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The Virtual Blue plans give members (small and large groups) 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.
The two Virtual Blue small group plans available in PRISM are the Virtual Blue Gold Tandem PPO 1500/45 and Virtual Blue Bronze Tandem PPO 7500/75. These can be identified by ‘Virtual Blue’ in the plan name.
When using the PRISM filter options for Narrow or Broad networks, select ‘All’ networks instead of ‘Broad’ only networks to generate plans for Blue Shield’s Virtual Blue, Trio HMO, and Tandem PPO plans.
If you need assistance, please contact our Quotes team at quotes@claremontcompanies.com or 800.696.4543.
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As you know, when a carrier group health plan is installed, the group enters into a contract for coverage with the carrier. This contract is typically referred to as the group contract but it can be called the group health plan contract, group service contract or group service agreement.
So, how do these group contracts work with the CCSB exchange when more than one carrier is providing coverage to the group?
CCSB does not issue group contracts. Rather, shortly after the group is installed, each carrier with enrollment will send a Group Service Agreement to the group. On receipt, the group should sign the Group Service Agreement and return to the carrier per the carrier instructions, and retain a copy in their files.
Have a follow-up or benefits administration question?
Contact our small group experts at 800.696.4543 or info@claremontcompanies.com.