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

 

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

 

Comprehensive Plan Safety Net Benefits Rider - 280.215

Comprehensive Plus Rider - 280.205

Deductible Carryover Rider - 280.230

 

(Addition of) Deductible Carryover Rider (NEW) - 280.245

Domestic Partnership Rider - 280.76 

 

Dual Option Comprehensive Certificate of Coverage - VEHI - 280.287

Expanded Mental Health and Substance Abuse Provider
Network Rider - 280.241

 

Grandfathered Benefits Rider (BCBSVT) - 280.289

Health Reimbursement Account Rider - 280.212

Health Reimbursement Account Rider with Preventive Care Benefits- 280.226

Health Savings Account Program Rider - 280.214

HSA Blue Rider w/ Preventive Care Benefits - 280.223

Medical Savings Account Program Rider - 280.181

Naturopathic Physicians Endorsement - 280.232

Open Network Mental Health and Substance Abuse Rider - 280.175

Outpatient Procedures Rider S - 280.172

 

Plan J/Comprehensive Certificate - 210.21 (2013)

 

Plan J / Comprehesive Certificate - 210.21 (2011)

 

Plan J / Comprehesive Certificate - 210.21 (2009)

Prescription Drug Benefit Rider - 280.171

 

Prescription Drug Benefits Rider V - 280.292

Rider Removing Precertification Program - 280.179

Rider Removing Prescription Drug Coverage - 280.198

Three-tier Prescription Drug Benefits Rider - 280.187

Waiver of Waiting Periods - 280.162

 

Wellness Drug Rider - 280.271

 

Updated: 01/15/13