Availity Portal

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

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Benefit Summaries - Grandfathered

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Blue Open Access (POS)

POS Benefit Summaries (effective 10/1/2010)
To view specific details of each Plan, click on the English version, as appropriate. 
100/60% Plans 

POS Plan G5006AX 
POS Plan G5007AX 
POS Plan G5008AX 
POS Plan G5009AX 
POS Plan G5010AX 
 
90/60% Plans 

POS Plan G5200AX 
POS Plan G5201AX 
 
80/60% Plans 

POS Plan G5505AX 
POS Plan G5506AX 
POS Plan G5507AX 
POS Plan G5508AX 
POS Plan G5509AX 
 
70/60% Plans 

POS Plan G5802AX 
POS Plan G5803AX 
POS Plan G5804AX 
POS Plan G5805AX 
 
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