Blue Shield Q2-2021 Updates
Jan 18, 2021, 3 Minute Read
Below are the updates, changes, and reminders to prepare for Q2-2021. Make sure to take advantage of the broker bonus programs.
Q2-2021 Rates
- Rates are now available through PRISM, our free and easy online quoting system.
- The Q2-2021 rate action statewide average is 1%.
New 2021 Medical Plan Design
The new Silver PPO 2225/50 plan has been added to the 2021 medical portfolio.
- The plan includes Value Based Benefits (VBB), and provides $0 office visits and lab tests for members with diabetes, asthma, chronic obstructive pulmonary disease (COPD), and coronary artery disease (CAD).
- It’s available on both Full PPO and Tandem PPO networks.
- Tier 1 and Tier 2 drugs are available with no deductible.
- Any eligible member can enroll in this plan. An eligible condition diagnosis is not required.
- Get the Value Based Benefits details.
- Learn more about the new Silver PPO 2225/50 plan.
Changes to Life Plans
Effective April 1, 2021, below are the enhancements to the Small Group Life plans:
- 12 existing multiple of salary (1x and 2x) plans with benefit maximums between $125,000 and $300,000 will be available for groups with as few as 10 eligible lives.
- 6 new multiple of salary (2x) plans have been added with higher benefit maximum amounts.
- 4 plans with benefit maximums between $350,000 and $500,000 will be available to groups with as few as 10 eligible lives.
- 2 plans with benefit maximums of $550,000 and $600,000 will be available to groups with 51+ eligible lives.
- Renewing groups with Life/AD&D composite rates will receive their Life/AD&D renewal rates (premiums) in the Small Group renewal packet.
- Please note: the Blue Shield marketing brochures for specialty plans that include the new benefit enhancements have not been updated as of this date.
Enhancements to The Bronze PPO Plans
As a result of the California expansion of Bronze AV legislation, Blue Shield has redesigned all of the non-HSA Bronze PPO plans, which now offer enhanced first dollar coverage prior to the deductible.
- Bronze PPO 6850/65 OffEx
5 non-preventative office visits with copay prior to meeting the deductible.
A separate pharmacy deductible is waived for Tier 1 drugs.
- Bronze PPO 6250/70 OffEx
1 non-preventative office visit with copay prior to meeting the deductible.
The plan deductible is waived for Tier 1 drugs.
- Bronze PPO 7500/50 OffEx
1 non-preventative office visit with copay prior to meeting the deductible.
- These plans are available on the Full PPO and Tandem PPO networks.
- $0 Teladoc medical and mental health consultations are standard.
Q2 Renewals
- April through June renewals are available online.
- Group renewal packets include an options census for quick quoting that displays the current and renewing rates along with several plan options with the new 2021 rates.
- Options also include Trio ACO and Tandem PPO plans comparable to the group’s current Access+ HMO or Full PPO plan selections.
- The statewide average rate difference between Trio HMO and Access+ HMO is 18%, and there is a 9% difference between Tandem PPO and Full PPO plans.
- Visit the Blue Shield Renewal Center to learn more.
Reminders
- Relaxed Participation Requirements for small businesses has been extended to December 31, 2021. Get the details.
- Blue Shield ID Cards – Members will receive a new ID card as a result of Blue Shield’s transition to a new pharmacy vendor, CVS Health. This change does not impact the benefits, formulary, or the pharmacy network.
Broker Bonuses
- Brokers can earn $50 per new member and $50 more for each member, new or renewing, who enrolls in a Trio HMO or Tandem PPO plan.
- Brokers can also earn $25 per member when using the Employer Enrollment Tool for medical coverage.
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Questions?
Contact your Claremont team at 800.696.4543 or info@claremontcompanies.com.
