Blue Cross® and Blue Shield® Service Benefit Plan
2024
A Fee-For-Service Plan (FEP Blue Standard and FEP Blue Basic Options) with a Preferred Provider Organization
IMPORTANT
This Plan’s health coverage qualifies as minimum essential coverage and meets the minimum value standard for the benefits it provides. See our FEHB Facts for details. This Plan is accredited. See Section 1.
Sponsored and administered by: The Blue Cross and Blue Shield Association and participating Blue Cross and Blue Shield Plans
Who may enroll in this Plan: All Federal employees, Tribal employees, and annuitants who are eligible to enroll in the Federal Employees Health Benefits Program
Enrollment codes for this Plan:
104 Standard Option - Self Only
106 Standard Option - Self Plus One
105 Standard Option - Self and Family
111 Basic Option - Self Only
113 Basic Option - Self Plus One
112 Basic Option - Self and Family
106 Standard Option - Self Plus One
105 Standard Option - Self and Family
111 Basic Option - Self Only
113 Basic Option - Self Plus One
112 Basic Option - Self and Family
RI 71-005