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.

View/Download our 2020 Blue Solutions Overview Brochure for complete details.

Pharmacy benefits

Prescription drug benefits are included in all Blue Solutions medical plans and provide us with a holistic view of members’ health and utilization. This benefit allows us to more effectively coordinate all aspects of members’ health care, which leads to improved outcomes and better control of overall costs. Members can access more than 68,000 participating retail and independent pharmacies in the FutureScripts® network.1

Vision benefits

Every Blue Solutions plan includes adult and pediatric vision benefits for children up to age 19, encouraging prevention, early diagnosis, and treatment to help detect more serious, costly conditions. Administered by Davis Vision®, the Davis Vision network offers over 84,000 points of access nationwide, including retail stores such as Visionworks.2

Pediatric dental benefits

Pediatric dental is a covered essential health benefit for enrolled dependents up to age 19. Administered by United Concordia Companies, Inc., PPO and DHMO pediatric dental plans include in-network preventive exams and cleanings covered in full to help children develop good oral health.

We also offer you the option to add comprehensive whole family dental coverage, or adult-only 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 network and around the world through Blue Cross Blue Shield Global Core®
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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
  • Emergency and urgent care access available outside the United States through Blue Cross Blue Shield Global Core®
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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
  • Away from Home Care® program for employees who temporarily reside outside the service area
  • 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.
  • Participating PCP coordinates employees’ primary care and refers them to in-network specialists for specialty care
  • 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
  • Away from Home Care® program for employees who temporarily reside outside the service area
  • Emergency and urgent care access available outside the United States through Blue Cross Blue Shield Global Core®
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 ibx.com
  • 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. Some Blue Solutions plans use the Preferred Pharmacy network, which includes more than 59,000 pharmacies. For these plans, filling a prescription at a non-participating pharmacy such as Rite Aid is considered out of network, and members must pay the total cost up front. They may be able to get reimbursed for part of this cost, but they will need to submit a claim and reimbursement will be at a lower rate.

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.