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Blue Shield Relaxed Participation: 25% or One Employee

Blue Shield Relaxed Participation: 25% or One Employee

Blue Shield Relaxed Participation: 25% or One Employee, Carrier News,

Underwriting participation requirements remain relaxed for small business groups with five or more enrolled employees with just 25% participation required for medical, dental, vision, and life insurance plans through December 31, 2019. Groups that enroll in Trio-only plans can enroll with as little as one employee.

Trio HMO Plans 

  • Participation requirements have been waived for Trio-only membership for groups of 1 to 100 eligible employees. Enroll as few as one member!
  • Your clients can purchase a Blue Shield medical plan and/or specialty benefits alongside another carrier with more lenient underwriting participation rules.

Relaxed Participation Requirements

  • Applies to new medical small business and specialty clients with off-exchange plans and effective dates of January 1, 2016, through December 31, 2019.
  • At least 25% of the total number of eligible employees enroll in a Blue Shield health plan with no fewer than five.
  • Only one carrier can be written alongside a Blue Shield plan.
  • EPO benefit-designed plans cannot be written alongside any Blue Shield medical plans.
  • Blue Shield must be the sole carrier when offering dental, vision, and life products.
  • Groups who contribute 100% of premiums for medical or specialty coverage must enroll 100% eligible employees (except those waiving due to other group coverage through another employer).
  • Groups must meet the qualified small employer group definition.
  • Normal eligibility and enrollment documents are required.
  • Refusal of Coverage forms will be required for employees not enrolling in Blue Shield plan(s).

Download the flyer for an example and more details. Visit the Blue Shield Trio website to learn more.

Additional Resources

Visit Blue Shield’s Broker Connection to learn more.

Contact your Claremont team at 800.696.4543 or



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