Claremont Insurance Services, Walnut Creek, Californian General Agency

800.696.4543

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Blue Shield of California 1-100

Blue Shield of California 1-100

For over 65 years, Blue Shield of California has provided high quality, select health care coverage to the people of California and continues to possess the strength, stability, and innovation to maintain its market leadership position.

Blue Shield of California offers an extensive array of products to create and sustain a healthy workplace for small (1-100 employee) groups.

Prepare your small group renewals with our helpful resources.

New Business Submittal Deadlines

Monday, November 6
Wednesday, December 6

Blue Shield of California 1-100

For over 65 years, Blue Shield of California has provided high quality, select health care coverage to the people of California and continues to possess the strength, stability, and innovation to maintain its market leadership position.

Blue Shield of California offers an extensive array of products to create and sustain a healthy workplace for small (1-100 employee) groups and large (101-299 employee) groups.

Blue Shield offers Small Business plans both on and off California's exchange, Covered California.

Blue Shield of California: Off-Exchange Package for Small Business

  • Flagship package: featuring a range of 16 healthcare options including PPO, HSA compatible HDHP, and HMO plans. Not available on the SHOP, these plans can be purchased from Blue Shield through a broker. Customers can choose among any plans in the package, or select PPO plans to offer alongside HMO’s from another carrier. Plans from this package can be sold individually, but cannot be offered alongside plans from any other Blue Shield package.

Blue Shield of California: Mirror Package for Small Business

  • This package offers 7 plans which include several HMO options and one PPO. These plans are also available for purchase on the Covered California for Small Business (formerly known as SHOP) online marketplace. Plans from this package can be sold individually, but cannot be offered alongside plans from any other Blue Shield package.

Dental

Available on a standalone basis or with Blue Shield of California medical coverage, competitively priced, these comprehensive plans satisfy both employer and employee needs.

  • Dental HMO Options.Blue Shield dental HMO plans give employees access to cost-effective dental care through the network dental provider of their choice. Blue Shield's dental HMO plans - Dental HMO Basic, Dental HMO Plus, and Dental HMO Deluxe, offer basic, middle and rich-level benefits, respectively.
  • 12 Dental PPO Options.The PPO Smile plans offer a wide range of affordable dental PPO plans providing employees the option to choose any dental provider they want, or save money by using a network provider.
  • In-Network Only (INO) Dental Plans  The Smile In-Network Only (INO) dental plan offers employees and their families a smart cost-cutting approach to save on dental coverage. The INO network uses the same providers as the dental PPO network. No benefits are paid if the member goes to out-of-network providers.

Access to extensive networks. The dental PPO and dental INO (in-network only) networks include more than 25,000 provider locations in California and 218,000 nationwide, and the dental HMO network includes more than 16,000 provider locations in California.

Vision

The vision plan portfolio provides an affordable range of options to satisfy employee needs for eyewear and vision exams. Blue Shield of California has one of the largest vision provider networks. Members have access to nearly 20,000 ophthalmologists, optometrists, and opticians nationwide, including 6,300 in California. Vision plans offer access to major retail chains-like Costco, Walmart and LensCrafers, professional eye care boutiques and even an online providers.

Group Term Life and AD&D Insurance

Life Insurance offers an affordable way for clients to provide employees with added financial security. Accidental death and dismemberment (AD&D) benefits provide financial support in the event bodily injury or loss of life due to an accident. With a variety of coverage amounts, life and AD&D insurance plans are easy to sell.

More information is available. Contact Claremont Insurance Services at 800.696.4543 or info@claremontcompanies.com.

New Groups

Claremont Insurance is here to assist you by providing carrier and product information, plan quotes and comparisons, employer presentations, open enrollment assistance and more for a variety of products offered by California's premier insurance carriers.

Plan summaries, enrollment and change forms, and information about Blue Shield and our other carriers are always available through Claremont. You can request materials online at materials@claremontcompanies.com or call our broker service representatives Monday through Friday 8:00 a.m. to 5:00 p.m. at 800.696.4543.

If you are ready to enroll your group in a Blue Shield plan, please click the Forms tab for a checklist of required paperwork.

Please note that the submission of all required paperwork, each filled out completely, aids in expediting the underwriting process. We look forward to receiving your enrollment forms and working with you to see your small group business placed.

Thank you for choosing Claremont Insurance.

Please submit your new group enrollment information to Claremont:

  • Electronically with our secure online service OR
  • By mail: 1000 Burnett Avenue, Suite 440, Concord, CA 94520.

Business Hours: 8 am to 5 pm, Monday - Friday

Need more information or assistance?
Contact the small group experts at 800.696.4543 or info@claremontcompanies.com.

Agent Resources

  • Blue Shield of California 1-100 Benefit Summaries
  • Benefit Summary Guide 2017

    Guide of all plans for 2017

    Revision Date: 1/1/2017
  • Blue Shield of California 1-100 Forms
  • Change Transmittal/Termination

    Submit a monthly summary of employee changes.

    Revision Date: 3/2012
  • Prior Carrier Accumulation

    Used to submit to Blue Shield for Credit of Prior Deductible.

    Revision Date: 12/2016
  • Language Assistance Program

    Used for employees to obtain free help in translating vital medical documents.

    Revision Date: 1/2009
  • Refusal of Personal Coverage 1/2017

    The Refusal of Personal Coverage form should be completed and submitted when eligible employees are refusing the employer's Blue Shield of California/Blue Shield of California Life & Health Insurance Company health plan coverage for themselves and/or their spouse, domestic partner, or dependent(s) if applicable.

    Revision Date: 1/2017
  • Check by Fax

    Use this form as another option to submit your cases. Be sure to complete the form and include your client's signature and a voided check.

    Revision Date: 1/15
  • New Group Submission Checklist

    A checklist of what is required for new group submission.

    Revision Date: 8/16
  • Rx Claim Form
  • Medical Service Claim Form
  • Temporary ID Card Instructions
  • Employer Application 4th QUARTER 2017- Spanish (Fillable)

    New/renewing groups effective October 1, 2017 and after

    Revision Date: 10/1/2017
  • Request for Contract Change Form 4th QUARTER 2017 (Fillable)

    Application to use for New Groups effective 10/2017 and after

    Version acceptability:

    • UW will require the October 2017 version of the forms for October 1, 2017 and later effective dates; no exceptions

    Request for Contract Change

    • Health plan selection area was changed to clarify which HMO plans can be offered together (same as MGA)
    • Removed the DE9C requirement for changing the group’s COBRA status (I&B process)
    Revision Date: 10/2017
  • Employee Application 4th QUARTER 2017 (Fillable)

    Application to use for New Groups effective 10/2017 and after

    Version acceptability:
    • UW will require the October 2017 version of the forms for October 1, 2017 and later effective dates; no exceptions.
    Employee Enrollment Form
    • A new section was added on Medicare information (now Section 6). Underwriting does not require this information, it is for claims payment purposes.
    • Other sections were renumbered - “COBRA/Cal-COBRA group continuation coverage” was changed from Section 6 to Section 7 and “Disclosure of personal and health information” was changed from Section 7 to Section 8 .
    • In the life insurance section, a statement was added about community property law along with lines for spouse/domestic partner signature and name to agree to the beneficiary designation.
    • The full-time/part-time questions were reworded to try to reduce the number of EEs that answer “yes” to both questions.

    Revision Date: 10/2017
  • Subscriber Change Form 4th QUARTER 2017 (Fillable)

    New/renewing groups effective October 1, 2017 and after

    Revision Date: 10/2017
  • Employer Application 4th QUARTER 2017 (Fillable)

    New/renewing groups effective October 1, 2017 and after

    Revision Date: 10/2017
  • Request for Contract Change Form 4th QUARTER _Spanish (Fillable)

    New/renewing groups effective October 1, 2017 and after

    Revision Date: 10/2017


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