We want enrollment to be easy for you and your employees. Here's a quick overview to help you understand the process.
Annual Open Enrollment
What Is Open Enrollment?
Open enrollment is a time period of at least 30 days in which eligible employees select their benefits.
You can arrange a benefit meeting for your employees to describe the plan benefit offerings and to help answer employee questions. Open enrollment should be at least 30 days in duration and conclude no later than 10 working days prior to the groups' effective renewal date.
You may contact your Blue Shield account manager to help you coordinate the meeting; however, open enrollment benefit meetings are not mandatory.
During open enrollment:
- An employee who originally declined coverage can now enroll.
- An employee and their dependents may cancel coverage provided by another carrier and enroll in a Blue Shield-sponsored plan, or switch from one Blue Shield plan to another (e.g., a Blue Shield HMO to a Blue Shield PPO).
Enrollment for New Employees
Help make the enrollment process go quickly. Have new employees complete an Employee Application during the eligibility waiting period established for your coverage.
Send us the applications immediately after new employees complete them and simply indicate the employee's future effective date.
Blue Shield must receive a completed Employee Application no later than 31 days after a new employee completes your group's waiting period.
To add a dependent, an employee must complete and submit the Subscriber Change Request form.
Important: HMO and POS members must select a Personal Physician for each dependent.
For fast processing, please mail these forms to the Membership Eligibility Processing Unit:
For companies with 1 to 50 eligible employees
Blue Shield of California
P.O. Box 3008
Lodi, CA 95241-1912
For companies with 51 or more eligible employees
Blue Shield of California
P.O. Box 629014
El Dorado Hills, CA 95762-9014
Electronic enrollment can help employers control and reduce administrative costs and is available to groups of 51+. Read more about Blue Shield's electronic enrollment solutions.
Managing Late Enrollment
A late enrollee is an eligible employee or dependent who declines coverage in a Blue Shield group plan during the initial or open enrollment period (the period during which an individual is eligible to enroll), and later requests enrollment in a plan.
- A late enrollee must wait until your company's next open enrollment period to obtain coverage.
- Blue Shield will not consider requests to be added for an earlier effective date. The same rules pertain to dependents of late enrollees who request enrollment after the initial enrollment period. There are a few exceptions for eligible employees who do not enroll during the initial enrollment period. For the following exceptions, Blue Shield will enroll these employees, along with newly acquired dependents, after the initial enrollment period:
- Following the birth of a newborn, the adoption of a child or a qualified medical child support order (QMCSO).
- After marriage.
- After the establishment of a domestic partnership.
- After the loss of eligibility of other coverage.
For enrollment in the above instances, an Employee Application must be submitted to Blue Shield no later than 31 days from the event. Pre-existing condition limitation provisions may apply. Please refer to your Blue Shield plan or policy for details.
If an enrolled employee acquires a new dependent through birth, adoption, marriage or establishment of a domestic partnership, the enrolled employee may change plans at that time if the employer offers more than one plan and may enroll all other eligible dependents.
Please reference your Administrator's Guide for more detailed information.