Benefit booklets

Choose a plan below to see a sample summary of what's covered in that plan.
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The following benefit booklets are only samples. For a copy of your specific Benefit Booklet, please log in to Blue Connect after your policy's effective date or call 877-275-9787.
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2026 individual benefit booklets

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Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors (PDF)
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Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors (PDF)
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Blue Advantage Gold Standard A | Nationwide Doctors (PDF)
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Blue Advantage Gold Standard A | Nationwide Doctors (PDF)
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Blue Advantage $0 | Nationwide Doctors (AI/AN) (PDF)
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Blue Advantage $0 | Nationwide Doctors (AI/AN) (PDF)
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Blue Advantage $0 A | Nationwide Doctors (AI/AN) (PDF)
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Blue Advantage $0 A | Nationwide Doctors (AI/AN) (PDF)
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Blue Advantage Bronze | Integrated | Nationwide Doctors (>300% AI AN) (PDF)
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Blue Advantage Bronze | Integrated | Nationwide Doctors (>300% AI AN) (PDF)
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Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors (PDF)
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Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors (PDF)
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Blue Advantage Bronze Basic A | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors (PDF)
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Blue Advantage Bronze Basic A | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors (PDF)
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Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors (PDF)
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Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors (PDF)
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Blue Advantage Bronze Complete A | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors (PDF)
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Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors (PDF)
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Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors (PDF)
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Blue Advantage Silver Access A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors (PDF)
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Blue Advantage Silver Choice A | $0 Deductible | 3 Free PCP | $5 Tier 1 Rx | Nationwide Doctors (CSR 94%) (PDF)
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Blue Advantage Silver Choice A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors (CSR 87%) (PDF)
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Blue Advantage Silver Preferred | $0 Deductible | $0 PCP | $0 Tier 1 Rx | Nationwide Doctors (CSR 94%) (PDF)
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2026 sample small group benefit booklets

Blue Options Benefit Booklet (PDF)

BlueHPN Benefit Booklet (PDF)

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2025 sample small group benefit booklets

Blue Options Specialist Step Benefit Booklet (PDF)

BlueHPN Specialist Step Benefit Booklet (PDF)

Blue Options HSA Benefit Booklet (PDF)

BlueHPN HSA Benefit Booklet (PDF)

Blue Options All Copay Benefit Booklet (PDF)

BlueHPN All Copay Benefit Booklet (PDF)

Blue Options Copay Benefit Booklet (PDF)

BlueHPN Copay Benefit Booklet (PDF)

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