Policy Documents for Small Group Qualified Health Plans
Below is a list of actual Blue Cross and Blue Shield of Illinois policy documents for Small Group Metallic Qualified Health Plans. These policies describe how the plans generally work and include eligible expenses, claim filing steps, appeals procedures, coverage limitations and exceptions, and more.
Help locating your policy
- Get your policy documents through your online member account or through the BCBSIL app. Learn more about the BCBSIL app.
- Contact a customer service representative at 1-800-538-8833 to get help finding or accessing your policy documents.
- If you don't want to log in to your account or contact customer service, find your policy from the list of plans below. You'll need to know the name of your plan. Your employer's benefit administrator may be able to help. Or, use option 1 or 2 above.
Small Group Metallic Qualified Health Plan policy documents for the 2027 plan year are not available yet. The links below go to placeholder files. The policy documents will be available in November. Please check back then.
PLATINUM PLANS
Blue PPO Platinum Plans
Blue Choice Preferred PPO Platinum Plans
- Blue Choice Preferred Platinum PPO 119 - Rx Copays
- Blue Choice Preferred Platinum PPO 136 - Rx Copays
- Blue Choice Preferred Platinum PPO 501 - Rx Copays
Blue Precision Platinum Plans
- Blue Precision Platinum HMO 107 - Rx Copays
- Blue Precision Platinum HMO 110 - Rx Copays
- Blue Precision Platinum HMO 200 - Rx Copays
Blue Options Platinum Plans
GOLD PLANS
Blue PPO Gold Plans
- Blue PPO Gold 101 - Rx Copays
- Blue PPO Gold 102 - Rx Copays
- Blue PPO Gold 107 - Rx Copays
- Blue PPO Gold 113
- Blue PPO Gold 114 - Rx Copays
- Blue PPO Gold 115
- Blue PPO Gold 116 - Rx Copays
- Blue PPO Gold 123
- Blue PPO Gold 502 - Rx Copays
Blue Precision Gold HMO Plans
- Blue Precision Gold HMO 101 - Rx Copays
- Blue Precision Gold HMO 201 - Rx Copays
- Blue Precision Gold HMO 402 - Rx Copays
Blue Options Gold Plans
- Blue Options Gold PPO 101 - Rx Copays
- Blue Options Gold PPO 102 - Rx Copays
- Blue Options Gold PPO 106 - Rx Copays
- Blue Options Gold PPO 200
- Blue Options Gold PPO 503 - Rx Copays
BlueChoice Preferred Gold PPO Plans
- Blue Choice Preferred Gold PPO 101 - Rx Copays
- Blue Choice Preferred Gold PPO 102 - Rx Copays
- Blue Choice Preferred Gold PPO 107 - Rx Copays
- Blue Choice Preferred Gold PPO 113
- Blue Choice Preferred Gold PPO 114 - Rx Copays
- Blue Choice Preferred Gold PPO 115
- Blue Choice Preferred Gold PPO 116 - Rx Copays
- Blue Choice Preferred Gold PPO 123
- Blue Choice Preferred Gold PPO 502 - Rx Copays
SILVER PLANS
Blue PPO Silver Plans
- Blue PPO Silver 104 - Rx Copays
- Blue PPO Silver 105 - Rx Copays
- Blue PPO Silver 120 - Rx Copays
- Blue PPO Silver 133
- Blue PPO Silver 200
Blue Precision Silver HMO Plans
BlueChoice Preferred Silver PPO Plans
- Blue Choice Preferred Silver PPO 104 - Rx Copays
- Blue Choice Preferred Silver PPO 105 - Rx Copays
- Blue Choice Preferred Silver PPO 120 - Rx Copays
- Blue Choice Preferred Silver PPO 133
- Blue Choice Preferred Silver PPO 200
Blue Options Silver PPO Plans
BRONZE PLANS
Blue PPO Bronze Plans
BlueChoice Preferred Bronze PPO Plans
Off Exchange
- Blue Choice Preferred Bronze PPO 106
- Blue Choice Preferred Bronze PPO 132
- Blue Choice Preferred Bronze PPO 401
Platinum Plans
Blue PPO Platinum Plans
Off Exchange
Blue Choice Preferred PPO Platinum Plans
Off Exchange
- P5E2BCE Blue Choice Preferred Platinum PPO 119
- P5E1BCE Blue Choice Preferred Platinum PPO 136
- P5M1BCE Blue Choice Preferred Platinum PPO 501
Blue Precision Platinum Plans
Off Exchange
- P506PSN Blue Precision Platinum HMO 107
- P5E1PSN Blue Precision Platinum HMO 110
- P5J1PSN Blue Precision Platinum HMO 200
Blue Options Platinum Plans
Gold Plans
Blue PPO Gold Plans
Off Exchange
- G530PPO Blue PPO Gold 101
- G531PPO Blue PPO Gold 102
- G532PPO Blue PPO Gold 107
- G533PPO Blue PPO Gold 113
- G534PPO Blue PPO Gold 114
- G535PPO Blue PPO Gold 115
- G536PPO Blue PPO Gold 116
- G537PPO Blue PPO Gold 123
- G5M2PPO Blue PPO Gold 502
Blue Precision Gold HMO Plans
Off Exchange
- G532PSN Blue Precision Gold HMO 101
- G5J2PSN Blue Precision Gold HMO 201
- G5N1PSN Blue Precision Gold HMO 402
Blue Options Gold Plans
Off Exchange
- G506OPT Blue Options Gold PPO 101
- G507OPT Blue Options Gold PPO 102
- G508OPT Blue Options Gold PPO 106
- G5K1OPT Blue Options Gold PPO 200
- G5M3OPT Blue Options Gold PPO 503
BlueChoice Preferred Gold PPO Plans
Off Exchange
- G530BCE Blue Choice Preferred Gold PPO 101
- G531BCE Blue Choice Preferred Gold PPO 102
- G532BCE Blue Choice Preferred Gold PPO 107
- G533BCE Blue Choice Preferred Gold PPO 113
- G534BCE Blue Choice Preferred Gold PPO 114
- G535BCE Blue Choice Preferred Gold PPO 115
- G536BCE Blue Choice Preferred Gold PPO 116
- G537BCE Blue Choice Preferred Gold PPO 123
- G5M2BCE Blue Choice Preferred Gold PPO 502
Silver Plans
Blue PPO Silver Plans
Off Exchange
- S531PPO Blue PPO Silver 104
- S535PPO Blue PPO Silver 105
- S532PPO Blue PPO Silver 120
- S534PPO Blue PPO Silver 133
- S5J1PPO Blue PPO Silver 200
Blue Precision Silver HMO Plans
Off Exchange
BlueChoice Preferred Silver PPO Plans
Off Exchange
- S531BCE Blue Choice Preferred Silver PPO 104
- S535BCE Blue Choice Preferred Silver PPO 105
- S532BCE Blue Choice Preferred Silver PPO 120
- S534BCE Blue Choice Preferred Silver PPO 133
- S5J1BCE Blue Choice Preferred Silver PPO 200
Blue Options Silver PPO Plans
Off Exchange
- S506OPT Blue Options Silver PPO 104
- S507OPT Blue Options Silver PPO 107
- S5N1OPT Blue Options Silver PPO 404
Bronze Plans
Blue PPO Bronze Plans
Off Exchange
BlueChoice Preferred Bronze PPO Plans
Off Exchange
Platinum Plans
Blue PPO Platinum Plans
Off Exchange
Blue Choice Preferred PPO Platinum Plans
Off Exchange
- P5E2BCE Blue Choice Preferred Platinum PPO 119
- P5E1BCE Blue Choice Preferred Platinum PPO 136
- P5M1BCE Blue Choice Preferred Platinum PPO 501
Blue Precision Platinum Plans
Off Exchange
- P506PSN Blue Precision Platinum HMO 107
- P5E1PSN Blue Precision Platinum HMO 110
- P5J1PSN Blue Precision Platinum HMO 200
Blue Options Platinum Plans
Gold Plans
Blue PPO Gold Plans
Off Exchange
- G530PPO Blue PPO Gold 101
- G531PPO Blue PPO Gold 102
- G532PPO Blue PPO Gold 107
- G533PPO Blue PPO Gold 113
- G534PPO Blue PPO Gold 114
- G535PPO Blue PPO Gold 115
- G536PPO Blue PPO Gold 116
- G537PPO Blue PPO Gold 123
- P5M2PPO Blue PPO Gold 502
Blue Precision Gold HMO Plans
Off Exchange
- G532PSN Blue Precision Gold HMO 101
- G5J2PSN Blue Precision Gold HMO 201
- G5N1PSN Blue Precision Gold HMO 402
Blue Options Gold Plans
Off Exchange
- G506OPT Blue Options Gold PPO 101
- G507OPT Blue Options Gold PPO 102
- G508OPT Blue Options Gold PPO 106
- G5K1OPT Blue Options Gold PPO 200
- G5M3OPT Blue Options Gold PPO 503
BlueChoice Preferred Gold PPO Plans
Off Exchange
- G530BCE Blue Choice Preferred Gold PPO 101
- G531BCE Blue Choice Preferred Gold PPO 102
- G532BCE Blue Choice Preferred Gold PPO 107
- G533BCE Blue Choice Preferred Gold PPO 113
- G534BCE Blue Choice Preferred Gold PPO 114
- G535BCE Blue Choice Preferred Gold PPO 115
- Blue Choice Preferred Gold PPO 116
- Blue Choice Preferred Gold PPO 123
- Blue Choice Preferred Gold PPO 502
Silver Plans
Blue PPO Silver Plans
Off Exchange
- S531PPO Blue PPO Silver 104
- S535PPO Blue PPO Silver 105
- S532PPO Blue PPO Silver 120
- S534PPO Blue PPO Silver 133
- S5J1PPO Blue PPO Silver 200
Blue Precision Silver HMO Plans
Off Exchange
BlueChoice Preferred Silver PPO Plans
Off Exchange
- S531BCE Blue Choice Preferred Silver PPO 104
- S535BCE Blue Choice Preferred Silver PPO 105
- S532BCE Blue Choice Preferred Silver PPO 120
- S534BCE Blue Choice Preferred Silver PPO 133
- S5J1BCE Blue Choice Preferred Silver PPO 200
Blue Options Silver PPO Plans
Off Exchange
- S506OPT Blue Options Silver PPO 104
- S507OPT Blue Options Silver PPO 107
- S5N1OPT Blue Options Silver PPO 404
Bronze Plans
Blue PPO Bronze Plans
Off Exchange
BlueChoice Preferred Bronze PPO Plans
Off Exchange
Platinum Plans
Blue PPO Platinum Plans
Off Exchange
Blue Choice Preferred PPO Platinum Plans
Off Exchange
Blue Precision Platinum Plans
Off Exchange
- P506PSN Blue Precision Platinum HMO 107
- P5E1PSN Blue Precision Platinum HMO 110
- P5J1PSN Blue Precision Platinum HMO 200
Blue Options Platinum Plans
Gold Plans
Blue PPO Gold Plans
Off Exchange
- G530PPO Blue PPO Gold 101
- G531PPO Blue PPO Gold 102
- G532PPO Blue PPO Gold 107
- G533PPO Blue PPO Gold 113
- G534PPO Blue PPO Gold 114
- G535PPO Blue PPO Gold 115
- G536PPO Blue PPO Gold 116
- G537PPO Blue PPO Gold 123
Blue Precision Gold HMO Plans
Off Exchange
- G532PSN Blue Precision Gold HMO 101
- G5J2PSN Blue Precision Gold HMO 201
- G5N1PSN Blue Precision Gold HMO 402
Blue Options Gold Plans
Off Exchange
- G506OPT Blue Options Gold PPO 101
- G507OPT Blue Options Gold PPO 102
- G508OPT Blue Options Gold PPO 106
- G5K1OPT Blue Options Gold PPO 200
BlueChoice Preferred Gold PPO Plans
Off Exchange
- G530BCE Blue Choice Preferred Gold PPO 101
- G531BCE Blue Choice Preferred Gold PPO 102
- G532BCE Blue Choice Preferred Gold PPO 107
- G533BCE Blue Choice Preferred Gold PPO 113
- G535BCE Blue Choice Preferred Gold PPO 115
Silver Plans
Blue PPO Silver Plans
Off Exchange
- S531PPO Blue PPO Silver 104
- S535PPO Blue PPO Silver 105
- S532PPO Blue PPO Silver 120
- S534PPO Blue PPO Silver 133
- S5J1PPO Blue PPO Silver 200
Blue Precision Silver HMO Plans
Off Exchange
BlueChoice Preferred Silver PPO Plans
Off Exchange
- S531BCE Blue Choice Preferred Silver PPO 104
- S535BCE Blue Choice Preferred Silver PPO 105
- S532BCE Blue Choice Preferred Silver PPO 120
- S534BCE Blue Choice Preferred Silver PPO 133
- S5J1BCE Blue Choice Preferred Silver PPO 200
Blue Options Silver PPO Plans
Off Exchange
- S506OPT Blue Options Silver PPO 104
- S507OPT Blue Options Silver PPO 107
- S5N1OPT Blue Options Silver PPO 404
Bronze Plans
Blue PPO Bronze Plans
Off Exchange
BlueChoice Preferred Bronze PPO Plans
Off Exchange
Last Updated: Aug. 13, 2026