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Blue Shield Q1-2020 Plan Updates

Blue Shield Q1-2020 Plan Updates

Blue Shield Q1-2020 Plan Updates

Oct 28, 2019, 5 Minute Read

Below are the 2020 plan updates for medical and specialty options, dates and updates for January renewals, and resources for enrolling both new and renewing business. Additional information can be found on Blue Shield’s Broker Connection.

Use the Plan Comparison Tool to quickly and easily select multiple plans and compare the benefits side by side, or select a single plan and see how benefits have changed from 2019 to 2020.

Rates for Q1-2020

January 2020 Renewals

Please note: due to regulatory approval delays, the group renewal kits and the Small Group Online Renewal (SGOR) tool do not include information on the new plan options.

Open Enrollment Resources

Medical Coverage 2020 Updates

New medical plans for small business groups beginning with January 1, 2020, effective dates:

Trio HMO and Tandem PPO plan enhancements:

Visit Blue Shield’s Product Cycle update on Broker Connection to learn more.

Plan Updates

Specialty Coverage 2020 Updates

The Blue Shield member portal will offer greater integration with dental and/or vision plan benefits. Members can view their benefits, find dental and vision providers, view account balance, payment information, and manage claims. The site also features a dental treatment cost estimator, the ability to view and print ID cards, and other resources.

Specialty underwriting will align with medical on the requirement that a group employs an eligible common-law employee to be eligible for group plans. All new sales effective January 1, 2020, will require a common-law employee, eliminating owner-only businesses. Documentation requirements for specialty business will be the same as for medical and based on the number of enrolling subscribers.

Six new dental plans are available beginning with January 2020 effective dates, they include:

Beginning with January 1, 2020 groups, the 12-month waiting period will no longer be waived on voluntary dental plans. For groups with prior Blue Shield dental coverage, the waiting period will be waived at the group level. Learn more.

16 new employee life insurance plans feature:

Three new dependent life insurance plans provide:

Rates will not increase with any of these increased life insurance plan benefits. Learn more.

Underwriting Updates and Reminders

In lieu of payroll documents, Blue Shield will accept simple attestation forms and W-4 forms for start-ups and spin-offs. Other standard documentation is still required. Get the new attestation forms and details here

The DE 9C requirement for small groups (5+ enrolling employees) will be waived when submitted with the completed and signed “Eligibility/Participation Attestation” and the most recent group medical bill.

Relaxed participation guidelines will be extended through the end of 2020, requiring only 25% employee participation with a minimum of five enrolled employees for medical plans. Download the flyer.

Part of the employer contribution rule will be eliminated. Previously, groups had to choose either a percentage or a dollar amount but could not mix them. Groups can now contribute a percentage for an employee and a dollar amount for dependents, or vice versa.

Since Q4 2018, Blue Shield accepts IFP waivers as a valid refusal of coverage.

Blue Shield Broker Resources

Additional Resources

Visit Blue Shield’s Broker Connection to learn more.

Contact the small group experts at 800.696.4543 or