MT Blue Choice HSA – Non-QHP Standard Actual Policy Documents
Below is a list of actual policy documents that describe how the plans generally work and include eligible expenses, claim filing and appeals procedures, and coverage limitations and exceptions, among other things.
While BCBSMT is posting every actual insurance policy as soon as it becomes available, including policies that contain customized benefit designs, your policy may not yet be available. If you are unable to locate your policy below, you may find it helpful to view one of the sample policies on the previous page, and you can also contact a customer service representative at 1-855-258-8471 for more information.
Non-Regulated Mid-Market (101-150 Employees)
- MBH2626D10 Blue Choice (HSA)
- MBH3030D10 Blue Choice (HSA)
- MBH3535D10 Blue Choice (HSA)
- MBH3564D90 Blue Choice (HSA)
- MBH4040D10 Blue Choice (HSA)
- MBH5050D10 Blue Choice (HSA)
- MBH5064D80 Blue Choice (HSA)