2019 Texas QHP Small Group Actual Policy Documents

Below is a list of actual policy documents for QHP small group coverage. These policies describe how the plans generally work and include eligible expenses, claim filing and appeals procedures, and coverage limitations and exceptions, among other things.

If you have questions, contact a customer service representative at 1-888-697-0683 for more information.

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Platinum Plans

Blue Choice Advantage Platinum PPO Plans
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Policy Books

Blue Choice Platinum PPO 810
Blue Choice Platinum PPO 810-in vitro
Blue Choice Platinum PPO 811
Blue Choice Platinum PPO 811-in

Blue Advantage Platinum HMO Plans
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Policy Books

Blue Advantage Platinum HMO 807
Blue Advantage Platinum HMO 807-in vitro
Blue Advantage Platinum HMO 808
Blue Advantage Platinum HMO 808-in vitro

Plan Descriptions

Blue Advantage Platinum HMO 807
Blue Advantage Platinum HMO 807-in vitro
Blue Advantage Platinum HMO 808
Blue Advantage Platinum HMO 808-in vitro

Gold Plans

Blue Choice Gold PPO Plans
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Policy Books

Blue Choice Gold PPO 801
Blue Choice Gold PPO 801-in vitro
Blue Choice Gold PPO 819
Blue Choice Gold PPO 819-in vitro
Blue Choice Gold PPO 820
Blue Choice Gold PPO 820-in vitro
Blue Choice Gold PPO 822
Blue Choice Gold PPO 822-in vitro
Blue Choice Gold PPO 823
Blue Choice Gold PPO 823-in vitro
Blue Choice Gold PPO 830
Blue Choice Gold PPO 830-in vitro 

Blue Advantage Gold HMO Plans
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Policy Books

Blue Advantage Gold HMO 801
Blue Advantage Gold HMO 801-in vitro
Blue Advantage Gold HMO 812
Blue Advantage Gold HMO 812-in vitro
Blue Advantage Gold HMO 814
Blue Advantage Gold HMO 814-in vitro
Blue Advantage Gold HMO 816
Blue Advantage Gold HMO 816-in vitro
Blue Advantage Gold HMO 817
Blue Advantage Gold HMO 817-in vitro
Blue Advantage Gold HMO 822
Blue Advantage Gold HMO 822-in vitro
Blue Advantage Gold HMO 830
Blue Advantage Gold HMO 830-in vitro

Plan Descriptions

Blue Advantage Gold HMO 801
Blue Advantage Gold HMO 801-in vitro 
Blue Advantage Gold HMO 812
Blue Advantage Gold HMO 812-in vitro
Blue Advantage Gold HMO 814
Blue Advantage Gold HMO 814-in vitro
Blue Advantage Gold HMO 816
Blue Advantage Gold HMO 816-in vitro
Blue Advantage Gold HMO 817
Blue Advantage Gold HMO 817-in vitro
Blue Advantage Gold HMO 822
Blue Advantage Gold HMO 822-in vitro
Blue Advantage Gold HMO 830
Blue Advantage Gold HMO 830-in vitro

Blue Premier Access Gold Plans
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Policy Books

Blue Premier Access Gold HMO 801
Blue Premier Access Gold HMO 801-in vitro

Plan Descriptions

Blue Premier Access Gold HMO 801
Blue Premier Access Gold HMO 801-in vitro

Blue Essentials Access Gold HMO Plans
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Policy Books

Blue Essentials Access Gold HMO 801
Blue Essentials Access Gold HMO 801-in vitro
Blue Essentials Access Standard Gold 926
Blue Essentials Access Standard Gold 926-in vitro

Plan Descriptions

Blue Essentials Access Gold HMO 801
Blue Essentials Access Gold HMO 801-in vitro
Blue Essentials Access Standard Gold 926
Blue Essentials Access Standard Gold 926-in vitro

Silver Plans

Blue Choice Silver PPO Plans
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Policy Books

Blue Choice Silver PPO 803
Blue Choice Silver PPO 803-in vitro
Blue Choice Silver PPO 824
Blue Choice Silver PPO 824-in vitro
Blue Choice Silver PPO 825
Blue Choice Silver PPO 825-in vitro
Blue Choice Silver PPO 827
Blue Choice Silver PPO 827-in vitro
Blue Choice Silver PPO 834
Blue Choice Silver PPO 834-in vitro
Blue Choice Silver PPO 844
Blue Choice Silver PPO 844-in vitro
Blue Choice Silver PPO 845
Blue Choice Silver PPO 845-in vitro

Blue Advantage Silver HMO Plans
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Policy Books

Blue Advantage Silver HMO 803
Blue Advantage Silver HMO 803-in vitro
Blue Advantage Silver HMO 804
Blue Advantage Silver HMO 804-in vitro
Blue Advantage Silver HMO 818
Blue Advantage Silver HMO 818-in vitro
Blue Advantage Silver HMO 820
Blue Advantage Silver HMO 820-in vitro
Blue Advantage Silver HMO 846
Blue Advantage Silver HMO 846-in vitro

Plan Descriptions

Blue Advantage Silver HMO 803
Blue Advantage Silver HMO 803-in vitro
Blue Advantage Silver HMO 804
Blue Advantage Silver HMO 804-in vitro
Blue Advantage Silver HMO 818
Blue Advantage Silver HMO 818-in vitro
Blue Advantage Silver HMO 820
Blue Advantage Silver HMO 820-in vitro
Blue Advantage Silver HMO 846
Blue Advantage Silver HMO 846-in vitro

Blue Premier Access Silver HMO Plans
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Policy Books

Blue Premier Access Silver HMO 802
Blue Premier Access Silver HMO 802-in vitro
Blue Premier Access Silver HMO 803
Blue Premier Access Silver HMO 803-in vitro
Blue Premier Access Silver HMO 804
Blue Premier Access Silver HMO 804-in vitro
Blue Premier Access Silver HMO 805
Blue Premier Access Silver HMO 805-in vitro

Plan Descriptions

Blue Premier Access Silver HMO 802
Blue Premier Access Silver HMO 802-in vitro
Blue Premier Access Silver HMO 803
Blue Premier Access Silver HMO 803-in vitro
Blue Premier Access Silver HMO 804
Blue Premier Access Silver HMO 804-in vitro
Blue Premier Access Silver HMO 805
Blue Premier Access Silver HMO 805-in vitro

Blue Essentials Access Silver HMO Plans
Off Exchange

Policy Books

Blue Essentials Access Silver HMO 802
Blue Essentials Access Silver HMO 802-in vitro
Blue Essentials Access Silver HMO 803
Blue Essentials Access Silver HMO 803-in vitro
Blue Essentials Access Silver HMO 804
Blue Essentials Access Silver HMO 804-in vitro
Blue Essentials Access Silver HMO 805
Blue Essentials Access Silver HMO 805-in vitro
Blue Essentials Access Standard Silver 907
Blue Essentials Access Standard Silver 907-in vitro

Plan Descriptions

Blue Essentials Access Silver HMO 802
Blue Essentials Access Silver HMO 802-in vitro
Blue Essentials Access Silver HMO 803
Blue Essentials Access Silver HMO 803-in vitro
Blue Essentials Access Silver HMO 804
Blue Essentials Access Silver HMO 804-in vitro
Blue Essentials Access Silver HMO 805
Blue Essentials Access Silver HMO 805-in vitro
Blue Essentials Access Standard Silver 907
Blue Essentials Access Standard Silver 907-in vitro

Bronze Plans

Blue Choice Bronze PPO Plans
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Policy Books

Blue Choice Bronze PPO 805
Blue Choice Bronze PPO 805-in vitro
Blue Choice Bronze PPO 806
Blue Choice Bronze PPO 806-in vitro
Blue Choice Bronze PPO 833
Blue Choice Bronze PPO 833-in vitro

Blue Advantage Bronze HMO Plans
Off Exchange

Policy Books

Blue Advantage Bronze HMO 806
Blue Advantage Bronze HMO 806-in vitro
Blue Advantage Bronze HMO 833
Blue Advantage Bronze HMO 833-in vitro

Plan Descriptions

Blue Advantage Bronze HMO 806
Blue Advantage Bronze HMO 806-in vitro
Blue Advantage Bronze HMO 833
Blue Advantage Bronze HMO 833-in vitro

Blue Premier Access Bronze HMO Plans
Off Exchange

Policy Books

Blue Premier Access Bronze HMO 806
Blue Premier Access Bronze HMO 806-in vitro

Plan Descriptions

Blue Premier Access Bronze HMO 806
Blue Premier Access Bronze HMO 806-in vitro

Blue Essentials Access Bronze HMO Plans
Off Exchange

Policy Books

Blue Essentials Access Bronze HMO 806
Blue Essentials Access Bronze HMO 806-in vitro

Plan Descriptions

Blue Essentials Access Bronze HMO 806
Blue Essentials Access Bronze HMO 806-in vitro