Eligibility and benefits
Search for and verify eligibility and benefits for Blue Shield of California, Blue Shield of California Promise Health Plan, Federal Employee Program and other Blue plan members with online resources and tools.
Member rosters
Download a list of members who have chosen you as their Personal Physician or medical group.
Benefit summaries
Get information about the variety of benefits available to our members.
If you have questions or would like more information, call Provider Information and Enrollment:
- Blue Shield Promise Medi-Cal: Los Angeles County – (800) 605‑2556; San Diego County – (855) 699‑5557
- Other Blue Shield of California plans: (800) 258‑3091
Summary of Benefits and Coverage
Access Evidence of Coverage (EOC) and Summary of Benefits (SOB) documents for IFP, Small Business and Mid/Large Group plans.
Medicare Advantage plan documents
Access Evidence of Coverage (EOC) and Summary of Benefits (SOB) documents for Medicare Advantage plans.
Blue Shield Promise Medi-Cal benefits
Access Evidence of Coverage (EOC) documents in multiple languages for Los Angeles and San Diego counties.
Preventive services, benefits policy and health guidelines
Learn about policy for preventive services, benefits, and health guidelines to ensure benefits are correctly configured and applied with the right billing codes..
Find preventive health guidelines for healthy children, adolescents and adults, including immunizations, screenings, patient-doctor discussion topics, and injury prevention. Review other codes associated with select benefits mandated by state, federal or regulatory agencies.
Benefits policy
Review and download benefits policies, including codes associated with select mandated benefits.
Benefits and member ID cards
Find benefit details for Blue Shield IPAs, medical groups and their contracted providers.
Eligibility and benefits contacts
Find benefit details for Blue Shield IPAs, medical groups and their contracted providers.
Primary Care Hybrid value-based reporting
View member attribution and patient data about visits, risk scores and provider incentive opportunities.
Notice: Nuna will be retired on June 30, 2025. After this date, all performance reports will be available directly through Provider Connection. No further action is required, as your reporting access will transition automatically.
Accountable Care Alliance reporting
View ACO financial, quality, member experience, and utilization reporting.
Notice: Nuna will be retired on June 30, 2025. After this date, contact your Provider Partnership lead to obtain your ACO performance reporting.
FFS+ value-based reporting
Find benefit details for Blue Shield IPAs, medical groups and their contracted providers.
Notice: Nuna will be retired on June 30, 2025. After this date, all performance reports will be available directly through Provider Connection. No further action is required, as your reporting access will transition automatically.
Specialty Care Reimagined reporting
View monitoring reports with detailed information on financial and quality performance and potentially opportunities.