Oct 06, 2017
Give your small group clients more product and network choices with new tools for brokers designed for faster service.
Growing networks for more choice
Blue Shield of California's Trio ACO HMO Network continues to expand with new medical groups and hospitals, with coverage now in 24 California counties. Visit blueshieldca.com/aco for more information on Trio HMO availability in your area. These plans can also be offered alongside their full network Access+ HMO® plans for savings and flexibility. Blue Shield is also introducing their new Tandem PPO Network in 2018 with six plan options. These plans are offered at a lower rate than the Full PPO Network plans with the same plan benefits. Be on the lookout for more updates on Tandem coming your way. Their dental PPO network is also growing, to more than 45,000 access points, and their vision provider network is the largest in California.
First quarter 2018 rate adjustments
Medical plans will experience a first quarter rate action of 1.1% for PPO plans and 2.4% for HMO plans. All Blue Shield's portfolio dental, vision and life insurance plan rates will remain unchanged.
Doing business with Blue Shield is easier and faster
Their Enrollment Spreadsheet reduces errors and turnaround time on new group submissions. Express Enrollment underwriting makes for faster and easier group installment, including the 25% relaxed participation requirement for groups of five or more enrolling.
Richer benefits in Blue Shield's 2018 PPO Savings plans
Chiropractic services are embedded in all 2018 PPO Savings plans. Beginning with October 2017 effective dates, HealthEquity is now offered as the health savings account (HSA) administrator for all their PPO Savings plans, including Silver 2000/20%.
Flexibility in HMO plan design
For 2018, all HMO plans can be offered with or without supplemental infertility (INF) coverage.
- Renewing groups with Off-Exchange HMO plans will be mapped to plan without INF coverage. To select supplemental INF benefits, a group must complete a Request for Contract Change (RCC) form.
- Renewing groups that have selected the INF rider for Off-Exchange PPO plans will be mapped to HMO plans with the INF rider as well.
- Selecting the optional INF rider applies to all plans and members.
- An optional benefits rider for supplemental INF will be offered for all Off-Exchange HMO and PPO plans and is included in renewal kits.
No-cost vaccines at retailers for HMO members
Select vaccines are covered under the pharmacy benefit and provided at no extra charge through retailers. Members still have the option to receive vaccines at their providers' offices.
Summary of Benefits will replace Benefit Summaries
Beginning in 2018, Blue Shield will be using Summary of Benefits (SOB) throughout their marketing materials in place of Benefit Summaries. You will see this change on Broker Connection and in pre- and post-enrollment materials.
