2020 Premium Credit Program

Program overview

Consistent with our mission to provide access to high-quality health care that is sustainably affordable, Blue Shield is applying a one-time premium credit to help ease the financial strain our customers are facing. The credit will be a percentage applied to one month’s premium. 

Premium credits will only be applied toward premiums for the following market segments:

  • Medicare Supplement medical, dental and/or vision plan subscribers
  • IFP dental plan and/or vision plan subscribers
    Note: IFP medical plans are not included in this program
  • Fully-insured employer group medical, dental and/or vision plan employers
    Exception: Flex-funded groups are not included in this program
     

The credit will be shown on customers’ November billing statement, whether received electronically or in the mail. Exception: On-exchange small business groups (CCSB) will have credits applied to their December bills.

The Premium Credit Program will apply a one-time credit of 10% to monthly medical premiums and 30% credit to monthly dental and/or vision premiums. Blue Shield will apply these percentages for all customers eligible to receive premium credits through this program, as described above.

  • For off-exchange customers, the credit will be calculated based on the customer's October billed premium
  • For on-exchange members, a 10% credit will be applied to their December medical premium bill 

Customers should review their billing statement for the specific amount credited. 
 

Premium Credit Program communications

Frequently asked questions

WHAT is the Premium Credit Program?

Blue Shield is applying a one-time premium credit for fully-insured medical, dental and vision plans.

How much is Blue Shield providing in premium credits? 
The Premium Credit Program will apply a one-time credit of 10% to monthly medical premiums and 30% credit to monthly dental and/or vision premiums. 

  • For off-exchange customers, the credit will be calculated based on the customer’s October billed premium
  • For on-exchange members, a 10% credit will be applied to their December medical premium bill

Blue Shield will apply these percentages for all customers eligible to receive premium credits through this program.
 

How did Blue Shield determine premium credit amounts?
The Premium Credit Program is designed to help relieve financial stress for customers, while maintaining financial responsibility for Blue Shield. 

The same percentages – 10% for medical and 30% for dental and vision –  are applied to all customers eligible for the program.

The premium credit is based on the October premium statement for the medical, dental and/or vision plan(s) and does not include any pass-though charges.

Does this program impact any other Blue Shield programs providing financial support to customers?
No.
 

Is there a terms and conditions document, or any other resource, that describes this credit?
Information for this program is provided to customers through their billing statement, and through communications directly to these customers. Members with questions regarding the credit should contact the number on the back of their Blue Shield ID card. Employers or brokers should contact Employer Services or Producer Services, respectively. 

Core and Premier employers or brokers should reach out to Core Priority, Core Shield Elite, or Premier Priority.
 

WHO is receiving premium credits?

Premium credits will be applied to fully-insured employer groups (except flex-funded) with medical, dental and/or vision plans, Medicare Supplement medical, dental and/or vision plan subscribers, and IFP dental plan and/or vision plan subscribers. 

Why isn’t Blue Shield providing premium credits to all lines of business or members? 
We are issuing premium credits to each market segment permitted by state regulators and Covered California. 

Why are premium credits applied to IFP dental plan and/or vision plan members only?
We are issuing premium credits to each market segment permitted by state regulators and Covered California. 

Can members or employer groups request a premium credit if they do not receive them automatically?
No. The Premium Credit Program is applied to eligible subscribers and employer groups only, as determined by the program parameters outlined in this web page.  

Can members or employer groups request a premium credit if they feel the amount credited is incorrect, or insufficient?
The Premium Credit Program is applied using the same percentages for all eligible customers and market segments. If customers feel the credit is incorrect, they may follow the standard grievances process. 

Does the premium credit apply to self-funded plans?
No. 

Are premium credits applied only to customers whose accounts are delinquent or in a grace period?
No. All customers in the eligible market segments will receive a credit, regardless of their account billing status. 

Do employer groups need to disperse the credit to their employees/group members?
Blue Shield is not a financial institution or tax advisor. We cannot provide legal, tax, or financial advice. Group administrators should contact their legal, tax, or financial advisors.

Are other Blues plans taking this action?
Blue Shield of California is implementing the Premium Credit Program independently. 
 

Large Group/Premier Accounts

The following questions/answers are specific to Large group / Premier group / custom accounts.

Does the premium credit apply to flex-funded plans?
No. Flex-funded accounts are out of scope for this program. 

Does the premium credit apply to GMAPD members?
Not at this time. 

Will mix-funded employer groups receive a premium credit? 
Yes. Mix-funded groups will receive premium credits for their fully-insured products.

How will this impact groups that were already given premium credits during renewal and/or as part of the negotiation?
The credit is for existing groups (including new groups enrolled effective 10/1/20), even those who received a premium credit previously. The program is not considered, presented, or provided as part of any renewal offering.

How will this program be implemented for fully-insured cases that self-bill? How will credit amounts be determined, and which month will it apply to? 
The credit will be applied to their November bill and calculated based on the customer’s October premium. Consistent with all other employer groups included in this program an approximately 10% credit on medical plans and approximately 30% credit on dental and/or vision plans will be applied to their November bill accordingly. 

When calculating the Premium Credit, were pass-throughs included?
No. The premium credit was calculated based on the actual premium amount. No pass-throughs were included in the credit calculation.

Does the Premium Credit Program include value-added services or buy-up options in calculating the credit amount? 
No.  

Does the Premium Credit apply to Stop Loss Coverage? 
No. 

Premium credits are applied to November bills for market segments included in the program, with the exception of on-exchange small business (CCSB) plans, for which the credit will be applied to December bills. 

When will customers see a credit applied to their bill?
Credits will be applied to November billing statements before they are mailed or posted online. Billing cycles vary by market segment, with most mailings in the second and third weeks of the month. Customers will not receive information on the credit prior to receiving their bill. 
 
When will customers receive their billing statements showing the premium credit? 
Billing cycles vary by market segment, and will be available on or after the dates shown below:
  • Medical Supplement: 10/13
  • IFP Specialty: 10/13
  • Small Group Off-Exchange: 10/15
  • Small Group On-Exchange (CCSB): 11/15
  • Large Group: 10/18
 
Will Blue Shield extend this credit for future months?
No. This is a one-time program for premium credit applied to the November billing cycle (December for CCSB). 
 
What if a customer already paid their premium prior to the credits being applied? Will they receive a refund?
Credits are applied prior to the billing statements being made available. If a customer pays the standard full premium amount, the credit balance will be carried to the next billing cycle. 
December bills. 
 
When will customers see a credit applied to their bill?
Credits will be applied to November billing statements before they are mailed or posted online. Billing cycles vary by market segment, with most mailings in the second and third weeks of the month. Customers will not receive information on the credit prior to receiving their bill. 
 
When will customers receive their billing statements showing the premium credit? 
Billing cycles vary by market segment, and will be available on or after the dates shown below:
  • Medical Supplement: 10/13
  • IFP Specialty: 10/13
  • Small Group Off-Exchange: 10/15
  • Small Group On-Exchange (CCSB): 11/15
  • Large Group: 10/18
 
Will Blue Shield extend this credit for future months?
No. This is a one-time program for premium credit applied to the November billing cycle (December for CCSB). 
 
What if a customer already paid their premium prior to the credits being applied? Will they receive a refund?
Credits are applied prior to the billing statements being made available. If a customer pays the standard full premium amount, the credit balance will be carried to the next billing cycle. 
 

HOW are premium credits applied? How is this being communicated?

Operations

Is the credit being applied automatically, or does it require enrollment?
Premium credits are applied automatically; no action is required of the customer to receive the credit. 

How will commissions be administered?
Consistent with our existing policies, Producer Services Agreement and related contracts, Blue Shield will pay commissions based on premiums received from customers.

How will the premium credit impact my taxes?
Blue Shield is not a financial institution or tax advisor. We cannot provide tax advice. Customers should consult their financial or tax advisor.
 

Communications

The credit will be shown on customers’ billing statement, whether received electronically or in the mail. 

Billing statements will show a line item for miscellaneous credits and debits. They will also have messaging when accessing their billing statements online. Email and letter communications will be sent to customers receiving premium credits. 

How will the credit be reflected on a customer's bill?
The bill will show: 

Miscellaneous Credits and Debits
One-time premium credit – $XXX.XX


Will this program be made public? 
Yes. The program will be shared through the Blue Shield News Center, as well as communications to brokers, employers, and impacted customers.  

How will brokers be informed of which customers are receiving premium credits, and how much?
general communication will be sent to all lines of business brokers with information on the program. There will not be specific communication to brokers identifying impacted customers or credited amounts.
 

WHY is Blue Shield providing premium credits?

Blue Shield is committed to our mission of providing access to high-quality health care that is sustainably affordable. Premium credits are one way we provide financial relief to our valued customers during the national health crisis and ensuing financial challenges.
 

Why is Blue Shield introducing this program now, when other carriers did so earlier in the economic fallout of COVID-19?
Blue Shield has provided financial support to customers through a variety of initiatives throughout the public health crisis and ensuing financial fallout. The Premium Credit Program is a continuation of our overall response to help ensure our customers maintain access to care.

How does this impact Blue Shield's 2% pledge?
Blue Shield of California remains committed to our 2% pledge.