Blue Shield Relaxed Participation: 25% or One Employee
Blue Shield Relaxed Participation: 25% or One EmployeeAugust 20, 2019
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).
- What’s New for Q4-2019 quick reference guide.
- Q4-2019 Small Business Sales brochure.
- 2019 Medical Plan Cheat Sheet.
- Trio HMO brochure and website.
- Teladoc brochure.
- Bundling Discount program.
- Pharmacy Directory.
- Specialty Drug Short Cycle Program Expansion RxNews Flash.
- Blue Shield Small Group Underwriting Guidelines.
- Relaxed Participation.
- New Small Business Multiple Subscriber Change Spreadsheet form for subscriber-level plan changes during renewal.
- Master Group Application form.
- Updated Employee Enrollment form.
- Blue Shield’s Renewal Center will help streamline the renewal process. You can:
- Complete your renewals, 100% paperless.
- Compare/add/edit/delete subscribers and dependents to calculate quotes.
- Submit group renewals and enroll clients’ employees online.
Visit Blue Shield’s Broker Connection to learn more.
Contact your Claremont team at 800.696.4543 or firstname.lastname@example.org.