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Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

Blue Shield of California Announces Major Pharmacy Benefits Revamp

Posted August 21, 2023 by Lori Berson

Blue Shield of California has announced a major revamp in its approach to pharmacy benefits. By 2025, Blue Shield will significantly reduce its ties with CVS Health’s PBM services. Instead, it will partner with Amazon Pharmacy, Mark Cuban’s Cost Plus Drug Company, and other firms to bring about potential massive savings and enhanced services for its customers. Here’s a high-level summary of the news, what it means for you, and some links to additional resources.

High-Level Summary

Blue Shield is projecting approximately $500 million in annual savings on drug costs by making this move.
Amazon Pharmacy will introduce fast and free at-home drug delivery and 24/7 pharmacist access.
Mark Cuban’s Cost Plus Drug Company will provide a simple, transparent, and more affordable pricing model, reducing surprise drug costs at the pharmacy pick-up counter.
CVS will retain its role in managing Blue Shield’s specialty pharmacy services.

What This Means For You

No immediate Impact. This change will come into effect in 2025, so your Blue Shield clients and their employees will not be affected just now.
Stay informed. The announcement is big news in the industry. Many of your clients and their employees will hear about it. Familiarize yourself and stay current on this development so that you can answer any questions from your clients.
Be the go-to advisor for your clients and prospects. The cost and availability of prescription drugs is a consistent pain point for your clients. With this change, Blue Shield is tackling the problem head on. Use this as a discussion point in your sales conversations about pharmacy benefits.

We will continue to keep you updated on this development. Contact us with any questions at 800.696.4543 or info@claremontcompanies.com.

Additional Resources

Blue Shield of California

Blue Shield’s New Partners

Contact us today for a Blue Shield quote.

Reminders

Reminder: Incentive Program now includes an Autopay incentive – earn 25 points for setting up a group on autopay during the initial enrollment. Claremont will assist you in putting this in place.
The current bonus program is in effect from February 1, 2023 through January 31, 2024.

Renewal Rewards Program
Blue Shield increased the points earned for every new membership in Tandem PPO and Virtual Blue PPO plans. You can earn:

100 points per new enrolled member in a Tandem PPO plan. February 2023 – January 2024 effective dates.
100 points per new enrolled member in a Virtual Blue plan. March 2023 – January 2024 effective dates.
Specialty plans. February 2023 – January 2024 effective dates.
– 10 points per new enrolled dental member.
– 5 points per new enrolled vision member.
– 5 points per new enrolled life member.

Bundled Saving Program
The 10% specialty discount is a perpetual program that is applied when a dental and/or vision plan is added to a new or existing small business medical group.

Relaxed Participation Promotion
The Relaxed Participation Promotion was extended through December 31, 2023.

More information and plan summaries can be found in Blue Shield’s Q4-2023 Medical Sales Guide and Specialty Sales Guide.

Contact us today for a Blue Shield quote.

Resources

COVID-19 Resources

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

Blue Shield of California – Instant Digital ID Cards

Posted August 21, 2023 by Lori Berson

You can now conveniently access and download digital member ID cards directly through Broker Connection.

To Access Digital ID Cards:

Log into Broker Connection.
Click “Get ID Card” at the top of the page.
Select your line of business (Individual & Family, Medicare, or Small Business) to access your Client List.
Search for your client’s name.
Click “Get ID Card.”
Select coverage type: Medical, Dental, Vision.
Choose a delivery method: download, email, or Member Portal (includes instructions to help your clients access their ID card).

Blue Shield of CA Digital ID Cards

The ID cards are provided as downloadable PDFs for immediate use. This self-service feature is one of many convenient online tools now available on Broker Connection.

Contact us today for a Blue Shield quote.

Reminders

Reminder: Incentive Program now includes an Autopay incentive – earn 25 points for setting up a group on autopay during the initial enrollment. Claremont will assist you in putting this in place.
The current bonus program is in effect from February 1, 2023 through January 31, 2024.

Renewal Rewards Program
Blue Shield increased the points earned for every new membership in Tandem PPO and Virtual Blue PPO plans. You can earn:

100 points per new enrolled member in a Tandem PPO plan. February 2023 – January 2024 effective dates.
100 points per new enrolled member in a Virtual Blue plan. March 2023 – January 2024 effective dates.
Specialty plans. February 2023 – January 2024 effective dates.
– 10 points per new enrolled dental member.
– 5 points per new enrolled vision member.
– 5 points per new enrolled life member.

Bundled Saving Program
The 10% specialty discount is a perpetual program that is applied when a dental and/or vision plan is added to a new or existing small business medical group.

Relaxed Participation Promotion
The Relaxed Participation Promotion was extended through December 31, 2023.

More information and plan summaries can be found in Blue Shield’s Q4-2023 Medical Sales Guide and Specialty Sales Guide.

Contact us today for a Blue Shield quote.

Resources

COVID-19 Resources

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

Blue Shield of California Resources During a Crisis

Posted August 7, 2023 by Lori Berson

With the serious fires affecting Canada and the potentially heavy fire season in California, Blue Shield of CA wants to remind you of the resources and support available to impacted members during times of crisis. Their priority is to ensure that you and your clients have the necessary assistance and care during these challenging situations.

In the event of state emergencies and evacuations, Blue Shield of CA will be communicating vital information with employers and members residing in the affected areas.

To help ensure members in affected areas continue to have uninterrupted access to care, Blue Shield is offering:

Prescription Refills. Members in mandatory evacuation zones can have their prescriptions refilled immediately, even if they are not yet due for a refill. This ensures continued access to essential medications.
Continuity of Care. The Blue Shield Medical Care Solutions team will reach out to members enrolled in care and disease management programs who are in mandatory evacuation zones, ensuring that their healthcare needs are taken care of during the crisis.
Virtual Care Options. Blue Shield of CA offers various virtual care options, such as Teladoc and NurseHelp 24/7^SM, which may vary depending on the plan. For detailed plan options, please visit blueshieldca.com.
Mental Health Support. To address the mental health aspect of such situations, Blue Shield’s mental health service administrator provides free access to resources, materials, and counseling services through a dedicated hotline at (800) 327-7451.
Vision Plan Assistance. Members who have lost or broken their eyewear may be eligible for a replacement pair. For assistance, members can call Vision Customer Service at (877) 601-9083.
Displaced Members. If a member has been displaced, they may see an appropriate out-of-network provider at in-network benefit levels. Additionally, they can replace any medical equipment and supplies if needed.
ID Card Access. If a member identification card is lost, members can easily view and print a new card from the Blue Shield website by logging into their online account at blueshieldca.com/login. Alternatively, the Blue Shield of California mobile app provides access to ID cards on a mobile device.

Additional Information

If a member needs assistance, please have them call Commercial Customer Service (800) 393-6130 (TTY: 711), or Medicare Customer Service (800) 776-4466 (TTY:711).
For updates on plan services, visit Blue Shield of CA.
For fire status updates and locations, please check CalFire.
To stay informed about the air quality in your area, visit https://www.airnow.gov and encouraging your employers to do the same.

California Emergency Alerts

Californians are reminded to dial 211 or 311 to get help or ask questions. For a critical emergency, call 911.
To stay informed, sign up for emergency alerts including warnings and evacuation notices at CalAlerts.org.

In times like these, it is crucial that we work together and support one another. Blue Shield of California is here to assist you and your clients during these challenging times, and they remain dedicated to providing the care and resources needed.

Contact us today for a Blue Shield quote.

Reminder: Incentive Program now includes an Autopay incentive – earn 25 points for setting up a group on autopay during the initial enrollment. Claremont will assist you in putting this in place.
The current bonus program is in effect from February 1, 2023 through January 31, 2024.

Renewal Rewards Program
Blue Shield increased the points earned for every new membership in Tandem PPO and Virtual Blue PPO plans. You can earn:

100 points per new enrolled member in a Tandem PPO plan. February 2023 – January 2024 effective dates.
100 points per new enrolled member in a Virtual Blue plan. March 2023 – January 2024 effective dates.
Specialty plans. February 2023 – January 2024 effective dates.
– 10 points per new enrolled dental member.
– 5 points per new enrolled vision member.
– 5 points per new enrolled life member.

Bundled Saving Program
The 10% specialty discount is a perpetual program that is applied when a dental and/or vision plan is added to a new or existing small business medical group.

Relaxed Participation Promotion
The Relaxed Participation Promotion was extended through December 31, 2023.

More information and plan summaries can be found in Blue Shield’s Q4-2023 Medical Sales Guide and Specialty Sales Guide.

Contact us today for a Blue Shield quote.

Resources

COVID-19 Resources

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

Blue Shield of California Q4-2023 Updates

Posted July 10, 2023 by Lori Berson

Blue Shield of California continues to offer your small group clients comprehensive, connected coverage that puts employees first. Here’s a summary of the updates to prepare for Q4.

Q4-2023 Rates

Rates are now available through PRISM, our free and easy online quoting system.
The Q4-2023 rate action is a statewide average of 1.4%.
More information can be found on Broker Connection.

Q4 Renewals

Groups renewing in October and November are available now.
Groups renewing in December will become available on Monday, August 28, 2023.
More information can be found on the Renewal Center page on Broker Connection or the Broker Renewal Guide.

Medical and Dental Plans
There are no changes to Blue Shield’s medical and dental plan portfolios from last quarter. For details or for a listing of medical plans offered for 2023, please refer to the 2023 Medical Plans at a Glance. To learn more about specialty plans for 2023, please refer to the Q4 Specialty Sales Guide.

2024 Vision Network Change
EyeMed will be the new vision network provider, replacing MES Vision for groups and members in 2024. Details about the transition will be forthcoming.

Reminder: Incentive Program now includes an Autopay incentive – earn 25 points for setting up a group on autopay during the initial enrollment. Claremont will assist you in putting this in place.
The current bonus program is in effect from February 1, 2023 through January 31, 2024.

Renewal Rewards Program
Blue Shield increased the points earned for every new membership in Tandem PPO and Virtual Blue PPO plans. You can earn:

100 points per new enrolled member in a Tandem PPO plan. February 2023 – January 2024 effective dates.
100 points per new enrolled member in a Virtual Blue plan. March 2023 – January 2024 effective dates.
Specialty plans. February 2023 – January 2024 effective dates.
– 10 points per new enrolled dental member.
– 5 points per new enrolled vision member.
– 5 points per new enrolled life member.

Bundled Saving Program
The 10% specialty discount is a perpetual program that is applied when a dental and/or vision plan is added to a new or existing small business medical group.

Relaxed Participation Promotion
The Relaxed Participation Promotion was extended through December 31, 2023.

More information and plan summaries can be found in Blue Shield’s Q4-2023 Medical Sales Guide and Specialty Sales Guide.

Contact us today for a Blue Shield quote.

Resources

COVID-19 Resources

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

Blue Shield – New Broker Rewards Programs, Q3-2023 Rates Now Available for Quoting

Posted April 17, 2023 by Lori Berson

Small Business Incentive Program

With Blue Shield’s Small Business Incentive Program, earning points for qualified sales has never been easier (February 1, 2023 to January 1, 2024 effective dates). You can redeem your points for rewards from hundreds of great options, such as gift cards, electronics, products for your home, and more. Or convert your points to cash with a Visa gift card. Best of all, there are no complicated tiers or calculations required!

You Can Earn

100 points per new member who enrolls in a Tandem PPO plan or a Virtual Blue plan as part of the initial sale.
50 points per new enrolled medical member on all plans, excluding Tandem and Virtual Blue PPO plans as part of the initial sale.
10 points per new enrolled member in a small business dental plan.
5 points per new enrolled member in a small business vision plan.
5 points per new enrolled member in a small business life insurance plan.
40 points (2x points) per new member enrolling in all three – dental, vision, and life.
25 points for setting up a group on autopay during initial enrollment.

With the Producer Rewards points-based bonus program, each point is equal to one dollar. Plus it’s easy to keep track of your point status and what you’ve earned.

Learn more about the Small Business Incentive Program and Producer Rewards Program. Enroll in the Blue Shield Producer Rewards Program today.

Groups written through Claremont are eligible for this program.

Renewal Rewards Program

As an additional incentive, earn points redeemable for rewards for renewing groups with new members into Blue Shield’s Tandem PPO, Virtual Blue, or specialty plans. What’s more, all point distributions are in addition to standard commissions.

How to Qualify

Applicable for small groups (1-100 employees).
Brokers must opt-in by submitting a W9 form. If a broker is part of an agency, the parent agency must opt in first.
Renewal submissions must be submitted through the Small Group Online Renewal Tool using the same broker profile as the one that opted in. New Blue Shield members enrolled at group renewal must be enrolled through Employer Connection.

You Can Earn

100 points per new enrolled member in a Tandem PPO plan. February 2023 – January 2024 effective dates.
100 points per new enrolled member in a Virtual Blue plan. March 2023 – January 2024 effective dates.
Specialty plans. February 2023 – January 2024 effective dates.
– 10 points per new enrolled dental member.
– 5 points per new enrolled vision member.
– 5 points per new enrolled life member.

Download the Renewal Rewards Program flyer to learn more.

Groups written through Claremont are eligible for this program.

Q3-2023 Rates

Rates are now available for quoting through PRISM, our free and easy online quoting system.
The Q3 rate action is a statewide average of 1.9%.

Contact us today for a Blue Shield quote and start earning rewards!

Resources

COVID-19 Resources

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

Blue Shield of California – Assistance to Members Affected by Winter Storms

Posted March 13, 2023 by Lori Berson

On March 1, 2023, Governor Gavin Newsom declared a state of emergency in numerous California counties to assist with disaster response and relief efforts.

In the affected counties, Blue Shield of California is providing assistance to its members to ensure their safety and well-being. Members of Blue Shield of California and Blue Shield of California Promise Health Plan who qualify can receive assistance. Get the details.

To help ensure members in affected areas continue to have uninterrupted access to care, Blue Shield is offering:

Immediate refill of prescriptions – even if they are not due to be refilled.
Virtual care options (Teladoc and NurseHelp 24/7^SM). They may differ slightly depending on the plan. To view plan options, visit Blue Shield of California or Blue Shield of California Promise.
Behavioral health services. Contact the Customer Service number on the back of the member identification (ID) card or call:
- Blue Shield of California (800) 327-7451 [TTY: 711] from 8 am to 8 pm weekdays.
- Blue Shield of California Promise Health Plan (855) 765-9701 [TTY: 711] from 8 am to 8 pm weekdays.
Mental health crises services. Call, text, or chat with the National Suicide Prevention Lifeline by dialing 988 or calling (800) 273-8255 [TTY: 711], 24 hours a day, 7 days a week.
A replacement pair of lenses and/or frames for vision plan members. They can use out-of-network providers as needed with claims paid at in-network costs. Call vision Customer Service at:
- Blue Shield of California (877) 601-9083.
- Blue Shield of California Promise Health Plan (800) 877-7195 [TTY: 711 (800) 428-4833] from 5 am to 6 pm weekdays and 7 am to 5 pm weekends.
Out-of-network provider service at in-network benefit levels. They may also replace medical equipment and supplies if needed.

Plan Information and Services

For assistance, members can call the Customer Service number on their member identification (ID) card. If they do not have their member ID card, they can contact:

Blue Shield of California
- Commercial plans: (800) 393-6130 [TTY: 711].
- Medicare plans: (800) 776-4466 [TTY: 711] from 8 am to 8 pm, seven days a week.
Blue Shield of California Promise Health Plan
- (800) 605-2556 [TTY: 711] from 8 am to 6 pm weekdays.

For lost member ID cards, members can view and print their card at www.blueshieldca.com/login or www.blueshieldca.com/promise. Or they can use the Blue Shield of California mobile app to access their ID card.

California Emergency Alerts

Californians are reminded to dial 211 or 311 to get help or ask questions. For a critical emergency, call 911.
To stay informed, sign up for emergency alerts including warnings and evacuation notices at CalAlerts.org.

Contact us today for a Blue Shield quote.

Resources

COVID-19 Resources

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

Blue Shield of California – New Virtual Blue Plans

Posted January 30, 2023 by Lori Berson

Effective January 2023, Blue Shield of California is launching two new Virtual Blue plans, available in both the Small Group and Large Group portfolios.

The new Virtual Blue plans give members the choice of virtual or in-person care. Virtual care includes $0 unlimited visits to primary care, behavioral health and specialty care through a new partnership with AccoladeCare. In-person care is available through the Tandem PPO network in California and via BlueCard when outside of the state.

Employer Advantages Include:

Improve employee recruitment and retention by providing popular and meaningful health benefits such as virtual care and expanded mental health access.
Improve employee productivity through less time away from work for healthcare appointments.
Lower healthcare costs by encouraging deeper utilization of primary care and avoiding unnecessary ER visits or other health issues down the road.

Employee Advantages Include:

A simple, holistic virtual-first healthcare experience that integrates primary, behavioral, and specialty care.
Members have ongoing relationships with their chosen virtual personal physician and virtual care team.
Virtual providers deliver holistic treatment at any hour because they know the member’s medical history.
Virtual Blue is powered by AccoladeCare. Their physicians come from the top 50 U.S. medical schools and are trained to deliver effective virtual care.

Learn more about Virtual Blue, including product resources, video explainers and plan summaries.

Additional Resources

Contact us today for a Blue Shield quote.

Resources

COVID-19 Resources

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

Blue Shield of California Q2-2023 Updates

Posted January 16, 2023 by Lori Berson

Blue Shield of California continues to provide value to your small group clients. Here’s a summary of the updates to prepare for Q2.

Q2-2023 Rates

Rates are now available through PRISM, our free and easy online quoting system.
The Q2-2023 rate action is a statewide average of 1.9%.

Medical Plan Changes
There are minimal changes to Blue Shield’s medical plan portfolio.

More information and plan summaries can be found in Blue Shield’s updated April 1, 2023 Medical Sales Guide and Specialty Sales Guide.

Contact us today for a Blue Shield quote.

Resources

COVID-19 Resources

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.

Blue Shield – Provider Contract Negotiation Updates

Posted January 16, 2023 by Lori Berson

Choice Medical Group Successful Contract Negotiation

Blue Shield of California has agreed to a multiyear provider contract negotiation with Choice Medical Group Apple Valley and Choice Medical Group Barstow in San Bernardino County.

Members who received contract termination letters will now receive “good news” letters with information on the successful negotiation.

Rady Children’s Health Network and Hospital Successful Contract Negotiation

Blue Shield of California and Blue Shield of California Promise Health have reached contract agreements with Rady Children’s Health Network (RCHN) and Rady Children’s Hospital in San Diego County.

Members who received contract termination letters regarding Rady Children’s Health Network (RCHN) will now receive “good news” letters with information on the successful negotiation.

Contact us today for a Blue Shield quote!

Resources

COVID-19 Resources

Questions?
Contact The Answer Team at 800.696.4543 or info@claremontcompanies.com.

Your success is important to us, and we’re actively working on new solutions to support you throughout the year. To get the latest news via text messaging in the future, simply provide your cell phone number here.