| Product Name | Effective as of 7/01/09 |
|---|---|
| Blue Care Elect Preferred 90 with Copayment | Summary of Benefits |
| Blue Care Elect $3000 Plan-Year Deductible | Summary of Benefits |
| Blue Care Elect Value Plus | Summary of Benefits |
| Blue Care Elect Enhanced Value | Summary of Benefits |
| Preferred Blue PPO Options v.2 | Summary of Benefits |
| Preferred Blue PPO $80 with Copayment | Summary of Benefits |
| Preferred Blue PPO $1000 Deductible | Summary of Benefits |
| Preferred Blue PPO $2000 Deductible | Summary of Benefits |
| Preferred Blue PPO Basic $2000 | Summary of Benefits |
| Preferred Blue PPO Saver $1500 | Summary of Benefits |
| Preferred Blue PPO Saver $2000 | Summary of Benefits |
| Preferred Blue PPO Saver $2900 | Summary of Benefits |
| Product Name | Effective as of 10/01/09 for 1-50 Employees |
|---|---|
| Blue Care Elect Preferred 90 with Copayment | Summary of Benefits |
| Blue Care Elect $3000 Plan-Year Deductible | Summary of Benefits |
| Blue Care Elect $4500 Deductible | Summary of Benefits |
| Blue Care Elect Value Plus | Summary of Benefits |
| Blue Care Elect Enhanced Value | Summary of Benefits |
| Preferred Blue PPO $80 with Copayment | Summary of Benefits |
| Preferred Blue PPO $1000 Deductible | Summary of Benefits |
| Preferred Blue PPO $2000 Deductible | Summary of Benefits |
| Preferred Blue PPO Basic $2000 | Summary of Benefits |
| Preferred Blue PPO Saver $1500 | Summary of Benefits |
| Preferred Blue PPO Saver $2000 | Summary of Benefits |
| Preferred Blue PPO Saver $2900 | Summary of Benefits |
| Preferred Blue PPO Options v3 | Summary of Benefits |
| Product Name | Effective as of 10/01/09 for 51+ Employees |
|---|---|
| Blue Care Elect Preferred 90 with Copayment | Summary of Benefits |
| Blue Care Elect $3000 Plan-Year Deductible | Summary of Benefits |
| Blue Care Elect $4500 Deductible | Summary of Benefits |
| Blue Care Elect Value Plus | Summary of Benefits |
| Blue Care Elect Enhanced Value | Summary of Benefits |
| Preferred Blue PPO $80 with Copayment | Summary of Benefits |
| Preferred Blue PPO $1000 Deductible | Summary of Benefits |
| Preferred Blue PPO $2000 Deductible | Summary of Benefits |
| Preferred Blue PPO Basic $2000 | Summary of Benefits |
| Preferred Blue PPO Saver $1500 | Summary of Benefits |
| Preferred Blue PPO Saver $2000 | Summary of Benefits |
| Preferred Blue PPO Saver $2900 | Summary of Benefits |
| Preferred Blue PPO Options v3 | Summary of Benefits |
| Closed Plans | Prior to 7/01/09 | Effective as of 07/01/09 | Effective as of 10/01/09 for 1-50 Employees |
Effective as of 10/01/09 for 51+ Employees |
|---|---|---|---|---|
| Blue Care Elect PreferredSM 90/70 | Summary of Benefits | Summary of Benefits | ||
| Blue Care Elect Preferred 80/60 | Summary of Benefits | |||
| Blue Care Elect $1,000 Deductible Option | Summary of Benefits | Summary of Benefits | ||
| Blue Care Elect $3000 Calendar-Year Deductible | Summary of Benefits | Summary of Benefits | Summary of Benefits | |
| Blue Care Elect $5,000 Deductible Option | Summary of Benefits | Summary of Benefits | ||
| Blue Care Elect SaverSM Lower Deductible | Summary of Benefits | Summary of Benefits | ||
| Blue Care Elect Saver Higher Deductible | Summary of Benefits | Summary of Benefits | ||
| Blue Care Elect 100/80 | Summary of Benefits | Summary of Benefits |