Small Business Medical, Pharmacy, and Vision Plans

Blue Solutions® Health Plans for Small Employers

Choose from our wide variety of medical plans designed to help you lower costs and help members get access to high-quality, affordable care. Our health plans cover all required essential health benefits — like doctor visits, preventive care, hospital stays, emergency services, and prescription drugs — and include dental coverage for children, plus vision coverage for both adults and children.

Download our pdf icon2019 Blue Solutions Overview Brochure for complete details.

Pharmacy benefits

Prescription drugs are a covered essential health benefit and our plans give your employees choices to help them lower their out-of-pocket costs. They can access up to 68,000 participating retail pharmacies in the FutureScripts® network1 and take advantage of mail order for additional savings and convenience.

pdf iconVision benefits

Pediatric vision is a covered essential health benefit for enrolled members up to age 19. Additionally, our plans include vision benefits for adults administered by Davis Vision®. The Davis Vision network offers over 72,000 points of access, including optometrists, ophthalmologists and retail stores such as Visionworks.2 Davis Vision members also have access to a routine hearing test and discounts on brand-name hearing aids through EPIC Hearing.

pdf iconPediatric dental benefits

Pediatric dental is a covered essential health benefit for enrolled dependents up to age 19. Administered by United Concordia Dental, pediatric dental coverage includes $0 in-network preventive exams, cleanings, and diagnostic treatment to help children maintain good oral health.

If you are looking to offer employees and their families comprehensive dental coverage, two of our new family PPO dental plans feature pediatric cosmetic orthodontia, as well as enhanced pediatric and adult dental benefits to help save on costs. We also offer you the option to add standalone adult dental benefits to complement your medical plans.

Personal Choice® PPO Plans

PPO plans offer your employees flexibility to choose in-network (preferred) or out-of-network (non-preferred) providers. The choice is always theirs to make. Much higher out-of-pocket costs may apply for out-of-network care.

  • In- and out-of-network coverage
  • Freedom to see any doctor or specialist without referrals
  • In-network benefits available coast-to-coast through the BlueCard® PPO network and around the world through Blue Cross Blue Shield Global Core®
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Personal Choice® EPO Plans

Exclusive Provider Organization (EPO) plans give your employees access to any doctor or hospital in our PPO network, without referrals:

  • Combine the flexibility of a PPO and the cost savings of an HMO
  • Members can choose any in-network provider and don’t need to pick a PCP or get referrals
  • In-network benefits covered out of area through the BlueCard® PPO. No out-of-network benefits, except for emergency and urgent care
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Keystone Direct POS Plans

Direct POS plans provide both in- and out-of-network coverage, with the flexibility to visit most specialists without a referral.3 Members pay less for care in the Keystone Health Plan East network, and more when they go out-of-network.

  • Must select a participating PCP to coordinate care
  • To pay the lowest cost, members should get a referral or prescription from their PCP and visit designated sites for lab work, radiology, and physical and occupational therapy
  • Away from Home Care® program for employees who temporarily reside outside the service area
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Keystone HMO Plans

HMO plans are designed to help your employees save money. A participating PCP coordinates all of their care.

  • In-network coverage only. Out-of-network benefits are available for emergency services only.
  • Participating PCP coordinates employees’ primary care and refers them to in-network specialists for specialty care
  • Emergency and urgent care access available outside the United States through Blue Cross Blue Shield Global Core®
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Keystone HMO Proactive Plans

Keystone HMO Proactive plans work just like a typical HMO and use a tiered network. Employees can choose providers in any tier but save by choosing providers in the lowest-cost tier.

  • Full access to the Keystone provider network with lower monthly premiums. Out-of-network benefits are available for emergency services only.
  • More than 50 percent of doctors and hospitals are in Tier 1 – Preferred, the lowest-cost tier
  • Certain covered services, including preventive care, urgent care, and prescription drugs, have the same cost-share across tiers
Learn more
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High-deductible Health Plans (HDHPs)

Choose from two fully integrated spending account options — either a BlueSaver® Health Savings Account (HSA) through our preferred vendor or a BlueSaver® Health Reimbursement Account (HRA). Both offer you:

  • Easy, integrated account maintenance and online reporting at
  • Convenient funding methods
  • Reduced federal, state, and FICA tax liability
Learn more
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1 FutureScripts is an independent company providing pharmacy benefits management services for Independence Blue Cross. Certain Blue Solutions plans use the FutureScripts Preferred Pharmacy network, which includes more than 50,000 retail pharmacies.

2 An affiliate of Independence Blue Cross has a financial interest in Visionworks.

3 Referrals are required for physical/occupational therapy, spinal manipulation, acupuncture, and radiology. For lab work, a member’s primary care physician will provide them with a requisition form.