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Plan Administration
Blue Cross Blue Shield of Georgia > Blue Care Network HMO > Add Plan
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Broker Name:
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BrokerXYZ
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Policy Number:
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34512435
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Original Plan Effective Date:
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12/11/2002
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Rate Guarantee Expiration Date:
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12/11/2002
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Plan Anniversary Date:
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12/11/2202
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Billing Cut-off Day of the Month:
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1
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Retroactive Termination Limit:
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30
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Divisions:
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All Divisions
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Locations:
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California
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Employee Classes:
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Full Time
Manager
Officer
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Validation Method:
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Automatic
Manual
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Waiting Period Information
Eligible employees are eligible as of the 1st of the month following the employee's hire date.
Termination of Coverage Information
When a plan participant is terminated from the company, the plan coverage ends on the last day of the month following the employee's termination date.
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Employee Cost
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Company Cost
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Total
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Employee
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$6.82
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$77.16
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$83.98
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Employee + Spouse
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$24.32
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$88.60
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$112.92
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Employee + Child(ren)
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$117.31
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$45.32
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$162.63
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Family
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$154.15
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$230.21
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$384.36
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