What's new for Small Businesses – Q4 2020
1-100 employees – Effective October 1, 2020
What's new for you
We’re adding new plans for 2020 – which means more choice for you and your employees.
Introducing the new and improved Tandem and Trio
We’ve expanded our Tandem PPO portfolio so that each of our PPO plans can be offered on the Full PPO and Tandem PPO networks. Tandem PPO plans have lower premiums and offer the same benefits as Full PPO plans – but on a select network of providers.
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™. Learn more about Heal.
- All Trio HMO and Tandem PPO members can take advantage of the Healthy Savings® program, 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 of our Trio HMO portfolio – Shield Concierge – is now available to Tandem PPO members who enroll or renew into a Tandem PPO plan. Learn more about Shield Concierge by visiting blueshieldca.com/shieldconcierge.
Visit blueshieldca.com/aco for full information on 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 benefits of your current plan selection with these new plan options by using our Plan Comparison Tool.
Heal is a trademark of Get Heal, Inc.
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 the coverage the richest offered by our plan options.
- Silver PPO Savings 2500/35%
We’ve also added a new Silver PPO Savings plan to our HSA-eligible plan options.
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 $1,500 deductibles.
This plan is available on each of our HMO networks.
Plans that changed deductibles and/or copays are outlined in the table below.
- Complete benefits for all of our small business plans can be found on Employer Connection at blueshieldca.com/employer.
- To see how these new plans compare with your current selection, visit blueshieldca.com/employerplans.
|2019 small business plan||Maps to 2020 small business plan|
|Off-exchange PPO plans|
|Silver Full PPO 1700/55 OffEx||Silver Full PPO 1800/55 OffEx|
|Silver Tandem PPO 1700/55 OffEx||Silver Tandem PPO 1800/55 OffEx|
|Silver Full PPO 2000/45 OffEx||Silver Full PPO 2300/45 OffEx|
|Silver FulSilver Tandem PPO 2000/45 OffExl PPO 2300/45 OffEx||Silver Tandem PPO 2300/45 OffEx|
|Bronze Full PPO 4500/70 OffEx||Bronze Full PPO 5000/70 OffEx|
|Bronze Tandem PPO 4500/70 OffEx||Bronze Tandem PPO 5000/70 OffEx|
|Bronze Tandem PPO 6500/50% OffEx||Bronze Tandem PPO 6500/50 OffEx|
|Bronze Full PPO 6000/65 OffEx||Bronze Full PPO 6850/65 OffEx|
|Bronze Full PPO 6500/50% OffEx||Bronze Full PPO 6500/50 OffEx|
|Off-exchange PPO HSA plans|
|Silver Full PPO Savings 2000/20% OffEx||Silver Full PPO Savings 2000/25% OffEx|
|Silver Tandem PPO Savings 2000/20%||Silver Tandem PPO Savings 2000/25%|
|Bronze Full PPO Savings 6650 OffEx||Bronze Full PPO Savings 6900 OffEx|
|Off-exchange HMO plans|
|Silver Access+ HMO® 1975/55 OffEx||
Silver Access+ HMO® 2350/65 OffEx
|Silver Local Access+ HMO® 1975/55 OffEx||
Silver Local Access+ HMO® 2350/65 OffEx
|Silver Trio HMO 1975/55 OffEx||
Silver Trio HMO 2350/65 OffEx
|Mirror HMO plans|
|Blue Shield Trio Gold 80 HMO 0/30 + Child Dental||
Blue Shield Trio Gold 80 HMO 250/25 + Child Dental
|Blue Shield Trio Silver 70 HMO 2000/45 + Child Dental||
Blue Shield Trio Silver 70 HMO 2250/50 + Child Dental
|Mirror PPO plans|
|Blue Shield Gold 80 PPO 0/30 + Child Dental||
Blue Shield Gold 80 PPO 250/25 + Child Dental
|Blue Shield Silver 70 PPO 2000/45 + Child Dental||
Blue Shield Silver 70 PPO 2250/50 + Child Dental
|Blue Shield Bronze 60 PPO 6300/75 + Child Dental||Blue Shield Bronze 60 PPO 6300/65 + Child Dental|
For exact terms and conditions of coverage for all 2020 plan offerings, refer to the Evidence of Coverage and the plan contract or contact your Blue Shield sales representative.
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 protection 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 that is associated with their credit file.*
- Credit Monitoring: Active monitoring of their Experian file for indicators of fraud.
- Internet Surveillance: Cyber monitoring to identify trading or selling of personal information on the dark web. Monitoring includes chat rooms and bulletin boards.
- Identity Restoration: Assistance to help address credit- and non-credit-related fraud.
- Experian IdentityWorks ExtendCARE™: Identity Restoration support even after 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: Internet Surveillance and monitoring to determine whether enrolled minors have an Experian credit report are available. Also included are Identity Restoration and up to $1M Identity Theft Insurance. Monitoring is available for 10 children up to 18 years old per household.
Members who wish to re-enroll from AllClear to Experian can go to experianid-works.com/blueshieldca. They will be asked to enter the activation code that they received in an email.
Or, if members have questions or want to enroll for the first time, they can call Experian’s customer service at 1-866-274-3891, Monday to Friday from 8 a.m. to 10 p.m. or Saturday and Sunday from 10 a.m. to 7 p.m. Central time. They will need to provide engagement number DB14224 as proof of eligibility for the benefit services by Experian.
Experian trademarks are registered trademarks of Experian Information Solutions, Inc., ConsumerInfo.com, Inc. or its affiliates.
* 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.
Round out your coverage with dental, vision, and life insurance*
This is a great time to help your employees stay happier, healthier, and more productive by offering them specialty coverage. All Blue Shield specialty plans give you the convenience of fully integrated billing and administration.
- Get a 10% discount on any dental and/or vision coverage premiums when they are added to your current medical coverage.
- All specialty plans can be purchased with or without a Blue Shield medical package.
Blue Shield members will enjoy a seamless experience when accessing their dental and/or vision plan benefits on the member portal. When logged in, members can view their benefits, find dental and vision providers, view their account balance and payment information, and manage claims. The site also features a dental treatment cost estimator, the ability to view and print ID cards, and other resources.
We’ve added six new dental plans to our portfolio:
- SmileSM Plus Gold 50/1500/Ortho/U90/ADV
- SmileSM Plus Gold 50/1500/No Ortho/U90/ADV
- SmileSM Plus Gold 50/2500/Ortho/U90/ADV
- SmileSM 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 ortho benefits
- No waiting periods for major services
- Higher OON reimbursements (UCR90)
- Annual max ranges from $1,500 to $2,500
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.
Small business employers can now offer two vision plan options to their employees. Your employees will benefit by having more than one vision plan option, which will allow them to choose the plan that best fits their needs.
To provide greater flexibility and more options, we’ve added 16 new employee life insurance plans. The new plans feature:
- Higher maximum amounts
- More benefit amount options
- Full guaranteed issue for all amounts
There are three new life insurance plans for dependents that provide:
- Higher maximum amounts, 10–100 segment
- Full guaranteed issue for all amounts, 50% rule applies
Rates will not increase with any of these increased life insurance plan benefits.
- All new groups receive a two-year rate guarantee on their life insurance coverage.
- Our life insurance Quick Match ProgramSM provides streamlined underwriting by matching rates from any other plan, for new or existing groups with 10–100 eligible employees.
* 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.