Carolina and more than 263,000

nationally. Referrals are not required before your covered employee sees a specialist. Visit www.BlueChoiceSC.com

for a comprehensive list of dental providers.

Let your BlueChoice representative help you find the best dental plan for your employees.

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Companion LifeCompanion Life offers a complete portfolio of innovative and competitive employee benefit plans. Because

Companion Life is a separate company from BlueChoice, Companion Life will be responsible for all services

related to these products. Companion Life specializes in comprehensive and affordable group life and disability

income programs with a variety of features and flexible plan design options. Products can be offered on a

voluntary or group basis.

LifeGroup term life insurance can be offered as a flat amount or multiple of salaries up to $500,000, with accidental

death and dismemberment included. Guaranteed issue amounts are available.

Short- and Long-Term DisabilityShort-term disability protection offers a wide selection of benefit percentages, waiting periods, benefit maximums

and payment durations up to one year. Partial disability is also available. Companion Life offers small group short-term

disability benefits down to two lives, with no pre-existing limitations on employer-paid plans.

Long-term disability protection provides choices for benefit payment maximums, elimination periods and benefit

duration periods. New enhancements include a less restrictive definition of a disability and a less restrictive

definition of own occupation.

Voluntary VisionYour BusinessADVANTAGE plan includes a routine vision program. If you prefer, you can also offer your employees

vision through Companion Life. To offer this service, two participants are required. Your employees will have access to

a national network of providers. You have the choice of three plans: exam-only, materials-only or exam and materials.

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More Options. More Value. It’s the little extras that make a big difference. Time and money savings can add up with these optional services.

QuickBillSM

QuickBill is an electronic benefit service that allows you to view and pay your invoices online, 24 hours a day,

seven days a week.

Bill PresentationView your invoices directly via the internet, 24 hours a day, seven days a week. New invoice notifications are sent

to you via email. Simply log in to QuickBill to view, print, export or create detailed reports.

Bill PaymentPay invoices via a one-time electronic funds transfer (EFT), establish a recurring credit card payment, or establish a

recurring bank draft from one of your corporate bank accounts. QuickBill offers a quick, easy and secure online payment

experience. Reduce the number of lost checks and invoices and decrease postage and check production costs.

Bill AdjustmentRequest and receive immediate invoice corrections. QuickBill Adjustment offers invoice approval and workflow

management capabilities designed to make your life easier. Adjustments are integrated with your health insurance

carrier’s membership system.

ChoiceEnroll — New in 2019!ChoiceEnroll is our new administration tool that gives you the ability to view and manage all of your BlueChoice

small group accounts in one place. ChoiceEnroll eliminates paper by allowing enrollments, changes and

terminations to be processed securely online. There’s no software to download and no investment from your

internal IT department. Best of all, this service is FREE!

Manage transactions and requests through a single online tool, including:

• Annual Enrollments

• Qualifying Life Events

• Terminations

• Demographic Changes

• ID Card Requests

All transactions are processed in five minutes or less per event! You will also have access to group-specific documents,

including Schedules of Benefits and Medicare Part D letters.

With seamless, daily updates to the membership and claims system, you can rest assured your clients’ eligibility data is

consistent and accurate. In addition, customized reporting and a history of all maintenance transactions are available.

HRA/HSA/FSA/COBRAWe have health reimbursement accounts (HRAs), health saving accounts (HSAs), flexible spending accounts (FSAs)

and COBRA administration solutions. These services help provide a convenient and streamlined process for all of

your business needs. With BlueChoice, you have the flexibility of choosing the vendor to meet your needs. We

can discuss your needs to help you determine which of our partners can help you accomplish your goals.

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Doctor & Hospital FinderHelping your employees find a participating provider is quick and easy! You can view and print customized lists of

health care providers and facilities. Your list will show providers or facilities in the ADVANTAGE network. You can find

providers and facilities located near you. You can even create directories based on the type of doctor you need.

To see if your doctor is in the network, visit www.BlueChoiceSC.com and select Find a Doctor on the homepage.

BusinessADVANTAGE

Advantage Network

14

BENEFIT FEATURE & DESCRIPTION GOLD 1000 GOLD 1001 GOLD 1002 GOLD 1003 GOLD 1012 GOLD 1100Coinsurance 15% 25% 20% 25% 30% 20%

Deductible (Single/Family) $1,000/$2,000 $1,000/$2,000 $1,000/$2,000 $1,000/$2,000 $1,000/$2,000 $1,100/$2,200

Maximum Out of Pocket (MOOP) (Single/Family) $7,000/$14,000 $4,500/$9,000 $5,000/$10,000 $5,000/$10,000 $4,000/$8,000 $5,000/$10,000

Annual Dollar Limits Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited

Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited

Primary Care Physician (PCP) Office Visits $30 $15 $20 $25 $25 $20

Doctors Care Office Visits $30 $15 $20 $25 $25 $20

Specialist Office Visits $60 $35 $40 $50 $50 $50

Inpatient Physician and Surgical Services 15% after deductible 25% after deductible 20% after deductible 25% after deductible 30% after deductible 20% after deductible

Outpatient Surgery Physician and Surgical Services 15% after deductible 25% after deductible 20% after deductible 25% after deductible 30% after deductible 20% after deductible

Urgent Care $50 $50 $50 $50 $50 $50

Free-Standing Ambulatory Surgical Center $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit

Emergency Room 15% after deductible$200, then deductible,

then 25%$200, then deductible,

then 20%25% after deductible 30% after deductible 20% after deductible

Chiropractic Care 15% after deductible 25% after deductible 20% after deductible 25% after deductible 30% after deductible 20% after deductible

Preventive Care/Screenings/Immunizations, including lactation support* $0 $0 $0 $0 $0 $0

Pediatric Vision One exam per benefit period. Eyeglass frames every two years. Eyeglass lenses once per benefit period. In network only.

Exam - $25 Eyeglasses - $50






Inpatient Hospital Services Including mental health and substance use disorder, habilitation and rehabilitation.

15% after deductible 25% after deductible 20% after deductible 25% after deductible 30% after deductible 20% after deductible

Outpatient Facility Fee (e.g., ambulatory surgical center) - Including mental health and substance use disorder.


Prescription DrugsSeparate Drug Deductible No No No No No No

Pharmacy Retail Copays reflect a 31-day supply. Can purchase a 90-day supply for three times the cost.

Tier 1 - $20 Tier 2 - $20 Tier 3 - $40 Tier 4 - 15% Tier 5 - 15% Tier 6 - 15%

Tier 1 - $15 Tier 2 - $15 Tier 3 - $35 Tier 4 - $70 Tier 5 - $250 Tier 6 - $250





Mail Order Up to a 90-day supply. Specialty medications are not available through mail-order program for a 90-day supply. Tier 5 and Tier 6 only applies to generic or brands within these tiers.







2019 Gold Level Plans

Important Notes for 2019: • These products provide out-of-network coverage at 50 percent with no deductible or out-of-pocket cost, except where noted otherwise. • Emergency room services received out of network are covered at the same level as in network. • Pharmacy benefits and preventive services are only covered at a participating provider. • All plans include: routine vision care, FOCUSfwd, EAP, personal health assessment and Blue CareOnDemand. • The MOOP for out-of-network services is unlimited. • All plans include an embedded deductible and MOOP.

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BENEFIT FEATURE & DESCRIPTION GOLD 1000 GOLD 1001 GOLD 1002 GOLD 1003 GOLD 1012 GOLD 1100Coinsurance 15% 25% 20% 25% 30% 20%





Primary Care Physician (PCP) Office Visits $30 $15 $20 $25 $25 $20

Doctors Care Office Visits $30 $15 $20 $25 $25 $20

Specialist Office Visits $60 $35 $40 $50 $50 $50

Inpatient Physician and Surgical Services 15% after deductible 25% after deductible 20% after deductible 25% after deductible 30% after deductible 20% after deductible


Urgent Care $50 $50 $50 $50 $50 $50


Emergency Room 15% after deductible$200, then deductible,

then 25%$200, then deductible,

then 20%25% after deductible 30% after deductible 20% after deductible














Prescription DrugsSeparate Drug Deductible No No No No No No















* Covered according to the United States Preventive Services Task Force (USPSTF), the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA). It includes prostate screening (PSA). These are independent organizations that offer health information on behalf of BlueChoice.

16

BENEFIT FEATURE & DESCRIPTION GOLD 1250 GOLD 1502 GOLD 2000 GOLD 2001 GOLD 2200 GOLD 2400 GOLD 2503 GOLD 3000Coinsurance 20% 20% 20% 0% 0% 0% 30% 30%

Deductible (Single/Family) $1,250/$2,500 $1,500/$3,000 $2,000/$4,000 $2,000/$4,000 $2,200/$4,400 $2,400/$4,800 $2,500/$5,000 $3,000/$6,000

Maximum Out of Pocket (MOOP) (Single/Family) $4,250/$8,500 $4,000/$8,000 $3,250/$6,500 $2,000/$4,000 $2,200/$4,400 $2,400/$4,800 $3,750/$7,500 $7,350/$14,700

Annual Dollar Limits Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited

Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited

Primary Care Physician (PCP) Office Visits $25 $15 $15 Deductible Deductible Deductible $25 30%

Doctors Care Office Visits $25 $15 $15 Deductible Deductible Deductible $25 30%

Specialist Office Visits $50 $40 $45 Deductible Deductible Deductible $50 30%

Inpatient Physician and Surgical Services 20% after deductible 20% after deductible 20% after deductible Deductible Deductible Deductible 30% after deductible 30% after deductible

Outpatient Surgery Physician and Surgical Services 20% after deductible 20% after deductible 20% after deductible Deductible Deductible Deductible 30% after deductible 30% after deductible

Urgent Care $50 $50 $50 Deductible Deductible Deductible $50 30%

Free-Standing Ambulatory Surgical Center $200 per visit $200 per visit $200 per visit Deductible Deductible Deductible $200 per visit $200 per visit

Emergency Room 20% after deductible 20% after deductible 20% after deductible Deductible Deductible Deductible 30% after deductible 30% after deductible

Chiropractic Care 20% after deductible 20% after deductible 20% after deductible Deductible Deductible Deductible 30% after deductible 30% after deductible

Preventive Care/Screenings/Immunizations, including lactation support* $0 $0 $0 $0 $0 $0 $0 $0











20% after deductible 20% after deductible 20% after deductible Deductible Deductible Deductible 30% after deductible 30% after deductible



PRESCRIPTION DRUGSSeparate Drug Deductible No No No No No No No No





All Tiers - Deductible




All Tiers - 30%









All Tiers - 30%

2019 Gold Level Plans


17

BENEFIT FEATURE & DESCRIPTION GOLD 1250 GOLD 1502 GOLD 2000 GOLD 2001 GOLD 2200 GOLD 2400 GOLD 2503 GOLD 3000Coinsurance 20% 20% 20% 0% 0% 0% 30% 30%





Primary Care Physician (PCP) Office Visits $25 $15 $15 Deductible Deductible Deductible $25 30%

Doctors Care Office Visits $25 $15 $15 Deductible Deductible Deductible $25 30%

Specialist Office Visits $50 $40 $45 Deductible Deductible Deductible $50 30%

Inpatient Physician and Surgical Services 20% after deductible 20% after deductible 20% after deductible Deductible Deductible Deductible 30% after deductible 30% after deductible

Outpatient Surgery Physician and Surgical Services 20% after deductible 20% after deductible 20% after deductible Deductible Deductible Deductible 30% after deductible 30% after deductible

Urgent Care $50 $50 $50 Deductible Deductible Deductible $50 30%

Free-Standing Ambulatory Surgical Center $200 per visit $200 per visit $200 per visit Deductible Deductible Deductible $200 per visit $200 per visit

Emergency Room 20% after deductible 20% after deductible 20% after deductible Deductible Deductible Deductible 30% after deductible 30% after deductible

Chiropractic Care 20% after deductible 20% after deductible 20% after deductible Deductible Deductible Deductible 30% after deductible 30% after deductible
























All Tiers - 30%









All Tiers - 30%


18

2019 Silver Level PlansBENEFIT FEATURE & DESCRIPTION SILVER 1500 SILVER 2000 SILVER 2001 SILVER 2400 SILVER 2501 SILVER 2502

Coinsurance 50% 30% 50% 50% 45% 50%





Primary Care Office (PCP) Visits $35 $25 $35 $30 $30 $0 for first two visits,

then 50% after deductible

Doctors Care Office Visits $35 $25 $35 $30 $30 $0 for first two visits, then

50% after deductible

Specialist Office Visits $70 $25 copayment,

then deductible, then 30%$70 $50 $60 50% after deductible

Inpatient Physician and Surgical Services 50% after deductible$250 copayment,

then deductible, then 30% 50% after deductible 50% after deductible 45% after deductible 50% after deductible


Urgent Care $50 $50 $50 $50 $50$50 for first two visits, then



Emergency Room 50% after deductible$250 copayment,












50% after deductible$250 copayment,




PRESCRIPTION DRUGSSeparate Drug Deductible No No No $150 deductible No No



Tier 1 - $10 Tier 2 - $10 Tier 3 - 30% after deductible Tier 4 - 30% after deductible Tier 5 - 30% after deductible Tier 6 - 30% after deductible


Tier 1 - Rx deductible, then $20 Tier 2 - Rx deductible, then $20 Tier 3 - Rx deductible, then $40 Tier 4 - Rx deductible, then $75 Tier 5 - Rx deductible, then 50% Tier 6 - Rx deductible, then 50%











19

BENEFIT FEATURE & DESCRIPTION SILVER 1500 SILVER 2000 SILVER 2001 SILVER 2400 SILVER 2501 SILVER 2502Coinsurance 50% 30% 50% 50% 45% 50%





Primary Care Office (PCP) Visits $35 $25 $35 $30 $30 $0 for first two visits,

then 50% after deductible

Doctors Care Office Visits $35 $25 $35 $30 $30 $0 for first two visits, then


Specialist Office Visits $70 $25 copayment,

then deductible, then 30%$70 $50 $60 50% after deductible

Inpatient Physician and Surgical Services 50% after deductible$250 copayment,



Urgent Care $50 $50 $50 $50 $50$50 for first two visits, then



Emergency Room 50% after deductible$250 copayment,












50% after deductible$250 copayment,




PRESCRIPTION DRUGSSeparate Drug Deductible No No No $150 deductible No No
















20

BENEFIT FEATURE & DESCRIPTION SILVER 2750 SILVER 2751 SILVER 3000 SILVER 3250 SILVER 3500 SILVER 3501 SILVER 4500Coinsurance 45% 40% 40% 40% 40% 30% 50%

Deductible (Single/Family) $2,750/$5,500 $2,750/$5,500 $3,000/$6,000 $3,250/$6,500 $3,500/$7,000 $3,500/$7,000 $4,500/$9,000

Maximum Out of Pocket (MOOP) (Single/Family) $7,750/$15,500 $7,350/$14,700 $7,500/$15,000 $7,900/$15,800 $7,000/$14,000 $6,850/$13,700 $7,000/$14,000

Annual Dollar Limits Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited

Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited

Primary Care Office (PCP) Visits $30 $35 $30 $25 $30 $30 $25

Doctors Care Office Visits $30 $35 $30 $25 $30 $30 $25

Specialist Office Visits $60 $60 $60 $25, then deductible,

then 40% $60 $60 $50

Inpatient Physician and Surgical Services 45% after deductible 40% after deductible 40% after deductible 40% after deductible 40% after deductible 30% after deductible 50% after deductible

Outpatient Surgery Physician and Surgical Services 45% after deductible 40% after deductible 40% after deductible 40% after deductible 40% after deductible 30% after deductible 50% after deductible

Urgent Care $50 $50 $50 $50 $50 $50 $50

Free-Standing Ambulatory Surgical Center $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit

Emergency Room 45% after deductible 40% after deductible 40% after deductible 40% after deductible 40% after deductible 30% after deductible 50% after deductible

Chiropractic Care 45% after deductible 40% after deductible 40% after deductible 40% after deductible 40% after deductible 30% after deductible 50% after deductible

Preventive Care/Screenings/Immunizations, including lactation support* $0 $0 $0 $0 $0 $0 $0










45% after deductible 40% after deductible 40% after deductible 40% after deductible 40% after deductible 30% after deductible 50% after deductible



PRESCRIPTION DRUGSSeparate Drug Deductible No No No No $500 deductible $150 deductible $250 deductible






Tier 1 - $25 Tier 2 - $25 Tier 3 - $50 Tier 4 - $75 Tier 5 - Rx deductible, then 40% Tier 6 - Rx deductible, then 40%


Tier 1 - $25 Tier 2 - $25 Tier 3 - $50 Tier 4 - Rx deductible, then 50% Tier 5 - Rx deductible, then 50% Tier 6 - Rx deductible, then 50%









2019 Silver Level Plans


21

BENEFIT FEATURE & DESCRIPTION SILVER 2750 SILVER 2751 SILVER 3000 SILVER 3250 SILVER 3500 SILVER 3501 SILVER 4500Coinsurance 45% 40% 40% 40% 40% 30% 50%





Primary Care Office (PCP) Visits $30 $35 $30 $25 $30 $30 $25

Doctors Care Office Visits $30 $35 $30 $25 $30 $30 $25

Specialist Office Visits $60 $60 $60 $25, then deductible,

then 40% $60 $60 $50

Inpatient Physician and Surgical Services 45% after deductible 40% after deductible 40% after deductible 40% after deductible 40% after deductible 30% after deductible 50% after deductible

Outpatient Surgery Physician and Surgical Services 45% after deductible 40% after deductible 40% after deductible 40% after deductible 40% after deductible 30% after deductible 50% after deductible

Urgent Care $50 $50 $50 $50 $50 $50 $50

Free-Standing Ambulatory Surgical Center $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit

Emergency Room 45% after deductible 40% after deductible 40% after deductible 40% after deductible 40% after deductible 30% after deductible 50% after deductible

Chiropractic Care 45% after deductible 40% after deductible 40% after deductible 40% after deductible 40% after deductible 30% after deductible 50% after deductible














PRESCRIPTION DRUGSSeparate Drug Deductible No No No No $500 deductible $150 deductible $250 deductible


















22

BENEFIT FEATURE & DESCRIPTION SILVER 5001 SILVER 5250 SILVER 6550 SILVER 6750 SILVER 6850 SILVER 7250 SILVER 7350 SILVER 7902Coinsurance 20% 0% 0% 0% 40% 0% 0% 0%





Primary Care Office (PCP) Visits $20 $45 $0 $0 $15 $0 $40 $0

Doctors Care Office Visits $20 $45 $0 $0 $15 $0 $40 $0

Specialist Office Visits $40 $90 $50 $45 $35 $45 $80 $45

Inpatient Physician and Surgical Services 20% after deductible Deductible Deductible Deductible 40% after deductible Deductible Deductible Deductible

Outpatient Surgery Physician and Surgical Services 20% after deductible Deductible Deductible Deductible 40% after deductible Deductible Deductible Deductible

Urgent Care $50 $50 $50 $50 $50 $50 $50 $50

Free-Standing Ambulatory Surgical Center $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit

Emergency Room 20% after deductible Deductible Deductible Deductible 40% after deductible Deductible Deductible Deductible

Chiropractic Care 20% after deductible Deductible Deductible Deductible 40% after deductible Deductible Deductible Deductible












20% after deductible Deductible Deductible Deductible 40% after deductible Deductible Deductible Deductible

Outpatient Facility Fee (e.g., ambulatory surgical center) - Includes mental health and substance use disorder.





Tier 1 - $20Tier 2 - $20Tier 3 - $45Tier 4 - DeductibleTier 5 - DeductibleTier 6 - Deductible
















2019 Silver Level Plans


23

BENEFIT FEATURE & DESCRIPTION SILVER 5001 SILVER 5250 SILVER 6550 SILVER 6750 SILVER 6850 SILVER 7250 SILVER 7350 SILVER 7902Coinsurance 20% 0% 0% 0% 40% 0% 0% 0%





Primary Care Office (PCP) Visits $20 $45 $0 $0 $15 $0 $40 $0

Doctors Care Office Visits $20 $45 $0 $0 $15 $0 $40 $0

Specialist Office Visits $40 $90 $50 $45 $35 $45 $80 $45

Inpatient Physician and Surgical Services 20% after deductible Deductible Deductible Deductible 40% after deductible Deductible Deductible Deductible

Outpatient Surgery Physician and Surgical Services 20% after deductible Deductible Deductible Deductible 40% after deductible Deductible Deductible Deductible

Urgent Care $50 $50 $50 $50 $50 $50 $50 $50

Free-Standing Ambulatory Surgical Center $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit

Emergency Room 20% after deductible Deductible Deductible Deductible 40% after deductible Deductible Deductible Deductible

Chiropractic Care 20% after deductible Deductible Deductible Deductible 40% after deductible Deductible Deductible Deductible













Outpatient Facility Fee (e.g., ambulatory surgical center) - Includes mental health and substance use disorder.






















24

2019 Bronze Level PlansBENEFIT FEATURE & DESCRIPTION BRONZE 4400 BRONZE 5550 BRONZE 5750 BRONZE 6000 BRONZE 7000 BRONZE 7100 BRONZE 7300

Coinsurance 50% 50% 50% 50% 0% 0% 0%





Primary Care Office Visits $45 $40 $45 $0 for first two visits,

then 50% after deductible $45 $45 Deductible

Doctors Care Office Visits $45 $40 $45 $0 for first two visits,

then 50% after deductible$45 $45 Deductible

Specialist Office Visits $45, then deductible, then 50% $40, then deductible, then 50% $90 50% after deductible $90 $90 Deductible

Inpatient Physician and Surgical Services $500, then deductible, then 50% $500, then deductible, then 50% 50% after deductible $300, then deductible, then 50% $500, then deductible Deductible Deductible

Outpatient Surgery Physician and Surgical Services 50% after deductible 50% after deductible 50% after deductible 50% after deductible Deductible Deductible Deductible

Urgent Care $50 $50 $50 $50 for the first two visits, then 50% after deductible $50 $50 Deductible

Free-Standing Ambulatory Surgical Center $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit Deductible

Emergency Room $500, then deductible, then 50% $500, then deductible, then 50% 50% after deductible $300, then deductible, then 50% $500, then deductible Deductible Deductible

Chiropractic Care 50% after deductible 50% after deductible 50% after deductible 50% after deductible Deductible Deductible Deductible


Pediatric Vision One exam per benefit period. Eyeglass frames every two years. Eyeglass lenses once per benefit period.In network only.









$500, then deductible, then 50%

$500, then deductible, then 50% 50% after deductible $300, then deductible, then 50% $500, then deductible Deductible Deductible


50% after deductible 50% after deductible 50% after deductible 50% after deductible Deductible Deductible Deductible

PRESCRIPTION DRUGSSeparate Drug Deductible/Coinsurance No No $400 deductible No No No No


All Tiers - 50% after deductible




Tier 1 - $35 Tier 2 - $35 Tier 3 - Deductible Tier 4 - Deductible Tier 5 - Deductible Tier 6 - Deductible












25

BENEFIT FEATURE & DESCRIPTION BRONZE 4400 BRONZE 5550 BRONZE 5750 BRONZE 6000 BRONZE 7000 BRONZE 7100 BRONZE 7300Coinsurance 50% 50% 50% 50% 0% 0% 0%





Primary Care Office Visits $45 $40 $45 $0 for first two visits,

then 50% after deductible $45 $45 Deductible

Doctors Care Office Visits $45 $40 $45 $0 for first two visits,

then 50% after deductible$45 $45 Deductible

Specialist Office Visits $45, then deductible, then 50% $40, then deductible, then 50% $90 50% after deductible $90 $90 Deductible

Inpatient Physician and Surgical Services $500, then deductible, then 50% $500, then deductible, then 50% 50% after deductible $300, then deductible, then 50% $500, then deductible Deductible Deductible

Outpatient Surgery Physician and Surgical Services 50% after deductible 50% after deductible 50% after deductible 50% after deductible Deductible Deductible Deductible

Urgent Care $50 $50 $50 $50 for the first two visits, then 50% after deductible $50 $50 Deductible

Free-Standing Ambulatory Surgical Center $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit $200 per visit Deductible

Emergency Room $500, then deductible, then 50% $500, then deductible, then 50% 50% after deductible $300, then deductible, then 50% $500, then deductible Deductible Deductible

Chiropractic Care 50% after deductible 50% after deductible 50% after deductible 50% after deductible Deductible Deductible Deductible











$500, then deductible, then 50%

$500, then deductible, then 50% 50% after deductible $300, then deductible, then 50% $500, then deductible Deductible Deductible


50% after deductible 50% after deductible 50% after deductible 50% after deductible Deductible Deductible Deductible

PRESCRIPTION DRUGSSeparate Drug Deductible/Coinsurance No No $400 deductible No No No No


















26


BENEFIT FEATURE & DESCRIPTION BRONZE 7900 BRONZE 7901Coinsurance 0% 0%

Deductible (Single/Family) $7,900/$15,800 $7,900/$15,800

Maximum Out of Pocket (MOOP) (Single/Family) $7,900/$15,800 $7,900/$15,800

Annual Dollar Limits Unlimited Unlimited

Lifetime Maximum Unlimited Unlimited

Primary Care Office Visits $50 $45

Doctors Care Office Visits $50 $45

Specialist Office Visits $100 $90

Inpatient Physician and Surgical Services Deductible $500, then deductible

Outpatient Surgery Physician and Surgical Services Deductible Deductible

Urgent Care $50 $50

Free-Standing Ambulatory Surgical Center $200 per visit $200 per visit

Emergency Room Deductible $500, then deductible

Chiropractic Care Deductible Deductible

Preventive Care/Screenings/Immunizations, including lactation support* $0 $0





Deductible $500, then deductible


Deductible Deductible

PRESCRIPTION DRUGSSeparate Drug Deductible/Coinsurance No No







2019 Bronze Level Plans

27

BENEFIT FEATURE & DESCRIPTION GOLD 2700 HD SILVER 3850 HD SILVER 4400 HDCoinsurance 0% 0% 0%

Deductible (Single/Family) $2,700/$5,400 $3,850/$7,700 $4,400/$8,800

Maximum Out of Pocket (MOOP) (Single/Family) $2,700/$5,400 $3,850/$7,700 $4,400/$8,800

Annual Dollar Limits Unlimited Unlimited Unlimited

Lifetime Maximum Unlimited Unlimited Unlimited

Primary Care Physician (PCP) Office Visits Deductible Deductible Deductible

Doctors Care Office Visits Deductible Deductible Deductible

Specialist Office Visits Deductible Deductible Deductible

Inpatient Physician and Surgical Services Deductible Deductible Deductible

Outpatient Surgery Physician and Surgical Services Deductible Deductible Deductible

Urgent Care Deductible Deductible Deductible

Free-Standing Ambulatory Surgical Center Deductible Deductible Deductible

Emergency Room Deductible Deductible Deductible

Chiropractic Care Deductible Deductible Deductible

Preventive Care/Screenings/Immunizations, including lactation support* $0 $0 $0






Deductible Deductible Deductible



PRESCRIPTION DRUGS

Separate Drug Deductible No No No


All Tiers - Deductible All Tiers - Deductible All Tiers - Deductible



2019 HDHP Plans


28

BENEFIT FEATURE & DESCRIPTION SILVER 5004 HD BRONZE 5501 HD BRONZE 6550 HDCoinsurance 0% 0% 0%























PRESCRIPTION DRUGSSeparate Drug Deductible No No No





Important Notes for 2019: • These products provide out-of-network coverage at 50 percent with no deductible or out-of-pocket cost, except where noted otherwise. • Emergency room services received out of network are covered at the same level as in network. • Pharmacy benefits and preventive services are only covered at a participating provider. • All plans include: routine vision care, FOCUSfwd, EAP, personal health assessment and Blue CareOnDemand. • The MOOP for out-of-network services is unlimited. • All plans include an embedded deductible and MOOP.* Covered according to the United States Preventive Services Task Force (USPSTF), the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA). It includes prostate screening (PSA). These are independent organizations that offer health information on behalf of BlueChoice.

2019 HDHP Plans

29

Statement of ConfidentialityBlueChoice knows how important it is to protect the privacy of each member’s confidential medical information.

Here are the efforts we make to protect your privacy.

Protection of PrivacyBlueChoice keeps all medical information about a member strictly confidential. BlueChoice has administrative,

technical and physical safeguards in place to protect the privacy of members’ personal health information. Our

information systems have advanced security that limits access to personal health information to authorized

personnel only. We require all staff to keep confidential any personal health information they learn in performing

their jobs. Additionally, staff is required to limit requests to external entities for a member’s personal health

information to the minimum necessary for their intended purpose.

BlueChoice requires all physicians and other health care professionals in our provider network to maintain the

confidentiality of their patients’ health information, and they must guard against unauthorized or inadvertent

disclosure of this confidential information. Through on-site visits, BlueChoice reviews each provider’s privacy

policies and methods for storing and protecting patients’ medical records.

BlueChoice requires all business associates, consultants and other entities with whom we contract for clinical or

administrative services to maintain such confidentiality and to have a privacy policy in place that protects against

unauthorized use or disclosure of confidential information. All such entities must sign an agreement attesting to

the fact that they are compliant with federal privacy regulations.

Collection, Use and Disclosure of Medical InformationBlueChoice may use and disclose medical information about you for the purposes of treatment, payment and

health care operations. Examples of these routine activities that involve the collection, use and disclosure of health

information include getting information from health care providers to determine medical necessity, processing

claims, issuing Explanations of Benefits to policyholders and conducting quality improvement activities.

If there is a need to release member-identifiable information for purposes other than those approved by law for

treatment, payment and health care operations, BlueChoice must first get a written authorization form signed by

the member. The authorization form allows the member to specify what information BlueChoice is authorized to

release, to whom it may be released and for what purpose.

BENEFIT FEATURE & DESCRIPTION SILVER 5004 HD BRONZE 5501 HD BRONZE 6550 HDCoinsurance 0% 0% 0%























PRESCRIPTION DRUGSSeparate Drug Deductible No No No





BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association.

BlueChoiceSC.com

Focus on life. Focus on health. Stay focused.

170102-BCS-2004-8-2018

Our Commitment to Keeping Employees HealthyBlueChoice has a commitment of offering quality comprehensive health care coverage. We participate in these

quality-focused programs:

• Health Employer Data and Information Set (HEDIS®) — a set of measures health plans use to uniformly collect

data and report on their performance.

• Consumer Assessment of Healthcare Providers and Systems (CAHPS) — standardized surveys of patients’ experiences.

• Touchpoints — a quality assurance (QA) program that measures performance of all Blue Plans on established

criteria the Blue Cross and Blue Shield Association sets.

In each of these programs, we consistently meet or exceed national averages on measures that most other

carriers don’t even track. From our 98 percent score on timeliness of prenatal care to an average claim processing

time of less than two days, BlueChoice is focused on providing exceptional quality and superior service.

Your representative can provide you with the most updated operational performance statistics.

businessadvantage · • preventive dental, one exam every six months: $50 • preventive dental,...

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