Product cycle updates and benefit changes

Small business (1-100)

Broker resources

Medical

Our 2020 plan enhancements feature more convenient and affordable ways for our Trio HMO and Tandem PPO members to access care.

All Trio HMO and Tandem PPO plans feature $0 Teladoc visits and $0 first visit using Heal^TM. Learn more about Heal.
All Trio HMO and Tandem PPO members can take advantage of Healthy Savings, which provides direct savings when purchasing healthy foods at Albertsons, Safeway, Kroger, Walmart, and Sam's Club. Find out more about Healthy Savings by visiting blueshieldca.com/healthysavings.
LifeSpring and Call the Car are available to eligible members, as determined by a Blue Shield case manager. LifeSpring provides meal delivery service and Call the Car provides non-emergency transportation.
Trio HMO plans can now be offered alongside Local Access+ HMO (Trio HMO has been available to pair with Access+ HMO since 2017).
One of the most powerful features in our Trio HMO portfolio – Shield Concierge – is now available to members who enroll or renew into a Tandem PPO plan on or after July 1, 2020. Tandem PPO plan members will receive new printed ID cards with the Shield Concierge phone number listed on the back. Learn more about Shield Concierge by visiting blueshieldca.com/shieldconcierge.

Visit blueshieldca.com/aco for full information on Trio plan benefits, programs, and coverage areas.

In addition to the expansion of our Tandem portfolio, we’re also offering three new plan designs for 2020. You can compare the benefits of your current plan selection to these new plan options by using our Plan Comparison Tool.

Off-exchange PPO plans

Platinum PPO 0/0
We’ve added a new Platinum PPO with no deductible, $0 primary care physician visits, and $0 pharmacy drugs (tier 1) – making it the richest coverage of our plan options.

Silver PPO Savings 2500/35%
We’ve also added to our HSA-eligible plan options with a new Silver PPO Savings plan.

Both of these new off-exchange PPO plans are offered on the Full PPO and Tandem PPO networks.

Off-exchange HMO plans

Gold HMO 1000/35
Our HMO portfolio now includes a Gold 1000/35 option – filling a gap between our existing gold plans that have $500 and $1500 deductibles. This plan is available on each of our HMO networks.

Specialty

Encourage your clients to take advantage of 10% savings with our specialty Bundled Savings discount program for groups adding dental or vision coverage to their medical plans.

Dental changes

We’ve added 6 new dental plans to our 2020 portfolio:

Smile^SM Plus Gold 50/1500/ Ortho/ U90/ ADV
Smile^SM Plus Gold 50/1500/ No Ortho/ U90/ ADV
Smile^SM Plus Gold 50/2500/ Ortho/ U90/ ADV
Smile^SM Plus Gold 50/2500/ No Ortho/ U90/ ADV
Ultimate Dental PPO for Small Business 50/2000/ Lifetime Ortho/ U90
Ultimate Dental PPO for Small Business 50/2000/ No Ortho/ U90

These plans include:

Options with and without lifetime orthodontic benefits
No waiting periods for major services
Higher OON reimbursements (UCR90)
Annual max ranges from $1,500 to $2,500

Beginning with 1/1/20 groups, we will no longer waive the 12-month waiting period on voluntary dental plans. For groups with prior dental coverage with Blue Shield, the waiting period will be waived at the group level.

Vision changes

Vision plans with a $10 eye exam copay (that replaced the vision plans with a $15 copay in 2019) are available for all new and renewing groups in 2020.

Beginning with October 2020 effective dates, small business groups may offer more than one vision plan. This flexibility helps employers provide choices to meet the needs of their employees. Learn about our vision plans here.

Life insurance changes

In order to provide greater flexibility and more options, we’ve added 16 new employee Life Insurance plans. The new plans feature:

Higher maximum amounts, 2-9 segment
Higher maximum amounts, 51-100 segment
More benefit amounts options
All amounts full guarantee issue

Three new Life Insurance plans for dependents that provide:

Higher maximum amounts, 10-100 segment
All amounts full guarantee issue 50% rule applies

Rates will not increase with any of these increased life insurance plan benefits.

Remember:

Quick Match program is available for groups of 10 or more.
Travel assistance is included in life insurance plan benefits.
Beneficiary assistance is included in life insurance benefits.
Composite life rates (for 10 or more lives) are based on final census

^* Underwritten by Blue Shield of California Life & Health Insurance Company.
^† Please refer to the plan contract and the Evidence of Coverage for a detailed description of covered benefits, limitations, and exclusions.

Specialty Underwriting changes

Specialty underwriting for new groups will align with medical on the requirement that a group employs an eligible common law employee to be eligible for group plans. All new sales effective 1/1/20 require a common-law employee, eliminating owner-only businesses. Documentation requirements for specialty business will be the same as for medical and based on the number of enrolling subscribers.

Pharmacy

Rx Spectrum Tiered pharmacy network is now available on On-Exchange (CCSB) and Mirrored plans, joining Tandem PPO and Trio HMO plans.

Level A (preferred): CVS, CVS at Target, Costco, and Safeway/Vons
Level B (non-preferred): All other pharmacies in Blue Shield’s national pharmacy network

Check out the full directory of Level A pharmacy locations.

Updates to identity protection services

Introducing our new identity theft protection services and credit monitoring provider, Experian^®, for Blue Shield members^* in the upcoming benefit year.

Blue Shield provides eligible members^* with identity repair and credit monitoring at no additional cost as an extra layer of security for their identity. They will not be asked to pay or provide payment information for these services as long as they are an eligible Blue Shield member.

Beginning December 2019, members enrolled with AllClear ID may have received a notice that their Allclear ID has been discontinued and that they can continue to receive identity theft protection services by enrolling with Experian.

Once enrolled, members have access to the following features through Experian:

Experian credit report at signup: Daily access to their credit report and information is associated with their credit file.*
Credit Monitoring: Active monitoring of their Experian file for indicators of fraud.
Internet Surveillance: Cyber monitoring, including chat rooms and bulletin boards, to identify trading or selling of personal information on the dark web.
Identity Restoration: Assistance to help address credit and non-credit related fraud.
Experian IdentityWorks ExtendCARE^™: Identity Restoration support even after their Experian IdentityWorks membership has expired.
$1 Million Identity Theft Insurance^**: Coverage for certain costs and unauthorized electronic fund transfers.
Lost Wallet: Assistance with canceling/replacing lost or stolen credit, debit, and medical cards.
Child Monitoring: For ten children up to 18 years old, Internet Surveillance and monitoring to determine whether enrolled minors in their household have an Experian credit report are available. Also included are Identity Restoration and up to $1M Identity Theft Insurance.

Members can go to experianidworks.com/blueshieldca, and then enter the activation code that they received in an email if they are re-enrolling from AllClear to Experian.

Or, if members have questions or want to enroll for the first time, they can call Experian’s customer service at (866) 274-3891 Monday through Friday 8 am-10 pm or Saturday-Sunday 10 am-7 pm Central Time. They will need to provide engagement number DB14224 as proof of eligibility for the benefit services by Experian.

Experian is a registered trademark.
^* Federal regulations prohibit Blue Shield of California from making this offer available to members enrolled in the Federal Employee Program (FEP), Medicare Part D, and Medicare Advantage plans.
^** Identity Theft Insurance underwritten by insurance company subsidiaries or affiliates of American International Group, Inc. (AIG). Please visit experianidworks.com/blueshieldca for more information.

Q4 2020 rates

We will have a statewide average rate change of -1.2% for fourth-quarter 2020. The statewide compounded average rate change for small businesses renewing in Q4 is 0.6%.

Complete rate tables for medical plans, dental plans, and vision plans are available in our rate books here, on Broker Connection. Rate tables for dental plans and vision plans are included in the same file as the medical plans for each region.

Rate tables for closed dental plans are posted on this page as well, as a separate file from the regional rate books; closed plan rate tables are not included in group renewal kits.

Go green. Go digital.

We continue to enhance and promote our digital tools for brokers that are designed to make your jobs easier while also reducing paper waste. You can learn about these resources by visiting blueshieldca.com/digital.

We've moved renewal kits online
This change not only reduces paper waste but also provides a better customer experience, making materials easier to search, share, and save. Each of our small business groups will now have a unique microsite which contains all the materials previously printed and mailed.

There are three ways to access these sites:

Brokers have access to all their renewing groups' sites through Shield Renewals.
An email will be sent to group administrators with a link, log in and password.
A one-page letter will be mailed to the group with a unique URL, log in, and password.

We want to ensure that each group does receive this important renewal information. If a group's microsite is not accessed within a week, we will send a reminder email. If there is no action within 10 days, we will mail a full paper renewal kit to the group.

Supporting open enrollment events virtually
Even before COVID-19 reset norms to shift from in-person to online group meetings, attending all open enrollment events for your small business clients was unlikely, if even at all possible. This is why we developed digital pre-enrollment kits and gave brokers direct access to create digital pre-enrollment kits for their clients earlier this year. If you missed this roll-out, now is a good time to catch up and prepare for the busy fourth-quarter. Instructional videos and other resources are available, along with access to the tool, when you select "Order Materials" from the Resources drop-down tab on Broker Connection (login required).

Within a few minutes, you can provide an enrollment microsite for any of your clients, complete with plan information, program fliers, enrollment forms, and more.

Bonus and rewards

Direct Elite Rewards

Our Direct Elite Rewards program continues to benefit direct-selling small business brokers in 2020, with elevated bonuses for new Blue Shield of California small business medical member sales. The rewards program is available to all small group brokers who sell direct, with effective dates from February 2020 through January 2021.

$100 per member for new small business medical groups if 75% or more of new business comes direct.
$75 per member for new small business medical groups if 50% to 74% of new small business comes direct.

Bundled Savings discount program

We’ve increased the savings for groups when they add a dental and/or vision plan to their existing medical plan:

Groups will now receive a 10% discount on their dental or vision premium when added to their medical plan.

Quick Match Program^SM

Matching for small business life insurance plans has been enhanced. We can now match a current group's combined Basic Life/AD&D renewal rates at $0.08 per $1,000, for amounts between $15,000 and $200,000.

Changes applied for groups with December 1, 2018, or later effective dates.