2024 QHP Small Group Policy Documents

Below is a list of actual policy documents for Blue Cross and Blue Shield of Illinois QHP small group coverage. These policies describe how the plans generally work and include eligible expenses, claim filing and appeals procedures, and coverage limitations and exceptions, among other things.

If you have questions, contact a customer service representative at 1-800-538-8833 for more information.

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Platinum Plans

Blue PPO Platinum Plans

Off Exchange

• P503PPO Blue PPO Platinum 119
• P5E1PPO Blue PPO Platinum 136

Blue Choice Preferred PPO Platinum Plans

Off Exchange

• P5E2BCE Blue Choice Preferred Platinum PPO 119
• P5E1BCE Blue Choice Preferred Platinum PPO 136

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

• P5N1OPT Blue Options Platinum PPO 403

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

• S530PSN Blue Precision Silver HMO 102
• S531PSN Blue Precision Silver HMO 106

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

• B535PPO Blue PPO Bronze 106
• B536PPO Blue PPO Bronze 132
• B5N1PPO Blue PPO Bronze 401

BlueChoice Preferred Bronze PPO Plans

Off Exchange

• B535BCE Blue Choice Preferred Bronze PPO 106
• B536BCE Blue Choice Preferred Bronze PPO 132
• B5N1BCE Blue Choice Preferred Bronze PPO 401