2020 Montana QHP Small Group Actual Policy Documents

Below is a list of actual policy documents for QHP small group coverage. These policies describe how the plans generally work and include eligible expenses, claim filing and appeals procedures, and coverage limitations and exceptions, among other things.

If you have questions, contact a customer service representative at 1-855-258-8471 for more information.

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Platinum Plans

Blue Preferred Platinum PPO Plans
Off Exchange

P911PFR Blue Preferred Platinum PPO 102
P910PFR Blue Preferred Platinum PPO 101

Blue Focus Preferred Platinum PPO Plans
Off Exchange

P6E1BLC Blue Focus Platinum POS 006 

Gold Plans

Blue Preferred Gold PPO Plans
Off Exchange

G931PFR Blue Preferred Gold PPO 107
G933PFR Blue Preferred Gold PPO 110
G930PFR Blue Preferred Gold PPO 105
G6E1PFR Blue Preferred Gold PPO 135
G936PFR Blue Preferred Gold PPO 123

Blue Focus Preferred Gold PPO Plans
Off Exchange

G6E1BLC Blue Focus Gold POS 005
G6E2BLC Blue Focus Gold POS 007
G6E3BLC Blue Focus Gold POS 008

Silver Plans

Blue Preferred Silver PPO Plans
Off Exchange

S931PFR Blue Preferred Silver PPO 117
S901PFR Blue Preferred Silver PPO 131
S933PFR Blue Preferred Silver PPO 122
S935PFR Blue Preferred Silver PPO 127
S932PFR Blue Preferred Silver PPO 120
S6E1PFR Blue Preferred Silver PPO 136

Blue Focus Preferred Silver PPO Plans
Off Exchange

S6E1BLC Blue Focus Silver POS 010
S6E2BLC Blue Focus Silver POS 003
S6E3BLC Blue Focus Silver POS 001
S6E4BLC Blue Focus Silver POS 004

Bronze Plans

Blue Preferred Bronze PPO Plans
Off Exchange

B902PFR Blue Preferred Bronze PPO 134
B930PFR Blue Preferred Bronze PPO 116

Blue Focus Preferred Bronze PPO Plans
Off Exchange

B6E1BLC Blue Focus Bronze POS 002
B6E2BLC Blue Focus Bronze POS 009