SMALL GROUP EMPLOYER APPLICATION - BCBSTX

Sample Plan #: B634ADT Metallic Level B Bronze, Silver, Gold, Platinum Benefit Design 634 633, 634, etc. Network/Product Name ADT ADT = Blue Advantage HMO. CHC = Blue Choice PPO. HMO = Blue Essentials Access HMO. HMH = Blue Premier Access Health Products/Benefit Plan Selection: The Left hand column lists the benefit designs. ................
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