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2024 Blue Cross and Blue Shield Service Benefit Plan Brochure - FEP Blue Standard™ and FEP Blue Basic™. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2022 - 12/31/2022 Blue Cross and Blue Shield Service Benefit Plan: Basic Option Coverage for: Self Only, Self Plus One or Self and Family | Plan Type: PPO 1 of 7 This brochure describes the benefits of the Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Standard and FEP Blue Basic Options under contract (CS 1039) between the Blue Cross and Blue Shield Association and the United States Office of Personnel Management, as authorized by the Federal Employees Health Benefits law. Adobe PageMaker is a software program used to create brochures, flyers, newsletters, reports and a variety of other professional-quality documents used for business or educational. Please note the following correction to the brochure: • Page 130: NSA information is identified as being in Section 3. desirulz Summary of Benefits: Page 162. Correction to 2024 brochure. Standard and Basic Options. If you are in a special enrollment category, contact the agency or Tribal employer that manages your health benefits enrollment. Types of coverage available for you and your family. prison life admin script 2023 org/brochure, and view the Glossary at wwwgov/ebsa/healthreform. Family member coverage. Please note the following correction to the brochure: • Page 165, Mental health and substance use disorder treatment - The Basic Option office visit copayment is $35, not $30. Blue Cross and Blue Shield Service Benefit Plan Brochure - 2024. will hynes baseball Before making a decision, please read this FEHB brochure. ….

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