BLUE CROSS AND BLUE SHIELD OF TEXASCertificate of Coverage • November 30th, 2023
Contract Type FiledNovember 30th, 2023This Certificate of Coverage (“Certificate”) is part of the Group Agreement (“Group Agreement”) between the Group and Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation (HMO). The Group Agreement determines the terms and conditions of coverage. Provisions of this Certificate include the SCHEDULE OF COPAYMENTS AND BENEFIT LIMITS and any amendments, Riders, or attachments, which may be delivered with the Certificate or added later.