Availity Portal

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Medical Policy, Clinical UM Guidelines, and Pre-Cert Requirements

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Benefit Summaries - Grandfathered

PW_B150326

Blue Open Access (HMO)

HMO Benefit Summaries (effective 10/01/2010)  
To view specific details of each Plan, click on the English version, as appropriate. 
100% Plans  

HMO Plan G6004AX 
HMO Plan G6005AX 
HMO Plan G6006AX 
HMO Plan G6007AX 
HMO Plan G6008AX 
HMO Plan G6009AX 
 
90% Plans  

HMO Plan G6200AX 
 
80% Plans  

HMO Plan G6501AX 
HMO Plan G6502AX 
 
70% Plans  

HMO Plan G6801AX 
HMO Plan G6802AX 
HMO Plan G6803AX 
 
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