Claremont Insurance Services

At Blue Shield of California, groups with 51-299 employees find variety and cost-savings through programs tailored for optimal coverage.

Blue Shield of California offers 66 health plans, 95 pharmacy plan options, a variety of riders, and an extensive provider network. With enhanced flexibility for customization available to groups enrolling 126+ employees, choices specific to the midsize business groups include:

	26 HMO health plans
	Access+ HMO 5-0 Inpatient Access+ HMO 10-0 Inpatient Access+ HMO 10-100/Day Inpatient Access+ HMO 10-200/Day Inpatient Access+ HMO 10-250/Admit Inpatient Access+ HMO SaveNet 10-250/Admit Inpatient Access+ HMO 15-500/Day Inpatient Access+ HMO 15-500//Admit Inpatient Access+ HMO SaveNet 15-500/Admit Inpatient Access+ HMO 20-250/Admit Inpatient Access+ HMO 20-500/Admit Inpatient Access+ HMO 25-500/Admit Inpatient Access+ HMO 25-750/Day Inpatient Access+ HMO 40-1000/Day Inpatient Access+ HMO 10-20%/Zero Facility Deductible Access+ HMO 15-10%/1500 Facility Deductible Access+ HMO 15-20%/Zero Facility Deductible Access+ HMO SaveNet 15-20%/Zero Facility Deductible Access+ HMO 20-25%/Zero Facility Deductible Access+ HMO 30-10%/1500 Facility Deductible Access+ HMO 30-20%/Zero Facility Deductible Access+ HMO 40-40%/Zero Facility Deductible Close Access+ HMO Plans Access+ HMO 10-1000/Admit Inpatient* Access+ HMO 15-1000/Admit Inpatient* Access+ HMO 20-1000/Admit Inpatient* Access+ HMO 25-1000/Admit Inpatient* *Plans are available to existing renewing groups only. 2 Access Baja HMO health plans Access Baja HMO Plan 5 Access Baja HMO Plan 10

	7 POS health plans
	Added Advantage POS 250-100/80/50 Added Advantage POS 300-100/70 Added Advantage POS 300-100/80/60 Added Advantage POS 300-100/90/70 Standard Added Advantage POS 300-100/90/70 Premier Added Advantage POS 500-100/80/60 Closed Added Advantage POS Plan Added Advantage POS 500-100/90/70* *Plan is available to existing renewing groups only.
	13 PPO health plans
	Shield Spectrum PPO 0/500-90/70 Standard Shield Spectrum PPO 0/500-90/70 Premier Shield Spectrum PPO 250-80/60 Shield Spectrum PPO 250-80/60 Standard Shield Spectrum PPO 250-90/70 Value Shield Spectrum PPO 250-90/70 Standard Shield Spectrum PPO 250-90/70 Premier Shield Spectrum PPO 500-80/60 Shield Spectrum PPO 500-90/70 Shield Spectrum PPO 1000-80/60 Premier¹ Shield Spectrum PPO 1000-90/70 Shield Spectrum PPO 2000-70/50¹ Shield Spectrum PPO 3000-80/60¹ ¹ Underwritten by Blue Shield Life Closed Shield Spectrum PPO Plans Shield Spectrum PPO 1000-80/50* Shield Spectrum PPO 1000-80/60* Shield Spectrum PPO 1500-80/60* Shield Spectrum PPO 1500-90/70* Shield Spectrum PPO 3000-80/50* * Plans are available to existing renewing groups only
	2 PPO Active Choice health plans (first dollar plans)
	Active Choice Plan 500 Active Choice Plan 750
	5 HSA-compatible PPO Savings Plus health plans
	Shield Spectrum PPO Savings Plus 1500 Shield Spectrum PPO Savings Plus 2250 Shield Spectrum PPO Savings Plus 2400 Indv/4800Fam Shield Spectrum PPO Savings Plus 2600 Ind/5200 Fam Shield Spectrum PPO Savings Plus 3000 Ind/6000 Fam

PlanSelect
PlanSelect offers umbrella coverage of 42 plans from which employees may choose. Thousands of plan combinations are now possible. Limitations may apply.

Riders and Pharmacy Options Tailor Plans to Employee Needs
All HMO/PPO/POS plans offer optional rider coverage for chiropractic, acupuncture/chiropractic, infertility services, and/or additional inpatient substance abuse care.

Mid-size employers can select money-saving Prescription Drug Plan Options for HMO and POS plans. Various co-pays and deductibles may be combined within a two-tier/closed or a three-tier/incentive formulary. Deductibles do not apply to generic drugs in either arrangement.

Comprehensive & Competitive Coverage through Blue Shield Packages
Add these affordable options to a medical plan to round out each employee portfolio:

Dental, Vision, Term Life, AD&D Plans
A variety of Blue Shield Dental HMO and Dental PPO Plans, Vision Plans and Group Term Life and Accidental Death & Dismemberment (AD&D) Coverage options can be added to most plans at an affordable rate.

Benefit Solutions
Generate employer premium savings of up to 3% on medical rates – for up to three years - by combining dental, vision and/or life coverage. Simplify plan administration and keep clients within projected budgets through three suites of bundled health and ancillary offerings.

Tax Saving Options
Blue Shield offers a wide variety of tax-savings options for employers and employees:

Premium Only Plans (POP) an easy, convenient way to increase employee take-home pay and reduce company payroll taxes. A company’s taxable payroll can be reduced by the amount employees contribute to certain employer-sponsored group benefit plans, which can lower payroll-related taxes.
Flexible Spending Account (FSA) can be a tax-free way for employees to save for qualified medical expenses during a single plan year. All Blue Shield health plans are FSA-eligible.
Health Reimbursement Arrangement (HRA) also called fixed contribution plans, personal care accounts or healthcare account plans. They can help reduce the cost of healthcare for an employer. In addition, money left at the end of the year can be rolled over to future years depending on the plan. All Blue Shield health plans are HRA-eligible.
Health Savings Account (HSA) is an account-based saving option that can allow individuals to pay for qualified medical expenses. This consumer-directed approach to health care is available only in conjunction with an HSA-eligible high-deductible health plan. Pre-tax funds can be deducted from employee paychecks, employees can make lump sum contributions and employers may make contributions individually or through payroll deduction. All Shield Spectrum PPO Savings Plus plans are HSA- eligible high- deductible health plans.

Web-Based Enrollment

Web based enrollment can help your clients manage multiple plans from multiple carriers while streamlining the enrollment process in a simple and cost-effective way. You can deliver the one-stop solution that meets the needs of your clients, such as:

Cross-carrier compatibility
Administrative cost savings
On-demand reporting

Lifepath Resources

Lifepath Resources^SM is a collection of valuable health programs and services. Many of the programs are included with Blue Shield coverage and are included at no extra charge.

Mylifepath^SM Alternative Health Services Discount Program. Through American Specialty Health Networks Inc. (ASH Networks), Blue Shield members receive up to a 25% discount off the practitioner’s published fees on the following alternative care services:

Massage Therapy
Acupuncture
Chiropractic

Discount Vision Program

Members of a Blue Shield health plan can receive a 20% discount off the published retail prices when they use a participating California provider in the MESVision Network for the following services and supplies:

Routine eye exams
Frames and lenses
Photochromic lenses
Tints and coatings

Lifepath Advisers

Following features are available to members day and night:

Registered nurses and trained counselors provide advice about health, family, work, financial and legal issues
Nurse Chat lets members have a confidential dialogue with a registered nurse online

Life Path Decision Guide

Designed for members facing an important medical decision, the Lifepath Decision Guide^SM includes powerful tools:

Treatment options tool
Hospital comparison tool
Pharmacy service resources

Health Management Programs & Resources

Health management programs can help alleviate the rising cost of health care for fully insured groups and increase the quality of care for members. Blue Shield strives to keep members healthy and out of the hospital. These no-cost services offer up to date health and wellness information and strategies for self-management:

Chart Your Course Diabetes Management Program
Reach Your Peak Asthma-Self-Management Program
Shield Your Heart^SM Cardiovascular Risk Reduction Program
Chronic Obstructive Pulmonary Disease Management Program
Congestive Heart Failure Program

BlueCard Program

Blue Shield members will be covered when they’re far from home. Participation in the BlueCross and BlueShield Association’s BlueCard^® Program allows employees access to care outside of California and around the world. The program includes:

85% of all the doctors in the US
Providers in more than 200 countries with the BlueCard Worldwide^® Network.

Producer Connection

Blue Shield offers brokers the Producer Connection. The online producer resource provides a wealth of the most up-to-date resources online to assist brokers. Producer Connection is a broker’s home base for support and success.