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Looking forward to a successful 2017!

Average quarterly rate increase – Second quarter 2017

Medical plans will experience a second quarter rate action. Specialty plan rates are staying flat.
Average quarterly rate increase – Second quarter 2017
Varies by plan (not by rating region)
Small Business Medical Plans1
PPO plans (including HSA-compatible) +0.8%
HMO plans +4.3%
 Small Business Specialty Plans
Dental PPO and INO Plans (1-50) 0%
Dental PPO and INO Plans (51-100) 0%
Dental HMO Plans (1-50) 0%
Dental HMO Plans (51-100) 0%
Vision plans2 (1-50) 0%
Vision plans2 (51-100) 0%
Life insurance plans2 (1-50) 0%
Life insurance plans2 (51-100) 0%
Annual customer rate of change will vary significantly by customer:
  • Annual customer rate of change will be based upon cumulative rate actions occurring since the prior years to this year’s renewal date; so customers with anniversary dates from April 1, 2017 through June 30 2017 will have the compounded impact of the pricing cycle rate actions for July 2016 (rate pass), October 2016 (rate action varied by plan and rating region), January 2017 (rate action varied by plan), and April 2017 (rate action varies by plan package, PPO or HMO).
  • Additional disruption will occur as the member’s age from one renewal date to the next renewal date.
  • Additional disruption could occur for subscribers who currently have more than 3 children under age 21, but who will have an increase in billable members if any children turn 21 on the customer’s renewal date.
  • Thus the annual rate of change applicable for Q2-2017 customers will vary significantly based on each customer’s demographics.
For more details, download our second quarter rate sheets»
1. The April 2017 rate actions represent rates applicable to new and renewing business.
2. Underwritten by Blue Shield of California Life & Health Insurance Company.

Teladoc – A new and convenient way to access care
As of 1/1/17 Teladoc is available for all new groups and existing groups as they come up for renewal.

Teladoc offers unlimited visits and is not subject to the deductible with all Small Business HMO and Full PPO plans with a $5 copay. Small Business PPO Savings plans have a $40 copay prior to the deductible and once the deductible is met, the $5 copay will apply.

Teladoc’s U.S. board-certified doctors, available 24/7/365 for non-emergency issues through phone or video consults.

Getting started is as easy as 1, 2, 3!

1. Members set up an account
2. Provide medical history
3. Request a consult

Learn more about Teladoc by downloading our flyer (PDF, 102KB) or by visiting

Plan pairing makes it easier to do business with Blue Shield!

Starting in October 2016, Blue Shield Small Business customers have more options. For the first time Blue Shield Small Business customers may purchase both Trio ACO HMO plans and Access+ HMO® plans. To date, customers have had the option of purchasing one or the other, but not both. To enroll simply complete the Master Group Application for newly applying customers, and the Request for Contract Change form for current customers.
Blue Shield HMO plans
Access+ HMO® plans, Local Access+ HMO® plans and Trio ACO HMO plans have different provider networks. Access+ HMO® plans, which have a full network, and Trio ACO HMO plans, which have a select network, may now be offered together. Local Access+ HMO® plans, however, may not be offered with Access+ HMO® plans or Trio ACO HMO plans. 
Why Blue Shield Trio ACO plans
Blue Shields Trio ACO (Accountable Care Organization) is an innovative care model between hospitals, doctors and Blue Shield that keeps employees healthy AND lowers costs. Using a select network Trio provides Blue Shield members with personalized, proactive care offering greater control at a lower cost. Trio ACO HMO is now available it 22 counties. Learn more about Trio ACO»
Covered California for Small Business Update
Covered California Small Business (CCSB) plans are expanding and now include Full PPO Network Plans for each metal level beginning 1/1/17. Consequently the Narrow Network PPO Bronze 60 plan is being withdrawn from the market.

We are also withdrawing the Local Access+ plans and replacing them with the Trio ACO HMO at the Gold, Silver and Bronze levels. CCSB  Trio ACO HMO plans are available in the same 22 counties as the off-Exchange plans, which now include Nevada.
NEW Broker Compensation Tool is now available
You can count on the convenience of online commission statements. Our new Broker Compensation Management Tool that allows you to review commission statements online anytime and includes:

• Access Anytime, Anywhere – 24/7
• Real-Time reports
• Easier to understand format
• Ability to download PDF and Excel format for Statement of Commission and Broker Book of Business
• Producer Tax ID From Statements removed

Log into Producer Connection and access our new Broker Compensation Management Tool.

Make sure that you are signed up for Direct Deposit. As of 9/1/16, commissions are paid via EFT (Electronic Fund Transfer). Paper commission statements are no longer issued.
News and remindersCurrent promotions |  Tools and resources
HealthEquity: Building health Savings
Matching HSA-compatible plans with HealthEquity
Your clients can now offer HealthEquity as the health savings account (HSA) administrator for these two plans:

  • Bronze Full PPO Savings 4500/30% OffEx
  • Bronze Full PPO Savings 5500/40% OffEx
HealthEquity is one of the nation’s oldest and largest dedicated health savings custodians. Individuals and families can build health savings while employers cut benefit costs through innovative, integrated healthcare account administration and investment platforms.

Choosing HealthEquity is an exciting option. Blue Shield will share eligibility and claims data with HealthEquity for a seamless process. When your clients select HealthEquity as their HSA administrator, there's no need to search for their own third-party HSA administrator. They can choose HealthEquity administration by checking the box on the Master Group Application (paper form) when newly enrolling, or on the Request for Contract Change form (paper) when renewing coverage. Please remember to send the paper form(s).

Learn more about HealthEquity
HealthEquity webinars demonstrate the key functions of the Health Equity employer portal including the various options for making contributions.
Specialty product update

DPPO network expansion
Starting 1/1/17 all of your existing Blue Shield PPO and INO (In-network only) groups – will have access to our newly expanded Dental PPO network.

This dental PPO network enhancement represents a 40% increase in provider access points. The expansion also puts Blue Shield in the top spot for carriers offering medical with specialty lines of dental, vision and life insurance benefits. The ease of being able to place all your lines of coverage with one carrier (for one consolidated point of administration with billing, renewals, enrollment and administration) just got that much better. 

The new group rating model enhancements for groups of 10 to 50 eligible employees provides more competitive composite life insurance rates. For more details, download our rate sheets.
*Underwritten by Blue Shield of California Life & Health Insurance Company.
Life Insurance*

All small businesses can enjoy:
  • Combined billing and administration.
  • A two-year rate guarantee on all new business for both vision and life insurance.
  • And, just like any of our specialty lines of coverage, life insurance plans can be added to an existing group at any time.
  • 50% bundling...

Groups with 10-100 employees:
  • New composite rate model translates to very competitive rates!
  • Easy to apply for your existing small businesses – just fill out the one page Request for Contract Change form to add at any time.
  • Simply contact your Blue Shield representative for a competitive, composite-rated life insurance quote.

For more details, download our rate sheets

Beneficiary Assistance – New Grief and loss support

LifeReferrals 24/7SM offers care and support for family members who have suffered a recent loss of a loved one. During this challenging time, a simple phone call connects members with a team of experienced professionals ready to assist with:
  • Grief support
  • Financial advice
  • Legal needs

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

News and reminders

Updated commission schedule for Blue Shield of California small business (1-100) Off-Exchange business

Blue Shield’s commission schedule remains competitive with other carriers. Our commitment to you extends to specialty benefits plans as well, with a 10% flat commission for sales of dental plans, vision plans and life insurance to groups of 1-100!

The 2017 Commission Schedule and Producer Agreement can now be downloaded.
Medical plans only
Blue Shield of California Off-Exchange Package for Small Business 1-100 Eligible Employees
Contract year Percentage
First year 5%
Renewal years 5%
New guidelines for start-ups that have five (5) or more employees enrolling

Blue Shield now considers start-up groups (new businesses) that have been in business for less than four weeks if at least five (5) or more employees are enrolling and the business has been operating for at least one pay period. Evidence of time in business and eligibility must be supported by payroll records. The payroll records for the most recent pay period for the employees are required. Remember, a start-up group must meet all small group requirements. The Underwriting Guidelines is being modified-see "New Guidelines".

Note: if less than five (5) employees are enrolling, please refer to the start-up rules published in the Underwriting Guidelines.
Don't forget to update your email information in Employer Connection Plus

Employer Connection Plus is Blue Shield’s web-based plan administration tool that enables employer groups (and their designated brokers) to securely manage their employees’ Blue Shield medical and specialty plan benefits online.

Once registered, you can securely log in 24/7 to:
  • Conduct open enrollment, enroll new hires and order member ID cards
  • View medical plan benefit details, such as deductible and copayment information
  • Add or terminate medical plan coverage for your employees and their dependents
  • Update member information
  • View eligibility details
  • Pay your bill online and much more

It's easy to get started! Go to and click on register now.

Employer Connection Plus was designed to give you greater control over your Blue Shield health plan benefits and save you time so that you can concentrate on your business.
Bringing it all together – current promotions

Relaxed Participation Requirement Promotion – Extended to June 30!

Blue Shield of California continues to maintain relaxed participation requirements for groups with 1-100 eligible employees through June 30, 2017! Download the special promotional flier (PDF, 50KB) to show your clients how the promotion works.
Tools and Resources

Members have a new home online

Members who log in to have improved navigation and easier access to benefits information, available in more languages.

Key enhancements members will experience after logging in to include:

  • Member Overview
    Members now have more insight into their healthcare coverage. Based on the member's plan type, the new design provides a quick and comprehensive view of important health plan information, such as: common copay amounts, annual deductible, and copay maximums.

  • View Claims
    Our redesigned claims experience gives members more flexibility to better understand their healthcare expenses. Both PPO and HMO members can view detailed medical claims information, with contribution breakdowns that may include amounts billed, allowed, and saved – plus, enhanced filters to customize their view of the information.
Updated educational resources

Medical plans will experience a fourth quarter rate action. Overall, specialty plan rates are staying flat with no quarterly increase other than the Dental HMO for groups of 1-50.
Health and wellness resources

Return to top
Broker Resources
What's new for Q2-2017 brochure
Q-2 2017 plan package brochure
2017 Network Guide
January 2017 product updates
Benefit summaries
Renewal center
Underwriting guidelines
Sales resources and collateral
Pediatric dental and vision coverage
TRUSTe Privacy Certification