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Mid-Size Group Plans
Employees: 51-150
The BlueFreedom group plan is available to employers with 51-150 employees to allow them to choose the right options for the coverage they need.
BlueFreedom
Download the BlueFreedom brochures, applications and other important documents.
2021 BlueFreedom Plan Options
Summaries of Benefits and Coverage (sbc.nebraskablue.com)
Schedule of Benefits Summaries
- Option 8 Rx Option 1
- Option 15 Rx Option 1
- Option 18 Rx Option 1
- Option 19 Rx Option 1
- Option 20 Rx Option 1
- Option 23 Rx Option 1
- Option 25 Rx Option 1
- Option 26 Rx Option 1
- Option 28 Rx Option 1
- Option 29 Rx Option 1
- Option 31 Rx Option 1
- Option 34 Rx Option 1
- Option 35 Rx Option 1
- Option 39 Rx Option 1
- Option 41 Rx Option 1
- Option 42 Rx Option 1
- Option 43 Rx Option 1
- Option 44 Rx Option 1
- Option 65 Rx Option 1
- Option 67 Rx Option 1
- Option 68 Rx Option 1
- Option 69 Rx Option 1
- Option 70 Rx Option 1
- Option 8 Rx Option 6
- Option 15 Rx Option 6
- Option 18 Rx Option 6
- Option 19 Rx Option 6
- Option 20 Rx Option 6
- Option 23 Rx Option 6
- Option 25 Rx Option 6
- Option 26 Rx Option 6
- Option 28 Rx Option 6
- Option 29 Rx Option 6
- Option 31 Rx Option 6
- Option 34 Rx Option 6
- Option 35 Rx Option 6
- Option 39 Rx Option 6
- Option 41 Rx Option 6
- Option 42 Rx Option 6
- Option 43 Rx Option 6
- Option 44 Rx Option 6
- Option 65 Rx Option 6
- Option 67 Rx Option 6
- Option 68 Rx Option 6
- Option 69 Rx Option 6
- Option 70 Rx Option 6
Download the BlueFreedom brochures, applications and other important documents.
2020 BlueFreedom Plan Options
Summaries of Benefits and Coverage (sbc.nebraskablue.com)
Schedule of Benefits Summaries
- Option 8 Rx Option 1
- Option 15 Rx Option 1
- Option 18 Rx Option 1
- Option 19 Rx Option 1
- Option 20 Rx Option 1
- Option 23 Rx Option 1
- Option 25 Rx Option 1
- Option 26 Rx Option 1
- Option 28 Rx Option 1
- Option 29 Rx Option 1
- Option 31 Rx Option 1
- Option 34 Rx Option 1
- Option 35 Rx Option 1
- Option 39 Rx Option 1
- Option 41 Rx Option 1
- Option 42 Rx Option 1
- Option 43 Rx Option 1
- Option 44 Rx Option 1
- Option 65 Rx Option 1
- Option 67 Rx Option 1
- Option 68 Rx Option 1
- Option 69 Rx Option 1
- Option 70 Rx Option 1
- Option 8 Rx Option 6
- Option 15 Rx Option 6
- Option 18 Rx Option 6
- Option 19 Rx Option 6
- Option 20 Rx Option 6
- Option 23 Rx Option 6
- Option 25 Rx Option 6
- Option 26 Rx Option 6
- Option 28 Rx Option 6
- Option 29 Rx Option 6
- Option 31 Rx Option 6
- Option 34 Rx Option 6
- Option 35 Rx Option 6
- Option 39 Rx Option 6
- Option 41 Rx Option 6
- Option 42 Rx Option 6
- Option 43 Rx Option 6
- Option 44 Rx Option 6
- Option 65 Rx Option 6
- Option 67 Rx Option 6
- Option 68 Rx Option 6
- Option 69 Rx Option 6
- Option 70 Rx Option 6
BlueFreedom Quoting Documents
We do not accept PDFs or paper applications for both BlueFreedom new sales and renewals. Please work with your sales and account management team to submit an application or new renewal.
Quote BlueFreedom Online (UWDataHub)
- UWDataHub User Guide
- 2021 Underwriting Guidelines
- 2020 Underwriting Guidelines
- Request For Pre-Screen
- Quoting Census Requirements – Combined GRx and Group Census Template Instructions
- Employer Risk Appraisal Questionnaire (RAQ)
BlueFreedom Sold Case Documents:
- EFT Authorization Agreement
- Nebraska Uniform Group Health Application
- BlueFreedom Plan Comparison Document
- Authorized Plan Contacts Form
- 2021 Master Group Application
- 2020 Master Group Application
- Sample BlueFreedom Group Renewal Reporting
- Employee Health Enrollment Form
- Employee Health Enrollment Form (non-fillable)
- Employee Health Enrollment Form (Spanish)
- Instructions for the Amendment of Application
- Amendment of Application for Group Contract
- Amendment of Application for Group Contract (non-fillable)
- Waiver of Probationary Period
- Open Enrollment Packet
- Network Flier