We are pleased to announce the Q4 2023 rate book is now available on the dedicated Rates page of Broker Connection. Our fourth-quarter 2023 rate action is a statewide average of 1.4%. Remember! The Employer Enrollment Tool lets you easily find quotes and provides a streamlined, digital experience for all your Q4 enrollments.
Complete rates 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.
Rates for closed Specialty benefits (dental and vision plans) are included in a variety of locations including:
Rate book – includes Medical and Specialty (all regions: 1-19)
Rate books 1-11
Closed Rate Book – includes closed Specialty (all regions: 1-19)
Groups renewing in October and November will be available to brokers through Shield Renewals on Monday July 10*, while group-level changes can be made using Small Group Online Renewal (SGOR) beginning July 14*. December groups will be available to brokers through Shield Renewals on Monday, August 28*, while group-level changes can be made using Small Group Online Renewal (SGOR) beginning August 31*. To review the exact renewal and enrollment dates for Q3, plus enrollment materials and updated rates books, visit our Renewal Center page on Broker Connection.
As a reminder, group renewal information is available as a microsite for each group, and these can be accessed through Shield Renewals. No download is required; you can open the site, find the information you need, and send the link or selected components to your clients. You can also access the medical choice chart, which provides you with information about your clients' current and new plan rates, the option to buy up or buy down, and if Trio or Tandem is available. The choice chart will include the rate differential if you choose to move your client.
View the schedule below to find out when you can manage your clients' renewal and enrollment (dates subject to change).
|Renewal Period||Download 60-day renewal kits from Shield Renewals||60-day renewal notice mailed to Group Administrator (Employer)||Make group-level changes using Online Renewal|
|October 2023||July 10, 2023||July 28, 2023||July 14, 2023|
|November 2023||July 10, 2023||August 28, 2023||July 14, 2023|
|December 2023||August 28, 2023||September 27, 2023||August 31, 2023|
If you have questions regarding SGOR, a training guide is available on Broker Connection for guidance.
* Dates subject to change
This year we have minimal changes and impacts to our plans. Both Mirror and Off-exchange plans have cost share changes. We are expanding our network for Bronze HMO 7000/70.
New Virtual BlueSM Plans offer comprehensive, connected coverage that puts employees first. This plan offers $0 virtual visits, and in-person care designed for people who prefer the convenience of 24/7 virtual care for most primary, specialty, and behavioral visits, with access to in-person. Learn more about Virtual BlueSM
Network expansion for Bronze HMO 7000/70
Now available on Access+ and Local Access+. This plan has rich benefits at a low cost. All professional services are available prior to deductibles. It includes integrated pharmacy deductibles, flat copays, and chiropractic services.
Mirror PPO plans update:
Mirror HMO plans update:
A list of small business medical plans that changed names for 2023 can be found here.
You can compare the benefits of your client's current plan selection with these new plan options by using our Plan Comparison Tool. We have added new enhancements to help you find the best plan that fits you and your employees.
For exact terms and conditions of coverage for all 2023 plan offerings, refer to the Evidence of Coverage and the plan contract, or contact your Blue Shield sales representative.
Effective January 1, 2023, The TRIO ACO network will expand to include additional parts of Monterey by adding 19 new zip codes. The expansion makes the entire roster of Aspire providers available to our Trio members.
|Salinas||93901, 93902, 93905, 93906, 93907, 93908, 93912, 93915|
|Carmel by the Sea||93921|
A few important reminders about our specialty offering:
Dental coverage is the benefit most requested by employees after medical coverage. With access to some of the largest dental provider networks in the country, our dental plans can add value to your benefits package, and help your employees better manage their oral and overall health. Offering access to preventive oral care can help keep employees happier and more productive at work, too.
These 8 new DPPO plans will provider your groups with more options and increased offerings. We now expanded our "Marketed" DPPO portfolio from 22 to a total of 30 DPPO portfolio plans. The newly designed plans include $1500 calendar year maximum option under Bronze DPPO and offering MAC out-of-network reimbursement option under Gold DPPO.
To view and compare all available dental plans use the plan comparison tool here.
New rate reductions for a new portfolio of dental plans
Starting 10/1/22 many of our dental plans are offered at up to 17% lower rates. And you can lock in that rate for 2 years. All plans come with a 2-year rate guarantee and can be purchased with or without a Blue Shield medical package.
DPPO and DINO plans withdrawals
As part of our product transformation and portfolio simplification efforts plans will be withdrawn for 2023 and 2024.
Plan withdrawals for 2023
Five DPPO plans and five DINO plans (listed here) will be withdrawn from our Specialty portfolio beginning January 1, 2023.
Groups currently enrolled in any of the 10 plans being withdrawn will automatically be mapped to a recommended plan during their 2023 renewal, as membership cannot remain in a withdrawn plan. Groups will be allowed to choose any other marketed portfolio plan.
For your groups that are impacted by these withdrawn plans, check out this dental plan mapping for withdrawn plans guide. Please reach out to your Blue Shield Account Executive with any questions.
Plan withdrawals for 2024
Thirteen DPPO plans and DINO plan (listed here) will be withdrawn from our Specialty portfolio beginning January 1, 2024.
We encourage our brokers and consultant partners to begin moving groups out of the plans as early as 2023 renewal. Groups in the fourteen plans being withdrawn will automatically be mapped to a recommended plan during 2024 renewal, as membership cannot remain in a withdrawn plan. Group will be allowed to choose any other marketed portfolio plan.
There are minimal updates to simplify the Vision SOB. The cost shares for hard and soft Non-Elective (Medically Necessary) were moved to each contact lens. We removed the list of eye conditions along with cost shares. Additional updates to the Vision Custon SOB include the addition of Eye Exam-Only plan to increase cost share ranges, this will provide a wider range of copays.
Our 2024 new vision vendor is EyeMed
EyeMed is taking over the administration of MES Vision benefits for our groups and members in 2024. For more than a year, EyeMED and MES have been working together to ensure a smooth transition. Most providers have been contracted by EyeMed to minimize member disruption.
We will be providing more information on the transition in the months to come.
There are no life insurance updates for Q2 2023.
We’ve increased the savings for groups when they add a dental and/or vision plan to their existing medical plan:
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.
New Continuous Glucose Monitors benefit
Provides members with easier access to Continuous Glucose Monitors as we expand coverage to retail pharmacies. Effective 1/1/23, CGMs will be accessible at retail pharmacies through the Blue Shield pharmacy benefit (prior authorization is required). Learn more
Weight loss drug exclusion removal
Previously, only members with morbid obesity could access weight loss drugs. This change will allow for more accessibility. Medical necessity requirements will continue to apply and all drugs for weight loss require prior authorization.
More ways to earn with the new autopay incentive program. Earn 25 points for setting up your group on autopay during their initial enrollment. Also increase your earnings by selling Virtual Blue and Tandem PPO plans. Learn more.
Keep business with Blue Shield of California and earn more. We have increased the points you earn with every new Tandem and Virtual Blue PPO membership. Learn more.
Our Direct Elite Rewards program will benefit direct-selling small business brokers. The rewards program is available to all small group brokers who sell direct. Learn more.
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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.