| SimplyBlue Plus Bronze 3 | TJD0 | Bronze | Deductible HSA | Yes | $828.63 | $2,361.60 | $5,500 | $7,500 | 50% subject to deductible | 50% subject to deductible | $10/40%/50% subject to deductible | |
| SimplyBlue Plus Bronze 4 | TJF6 | Bronze | Deductible HSA | Yes | $767.47 | $2,187.29 | $8,500 | $8,500 | 100% subject to deductible | 100% subject to deductible | 100% subject to deductible | |
| SimplyBlue Plus Bronze 5 | TJQ8 | Bronze | Deductible HSA | Yes | $834.43 | $2,378.11 | $6,000 | $7,500 | $40 copay subject to deductible | $60 copay subject to deductible | $10/$45/$90 subject to deductible | |
| SimplyBlue Plus Bronze 7 | TKI4 | Bronze | Deductible | No | $685.81 | $1,954.55 | $10,600 | $10,600 | 100% subject to deductible | 100% subject to deductible | 100% subject to deductible | |
| SimplyBlue Plus Gold 5 | TIZ2 | Gold | Copay | No | $1,216.57 | $3,467.23 | None | $9,200 | $40 copay | $70 copay | $15/40%/50% | |
| SimplyBlue Plus Gold 6 | TJA8 | Gold | Deductible HSA | Yes | $1,121.11 | $3,195.15 | $2,000 | $4,000 | 80% subject to deductible | 80% subject to deductible | $5/$45/$90 subject to deductible | |
| SimplyBlue Plus Gold 14 | TJK4 | Gold | Hybrid | No | $1,158.23 | $3,300.94 | $1,400 | $7,500 | $25 copay subject to deductible | $40 copay subject to deductible | $5/$35/$70 (no deductible) | |
| SimplyBlue Plus Gold 17 | TJV6 | Gold | Hybrid | No | $1,175.81 | $3,351.05 | $1,100 | $8,250 | $40 copay | $70 copay | $10/$45/$90 (no deductible) | |
| SimplyBlue Plus Gold 19 | TJY8 | Gold | Hybrid | No | $1,122.75 | $3,199.83 | $2,500 | $7,500 | $40 copay | $60 copay | $5/$45/$90 (no deductible) | |
| SimplyBlue Plus Gold 21 | TKG8 | Gold | Deductible HSA | Yes | $1,129.90 | $3,220.21 | $2,000 | $5,500 | $10/$25 copay subject to deductible | $40 copay subject to deductible | $5/$45/$90 subject to deductible | |