What's new for small businesses – Q1 2027

1-100 employees – Effective January 1, 2027

2027 Enhancements Designed to Support Employers and Their Employees

Blue Shield’s 2027 Small Business portfolio combines required regulatory updates with targeted enhancements that support affordability, access, and long-term plan sustainability. Key changes include expanded pharmacy savings, enhanced telehealth access for high-deductible health plans, improved behavioral health benefits, and plan design updates to maintain compliance with federal and state requirements.

Expanded Pharmacy Savings Through Rx Spectrum

Beginning January 1, 2027, the Rx Spectrum tiered pharmacy network will be available across HMO and PPO offerings for Off-exchange and Mirror plans.

Members can maximize savings by using preferred Level A pharmacies, including:

• CVS Pharmacy
• CVS at Target
• Costco Pharmacy
• Safeway and Vons Pharmacy locations

Members currently filling maintenance medications at non-preferred pharmacies will receive advance communications about available savings opportunities, including transferring prescriptions to a preferred pharmacy or using convenient home delivery services.

Additional helpful resources

• Compare prescription drug prices using our Price Check My Rx tool.
• Consider home delivery options through Amazon Pharmacy or PillPack.
• Use our online pharmacy locator tool to find a nearby Level A in-network pharmacy.

Virtual First and Telehealth Enhancements

Blue Shield continues to expand convenient, affordable care options through its Virtual First approach. Beginning in 2027, deductibles for telehealth services will be waived on HDHP plans, helping members access timely virtual care at a lower cost. These enhancements can improve employee access to care, support a better member experience, and encourage the use of cost-effective care options. 

Learn how our VirtualBlue^SM integrated program is a convenient option for your employees.

Updates to Medical Plans

For 2027, Blue Shield continues to focus on helping your employees access high-quality, cost-effective care while maintaining a broad range of plan options for employer groups. 

Additional benefit changes include:

• Enhanced behavioral health coverage, with Mental Health and Substance Use (MHSU) outpatient services moving to no-cost-share in applicable plans.
• Updated annual out-of-pocket maximums to align with regulatory requirements.
• Updated deductible and out-of-pocket maximum limits for HDHP/HSA-qualified plans to reflect annual IRS guidelines.
• Benefit refinements to imaging, outpatient surgery, and emergency room services on select off-exchange plans.

For exact terms and conditions of coverage for all 2027 plan offerings, refer to the Evidence of Coverage for the plan, or contact your Blue Shield sales representative.

Plan name changes for 2027

To help employers better identify plan features, several HMO, PPO, and PPO Savings plans will feature updated plan names for 2027.

Compare benefits by using our plan comparison tool where you can:

• Compare multiple plans across multiple years to see changes and updates to our plans.
• Compare cost shares across all of our available plans for 2027.
• Use the network comparison tool to see current and future providers in our network.

Because Virtual Blue benefits are now included in our PPO plans, the following Virtual Blue plans will no longer be available in 2027. Groups enrolled in these plans will be automatically mapped to an equivalent PPO plan with Virtual Blue program enhancements.

Use the plan comparison tool to compare benefits year over year, including a withdrawn plan against its recommended replacement or any other available plan.

Employer groups currently offering any of the following withdrawn medical plans will:

1. Receive a 90-day notification before your renewal date informing you of your plan withdrawal.
2. Be mapped to a recommended available plan upon renewal.
3. Have the option to opt out of the recommended plan and choose any available marketed plan.

Medicare Creditable Coverage Changes

Due to changes in the CMS standard for Medicare creditable coverage, some plans will no longer be Medicare creditable upon renewal in 2027. This means that the plan’s expected value falls below that of standard Medicare Part D coverage. This change may affect Medicare-eligible employees, dependents, and retirees, especially regarding potential Medicare Part D late enrollment penalties. 

You can visit the Small Business Renewal page for a full list of Non-creditable plans for both HMO and PPO.

Employer groups offering any of these plans have two options:

1. They may keep their plan and notify their employees that their prescription coverage is not Medicare creditable using CMS Model Notice language. 
2. Select an alternative plan that is Medicare creditable. Visit the Medicare Creditable section on the renewal page for a listing of all creditable and non-creditable plans.

Dental and Vision Benefits Reminder

While there are no specialty product or benefit changes at this time, we’re continuing to offer a strong, valuable portfolio of services, including:

• Bundled Savings – Cover more of your employees’ overall health needs and get a 10% discount for your business when adding Vision or Dental policies to your medical plan.
• Two-year initial rate guarantee applies to both new and existing medical groups when dental, vision, or life insurance coverage is added. The guarantee lasts until the second renewal anniversary of the medical policy after the addition. If coverage is added mid-term, the guarantee period will be less than 24 months.
• Streamlined administration - all of our group plans offer streamlined administration, which means one bill, one renewal, and one point of administration for all of your clients' Blue Shield business, all easily accessible through Employer Connection.

Insight discount with EyeMed¹ Doctors for 2027

Use your discount with these three easy steps:

1. Locate an eye doctor – Select from a broad network of independent eye doctors. Visit Blueshieldca.com to find a provider near you.
2. Schedule an appointment – Call ahead or stop by one of the many eye doctors that offer walk-in appointments.
3. Use your discount – When you arrive, let the eye doctor know you have a discount plan through Blue Shield of California.

Please note your discount cannot be combined with any other discounts, coupons, or promotional offers. Learn more about our vision discount.

Life Plans² reminders

Get more out of your Blue Shield life insurance with these services:

• Beneficiary assistance services offers your employees care and support for family members who have suffered a recent loss of a loved one. 
• Travel assistance services offers your employees and their families a broad range of worldwide travel and medical assistance services.

For exact terms and conditions of coverage, refer to the Evidence of Coverage, the Plan Contract, and the Summary of Benefits for a comprehensive summary of plan benefits. You can access these plan documents here.

Making Renewals Easier with Employer Connection

Blue Shield is making it easier for Small Group employers to manage renewals by giving primary contacts direct access to their renewal microsite and renewal packet after signing in to Employer Connection. This access was first introduced in Q4 2025 and is now fully available to support a more seamless renewal experience. This new access point helps employers find important renewal materials faster, while keeping existing renewal emails, letters, plan administration, billing, and permissions the same. Primary contacts can simply sign in, go to Resources, and select Renewal Packets to view their information. This update supports a simpler, more convenient experience and reinforces Blue Shield’s commitment to making it easier to do business with us.