Refer to your Outline of Coverage to determine which documents apply to your plan.

2010 Benefit Changes Rider (280.264)

2010 Benefit Changes Rider - Grandfathered (280.265)

2012 BCBSVT Benefit Mandates Rider (280.316)

BCBSVT Acupuncture Benefits Rider (280.294)

BCBSVT Plan Year Accumulator Rider - 280.274

BCBSVT Prescription Drug Benefits w/Exclusions Rider - 280.281

BCBSVT Preventive Care Rider (280.303)

BCBSVT Small Group RX Rider - 280.276

BCBSVT Vision Exam Rider - 280.273

Benefit Enhancement Rider - 280.242

Deductible Carryover Rider - 280.230

 (Addition of) Deductible Carryover Rider - 280.245

Domestic Partnership Rider - 280.76 
 

Expanded Mental Health and Substance Abuse Provider
Network Rider - 280.241

Grandfathered Benefits Rider (BCBSVT) - 280.289

HRA Rider w/Preventive Benefits - 280.226

Naturopathic Physicians Endorsement - 280.232

Open Network Mental Health and Substance Abuse Rider - 280.175
 

Plan J/Comprehensive Certificate - 210.21 (2013)

Plan J / Comprehensive Certificate - 210.21 (2011)

Plan J / Comprehensive Certificate - 210.21 (2009)

Plan J Rider - 280.247

Prescription Drug Benefit Rider - 280.171

Prescription Drug Benefits Rider V - 280.292

Rider Removing Precertification Program - 280.179

Three-tier Prescription Drug Benefits Rider - 280.187

Waiver of Waiting Periods - 280.162

Wellness Drug Rider - 280.271

Updated: 03/29/13