Blue Shield’s new and innovative offerings

Here you will find just a few of the added benefits your clients receive with Blue Shield of California. Contact your account representative today to learn more about how our benefits programs can make a difference for you and your clients!

LifeReferrals24/7^SM

Small Business groups now have access to Blue Shield’s LifeReferrals 24/7^SM program. The program is available for both new business and upon renewal for existing business.

LifeReferrals 24/7 provides members with access to confidential and professional assistance to help them better manage the demands of home, health, and career. The program includes personal counseling, work/life productivity services, financial and legal services.

Critical Incident Response Services (CIR)* are one facet of the program, offering onsite behavioral health clinical support for scenarios such as an employee death, company re-organization, natural or manmade disasters. Additionally, Employee Training & Development Programs are designed to help employees stay productive, healthy, and engaged. Training topics include emotional well-being, leadership, and many more.

* Qualifies as a buy-up services where, for an additional cost, employers have access to customized services to support special circumstances and specific workforce needs.

Wellvolution’s personalized tools and health programs

Our Wellvolution platform offers health programs chosen by our experts to equip your clients and their employees with the support and tools to manage health and wellbeing. Wellvolution’s collection of lifestyle-based tools and personalized support address health concerns such as weight loss, diabetes treatment, lowering stress, and more. Two apps recently added to the platform are:

Headspace: Blue Shield of California members can now access the full premium version of the app at no additional cost. Headspace users can access world’s most science-backed meditation app. The app can help reduce stress, increase resilience, and get a better night’s rest. By dedicating just a few minutes a day Headspace helps members use meditation to improve mental well-being.

Ginger: We offer the Ginger app at no cost to our Small Business clients! Ginger provides mental health, coaching via text-based chats, and self-care activities – all from the privacy of a smartphone. Ginger coaches are available 24/7 and all conversations are completely confidential.

Encourage your clients to explore Wellvolution’s suite of programs and make the most out of their health plan.

Virtual care with Trio HMO and Tandem PPO

Digital health tools have long been at the forefront of our innovate health initiatives. Our flagship plans Trio HMO and Tandem PPO deliver access to virtual care options for medical and behavioral health visits, wellness programs, high-touch concierge services, and other perks your clients and their employees want. View and share our virtual care flyer here and watch our interactive video to learn more about our plans and unique benefits.

Save the date! Fall Broker Roadshow

Mark your calendars! We excited to announce the dates for the Q1 2023 Broker Roadshow, which are:

Tuesday, September 20, from 11 a.m. to 12 p.m.
Thursday, September 22, from 1 p.m. to 2 p.m.

We’ll follow up with an official invite soon, so stay tuned and we look forward to seeing you there.

Decreased Specialty rates in Q4 and new dental plans

We are pleased to announce an average 15% rate reduction for bronze, silver, and gold plans for 1-50 groups, and an average 10% rate reduction for 51-100 groups in Q4 2022. The rate reduction does not apply to Platinum and Diamond tier plans.

We introduced 22 new DPPO plans, beginning in January of 2022, to provide your clients with easy-to-understand options. The plans (listed below) are in five categories, mirroring the naming convention of medical plans: Bronze/Bronze Voluntary, Silver, Gold, Platinum, and Diamond. We also added more flexibility around how members can access the dental cleaning benefits included in their plans. Instead of the previously allowed one cleaning in a 6-month period, starting January 2022 members are eligible for two cleanings per a consecutive 12-month period.

Legal Plan Name
Bronze DPPO/$1000/MAC
Bronze DPPO/$1000/MAC/Child Only Ortho
Bronze Voluntary DPPO/$1000/MAC
Bronze Voluntary DPPO/$1000/MAC/Child Only Ortho
Silver DPPO/$1500/MAC
Silver DPPO/$1500/MAC/Adult+Child+Ortho
Silver DPPO/$1500/U90
Silver DPPO/$1500/U90/Adult+Child+Ortho
Gold DPPO/$1500/U90
Gold DPPO/$1500/U90/Adult+Child+Ortho
Gold DPPO/$2000/U90
Gold DPPO/$2000/U90/Adult+Child+Ortho
Platinum DPPO/$2500/U90
Platinum DPPO/$2500/U90/Adult+Child+Ortho
Platinum DPPO/$3000/U90
Platinum DPPO/$3000/U90/Adult+Child+Ortho
Platinum DPPO/$5000/U90
Platinum DPPO/$5000/U90/Adult+Child+Ortho
Diamond DPPO/$3000/U95
Diamond DPPO/$3000/U95/Adult+Child+Ortho
Diamond DPPO/$5000/U95
Diamond DPPO/$5000/U95/Adult+Child+Ortho

More information available as always in our current Specialty sales guide. To view rates for marketed and closed dental plans, log into broker connection.

New Broker Bonus Calculator available now!

Our new and improved Broker Bonus Calculator has launched! The calculator will help you better understand our different reward programs and estimate your earnings. Use this tool to estimate your rewards in both points and cash bonus.

One sale, three bonus programs

We put great value in renewing customers. Introducing the latest addition to our incentive programs – Renewal Rewards for Producers!

Earn reward points for each new enrolled Blue Shield member to our Small Business Trio HMO Bronze 7000/70 plan. Earn even more points for specialty plan upsells from June 2022 to December 2022! Contact your Blue Shield representative or go to our Broker Connection Rewards and Commissions page to learn more.

Continue earning rewards for new sales through Producer Rewards! Be sure to check your profile for points earned for enrollments made with 2/1/22 effective dates. To learn more about the program or to opt-in, visit our Producer Rewards page on Broker Connection.

Lastly, don’t forget about our Direct Elite Rewards program, which continues to benefit direct-selling Small Business brokers. Thanks to our enhanced Direct Elite Rewards, you can earn $100 for any new groups sold direct with Blue Shield in addition to our current Rewards programs.

Contact your sales representative for more information on any of our rewards programs.

Q4 2022 cycle launch recap

Earlier this month we announced our Q4 2022 rate book is available on the dedicated Rates page on Broker Connection. Our fourth-quarter 2022 rate action is a statewide average of 2.9% and the Rates page includes rates for closed dental plans, which is not available in renewal packets.

Groups renewing in October and November will be available to brokers through Shield Renewals on Monday, July 11* while group-level changes can be made using Small Group Online Renewal (SGOR) beginning July 14.* Groups renewing in December will be available on Tuesday, August 23* while group-level changes can be made beginning August 30.* To review exact renewal and enrollment dates for Q4, plus enrollment materials and updated rates books, visit our Renewal Center page on Broker Connection.

Medical Plans

Heading into Q4, you’ll find minimal changes to our existing medical portfolio. This is due to decreased out-of-pocket maximums in many plans, no actuarial value calculator changes resulting in minimal cost share changes, and our focus on providing more plan options with a greater value for our members.

We’ve included several new plans in our 2022 medical portfolio, listed below.

Off-exchange HMO plans:

Bronze 7000/70 Trio HMO

Our Bronze 7000/70 Trio HMO plan for Small Businesses covers professional services at set copayments not subject to deductible. This plan has comparably richer benefits at a lower cost versus rival health plans. Trio HMO Bronze includes integrated pharmacy deductibles, flat copays, chiropractic, and acupuncture coverage. What’s more, Trio comes standard with $0 copayment for virtual medical and behavioral care as well as concierge-level customer support.

This is an excellent plan for clients looking for cost-effective options with great coverage. Beginning with Q3 2022 enrollments, you will earn an additional bonus for each member enrolling in this plan for both renewals and new group sales. More information coming soon!

Silver HMO 2750/65

This plan provides a great lower cost option with the richness that a Silver plan offers. Benefits includes flat copays for office visits, tier 1, and tier 2 prescription drugs that are not subject to the deductible.

Off-exchange PPO plans:

Bronze PPO 5500/65 and Bronze 6500/70

Our new bronze plans feature competitive pricing with lower medical deductible and pharmacy deductibles. These plans include first-dollar coverage for primary care, specialist, and mental health office visits, which means immediate access to these benefits.

* Dates subject to change

Reminder: Healthy Dose of Dialogue podcast on pharmacy policies

Last month we mentioned our most recent Healthy Dose of Dialogue podcast, with Gina Guinasso, president at CivicaScript. In the episode Gina talks about the exorbitant costs in today’s prescription drugs and how her organization – together with the industry – is leveling the playing field by distributing generic drugs directly to pharmacies. In her conversation with host Andy Chasin, Blue Shield of California’s Vice President of Federal Policy and Advocacy, she discusses the beginnings of CivicaScript, spotlights industry factors that have led to inflated drug costs, and outlines how transparent drug pricing and direct distribution to pharmacies can make drugs like insulin more affordable and accessible to patients across the country.

Visit Civicarx.org to learn more about CivicaScript and the company’s mission to provide equitable pharmaceuticals at the lowest sustainable prices to patients.

Specialty DPPO and DINO plans will be withdrawn in 2023

Five DPPO plans and five DINO plans (listed here) will be withdrawn from our Specialty portfolio beginning January 1, 2023, as part of our product transformation and portfolio simplification efforts.

We encourage our broker and consultant partners to begin moving groups out of the plans as early as 2022 renewal. Groups in the ten plans being withdrawn will automatically be mapped to a recommended plan during 2023 renewal, as membership cannot remain in a withdrawn plan. Groups will be allowed to choose any other marketed portfolio plan.

Please reach out to your Blue Shield Account Executive with any questions.

Tools for trusted advisors: New Small Group Admin email

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.

We created a new, dedicated email address for Small Group Administrators! Please use Employerservices@blueshieldca.com for requests such as:
- Billing inquiries
- Eligibility Inquires
- Processing Status
- Access to Care issues
- Benefit inquiries
- Online support

Accessing Employer Connection: To view our Employer Connection portal, first sign into Broker Connection. After selecting the “Small Business” dropdown menu at the top of the page, click “Administer Member Level Changes” on the lefthand side of the menu. You will then be redirected to Employer Connection.

A quick reminder, relaxed participation requirements were extended through December 31, 2022. This means we relaxed underwriting participation requirements for groups with five or more enrolled employees to just 25% for our medical, dental, vision, and life insurance plans. View the latest Relaxed Participation Flyer here.

The Plan Comparison Tool allows you to quickly select from our portfolio medical, dental, or vision plans and compare key benefits side by side. These high-level comparisons are easy to share with clients before diving into more comprehensive plan documents (SBC, EOC, etc.).

For all your Small Business renewal needs, visit the Renewals Center. If you have questions regarding SGOR, a training guide is available on Broker Connection for guidance.

Small Business plan documents (SOB, SBC, EOC) for medical plans, pharmacy plans, dental plans, and life insurance plans are available in one location for each line of business.

Your Blue Shield support team is available to support you throughout the year. Producer Services: (800) 559-5905.