Preferred Provider Organization (PPO) Plans
The PPO Plans offer you the most flexibility in your
choice of doctors and hospitals (providers). PPO Plans
provide coverage (at different levels) for services from
both Participating and Non-Participating Providers.
Please see the PPO Plan section of this brochure for
definitions of these and other terms related to PPO Plan
Coverage. blu cross

Health Maintenance Organization (HMO) Plans
The Blue Cross of California HMO Plans cover more of
the costs of your health care than any other plan type.
HMO Plans provide coverage only for services received
from doctors and hospitals within the HMO Network.
You choose a specific health care group and physician
within the network to coordinate all of your health care
needs.

Group Insurance - Dental Plans - MediCare Supplement - Freedom Blue PPO - Blue Cross Medicare Rx Benefits

Individual and group plans name Health Plans in California :
Aetna PPO 500
Aetna PPO 1500
Aetna PPO 2500
Aetna PPO 5000
Aetna PPO HSA 1
Aetna PPO HSA 2
Aetna PPO Value 1500
Aetna PPO Value 2500
Aetna PPO Value 5000

Blue Cross Tonik 1500

Blue Cross Tonik 5000

Blue Cross Tonik 3000

Blue Cross core 5000
Blue Cross Basic PPO 2500
Blue Cross Basic PPO 1000
Blue Cross PPO 3500
Blue Cross PPO 3500 HSA
Blue Cross PPO Share 5000
Blue Cross PPO Saver
Blue Cross PPO Share 2500
Blue Cross PPO Share 1500
Blue Cross PPO Share 1000
Blue Cross PPO Share 500
Blue Cross EPO (HSA Compatible)
Blue Cross HMO Saver
Blue Cross HMO 100
BC Select HMO BC Select HMO
BC Right Plan Right Plan - No Rx
BC Right Plan Right Plan - Generic Rx
BC Right Plan Right Plan - Full Rx
BC Tonik Tonic 1500
BC Tonik Tonic 3000
BC Tonik Tonic 5000
Blue Shield Shield Spectrum PPO 500
Blue Shield Shield Spectrum PPO 750
Blue Shield Shield Spectrum PPO 1500
Blue Shield Shield Spectrum PPO 2000
Blue Shield Shield Spectrum PPO 5000
Blue Shield Spectrum PPO Savings 2400
Blue Shield Spectrum PPO Savings 4000
Blue Shield Access+ HMO
Blue Shield Access+ Value HMO
BS Subscriber Only Active Start 35
BS Subscriber Only Active Start 25
BS Subscriber Only Essential 3000
BS Subscriber Only Essential 3000
Health Net HMO 15
Health Net HMO 40
Health Net SmartChoice HSA 2500
Health Net SimpleChoice HSA 4000
Health Net FirstChoice PPO
Health Net SimpleChoice 50
Health Net SimpleChoice 40
Health Net SimpleChoice 35
Health Net SimpleChoice 25
Health Net SimpleChoice 15
Health Net VB Value Choice 1500
Health Net VB SimpleValue 50
Health Net VB SimpleValue 50 Rx
Health Net VB SimpleValue 40
Health Net VB SimpleValue 40 Rx
Health Net VB SimpleValue 30
Health Net VB SimpleValue 30 Rx
Nationwide PPO 25 $750 Ded
Nationwide PPO 25 $1500 Ded
Nationwide PPO 25 $2500 Ded
Nationwide Lifestyle 1750 Gen Rx
Nationwide Lifestyle 1750
Nationwide Lifestyle 2500 Gen Rx
Nationwide Lifestyle 2500
Nationwide Lifestyle 3500 Gen Rx
Nationwide Lifestyle 3500
Nationwide Lifestyle 4500 Gen Rx
Nationwide Lifestyle 4500
Pacificare HMO 10-35/250
Pacificare HMO 20-35/80
Pacificare HMO 35/70
Pacificare HMO 35/50
Pacificare PPO 70/50/500
Pacificare PPO 70/50/1000
Pacificare PPO 70/50/2000
Pacificare PPO 60/50/2500
Pacificare PPO 70/50/3000
Pacificare PPO 70/50/5000
Pacificare PPO HSA 2700
Pacificare PPO HSA 5000
Pacificare PPO 70/50/3000 SD
Pacificare PPO 70/50/5000 SD
Pacificare PPO 70/50/1000 Maternity
Pacificare PPO 70/50/1500 Maternity

Aetna HMO Plan 10-30
Aetna HMO Plan 20-40
Aetna HMO Plan 30-40
Aetna EPO 90
Aetna EPO 80
Aetna Basic PPO
Aetna MC Zero 90/60 PPO
Aetna MC $250 90/70 PPO
Aetna MC $500 90/70 PPO
Aetna MC $250 80/60 PPO
Aetna MC $500 80/60 PPO
Aetna mc $500 80/50 PPO
Aetna MC $1000 80/50 PPO
Aetna MC $2000 80/50 PPO
Aetna HSA 2100
Aetna HSA 3000
Aetna Value HMO Value HMO 25-40
Aetna Value HMO Value HMO 15-30
Aetna Value HMO Value HMO 10-20
Blue Cross Saver HMO
Blue Cross Classic HMO
Blue Cross HMO 100
Blue Cross Basic PPO
Blue Cross Hospital BeneFits
Blue Cross Hospital BeneFits Plus
Blue Cross Hospital BeneFits Pref
Blue Cross High Deductible EPO
Blue Cross Saver PPO
Blue Cross PPO 40
Blue Cross PPO 30
Blue Cross PPO 35 GenRx
Blue Cross Power Fund 750
Blue Cross Power Fund 500
Blue Cross Advantage 25 PPO
Blue Cross Premier 20 PPO
Blue Cross Premier 10 PPO
Blue Cross PPO 2400
Blue Cross PPO 3500
Blue Cross PS HMO Power Select HMO Plan
Blue Shield Access+ HMO 5
Blue Shield Access+ HMO 10
Blue Shield Access+ HMO 15
Blue Shield Access+ HMO 20
Blue Shield Access+ H00025
Blue Shield Access+ HMO 40
Blue Shield Added Advantage POS 300
Blue Shield Pref Sav $1250 Ded
Blue Shield Pref Sav $2250 Ded
Blue Shield Pref Sav $2600 Ded
Blue Shield Spectrum PPO Zero Deductible
Blue Shield Spectrum PPO 250 Premier
Blue Shield Spectrum PPO 250 Standard
Blue Shield Spectrum PPO 500 Value
Blue Shield Spectrum PPO 500 Standard
Blue Shield Spectrum PPO 500 Premier
Blue Shield Spectrum PPO 1000
Blue Shield Spectrum PPO 3000
Blue Shield Active Choice 500
Blue Shield Active Choice 750
Health Net HMO 10
Health Net HMO 15
Health Net HMO 20
Health Net HMO 30
Health Net HMO 35
Health Net HMO 40
Health Net HMO Xtra Value 20
Health Net HMO Xtra Value 40
Health Net Variable Hosp Copay HMO 25
Health Net Variable Hosp Copay HMO 35
Health Net Elect Open Acces 30
Health Net Elect Open Access 25
Health Net Elect Open Access 20
Health Net Elect Open Access 10
Health Net Select 30 POS
Health Net Select 20 POS
Health Net Sel Prem 10 POS
Health Net Saver PPO
Health Net PPO 40
Health Net PPO 35
Health Net PPO 30
Health Net PPO 25
Health Net PPO 20
Health Net PPO 15
Health Net PPO 10
Health Net HSA 2000
Health Net HSA 3000
Health Net Silver HMO 20 Silver
Health Net Silver HMO 40 Silver
Health Net Silver HMO Xtra Value 20 Silver
Health Net Silver HMO Xtra Value 40 Silver
Health Net Salud Salud HMO
Health Net Salud Salud PPO
Kaiser HMO Ded 30/1000
Kaiser HMO Ded 30/1500
Kaiser HMO Plan 5
Kaiser HMO Plan 15
Kaiser HMO Plan 20
Kaiser HMO Plan 30
Kaiser HMO Plan 50
Kaiser Point of Service Plan
Nationwide Plan 1
Nationwide Plan 2
Nationwide Plan 3
Nationwide Plan 4
Nationwide Plan 5
Nationwide Plan 6
PacifiCare HMO 10
PacifiCare HMO 15
PacifiCare HMO 10/500d
PacifiCare HMO 20
PacifiCare HMO 35/600d
PacifiCare POS 15/80-60
PacifiCare PPO 80/60-250
PacifiCare PPO 70/50-250
PacifiCare PPO 80/60-500
PacifiCare PPO 70/50-1000
PacifiCare PPO 35-50/50-1000
PacifiCare PPO 70/50-2000
PacifiCare PPO 70/50-3500
PacifiCare PPO 80/50-2000/freedom
PacifiCare PPO 70/50-2000/freedom
PacifiCare PPO 50/50-3000/freedom
PacifiCare PPO HSA 2700
PacifiCare PPO HSA 3500
PacifiCare PPO HSA 5000
Pacificare Adv HMO HMO 10/500d
Pacificare Adv HMO HMO 35/600d
Sharp Health Plan HMO Plan A
Sharp Health Plan HMO Plan AB
Sharp Health Plan HMO Plan C
Sharp Health Plan HMO Plan AD

Sharp Health Plan HMO Plan AE
Western Health Adv HMO Premier 5
Western Health Adv HMO Premier 10
Western Health Adv HMO Premier 15
Western Health Adv HMO Premier 20
Western Health Adv HMO Advantage 15-30
Western Health Adv HMO Advantage 420
Western Health Adv HMO Advantage 70
Western Health Adv HMO Advantage 30-40
Western Health Adv HMO Advantage 40
Western Health Adv HMO Deductible 1000