BROKER UPDATES

Pharmacy Care Reimagined, with FAQs now available

Blue Shield of California made headlines in August after announcing the next phase of reimagining pharmacy care with a new prescription drug supply chain model. The model is built to provide our members with convenient, transparent access to prescription medications. Once fully implemented in 2025, the supply chain model has the potential for significant annual drug cost savings.

To help answer questions about Pharmacy Care Reimagined, we created this helpful FAQ document to inform you and your clients about the ins-and-outs of the new care model.

Support your success by leveraging the new, robust Account Management Tool

It’s our goal each year to provide the tools and resources you need for a successful Open Enrollment whether it be in person or virtual.

Now is a perfect time to familiarize yourself with the new Broker Connection Account Management Tool (AMT). The AMT is a unique self-service agency account administration where primary agents can open new user accounts, assign roles, grant permissions, and customize access to client lists and commission statements. Check out the AMT page on Broker Connection for user guides, video tutorials, and FAQs.

Additional Open Enrollment resources include:

• Customized microsite links, including benefit summaries.
• Virtual open enrollment meetings can be conducted via platforms like Zoom, Teams, and Webex.
• The “Forms and Applications” pages for Small Business and Large Group on Broker Connection house key resources like SOBs, EOCs, and rate information.
• The Employer Enrollment Tool resource page has all the materials you need for success with our primary enrollment channel.
  • Paper forms are still available on the Broker Connection links above. 
  • Scroll to the full Employer Enrollment Tool topic below for more information. 
• Employer Connection’s Administrative Resources page houses integral links and materials like:
  • Administrator Guides for both Small Business and Large Group.
  • The Reference Library with forms, help topics, and Summary of Benefits and Coverage.

Contact your Blue Shield representative for additional assistance and, as always, we look forward to our continued partnership.

Driving biosimilar adaption for affordable, sustainable health care

We are excited to share our success in advancing biosimilar adoption, contributing to substantial savings for our members. Biosimilars, costing 15-45% less than reference biologics, significantly reduce member out-of-pocket expenses. Blue Shield's commitment to biosimilars extends beyond cost savings; it fosters market competition, further lowering prices.

Our efforts in oncology have yielded remarkable progress, with all three therapeutic biosimilars (rituximab, bevacizumab, and trastuzumab) predominantly making up the majority of the market share for their respective product class. Biosimilars maintain efficacy and safety standards comparable to reference biologics. They also ensure quality care at a fraction of the cost.

As the U.S. biosimilar market gains momentum, we continue to collaborate proactively with healthcare providers to enhance adoption. Our shared goal is to ensure that biosimilars become an integral and accessible component of high-quality and sustainable health care.

Ensure you're prepared for the upcoming EyeMed transition

Blue Shield of California's contract with MES is set to end on December 31, 2023, as MES was acquired by EyeMed. Starting January 1, 2024, EyeMed will administer all Blue Shield of California vision plans. EyeMed is a leading vision benefits company known for its diverse network of providers, online options, and easy-to-use services.

EyeMed's network has a 97% provider overlap with MES, and they are actively recruiting providers not currently in their network. Members will continue to have access to retailers such as LensCrafters, Target Optical, Walmart, and Costco through EyeMed's network.

The migration of members from MES to EyeMed's network will take place on January 1, 2024. The Vision Member Service number (877-601-9083) will remain the same. EyeMed will issue Vision ID Cards to both existing (regardless of their renewal date) and new subscribers with their "Welcome Kit" at the beginning of the year. Subscribers should receive these cards towards the end of 2023, close to the new year. ID cards will not be reissued during subsequent renewal years.

Price Check My Rx Tool Offers Cost Control for Commercial Members

Commercial members now have a better way to manage their medication costs online. The Price Check My Rx tool creates a personalized experience with real-time information from the member’s formulary and benefits usage. 

Once logged into their Blue Shield account, members can: 

1. View their active prescriptions and see their current costs.
2. See lower-cost alternative options and potential savings specific to the member (if available).
3. Perform a price comparison between prescription costs at different network pharmacies. 
4. Search for any drug and the cost of its brand or generic formulation (if available). 

The Price Check My Rx tool will be continually enhanced to provide the best and most efficient user experience. A recent enhancement to the tool allows members to compare medication prices by searching for a new drug and their existing prescription drug in one query. The search result will display the costs and information for both drugs in a single view.

Blue Shield launched the tool to Medicare members in January of this year. So far, more than 9,000 Blue Shield Medicare members have used the tool to confirm their current prescription drug costs and to identify lower-cost alternatives. Be sure to let your clients know about the online Price Check My Rx Tool available now. 

Broker-assisted Autopay is here!

Autopay is now live on Broker Connection! You can set up automatic payments for your clients directly from your Client List. The Autopay feature enables: 

• Effortless Payments: No more manual payments. Autopay ensures your clients never miss a payment, keeping their coverage seamless.
• Payment Flexibility: You can choose the payment amount and type to suit your client's needs.
• Easy Confirmation: Access and share payment confirmations effortlessly, giving your clients peace of mind. 
• Timesaving: Streamline your operations from your Client List with less keying of information to set up payments. 
• Specialty: Autopay is also available for stand-alone dental and vision plans.

To get started with Autopay, log in to your Broker Connection account to see the new Autopay setup options in your client list.

Instant Digital ID cards are now available on Broker Connection

Great News! You can now download digital member ID cards and forward them directly to your clients. This self-serve option is available from your online Client List after you log in to Broker Connection.

How To: 

• Log in to Broker Connection
• At the top of the page, click Get ID Card
• Select your line of business (Individual & Family, Medicare, or Small Business) to access your Client List
• Search for clients by name
• Select and click Get ID card
• Select coverage type Medical, Dental, or Vision
• Select delivery method Download ID card, Send ID card via email, or Receive ID via member portal

ID cards are provided in PDF format and available for immediate use. Instant access to digital ID cards is just one of the many self-service tools now available on Broker Connection. Brokers and employers are also able to download member ID cards in the Employer Enrollment Tool. 

Tools for the trusted advisor

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. 

• Live Agent Chat is available now! You can solve your client’s challenges, upload supporting documentation, and get help navigating our self-service capabilities with our secure chat platform. The chat feature is available on all pages once you log in and check out this chat demonstration video for additional information. Our team is available 8:00 a.m. to 6:00 p.m. PST Monday to Friday.
• Broker bonus programs: visit the Rewards and Commissions page on Broker Connection for full details! 
  • Small Business Incentive Program: Sell more, earn more. We’re making it easier for you to earn more when you enroll in membership.
  • Direct Elite Rewards: Boost your earnings with this program that benefits direct-selling small business brokers.  
• We’re relaxing underwriting participation requirements for groups with five or more enrolled employees to just 25% for our medical, dental, vision, and life insurance plans through December 31, 2023. Check out the 2023 relaxed participation flyer here for additional criteria and information. 
• Save time and update your profile’s 1099 documents
  You should have already received your 2022-2023 1099 documents. Please be sure your contact information is up to date and correct on our “Update Your Profile” page. This ensures your 1099 documents are sent to the correct address. It is important to maintain updated demographic information to ensure you get the essential information you need. It will save you time at the end of the year.
• Doing business with Blue Shield of California: resources for our Small Business brokers.
• The new Small Business Contact Sales & Support page on Broker Connection allows you to easily find the dedicated Account Executive and Sales Executive in each region. 
• 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. 
• 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.

---

Tools for the trusted advisor

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.

• New hours of operations
  Our Broker and Employer Services teams have adjusted their hours of operation and are now open 8:00 a.m. to 6:00 p.m. PST.
• Save time and update your profile’s 1099 documents
  You should have already received your 2022-2023 1099 documents. Please be sure your contact information is up to date and correct on our “Update Your Profile” page. This ensures your 1099 documents are sent to the correct address. It is important to maintain updated demographic information to ensure you get the essential information you need. It will save you time at the end of the year.
• 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.