BCBSIL Group Plans

BCBSIL Small Group Health Insurance Plans

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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

Tier 1 refers to the benefit level when using the Blue Choice OPT PPO network, Tier 2 refers to the benefit level when using the PPO network.

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

Tier 1 refers to the benefit level when using the Blue Choice OPT PPO network, Tier 2 refers to the benefit level when using the PPO network.

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

Tier 1 refers to the benefit level when using the Blue Choice OPT PPO network, Tier 2 refers to the benefit level when using the PPO network.

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

Tier 1 refers to the benefit level when using the Blue Choice OPT PPO network, Tier 2 refers to the benefit level when using the PPO network.

*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.