Starting in mid-September, we will send all IFP members information on any changes to their medical, dental, and/or vision plan's rates and benefits. If a member does not have a rate or benefit change, they will still receive a renewal packet informing them there were changes to their plan.
|September 16, 2021||Renewal notices start being mailed.|
|October 1, 2021||Member renewal tool and broker renewal tool are available. Early renewals begin.|
|November 1, 2021||Open enrollment begins. Quote & Apply tool is available.|
|December 31, 2021||Final date for new and renewing members to apply for coverage effective January 1, 2022.|
|January 31, 2022||Open enrollment ends. Final date to apply for coverage effective February 1, 2022.|
Samples of what your clients will receive are available below. Documents may vary depending on plan and underwriter. Please feel free to reference these documents:
DHMO plan to DPPO plan notice
Sent to subscribers who were enrolled in Dental HMO or Dental Standard HMO outside their service area (ZIP code). They will be moved into a Dental PPO plan for 2022.
DHMO to DPPO notice (PDF, 260KB)
Member renewal kit letter
Cover Letter (PDF, 40KB)
On-exchange renewal letter (PDF, 226KB)
Off-exchange renewal letter (PDF, 341KB)
Off-exchange specialty renewal letter (PDF, 199KB)
On-exchange Family Dental Plan renewal letter (PDF, 182KB)
Grandfathered renewal letter (PDF, 161KB)
Alternate Coverage Model Notice
Covered California Model Notice informs members who are directly enrolled through a health plan provider that they can also purchase health insurance through Covered California. They can also receive guidance from Covered California on help paying for their health insurance.
Alternative Coverage Notice (PDF, 75KB)
Creditable Coverage Notice
This notice will give members information about their current prescription drug coverage with Blue Shield of California and their options under Medicare’s prescription drug coverage. This information can help them decide whether or not they want to join a Medicare drug plan. They will receive one of two possible notices, informing them their current coverage is considered to be Creditable Coverage or Non-Creditable Coverage.
Creditable Coverage (PDF, 45KB)
Non-Creditable Coverage (PDF, 54KB)
Nondiscrimination and Accessibility Requirements Notice (PDF, 1.1MB)
Informs members who are directly enrolled through a health plan provider that they are also able to buy insurance through Covered California, where they can also get help paying for their health insurance. Blue Shield does not discriminate or treat our members differently because of race, color, national origin, age, disability, or sex. Our nondiscrimination notice is paired with the Language Assistance Program Notice. These documents help provide meaningful communication for members with limited English proficiency and accessible communications for members with disabilities. It also notifies Blue Shield of California members that vital documents are available in Spanish, Chinese, Vietnamese, and other languages.
Gramm-Leach-Bliley Privacy Notice (PDF, 110KB)
Notifies Blue Shield of California Life & Health Insurance Company members on how Blue Shield of California collects, uses, shares, and protects the privacy of member's non-public personal and financial information (NPI).
Informs Blue Shield of California Life & Health Insurance Company members of the privacy safeguards Blue Shield uses in collecting, using, and sharing personal information.
Only specific medical plans will have revisions to their benefits. Please see the chart below to determine if your client will receive a change guide for their particular plan.
|Platinum 90 PPO||Download (PDF, 18KB)|
|Platinum 90 Trio HMO||Download (PDF, 18KB)|
|Gold 80 PPO||Download (PDF, 18KB)|
|Gold 80 Trio HMO||Download (PDF, 18KB)|
|Silver 70 PPO, Silver 70 Off Exchange PPO||Download (PDF, 34KB)|
|Silver 70 Trio HMO, Silver 70 Off Exchange Trio HMO||Download (PDF, 35KB)|
|Silver 94 PPO||Download (PDF, 21KB)|
|Silver 94 Trio HMO||Download (PDF, 21KB)|
|Silver 87 PPO||Download (PDF, 26KB)|
|Silver 87 Trio HMO||Download (PDF, 27KB)|
|Silver 73 PPO||Download (PDF, 25KB)|
|Silver 73 Trio HMO||Download (PDF, 25KB)|
|Silver 1750 PPO (New plan name for 2022)||Download (PDF, 29KB)|
|Silver 2600 HDHP PPO||Download (PDF, 21KB)|
|Bronze 60 PPO||Download (PDF, 18KB)|
|Bronze 60 HDHP PPO||Download (PDF, 21KB)|
|$0 Cost Share AI-AN PPO||Download (PDF, 18KB)|
|$0 Cost Share AI-AN Trio HMO||Download (PDF, 18KB)|
|Minimum Coverage PPO||Download (PDF, 23KB)|
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Health insurance products are offered by Blue Shield of California Life & Health Insurance Company. Health plans are offered by Blue Shield of California.