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Broker Guide
Shield Source March 2008

March 2008

Grow Your Business




PlanSelect

Blue Shield’s PlanSelect makes it easier than ever for you to meet your clients’ needs with more affordable plans and more flexible ways to offer them to employees.

Offering multiple plans has never been easier for qualifying groups. PlanSelect is one of the most flexible programs available for small businesses. Now, groups of 2 to 50 enrolled employees can pick ANY combination from 2 to 27 different health plan choices.

Here’s how:

Step 1: Pick any number of plans from these types: 11 PPO plans, 8 HMO plans, 5 HSA-eligible high-deductible health plans, 2 Active ChoiceSM (first dollar) plans*, and 1 POS plan.

Step 2: Select a monthly employer contribution option, a minimum of: $100 per enrolled employee or 50% of total employee rates.

Step 3: You’re done!

With some of the largest provider networks and an expanded choice of 27 plans - including our lowest-rate PPO plans - there has never been a better time to choose Blue Shield.

Talk to your Blue Shield sales representative to get started.

It’s easy! To qualify, groups must meet one of two participation requirements:

  • If offered as the sole carrier, a minimum of two enrolled employees is required, subject to standard underwriting guidelines.
  • If offered in conjunction with another carrier’s HMO plan, the combined Blue Shield plan enrollment must equal the greater of five enrolled employees or 75% of the total number of enrolled employees in all plans.

*Underwritten by Blue Shield of California Life & Health Insurance Company.



Suite Deal

Suite Deal is an exciting new package of 7 Blue Shield health plans designed to grow your Small Group business. Plans included in the package:

Give your clients options
If your clients choose the Suite Deal package, they have access to all of the 7 competitively priced plans offered within the package. Enrollment in all plans is not required.

Reduced participation requirements
The participation requirement for the Suite Deal is 65%. This reduced participation requirement is only available for groups that enroll under the Suite Deal program.

If offered with another carrier’s HMO, the minimum participation in the combined Blue Shield plans must be equal to or the greater of five actively enrolled employees or 50% of the total number of actively enrolled employees.



Suite Deal RAF Programs

Choose our new Suite Deal and save. These RAF programs are only available to clients who choose our Suite Deal package. The RAF program is effective Feb. 1, 2008.

Renewal RAF program:

  • .90 RAF guarantee for groups of 10 or more enrolling employees
  • 10-point RAF reduction for groups of 6-9 enrolling employees
  • Applies to groups within 9 months of their most recent renewal*
  • A qualifying renewal RAF of 1.05 (or lower), with no health statements and no employer questionnaires required

RAF program for groups with no prior coverage:

  • .90 RAF guarantee for groups of 10 or more enrolling employees
  • 1.0 RAF guarantee for groups of 6-9 enrolling employees**
  • No health statements required


2nd Quarter Rates Update

There are no rate changes for medical plans for April 2008. There are rate increases for dental PPO plans in Southern California. For details, please check the rate tables. To view our rate tables on Producer Connection visit https://www.blueshieldca.com/producer/. Select "Small Group" from the "Plans and Rates" section.
(NOTE: The rate tables are locked on Producer Connection and require log-on)

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Plan Updates



Shield Spectrum PPO Savings Plan 3000/6000

In February, we introduced a brand new small group plan, Shield Spectrum PPOSMSavings Plan 3000/6000. Click the plan name to read the Summary of Benefits.



HMO Plan 20 Value

The inpatient copayment is waived for the Hospital Admission and Emergency Room benefit, if the member is admitted through an emergency.



1/08 Plan Modifications Update

We have made updates to the January 2008 Plan Modifications. Please see Updates to January 2008 Plan Modifications for details.



Blue Shield vision advantages are so clear, they’re in 20/20!

New tools:

  • Value of Vision: Use this tool to promote our enhanced vision benefits offered with our $130 frame allowance plans, including progressive and photochromic lenses!
  • Vision FAQs for Small Groups: Want to know how our vision plans stack up against the competition? Use this flyer to highlight our competitive advantages over VSP!

These clearly valuable tools can be found on Producer Connection at www.blueshieldca.com/producer under Plans and Rates > Small Group > Vision.

Key vision advantages:

  • Our network includes over 5,200 providers in California and 16,000 nationwide.
  • Our vision plans with a $130 eyewear frame allowance offer enhanced benefits including progressive lenses, photochromic lenses, anti-reflective coating.
  • All vision plans include polycarbonate lenses for children.


Make life easier

Life has been simplified, making it easier to sell! The Group Term Life Producer Guide has been updated to reflect our new life insurance product, simply called Life.

Key features of the Life product include:

  • New, higher GI limits for groups 2-50*
  • Salary, flat or graded plan designs
  • Accidental death and dismemberment (AD&D) insurance included
  • One dependent rate to cover all family members
  • Available with or without medical coverage

The Group Term Life Producer Guide is available for download on Producer Connection at www.blueshieldca.com/producer under Plans and Rates > Small Group > Life.

*Group term life insurance for groups of 2-9 employees is administered and underwritten through a small group employer trust.

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News & Resources



Keep your clients’ private information secure

We know that you value your clients’ privacy and share our commitment to keeping their personal information secure. We are now requiring all producers to use a secure email address to receive messages containing applicants’ and members’ Personal and Health Information (PHI).

It takes only a few minutes to sign up for secure email, using the simple registration instructions. Call to find out more about our secure email policy from Producer Services at (800) 559-5905.



New mail service pharmacy numbers

For your clients’ convenience, we now have two toll-free phone numbers to reach our mail service pharmacy vendor. The numbers are (866) 346-7200 and (866) 346-7197 (TTY/TDD).



Online Client List tools

Check renewal mailing dates, review client plans, and keep an eye on all your client activity. Log in to blueshieldca.com/clientlist today to review dates and rates, and to keep you and your clients in sync.



We’ve redesigned our homepage

Our website reflects our focus on making it easier to choose and use Blue Shield. We’re pleased to present the new look and feel of our homepage at blueshieldca.com. Your suggestions helped us make it easier for you, members, employers, and providers to find what they need online with:

  • A redesigned homepage, simplifying navigation from the start
  • Direct paths to access helpful resources and tools
  • An improved search function to find relevant content quickly


Redeem your Producer Rewards Club points

You can earn Producer Rewards ClubSM points when you sell dental, vision and life insurance to existing medical plan clients, too. Choose the rewards* you want from our large selection of entertainment, merchandise and business-building rewards.

Here are important dates regarding your unused points:

  • December 31, 2007: If you did not achieve the Bronze, Silver or Gold tier in 2007, the points in your account will expire. If you reached a tier in 2007, your points will roll over and remain available for you to redeem until March 31, 2008.
  • Beginning January 1, 2008: Points for new sales will be counted toward your 2008 Producer Rewards Club balance.
  • January 1 to March 31, 2008: Producers who have reached the Bronze, Silver or Gold tier can combine unexpired 2007 rollover points with 2008 points and redeem them for rewards on the site.
  • March 31, 2008: Unredeemed 2007 rollover points will expire.

There’s no need to enroll or apply - you’re already a member! Check and redeem points online by going to blueshieldca.com/producer/rewards or by calling Producer Services at (800) 559-5905.

*For the Producer Rewards Club terms and conditions, go to the Rewards section of blueshieldca.com/producer.



Producer Services is here to help you

Think of our knowledgeable Producer Services representatives as your one-stop team for answers to all your questions - from plans and services to commissions and bonuses.

We’re making it easier for you to sell Blue Shield, with our process improvements.

You can now use your producer license number as identification when you call your sales representative or Producer Services. We will ask you only for the last four digits of your Producer Identification Number as further verification.

We’ve enhanced our service with a new automated self-service phone system, giving you easier access to what you need, anytime you need it. Available 24 hours a day, seven days a week, the new system offers several self-service options:

  • Billing and payment information
  • Application status
  • Fax/email reports on billing or application status
  • Request forms
  • Commission check
  • Request ID card for client
  • Eligibility and benefits
  • Claims information
  • Physician information
  • Quick reference guide

To use the system, you will need to provide your license number first, followed by the last four digits of your Producer Identification Number.

If you have any questions, please contact Producer Services by email at producerservices@blueshieldca.com or call us at (800) 559-5905.



Dental PPO rate action for Southern California

There are rate increases for dental PPO plans in Southern California effective April 1, 2008. Rate increases average 7%. Please see the small group rate tables for exact rates.

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