Off-Exchange Package for Small Business - PPO Plans

Off-Exchange Package for Small Business - PPO Plans

Blue Shield Off-Exchange PPO Plans Summary of Benefits Disclosures Optional Benefit
Platinum Full PPO 0/0 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.8MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Platinum Tandem PPO 0/0 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.8MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Platinum Full PPO 0/10 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.8MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Platinum Tandem PPO 0/10 OffEx  English (PDF, 1.1MB)
Spanish (PDF, 1.8MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Platinum Full PPO 250/10 OffEx English (PDF, 1.1MB) 
Spanish (PDF, 1.8MB) 
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Platinum Tandem PPO 250/10 OffEx  English (PDF, 1.1MB)
Spanish (PDF, 1.8MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Platinum Full PPO 250/15 OffEx English (PDF, 1.1MB) 
Spanish (PDF, 1.8MB) 
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Platinum Tandem PPO 250/15 OffEx  English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Gold Full PPO 0/25 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.8MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Gold Tandem PPO 0/25 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.8MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Gold Full PPO 500/30 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.8MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Gold Tandem PPO 500/30 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Gold Full PPO 750/30 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.8MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Gold Tandem PPO 750/30 OffEx  English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Gold Full PPO 1000/35 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.8MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Gold Tandem PPO 1000/35 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Silver Full PPO 2000/60 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.8MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Silver Tandem PPO 2000/60 OffEx  English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Silver Full PPO 2350/65 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.8MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Silver Tandem PPO 2350/65 OffEx  English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Silver Full PPO 2550/70 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.8MB)  
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Silver Tandem PPO 2550/70 OffEx  English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Bronze Full PPO 5500/65 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Bronze Tandem PPO 5500/65 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Bronze Full PPO 6250/65 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Bronze Tandem PPO 6250/65 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Bronze Full PPO 6500/70 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Bronze Tandem PPO 6500/70 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Bronze Full PPO 7500/65 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Bronze Tandem PPO 7500/65 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Bronze Full PPO 6850/55 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Bronze Tandem PPO 6850/55 OffEx English (PDF, 1.1MB)
Spanish (PDF, 1.9MB)
English (PDF, 1.1MB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)

 

Virtual Blue Plans Summary of Benefits Disclosures Optional Benefit
Virtual Blue℠ Gold Tandem PPO 1500/45 OffEx English (PDF, 275KB)
Spanish (PDF, 344KB)
English (PDF, 310KB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)
Virtual Blue℠ Bronze Tandem PPO 7500/75 OffEx English (PDF, 288KB)
Spanish (PDF, 353KB)
English (PDF, 310KB) 
 
Infertility
English (PDF, 996.7KB) 
Spanish (PDF, 1.7MB)

 

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