Blue Shield Q3-2016 Small Group Rate Pass and Updates
Blue Shield Q3-2016 Small Group Rate Pass and UpdatesApril 20, 2016
The Blue Shield of California small business medical and specialty benefits plan rates will remain unchanged through September 2016. There will be no plan or benefit changes for Q3 from the plans and rates released effective January 1, 2016.
Below are the key updates that impact employers (1-100 employees), plus several resources to help you serve your clients.
Reminders and Updates
New Medical Plans Added (effective January 1, 2016)
- Gold Full PPO 250/20 OffEx
- Platinum HMO 0/20 OffEx (Access+, Local Access+ and Trio)
- Platinum HMO 0/30 OffEx (Access+, Local Access+ and Trio)
- Gold HMO 750/30 OffEx (Access+, Local Access+ and Trio)
- Dental PPO and INO rates decreased by 10%, effective January 1, 2016.
- Dental Smile Rollover Rewards program.
- Pediatric dental benefits are now included and embedded with 2016 Blue Shield medical plans.
- The Ultimate, Preferred, and Enhanced Vision plans will see a rate reduction of 20%.
Pharmacy Tier 4 Benefit Changes (effective July 1, 2016)*
- New maximum cost share for Tier 4 drugs. Previously there was no maximum cost share.
– Platinum, Gold & Silver Plans now have a $250 maximum cost share for a 30-day supply.
– Bronze now has a $500 maximum cost share for a 30-day supply.
- Existing groups that want to change their renewal month and move away from the 4th quarter will be assigned the rates and plans that are available for the requested effective date. So, if a group wants to move their renewal after July, the new Tier 4 drug benefit will be included in their plans.
*For new groups effective July 1, 2016, and existing groups renewing after July 1, 2016.
July renewal packets are now available on the Renewal Center.
- What’s New for 2016 quick reference guide.
- 2016 Packages for Small Business (1-100 employees).
- Transition of groups with 51-100 employees to the small group market.
- Embedded pediatric dental and vision benefits FAQs.
- Renewal month change option and form.
- Relaxed Participation Promotion.
- Manage plans online with Employer Connection Plus.
Visit the Blue Shield Producer Connection to learn more.
Contact the small group experts at 800.696.4543 or email@example.com.