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Page numbers referenced within this brochure apply only to the printed brochure

Blue Cross® and Blue Shield® Service Benefit Plan

www.fepblue.org

2023



IMPORTANT:
  • Rates
  • Changes for 2023
  • Summary of Benefits
A Fee-For-Service Plan (FEP Blue Standard and FEP Blue Basic Options) with a Preferred Provider Organization

This Plan’s health coverage qualifies as minimum essential coverage and meets the minimum value standard for the benefits it provides. See page 9 for details. This Plan is accredited. See page 13.

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
Federal Employees Health Benefits Program seal
OPM Logo