Benefit Summaries

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District of Columbia Small Business Plan Guide

Optimum Choice

• OPTIMUM CHOICE, Inc. (Plan KVB)
• OPTIMUM CHOICE, Inc. (Plan KVE)

Choice

• Choice Traditional – 25/100% (Plan D1D)
• Choice Traditional – 30/100% (Plan D1F)
• Choice Edge – 30/1000/100% (Plan 2HK)
• Choice Definity HRA – 1000/90% (Plan D3F)
• Choice Definity HSA – 2000/100% (Plan D2A)

Choice Plus

• Choice Plus Traditional – 25/100% (Plan D4D)
• Choice Plus Traditional – 30/100% (Plan D4F)
• Choice Plus Edge – 30/1000/100% (Plan Y3F)
• Choice Plus Definity HRA – 2000/80% (Plan W8I)
• Choice Plus Definity HSA – 2000/100% (Plan D6E)

Options PPO

• Options PPO Traditional – 15/100% (Plan D9B)
• Options PPO Traditional – 20/100% (Plan D9A)

Non-Differential PPO

• Non-Differential PPO – 1500/80% (Plan D7A)
• Non-Differential PPO – 2000/80% (Plan D7B)

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