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2025 Small Group Plan Summaries
2025 BCBSIL Blue PPO
Platinum & Gold
| Plan Name | Deductible Ind/Fam | Out of Pocket Ind/Fam | Coinsurance | PCP Visit | Specialist Visit |
| Blue PPO Platinum 119 | $350 / $1,750 | $1,750/ $5,250 | 80% | $35 | $70 |
| Blue PPO Platinum 136 | $600/ $1,800 | $1,750 / $5,250 | 90% | $25 | $50 |
| Blue PPO Platinum 501 | $1,500 / $3,000 | $3,000 / $6,000 | 100% | $15 | $30 |
| Blue PPO Gold 502 | $1,500 / $3,000 | $3,000 / $6,000 | 100% | $15 | $30 |
| Blue PPO Gold 114 | $1,100 / $3,300 | $8,000 / $16,000 | 80% | $50 | $75 |
| Blue PPO Gold 107 | $1,600 / $3,200 | $6,500 / $13,000 | 80% | $45 | $70 |
| Blue PPO Gold 116 | $2,100 / $6,300 | $6,000 / $18,000 | 90% | $50 | $75 |
| Blue PPO Gold 102 | $2,600 / $5,200 | $5,250 / $10,500 | 80% | $25 | $70 |
| Blue PPO Gold 123 | $3,200 / $9,600 | $3,200 / $9,600 | 100% | DC | DC |
| Blue PPO Gold 101 | $4,000 / $12,000 | $5,500 / $16,500 | 100% | $50 | $70 |
| Blue PPO Gold 113 | $3,300 / $9,900 | $3,800 / $11,400 | 90% | DC | DC |
| Blue PPO Gold 115 | $3,300 / $9,900 | $5,250 / $14,000 | 80% | DC | DC |
Silver
| Plan Name | Deductible Ind/Fam | Out of Pocket Ind/Fam | Coinsurance | PCP Visit | Specialist Visit |
| Blue PPO Silver 120 | $3,700 / $11,100 | $9,200 / $18,400 | 60% | $60 | $80 |
| Blue PPO Silver 104 | $5,100 / $15,300 | $9,200 / $18,400 | 70% | $50 | $75 |
| Blue PPO Silver 105 | $8,000 / $16,000 | $9,200 / $18,400 | 100% | $50 | $75 |
| Blue PPO Silver 133 | $5,350 / $16,000 | $5,350 / $16,000 | 100% | DC | DC |
| Blue PPO Silver 200 | $6,350 / $12,700 | $6,350 / $12,700 | 100% | DC | DC |
Bronze
| Plan Name | Deductible Ind/Fam | Out of Pocket Ind/Fam | Coinsurance | PCP Visit | Specialist Visit |
| Blue PPO Bronze 132 | $7,050/ $14,100 | $7,400 / $14,800 | 80% | DC | DC |
| Blue PPO Bronze 106 | $7,300 / $14,600 | $7,300 / $14,600 | 100% | DC | DC |
| Blue PPO Bronze 401 | $7,350 / $14,700 | $7,600 / $15,200 | 70% | DC | DC |
2025 BCBSIL Blue Choice Preferred PPO
Platinum & Gold
| Plan Name | Deductible Ind/Fam | Out of Pocket Ind/Fam | Coinsurance | PCP Visit | Specialist Visit |
| Blue Choice Preferred Platinum PPO 119 | $300 / $1,050 | $1,750 / $5,250 | 80% | $35 | $70 |
| Blue Choice Preferred Platinum PPO 136 | $600 / $1,800 | $1,750 / $5,250 | 90% | $25 | $50 |
| Blue Choice Preferred Platinum PPO 501 | $1,500 / $3,000 | $3,000 / $6,000 | 100% | $15 | $30 |
| Blue Choice Preferred Gold PPO 114 | $1,100 / $3,300 | $8,000 / $16,000 | 80% | $50 | $75 |
| Blue Choice Preferred Gold PPO 107 | $1,600 / $3,200 | $6,500 / $13,000 | 80% | $45 | $70 |
| Blue Choice Preferred Gold PPO 116 | $2,100 / $6,300 | $6,000 / $18,000 | 90% | $50 | $75 |
| Blue Choice Preferred Gold PPO 102 | $2,600 / $5,200 | $5,250 / $10,500 | 80% | $25 | $70 |
| Blue Choice Preferred Gold PPO 502 | $2,500 / $5,000 | $7,500 / $15,000 | 100% | $30 | $60 |
| Blue Choice Preferred Gold PPO 123 | $3,200 / $9,600 | $3,200 / $9,600 | 100% | DC | DC |
| Blue Choice Preferred Gold PPO 101 | $4,000 / $12,000 | $5,500 / $16,500 | 100% | $50 | $70 |
| Blue Choice Preferred Gold PPO 113 | $3,300 / $9,900 | $3,800 / $11,400 | 90% | DC | DC |
| Blue Choice Preferred Gold PPO 115 | $3,300 / $9,900 | $5,250 / $14,000 | 80% | DC | DC |
Silver
| Plan Name | Deductible Ind/Fam | Out of Pocket Ind/Fam | Coinsurance | PCP Visit | Specialist Visit |
| Blue Choice Preferred Silver PPO 120 | $3,700 / $11,100 | $9,200 / $18,400 | 60% | $60 | $80 |
| Blue Choice Preferred Silver PPO 104 | $5,100 / $15,300 | $9,200/ $18,400 | 70% | $50 | $75 |
| Blue Choice Preferred Silver PPO 105 | $8,000/ $16,000 | $9,200/ $18,400 | 100% | $50 | $75 |
| Blue Choice Preferred Silver PPO 133 | $5,350 / $16,000 | $5,350/ $16,000 | 100% | DC | DC |
| Blue Choice Preferred Silver PPO 200 | $6,350 / $12,700 | $6,350/ $12,700 | 100% | DC | DC |
Bronze
| Plan Name | Deductible Ind/Fam | Out of Pocket Ind/Fam | Coinsurance | PCP Visit | Specialist Visit |
| Blue Choice Preferred Bronze PPO 132 | $7,050/ $14,100 | $7,400 / $14,800 | 80% | DC | DC |
| Blue Choice Preferred Bronze PPO 106 | $7,300 / $14,600 | $7,300 / $14,600 | 100% | DC | DC |
| Blue Choice Preferred Bronze PPO 401 | $7,350 / $14,700 | $7,600 / $15,200 | 70% | DC | DC |
2025 BCBSIL Blue Options PPO
Platinum & Gold
| Plan Name | Deductible Ind/Fam | Out of Pocket Ind/Fam | Coinsurance | PCP Visit | Specialist Visit |
| Blue Options Platinum PPO 403 | $350 Tier 1 / $850 Tier 2 || $1,050 Tier 1 / $2,550 Tier 2 | $2,500 Tier 1 / $7,000 Tier 2 || $7,500 Tier 1 / $18,400 Tier 2 | 90% Tier 1/ 70% Tier 2 50% | $20 Tier 1 / $35 Tier 2 |
$40 Tier 1 / $70 Tier 2 |
| Blue Options Gold PPO 101 | $850 Tier 1 / $2,100 Tier 2 || $2,550 Tier 1 / $6,300 Tier 2 | $7,000 Tier 1 / $8,750 Tier 2 / || $17,500 Tier 1 / $18,400 Tier 2 | 80% Tier 1/ 60% Tier 2 / 50% | $45 Tier 1/ $65 Tier 2 | $70 Tier 1/ $110 Tier 2 |
| Blue Options Gold PPO 106 | $1,600 Tier 1/ $3,850 Tier 2 || $4,800 Tier 1 / $11,550 Tier 2 | $6,150 Tier 1 / $8,150 Tier 2 || $15,375 Tier 1 / $18,200 Tier 2 | 90% Tier 1/ 70% Tier 2 / 50% | $40 Tier 1/ $65 Tier 2 | $60 Tier 1/ $110 Tier 2 |
| Blue Options Gold PPO 102 | $2,100 Tier 1 / $3,600 Tier 2 || $4,200 Tier 1 / $10,800 Tier 2 | $4,600 Tier 1/ $7,600 Tier 2 || $9,550 Tier 1/ $18,400 Tier 2 | 90% Tier 1/ 70% Tier 2 / 50% | $40 Tier 1/ $65 Tier 2 | $60 Tier 1/ $110 Tier 2 |
| Blue Options Gold PPO 503 | $3,000 Tier 1 / $5,500 Tier 2 || $6,000 Tier 1 / $11,000 Tier 2 | $7,500 Tier 1 / $9,000 Tier 2 || $15,000 Tier 1 / $18,000 Tier 2 | 100% Tier 1 / 80% Tier 2 / 50% | $25 Tier 1 / $50 Tier 2 |
$50 Tier 1 / $100 Tier 2 |
| Blue Options Gold PPO 200 | $3,300 Tier 1/ $4,700 Tier 2 || $9,900 Tier 1/ $14,100 Tier 2 | $3,300 Tier 1/ $6,650 Tier 2 || $9,900 Tier 1/ $14,100 Tier 2 | 100% Tier 1/ 80% Tier 2 / 60% | DC | DC |
Silver
| Plan Name | Deductible Ind/Fam | Out of Pocket Ind/Fam | Coinsurance | PCP Visit | Specialist Visit |
| Blue Options Silver PPO 104 | $5,350 Tier 1/ $6,350 Tier 2 || $16,050 Tier 1 / $18,200 Tier 2 | $8,400 Tier 1/ $9,200 Tier 2 || $18,400 Tier 1/ $18,400 Tier 2 | 80% Tier 1/ 60% Tier 2 / 50% | $55 Tier 1/ $75 Tier 2 | $80 Tier 1/ $120 Tier 2 |
| Blue Options Silver PPO 107 | $4,900 Tier 1/ $5,600 Tier 2 || $14,700 Tier 1 / $15,000 Tier 2 | $4,900 Tier 1 / $7,350 Tier 2 || $14,700 Tier 1 / $15,000 Tier 2 | 100% Tier 1 / 70% Tier 2 / 50% | DC | DC |
| Blue Options Silver PPO 404 | $5,350 Tier 1 / $6,350 Tier 2 || $13,350 Tier 1 / $15,200 Tier 2 | $5,350 Tier 1/ $7,600 Tier 2 || $13,350 Tier 1/ $15,200 Tier 2 | 100% Tier 1 / 70% Tier 2 / 50% | DC | DC |
2025 BCBSIL Blue Precision HMO
Platinum & Gold
| Plan Name | Deductible Ind/Fam | Out of Pocket Ind/Fam | Coinsurance | PCP Visit | Specialist Visit |
| Blue Precision Platinum HMO 107 | $0 | $1,750 / $5,250 | 100% | $15 | $45 |
| Blue Precision Platinum HMO 200 | $0 | $2,500 / $7,500 | 100% | $20 | $30 |
| Blue Precision Gold HMO 402 | $0 | $6,500 / $13,000 | 80% | $45 | $65 |
| Blue Precision Platinum HMO 110 | $1,100 || $3,300 | $3,100 || $9,300 | 80% | $30 | $60 |
| Blue Precision Gold HMO 201 | $0 | $5,000 / $15,000 | 100% | $50 | $70 |
| Blue Precision Gold HMO 101 | $2,850 || $8,550 | $9,200 || $18,200 | 70% | $60 | $85 |
Silver
| Plan Name | Deductible Ind/Fam | Out of Pocket Ind/Fam | Coinsurance | PCP Visit | Specialist Visit |
| Blue Precision Silver HMO 106 | $3,350 / $10,050 | $9,200 / $18,200 | 70% | $35 | $70 |
| Blue Precision Silver HMO 102 | $7,100 / $17,200 | $9,200 / $18,200 | 70% | $60 | $85 |
*All plan summaries shown on this page reflect in-network deductible and out of pocket maximums. For OOO costs, please download the linked plan summaries.