Blue High-Performance Network expansion: delivering quality care at a lower cost

Blue Shield of California’s High-Performance Network (BlueHPN^SM) is a national exclusive provider organization (EPO) designed to provide access to quality care at a lower cost while delivering better outcomes and value through provider collaboration. BlueHPN^SM offers access to carefully selected high-performing doctors and hospitals in more than 65 metropolitan areas nationwide. It also allows members to self-refer to specialists within the BlueHPN^SM network without a referral from their primary care physicians (PCP).

Effective January 1, 2023, BlueHPN will be available in 11 new Northern California and Central Coast counties, expanding the network to 33 total counties, covering more of the state’s rural areas that may currently have fewer low-cost options. The new counties are: Alpine, Amador, Calaveras, Colusa, Lake, Mariposa, Merced, Monterey, Napa, Nevada, and Sierra.

BlueHPN offers group plan sponsors more than 11 percent total cost of care savings on average (nationally), and up to 20 percent savings in some markets. This is in addition to the industry-leading savings with the broad PPO network available through Blue Cross Blue Shield companies. When offered alongside the broad PPO, the unique EPO structure of BlueHPN^SM creates a seamless national network leveraging a targeted set of providers to achieve greater savings and quality improvements.

Read more about BlueHPN on our News Center and download materials to share with your clients, here.

Please contact your sales representative with questions.

Supporting your success during Open Enrollment 2022

We continue to provide support for virtual and in-person Open Enrollments by developing tools and resources to support your experience, including:

Customized Microsite link which includes benefit summaries
Virtual enrollment can be conducted via platforms like Zoom, Teams, and Webex
The Forms and Applications page on Broker Connection features resources covering web-based enrollments, SOBs, and more
Value-added flyers such as: Teladoc, Wellvolution, NurseHelp, LifeReferrals, Mobile App and Wellness Discounts. Benefit summaries, enrollment kits and additional wellness flyers may be made available via soft copy upon request.
Wellvolution - www.wellvolution.com
- Access to over 50 digital app platforms
- Manage Sleep Better
- Eat Healthier
- Manage Stress
- Move More
- Ditch Cigarettes

Contact your Blue Shield representative for additional assistance. We look forward to our continued partnership and look forward to a successful enrollment season.

Aspire Health partnership brings Trio HMO to new areas of Monterey County

Blue Shield of California Trio HMO is now available in 19 additional Monterey County zip codes thanks to our new ACO partnership with Aspire Health. The expansion takes effect January 1, 2023, and increases the Trio service area to 27 total zip codes. Covered communities will include: Marina, Monterey, Pacific Grove, Pebble Beach, Seaside, Big Sur, Carmel, Carmel Valley, Castroville, Chualar, Gonzales, Moss Landing, Salinas, Soledad, and Spreckels.

Aspire Health is owned by Montage Health and the Salinas Valley Memorial Healthcare System. Our expanded partnership applies cross lines of business and grants members access to more providers in Aspire’s comprehensive network in Monterey County.

Please contact your sales representative with any questions with any questions.

The Blue Shield of California Foundation and the campaign to end domestic violence

October has served as National Domestic Violence Awareness Month since 1987, becoming an important part in raising awareness for the issue, influencing legislation, and driving support for victims and survivors of domestic violence. At Blue Shield of California, ending domestic violence is a cause we support year-round through the extensive work of our foundation.

The Blue Shield of California Foundation is an organization funded entirely by contributions from Blue Shield of California, with the mission of supporting lasting and equitable solutions to make California the healthiest state and to end domestic voice.

The Foundation provides millions in grants each year to organizations working to further the Foundation’s mission of systemic change. In 2022, the Blue Shield of California Foundation distributed $29.5 million in grants to such organizations on the local and national level.

Visit the Blue Shield of California Foundation homepage for more on their mission, strategy, and grantee organizations. Subscribe to their newsletter, Intersections, here.

The National Coalition Against Domestic Violence is a great place to learn about the organization and for ways to support their work, with LetsEndDV.org offering additional resources.

COVID-19 Bivalent Boosters and Flu Shots are now available

COVID-19 and flu vaccines remain an important way to keep your clients, their employees, and their community protected as we head into this holiday season. The updated COVID-19 booster, known as the bivalent booster, is now available and fully covered at no cost to our members. These bivalent boosters provide immunity against both older and newer strains, are safe and effective, and can be received at the same time as the flu shot.

As the pandemic approaches an endemic state, it’s anticipated that the cost of the COVID-19 vaccine and booster will no longer be funded by the government and instead will be transferred back to health plans. Blue Shield of California believes that COVID-19 vaccines should be readily available to all our members without financial burden, but also that there is a shared responsibility for long term health care affordability. Encouraging your clients and their employees who plan to get vaccinated to do so before the end of the year may help keep the group’s plan costs lower.

Blue Shield recently reached out to our members to encourage them to get boosted and vaccinated against both COVID-19 and the flu. In this member outreach we also shared resources on when members should get the booster and how to secure an appointment.

We encourage you to reach out to your employer groups about encouraging employees to stay safe and protected by getting vaccinated before the holiday season rolls around.

News regarding Medical Loss Ratio (MLR) for 2021

Blue Shield of California (Blue Shield) does not owe Medical Loss Ratio rebates for 2021 to the following subscribers and employer groups since Blue Shield met or exceeded the MLR targets for those health plans.

Individual and Family subscribers with Blue Shield and Blue Shield of California Life & Health Insurance Company (Blue Shield Life) plans
Small Business groups with Blue Shield plans
Large groups with Blue Shield and Blue Shield Life plans

Visit our Mandates page for more information.

Article: Increased offerings spotlight the need for benefit education and engagement

In the competition to gain and retain talented workforce, companies are vying to offer employees and job candidates benefits covering an increasingly wide range of working arrangements, generational health needs, and expectations.

The good news is employers and insurers have an opportunity to add value through benefit education and engagement, ensuring employees/members make the most of their health plans. At Blue Shield, we’re addressing the complexity issue by leveraging digital health solutions and engagement methods to create personalized and easily accessible health benefits.

Check out the full article on our dedicated B2B page for more on our efforts in this space and the importance of enhanced benefit programs.

Wildfire resources and support for impacted members

Wildfires are being reported in some areas of California. We know how quickly situations like this change and wanted to reach out with a list of our available resources for your affected Blue Shield of California members.

A reminder of the support available through Blue Shield:

Immediate assistance is available on our customer support line at (800) 393-6130 (TTY: 711).
We are allowing the immediate refill of prescriptions in mandatory evacuation zones.
Virtual care options may differ slightly depending on the plan. Some of these telehealth options are TeladocTM and NurseHelp 24/7. Members can visit blueshieldca.com to view their plan options.
Magellan Health, Blue Shield’s contracted managed care plan for behavioral health services, is providing free access to resources, materials, and counseling services at (800) 327-7451.
Vision Care plan members in affected areas can get replacement glasses and can use non-network providers as needed with claims paid at network costs. For Vision support call (877) 601-9083.
Displaced members may see an appropriate out-of-network provider at in-network benefit levels and may replace medical equipment and supplies, if needed. Misplaced identification cards can be printed at blueshieldca.com, and members can access their I.D. cards digitally on our app.

Additional information

For fire status updates and locations, please visit CalFire.

Be informed. Learn about the air quality in your group’s area and encourage your clients to do so as well - https://www.airnow.gov

Tools for Trusted Advisors

Being a subject matter expert for your clients is fundamental to your work and, when the subject is Blue Shield of California, we want to ensure you are always prepared.

Large Group plan documents (SOB, SBC, EOC) for medical plans, pharmacy plans, dental plans, and life insurance plans are available in one location.

The Blue Shield News Center is your go-to source for the latest news and services from Blue Shield of California. Stay up to date by following us on LinkedIn and subscribe here to have News Center alerts delivered directly to your inbox.