Notice of Amendment to Annual Action Plan
Document Actions
Blue Cross Blue Shield
| Family | Individual | |
|---|---|---|
| Master Medical 52 week Pay Mode | $127.03 | $50.25 |
| Master Medical 42 week Pay Mode | $157.27 | $62.22 |
| Network Blue HMO 52 week Pay Mode | $97.46 | $41.49 |
| Network Blue HMO 42 week Pay Mode | $120.67 | $51.37 |
| Blue Preferred PPO 52 week Pay Mode | $108.80 | $44.67 |
| Blue Preferred PPO 42 week Pay Mode | $134.71 | $55.31 |
|
Network Blue HMO Monthly Retirees (non medicare eligible) |
$422.33 | $179.79 |
|
Blue Preferred PPO Monthly Retirees (non medicare eligible) |
$471.47 | $193.57 |
To find a doctor or to learn more about the benefits of your Blue Cross Membership, click here: Member Services
