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Login To PrismWhy are some small business Blue Shield contract holders getting a small rebate relative to the total premium amount they paid in 2015?
In 2015, some groups’ Blue Shield plans were regulated by the California Department of Insurance (CDI) for 11 months and by the Department of Managed Health Care (DMHC) for one month. Blue Shield only owes rebates in DMHC-regulated plans for 2015. For these groups, Blue Shield will pay a rebate for the one month their plan was regulated by the DMHC.
Qualifying 2015 Blue Shield Small Business plans for a MLR rebate are as follows:
Platinum Full PPO 0 DMHC
Platinum Full PPO 150 DMHC
Gold Full PPO 0 DMHC
Gold Full PPO 750 DMHC
Gold Full PPO 1000 DMHC
Silver Full PPO 1250 DMHC
Silver Full PPO 1700 DMHC
Bronze Full PPO 4500 DMHC
Bronze Full PPO 3000 DMHC
Silver Full PP HSA2000 DMHC
Bronze Full PPO HSA3500 DMHC
Bronze Full PPO HSA5500 DMHC
Platinum Access+HMO $25 DMHC
Platinum Local Access+HMO $25 DMHC
Platinum Trio ACO HMO $25 DMHC
Gold Access+HMO $30 DMHC
Gold Local Access+HMO $30 DMHC
Gold Trio ACO HMO $30 DMHC
Silver Access+HMO $55 DMHC
Silver Local Access+HMO $55 DMHC
Silver Trio ACO HMO $55 DMHC
Bronze 60 PPO Mirror DMHC
Platinum 90 HMO Network 2 Mirror DMHC
Platinum 90 HMO Network 1 Mirror DMHC
Gold 80 HMO Network 2 Mirror DMHC
Gold 80 HMO Network 1 Mirror DMHC
Silver 70 HMO Network 2 Mirror DMHC
Silver 70 HMO Network 1 Mirror DMHC
There may be a more recent answer to this question. Contact Claremont for an update.