All PDFs
Blue Solution Comparison Charts
Copay Plans
Deductible Plans
HSA Plans
Blue Solution Copay Plans
HMO 1 with
$10/$20/$35 Rx
HMO 1.1 with
$10/$40/$70 Rx
HMO 2 with
$10/$20/$35 Rx
HMO 2.1 with
$10/$40/$70 Rx
HMO 3 with
$7/50%/$125 Max Rx
HMO 3.1 with
$10/$45/$75 Rx
HMO 5 with
$7/50%/$125 Max Rx
HMO 5.1 with
$10/$45/$75 Rx
Direct POS 1
with
$10/$20/$35 Rx
Direct POS 1.1
with
$10/$40/$70 Rx
Direct POS 2
with
$10/$20/$35 Rx
Direct POS 2.1
with
$10/$40/$70 Rx
Direct POS 3
with
$10/$20/$35 Rx
Direct POS 3.1
with
$10/$40/$70 Rx
Direct POS 5
with
$7/50%/$125 Max Rx
Direct POS 5.1
with
$10/$45/$75 Rx
Personal Choice PPO 1
with
$10/$20/$35 Rx
Personal Choice PPO 1.1
with
$10/$40/$70 Rx
Personal Choice PPO 2
with
$10/$20/$35 Rx
Personal Choice PPO 2.1
with
$10/$40/$70 Rx
Personal Choice PPO 3
with
$10/$20/$35 Rx
Personal Choice PPO 3.1
with
$10/$40/$70 Rx
Personal Choice PPO 4
with
$7/50%/$125 Max Rx
Personal Choice PPO 4.1
with
$10/$45/$75 Rx
Personal Choice PPO 5
with
$7/50%/$125 Max Rx
Personal Choice PPO 5.1
with
$10/$45/$75 Rx
Personal Choice PPO 6
with
$7/50%/$125 Max Rx
Personal Choice PPO 6.1
with
$10/$45/$75 Rx
Blue Solution Deductible Plans
HMO Deductible 4 with
$7/50%/$125 Max Rx
HMO Deductible 4.1 with
$10/$45/$75 Rx
HMO Deductible 6 with
$250 Ded/$20/$40/$60 Rx
HMO Deductible 6.1 with
$250 Ded/$10/$45/$75 Rx
HMO Deductible 7 with
$250 Ded/$20/$40/$60 Rx
HMO Deductible 7.1 with
$4 Generic/Brand Discount Rx
Direct POS Deductible 4 with
$7/50%/$125 Max Rx
Direct POS Deductible 4.1 with
$10/$45/$75 Rx
Direct POS Deductible 6 with
$250 Ded/$20/$40/$60 Rx
Direct POS Deductible 6.1 with
$250 Ded/$10/$45/$75 Rx
Direct POS Deductible 7 with
$250 Ded/$20/$40/$60 Rx
Direct POS Deductible 7.1 with
$4 Generic/Brand Discount Rx
Personal Choice PPO 7 with
$10/$45/$75 Rx
Personal Choice PPO 7.1 with
$250/$10/$45/$75 Rx
Personal Choice PPO 8 with
$10/$45/$75 Rx
Personal Choice PPO 8.1 with
$250/$10/$45/$75 Rx
Blue Solution HSA Plans
PPO HSA HDHP 1 with $20/$40/$60 Rx (Contract Year)
PPO HSA HDHP 2 with $20/$40/$60 Rx (Contract Year)
PPO HSA HDHP 3 with $20/$40/$60 Rx (Contract Year)
PPO HSA HDHP 4 with $20/$40/$60 Rx (Contract Year)
PPO HSA HDHP 5 with $20/$40/$60 Rx (Contract Year)
Blue Solution Vision & Dental Plans
PPO Vision
HMO/POS Vision
KHP Basic Dental
Drug Formulary Information
Select Drug Program Formulary Guide
Existing Sole Proprietors May Select Either:
HMO 3 with
$7/50%/$125 Max Rx
-- OR --
PPO HSA HDHP 2 with $20/$40/$60 Rx (Contract Year)
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