Product cycle updates and benefit changes

Rates

We are pleased to announce the Q2 2023 rate book is now available on the dedicated Rates page of Broker Connection. Our Second-quarter 2023 rate action is a statewide average of 1.9%. Remember! The Employer Enrollment Tool lets you easily find quotes and provides a streamlined, digital experience for all your Q1 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)

April, May, and June renewals

Groups renewing in April, May and June will be available to brokers through Shield Renewals on Wednesday, January 11* while group-level changes can be made using Small Group Online Renewal (SGOR) beginning January 16.*  To review the exact renewal and enrollment dates for Q2, 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
April 2023	January 11, 2023	January 26, 2023	January 16, 2023
May 2023	January 11, 2023	February 24, 2023	January 16, 2023
June 2023	January 11, 2023	March 24, 2023	January 16, 2023

If you have questions regarding SGOR, a training guide is available on Broker Connection for guidance.

* Dates subject to change

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Medical plan updates

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.

Off-Exchange PPO plans update:

New Virtual Blue^SM 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 Blue^SM

• Virtual Blue^SM Gold PPO 1500/45
• Virtual Blue^SM Bronze PPO 7500/75

Impacted PPO plans with cost share changes:

• Silver PPO 2000/60
• Silver PPO 2350/65
• Silver PPO 2550/70
• Bronze PPO 5500/65
• Bronze PPO 6500/70
• Bronze PPO 6850/55
• Bronze PPO 7500/65
• Gold PPO Savings 1750/15% HDHP Prev RX
• Silver PPO Savings 2300/25%
• Silver PPO Savings 2600/35% HDHP Prev RX
• Blue Shield Silver 70 PPO 2500/55

Off-exchange HMO plans update:

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.

Impacted HMO plans with cost share changes:

• Platinum HMO 0/20
• Gold HMO 0/30
• Silver HMO 2750/70
• Bronze Trio HMO 7000/70
• Blue Shield Trio Silver 70 HMO 2500/55

A list of small business medical plans that changed names for 2023 can be found here.

Learn more about the 2023 small business medical plans

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.

2023 Trio Network Expansion Monterey (partial county)

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. 

City	Zip codes
Salinas	93901, 93902, 93905, 93906, 93907, 93908, 93912, 93915
Big Sur	93920
Carmel by the Sea	93921
Carmel	93922, 93923
Carmel Valley	93924
Chualar	93925
Gonzales	93926
Soledad	93960
Spreckels	93962
Castroville	95012
Moss Landing	95039

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Specialty plan updates

A few important reminders about our specialty offering:

• Our dental plans come with a two-year rate guarantee.
• Groups can now select two vision plans to offer members.
• Life insurance includes beneficiary assistance and travel assistance.

Dental plan changes

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.

Introducing new Dental PPO plans

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. 

New plans:

• Bronze DPPO/1500/MAC
• Bronze DPPO/MAC/Child Only Ortho
• Bronze Voluntary DPPO/ $1500/MAC
• Bronze Voluntary DPPO/$1500/MAC/Child Only Ortho
• Gold DPPO/$1500/MAC
• Gold DPPO/$1500/MAC/Adult+Child Ortho
• Gold DPPO/$2000/MAC
• Gold DPPO/$2000/MAC/Adult+Child Ortho

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 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.

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. 

Vision plan changes

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. 

Life insurance changes

• There are no life insurance updates for Q2 2023.

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Specialty and medical together is a win-win

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.

Download the full program details here.

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.

Download the full program details here.

Important pharmacy updates

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.

Broker Bonus Programs for 2023

Producer Rewards: Your work. Your rewards.

Blue Shield of California rewards our producers with a points-based bonus program for the work they do. Learn more about producer rewards. 

Multiple bonus programs are better than one. 

Blue Shield of California has multiple Small Group bonus programs. Brokers can be eligible for all of them at the same time. Visit the rewards and commissions page to learn more.

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