Commercial plan documents
Plan documents for Blue Cross and Blue Shield of Minnesota and Blue Plus health plans are available below.
Plan documents for Blue Cross and Blue Shield of Minnesota and Blue Plus health plans are available below.
Plans with Blue Plus Metro MN Network | Summary of benefits & coverage (SBC) | Benefit booklet |
---|---|---|
Blue Plus Metro MN off-exchange plans | ||
Blue Plus Metro MN HSA Bronze $8300 Plan 258 | 258 SBC | 258 Benefit booklet |
Blue Plus Metro MN Bronze $7750 Plan 259 | 259 SBC | 259 Benefit booklet |
Blue Plus Metro MN HSA Silver $3300 Plan 253 | 253 SBC | 253 Benefit booklet |
Blue Plus Metro MN Gold Rx Copay $1200 Plan 254 | 254 SBC | 254 Benefit booklet |
Blue Plus Metro MN MNsure plans | ||
Blue Plus Metro MN HSA Bronze $8300 Plan 458 | 458 SBC | 458 Benefit booklet |
Blue Plus Metro MN Bronze $7750 Plan 459 | 459 SBC | 459 Benefit booklet |
Blue Plus Metro MN HSA Silver $3300 Plan 453 | 453 SBC | 453 Benefit booklet |
Blue Plus Metro MN Gold Rx Copay $1200 Plan 455 | 455 SBC | 455 Benefit booklet |
Blue Plus Metro MN MNsure variation plans | ||
Blue Plus Metro MN Bronze AI/AN Zero Cost Share Reduction Plan 458a | 458a SBC | 458a Benefit booklet |
Blue Plus Metro MN Bronze $8300 AI/AN Limited Cost Share Reduction Plan 458b | 458b SBC | 458b Benefit booklet |
Blue Plus Metro MN Bronze AI/AN Zero Cost Share Reduction Plan 459a | 459a SBC | 459a Benefit booklet |
Blue Plus Metro MN Bronze $7750 AI/AN Limited Cost Share Reduction Plan 459b | 459b SBC | 459b Benefit booklet |
Blue Plus Metro MN Silver AI/AN Zero Cost Share Reduction Plan 453a | 453a SBC | 453a Benefit booklet |
Blue Plus Metro MN Silver $3300 AI/AN Limited Cost Share Reduction Plan 453b | 453b SBC | 453b Benefit booklet |
Blue Plus Metro MN Silver $2000 Cost Share Reduction Plan 453c | 453c SBC | 453c Benefit booklet |
Blue Plus Metro MN Silver $300 Cost Share Reduction Plan 453d | 453d SBC | 453d Benefit booklet |
Blue Plus Metro MN Silver No Deductible Cost Share Reduction Plan 453e | 453e SBC | 453e Benefit booklet |
Blue Plus Metro MN Gold AI/AN Zero Cost Share Reduction Plan 455a | 455a SBC | 455a Benefit booklet |
Blue Plus Metro MN Gold Rx Copay $1,200 AI/AN Limited Cost Share Reduction Plan 455b | 455b SBC | 455b Benefit booklet |
Plans with Blue Plus Minnesota Value Network | Summary of benefits & coverage (SBC) | Benefit booklet |
---|---|---|
Blue Plus Minnesota Value off-exchange plans | ||
Blue Plus Minnesota Value HSA Bronze $8300 Plan 200 | 200 SBC | 200 Benefit booklet |
Blue Plus Minnesota Value HSA Silver $3300 Plan 201 | 201 SBC | 201 Benefit booklet |
Blue Plus Minnesota Value Gold Rx Copay $1200 Plan 202 | 202 SBC | 202 Benefit booklet |
Blue Plus Minnesota Value Bronze $7750 Plan 206 | 206 SBC | 206 Benefit booklet |
Blue Plus Minnesota Value HSA Gold $3300 Plan 207 | 207 SBC | 207 Benefit booklet |
Blue Plus Minnesota Value Bronze $5800 Plan 203 | 203 SBC | 203 Benefit booklet |
Blue Plus Easy Compare Silver and Rx Copay Blue Plus Minnesota Value Plan 204 | 204 SBC | 204 Benefit booklet |
Blue Plus Easy Compare Gold and Rx Copay Blue Plus Minnesota Value Plan 205 | 205 SBC | 205 Benefit booklet |
Blue Plus Easy Compare Bronze Blue Plus Minnesota Value Plan 208 | 208 SBC | 208 Benefit booklet |
Blue Plus Minnesota Value MNsure plans | ||
Blue Plus Minnesota Value HSA Bronze $8300 Plan 400 | 400 SBC | 400 Benefit booklet |
Blue Plus Minnesota Value HSA Silver $3300 Plan 401 | 401 SBC | 401 Benefit booklet |
Blue Plus Minnesota Value Gold Rx Copay $1200 Plan 402 | 402 SBC | 402 Benefit booklet |
Blue Plus Minnesota Value Bronze $7750 Plan 406 | 406 SBC | 406 Benefit booklet |
Blue Plus Minnesota Value HSA Gold $3300 Plan 407 | 407 SBC | 407 Benefit booklet |
Blue Plus Minnesota Value Bronze $5800 Plan 403 | 403 SBC | 403 Benefit booklet |
Blue Plus Easy Compare Silver and Rx Copay Blue Plus Minnesota Value Plan 404 | 404 SBC | 404 Benefit booklet |
Blue Plus Easy Compare Gold and Rx Copay Blue Plus Minnesota Value Plan 405 | 405 SBC | 405 Benefit booklet |
Blue Plus Easy Compare Bronze Blue Plus Minnesota Value Plan 408 | 408 SBC | 408 Benefit booklet |
Blue Plus Minnesota Value MNsure variation plans | ||
Blue Plus Minnesota Value Bronze AI/AN Zero Cost Share Reduction Plan 400a | 400a SBC | 400a Benefit booklet |
Blue Plus Minnesota Value Bronze $8300 AI/AN Limited Cost Share Reduction Plan 400b | 400b SBC | 400b Benefit booklet |
Blue Plus Minnesota Value Silver AI/AN Zero Cost Share Reduction Plan 401a | 401a SBC | 401a Benefit booklet |
Blue Plus Minnesota Value Silver $3300 AI/AN Limited Cost Share Reduction Plan 401b | 401b SBC | 401b Benefit booklet |
Blue Plus Minnesota Value Silver $2000 Cost Share Reduction Plan 401c | 401c SBC | 401c Benefit booklet |
Blue Plus Minnesota Value Silver $300 Cost Share Reduction Plan 401d | 401d SBC | 401d Benefit booklet |
Blue Plus Minnesota Value Silver No Deductible Cost Share Reduction Plan 401e | 401e SBC | 401e Benefit booklet |
Blue Plus Minnesota Value Gold AI/AN Zero Cost Share Reduction Plan 402a | 402a SBC | 402a Benefit booklet |
Blue Plus Minnesota Value Gold Rx Copay $1,200 AI/AN Limited Cost Share Reduction Plan 402b | 402b SBC | 402b Benefit booklet |
Blue Plus Minnesota Value Bronze AI/AN Zero Cost Share Reduction Plan 406a | 406a SBC | 406a Benefit booklet |
Blue Plus Minnesota Value Bronze $7750 AI/AN Limited Cost Share Reduction Plan 406b | 406b SBC | 406b Benefit booklet |
Blue Plus Minnesota Value Gold AI/AN Zero Cost Share Reduction Plan 407a | 407a SBC | 407a Benefit booklet |
Blue Plus Minnesota Value Gold $3300 AI/AN Limited Cost Share Reduction Plan 407b | 407b SBC | 407b Benefit booklet |
Blue Plus Minnesota Value Bronze AI/AN Zero Cost Share Reduction Plan 403a | 403a SBC | 403a Benefit booklet |
Blue Plus Minnesota Value Bronze $5800 AI/AN Limited Cost Share Reduction Plan 403b | 403b SBC | 403b Benefit booklet |
Blue Plus Easy Compare Silver Blue Plus Minnesota Value Plan 404a | 404a SBC | 404a Benefit booklet |
Blue Plus Easy Compare Silver and Rx Copay Blue Plus Minnesota Value Plan 404b | 404b SBC | 404b Benefit booklet |
Blue Plus Easy Compare Silver and Rx Copay Blue Plus Minnesota Value Plan 404c | 404c SBC | 404c Benefit booklet |
Blue Plus Easy Compare Silver and Rx Copay Blue Plus Minnesota Value Plan 404d | 404d SBC | 404d Benefit booklet |
Blue Plus Easy Compare Silver and Rx Copay Blue Plus Minnesota Value Plan 404e | 404e SBC | 404e Benefit booklet |
Blue Plus Easy Compare Gold Blue Plus Minnesota Value Plan 405a | 405a SBC | 405a Benefit booklet |
Blue Plus Easy Compare Gold and Rx Copay Blue Plus Minnesota Value Plan 405b | 405b SBC | 405b Benefit booklet |
Blue Plus Easy Compare Bronze Blue Plus Minnesota Value Plan 408a | 408a SBC | 408a Benefit booklet |
Blue Plus Easy Compare Bronze Blue Plus Minnesota Value Plan 408b | 408b SBC | 408b Benefit booklet |
Plans with Blue Plus Southeast MN Network | Summary of benefits & coverage (SBC) | Benefit booklet |
---|---|---|
Blue Plus Southeast MN off-exchange plans | ||
Blue Plus Southeast MN HSA Bronze $8300 Plan 270 | 270 SBC | 270 Benefit booklet |
Blue Plus Southeast MN HSA Silver $3300 Plan 271 | 271 SBC | 271 Benefit booklet |
Blue Plus Easy Compare Silver and Rx Copay Blue Plus Southeast MN Plan 273 | 273 SBC | 273 Benefit booklet |
Blue Plus Southeast MN Gold Rx Copay $1200 Plan 272 | 272 SBC | 272 Benefit booklet |
Blue Plus Easy Compare Bronze Blue Plus Southeast MN Plan 274 | 274 SBC | 274 Benefit booklet |
Blue Plus Easy Compare Gold and Rx Copay Blue Plus Southeast MN Plan 275 | 275 SBC | 275 Benefit booklet |
Blue Plus Southeast MN MNsure plans | ||
Blue Plus Southeast MN HSA Bronze $8300 Plan 470 | 470 SBC | 470 Benefit booklet |
Blue Plus Southeast MN HSA Silver $3300 Plan 471 | 471 SBC | 471 Benefit booklet |
Blue Plus Easy Compare Silver and Rx Copay Blue Plus Southeast MN Plan 473 | 473 SBC | 473 Benefit booklet |
Blue Plus Southeast MN Gold Rx Copay $1200 Plan 472 | 472 SBC | 472 Benefit booklet |
Blue Plus Easy Compare Bronze Blue Plus Southeast MN Plan 474 | 474 SBC | 474 Benefit booklet |
Blue Plus Easy Compare Gold and Rx Copay Blue Plus Southeast MN Plan 475 | 475 SBC | 475 Benefit booklet |
Blue Plus Southeast MN MNsure variation plans | ||
Blue Plus Southeast MN Bronze AI/AN Zero Cost Share Reduction Plan 470a | 470a SBC | 470a Benefit booklet |
Blue Plus Southeast MN Bronze $8300 AI/AN Limited Cost Share Reduction Plan 470b | 470b SBC | 470b Benefit booklet |
Blue Plus Southeast MN Silver AI/AN Zero Cost Share Reduction Plan 471a | 471a SBC | 471a Benefit booklet |
Blue Plus Southeast MN Silver $3300 AI/AN Limited Cost Share Reduction Plan 471b | 471b SBC | 471b Benefit booklet |
Blue Plus Southeast MN Silver $2000 Cost Share Reduction Plan 471c | 471c SBC | 471c Benefit booklet |
Blue Plus Southeast MN Silver $300 Cost Share Reduction Plan 471d | 471d SBC | 471d Benefit booklet |
Blue Plus Southeast MN Silver No Deductible Cost Share Reduction Plan 471e | 471e SBC | 471e Benefit booklet |
Blue Plus Southeast MN Gold AI/AN Zero Cost Share Reduction Plan 472a | 472a SBC | 472a Benefit booklet |
Blue Plus Southeast MN Gold Rx Copay $1,200 AI/AN Limited Cost Share Reduction Plan 472b | 472b SBC | 472b Benefit booklet |
Blue Plus Easy Compare Silver Blue Plus Southeast MN Plan 473a | 473a SBC | 473a Benefit booklet |
Blue Plus Easy Compare Silver and Rx Copay Blue Plus Southeast MN Plan 473b | 473b SBC | 473b Benefit booklet |
Blue Plus Easy Compare Silver and Rx Copay Blue Plus Southeast MN Plan 473c | 473c SBC | 473c Benefit booklet |
Blue Plus Easy Compare Silver and Rx Copay Blue Plus Southeast MN Plan 473d | 473d SBC | 473d Benefit booklet |
Blue Plus Easy Compare Silver and Rx Copay Blue Plus Southeast MN Plan 473e | 473e SBC | 473e Benefit booklet |
Blue Plus Easy Compare Bronze Blue Plus Southeast MN Plan 474a | 474a SBC | 474a Benefit booklet |
Blue Plus Easy Compare Bronze Blue Plus Southeast MN Plan 474b | 474b SBC | 474b Benefit booklet |
Blue Plus Easy Compare Gold Blue Plus Southeast MN Plan 475a | 475a SBC | 475a Benefit booklet |
Blue Plus Easy Compare Gold and Rx Copay Blue Plus Southeast MN Plan 475b | 475b SBC | 475b Benefit booklet |
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View plan documents for Medicare or Medical Assistance (Medicaid).
*You may request a paper version of a summary of benefits and coverage (SBC) by calling 1-800-531-6685.