Blue Advantage

Plan Type :

HMO

Plan # :

MIBAH2010

Weekly ($)

Employee only:

$50.36

Employee + Spouse:

$161.68

Employee + Child:

$95.15

Family:

$251.26

Blue Choice Options (Low Deductible)

Plan Type :

PPO

Plan # :

MIBCO2000

Weekly ($)

Employee only:

$57.72

Employee + Spouse:

$180.97

Employee + Child:

$105.93

Family:

$277.25

BluePrint

Plan Type :

PPO

Plan # :

MIBPP2050

Weekly ($)

Employee only:

$73.45

Employee + Spouse:

$222.16

Employee + Child:

$135.97

Family:

$332.75

Blue Choice Options (High Deductible)

Plan Type :

PPO

Plan # :

MICOE1051

Weekly ($)

Employee only:

$34.76

Employee + Spouse:

$120.83

Employee + Child:

$80.26

Family:

$196.22

HMO - Application tips

Selecting primary care physician

If you are electing HMO medical insurance coverage, you will be required to elect a primary care physician.  The list of providers can be obtained using the provider search link at the bottom.

Once you have selected a primary care physician the following information must be added to the enrollment form.

1. Doctors Name

2. PCP#

3. IPA#

This information will be found on the doctors profile once you click their name.

 

Please review the completed sample below.

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