Blue Cross Blue Shield PPO Rates and Benefits
2016 Blue Cross Blue Shield Service Benefit Plan Rates
|Rate Plan||Self (111)||Self + One (113)||Self and family (112)|
|Postal bi-weekly (Category 1)||56.84||135.14||137.06|
|Postal bi-weekly (Category 2)||68.48||160.75||164.20|
|Rate Plan||Self (104)||Self + One (106)||Self and family (105)|
|Postal bi-weekly (Category 1)||88.32||205.70||211.10|
|Postal bi-weekly (Category 2)||100.18||231.31||238.24|
To view a table that gives a brief overview of the BCBS Service Benefit Plan PPO Benefits, including what you'll pay for various services, access the Service Benefit Plan Comparison of Benefits guide (PDF, 230 KB). Please refer to the BCBS Service Benefit Plan Contract Brochure RI 71-005 (PDF, 2.13MB) for detailed terms and conditions of coverage, including plan limitations and exclusions.
|2016 BCBS Service Benefit Plan (PPO) Contract Brochure RI-005 (PDF, 2.1MB)|
|2016 BCBS Standard and Basic Option Service Benefit Plan Summary Guide (PDF, 6.9MB)|
Our Customer Services team is ready to answer your questions and provide assistance at (800) 824-8839.