Policy Documents for Small Group Pre-Affordable Care Act Plans

Below is a list of Blue Cross and Blue Shield of Illinois policy documents for Pre-Affordable Care Act policies in the small group market, also called grandfathered and transitional small group plans. These policies describe how the plans generally work and include eligible expenses, claim filing steps, appeals procedures, coverage limitations and exceptions, and more.

The following is true for those with pre-Affordable Care Act small group coverage: 

• Usted está asegurado con cobertura médica a través de un empleador.
• Su cobertura actual tiene vigencia antes del 1 de enero de 2014.
• El empleador tiene entre 1 y 50 empleados.
• Your plan is not a "metallic" (platinum, gold, silver or bronze) health plan.

Help locating your policy

If you're not able to find your policy from the list below, here are two options.

• Get your policy documents through su cuenta en línea.
• Get your policy document through the BCBSIL app. Learn more about the BCBSIL app. 
• Contact a customer service representative at 1-800-538-8833 to get help finding or accessing your policy documents.
• If you have coverage through an employer, you may want to contact the employer's benefit administrator to get the name of your plan.
• If you know you have a Small Group Pre-Affordable Care Act Plan, and you know its name, find it below and download the policy.

PPO Blue Choice

• BCP73436 Blue Choice PPO
• BCPC3433 Blue Choice PPO

Blue Advantage Entrepreneur PPO

• E2P12312 Blue Advantage Entrepreneur PPO
• E2P12322 Blue Advantage Entrepreneur PPO
• E2P12323 Blue Advantage Entrepreneur PPO
• E2P41116 Blue Advantage Entrepreneur PPO
• E2P42312 Blue Advantage Entrepreneur PPO
• E2P42313 Blue Advantage Entrepreneur PPO
• E2P42322 Blue Advantage Entrepreneur PPO
• E2P42323 Blue Advantage Entrepreneur PPO
• E2P43424 Blue Advantage Entrepreneur PPO
• E2P72312 Blue Advantage Entrepreneur PPO
• E2P72322 Blue Advantage Entrepreneur PPO
• E2P72323 Blue Advantage Entrepreneur PPO
• E2P73423 Blue Advantage Entrepreneur PPO
• E2P73433 Blue Advantage Entrepreneur PPO
• E2P73436 Blue Advantage Entrepreneur PPO
• E2P82323 Blue Advantage Entrepreneur PPO
• E2P83422 Blue Advantage Entrepreneur PPO
• E2P83433 Blue Advantage Entrepreneur PPO
• E2P92422 Blue Advantage Entrepreneur PPO
• E2P93422 Blue Advantage Entrepreneur PPO
• E2P93423 Blue Advantage Entrepreneur PPO
• E2P93433 Blue Advantage Entrepreneur PPO
• E2PC3423 Blue Advantage Entrepreneur PPO
• E2PC3433 Blue Advantage Entrepreneur PPO
• E2SP101c Blue Advantage Entrepreneur PPO
• E2SP102c Blue Advantage Entrepreneur PPO
• E2SP103c Blue Advantage Entrepreneur PPO
• E2SP104c Blue Advantage Entrepreneur PPO
• E2SP108c Blue Advantage Entrepreneur PPO
• E2SP112c Blue Advantage Entrepreneur PPO
• E2SP804c Blue Advantage Entrepreneur PPO
• E2SP810c Blue Advantage Entrepreneur PPO
• E2SP811c Blue Advantage Entrepreneur PPO
• E2SP907c Blue Advantage Entrepreneur PPO
• E2SP908c Blue Advantage Entrepreneur PPO
• E2SP909c Blue Advantage Entrepreneur PPO
• E2SP918c Blue Advantage Entrepreneur PPO
• E2SP922c Blue Advantage Entrepreneur PPO
• E2SP923c Blue Advantage Entrepreneur PPO
• E2SP925c Blue Advantage Entrepreneur PPO
• E2SP926c Blue Advantage Entrepreneur PPO
• E2SP109c Blue Advantage Entrepreneur PPO
• E2SP111c Blue Advantage Entrepreneur PPO
• E2SP102s Blue Advantage Entrepreneur PPO
• E2SP810s Blue Advantage Entrepreneur PPO
• E2TP102c Blue Advantage Entrepreneur PPO
• E2TP111c Blue Advantage Entrepreneur PPO

BluePrint PPO

• Cobertura BluePrint BPP11112
• Cobertura BluePrint BPP42212
• Cobertura BluePrint BPP42322
• Cobertura BluePrint BPP73333
• Cobertura BluePrint BPP83323

Blue Access Entrepreneur HMO

• BPHB011 Blue Access Entrepreneur HMO
• BPHB013 Blue Access Entrepreneur HMO
• BPHB103 Blue Access Entrepreneur HMO
• BPHB106 Blue Access Entrepreneur HMO
• BPHB131 Blue Access Entrepreneur HMO
• BPHB133 Blue Access Entrepreneur HMO
• BPHB163 Blue Access Entrepreneur HMO
• BPHB166 Blue Access Entrepreneur HMO
• BPHB193 Blue Access Entrepreneur HMO
• BPHB194 Blue Access Entrepreneur HMO
• BPHB196 Blue Access Entrepreneur HMO
• BPHB201 Blue Access Entrepreneur HMO

Blue Advantage Entrepreneur HMO

• E2thb215 Blue Advantage Entrepreneur HMO

HMO Blue Advantage

• E2THB196 Blue Advantage HMO

HSA Blue Edge

• EOEQ380526 BlueEdge HSA
• EPAP3V0526 BlueEdge HSA
• EPEQ180526 BlueEdge HSA
• EPEQ1Z0726 BlueEdge HSA
• HSA BlueEdge BPEC1705
• HSA BlueEdge BPEC1807
• HSA BlueEdge BPEC3805
• HSA BlueEdge BPE9160526
• BPAP3V0526 BlueEdge HSA
• BPAQ1Z0726 BlueEdge HSA
• HSA BlueEdge E2EC1705