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Access+ HMO
Small Groups (2 to 50)

January 2012 Update
We're excited to offer you a new way to grow and retain your book of business. Simply Shield – our redesigned small group portfolio – offers your clients a simple approach to healthcare coverage.

To make way for our new Simply Shield portfolio, we are streamlining our plan offerings by withdrawing many of our plans from the previous portfolio. To learn more about renewals and withdrawals, your clients' next steps, and how you can assist them, please visit our Renewal and Withdrawal Center.

Please note: If your client currently offers one of Blue Shield's plan packages – PlanSelectSM, Suite Deal, or Dual Choice – they may have some plans without enrollees, and those plans may no longer be available at their next renewal. Only those medical plans included in the new Simply Shield portfolio will be available for enrollment at their next renewal date.

The new portfolio will feature all new Access+ HMO® and Local Access+ HMO®. If you have questions, please contact your Blue Shield account manager.
Access+ HMO plans
Our most comprehensive coverage, Access+ HMO®* plans offer members a wide range of benefits, including preventive care, inpatient and outpatient hospital services and emergency care.

These plans feature: 
  • Twelve HMO plans ranges from $5 to $40 office visit copayments
  • Preventive care office visits covered at no charge
  • Access+ SpecialistSM: Members can go directly to a participating Access+ Specialist in the same medical group or IPA as their personal physician without a referral for a fixed $30 to $45 office visit copayment, depending on the plan
  • Access+ SatisfactionSM*: Members can get a copayment refund if they are dissatisfied with the service they received during a covered office visit with an HMO network physician
  • Out-of-area coverage: Members can access urgent and emergency care worldwide
Access+ HMO and Local Access+ HMO networks have grown
  • Both HMO networks have grown and offer a wider selection of providers.
  • Access+ HMO now serves Imperial County, giving you more opportunities to sell in Southern California.
  • The Local Access+ HMO service area now has seven additional counties, including some in Northern, Southern, and Central California – with coverage in a total of 13 counties!1  Employees will still get all the great benefits of our comprehensive Access+ HMO plans – like $0 deductible, no charge for preventive care office visits, and the option to see a specialist2 without a referral.
Learn more about Local Access+ HMO.
* To use this option, members must select a personal physician who is affiliated with a medical group or IPA that is an Access+ provider group, which offers the Access+ Specialist feature. Members should then select a specialist within that medical group or IPA. Access+ Specialist visits for mental health or substance abuse services must be provided by a MHSA network participating provider. Access+ Specialist visits for mental health services for non-severe mental illness, or non-serious emotional disturbances of a child or substance abuse will accrue toward the 20 visit per calendar year maximum.

1. Employees and all enrolled dependents must live or work in the Local Access+ HMO "service area," which includes designated counties: portions of Orange, Los Angeles, San Diego, San Bernardino, Riverside, San Mateo, Sacramento, Kern, and Ventura counties, as well as in all of San Luis Obispo, Santa Clara, Santa Cruz, and Yolo counties. Please review the Benefit Summary Guide (A16609) for detailed information regarding the Local Access+ HMO service area.
2. To use the Access+ Specialist option, you must choose a personal physician in a medical group or IPA that participates in the Access+ HMO program.
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simply shield - small group porfolio
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