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Delta Dental Quoting

Employer contribution entered in Dental Contribution under Group Information affects the Delta Dental plans and rates returned. Please be aware that Delta Dental will require groups with 100% employer contribution to have 100% participation.

If you need assistance, please contact our Quotes team at quotes@claremontcompanies.com or 800.696.4543.

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Blue Shield of California

What is Blue Shield doing to make it easier for members to receive their prescriptions?

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Learn more.

What emotional, behavioral and mental health services and benefits does Blue Shield provide for employees and their families?

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Contact Claremont for more information.

What services does Blue Shield offer for members with anxiety over this outbreak?

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Through September 30, 2020, Blue Shield is making Teladoc health, including behavioral health services, available with no member cost sharing for all members with access, including all Blue Shield fully insured commercial plans.

During this time, all Teladoc behavioral health services will be exempt from copays, regardless of the reason for the visit, including encounters with psychiatrists, psychologists, licensed clinical social workers, and marriage family therapists.

Mental health services also continue to be available from providers other than Teladoc. If the Evidence of Coverage (EOC) or Certificate of Insurance (COI) states that mental health services are available through Mental Health Services Administrator (MHSA) network, members can search for providers in the MHSA network through the provider directory. The standard office visit copay applies to MHSA Tele-behavioral health appointments.

If an employee is laid off and then re-hired, how long is the waiting period before they can join the medical plan?

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Blue Shield standard provision allows for waiving of waiting period if rehired within 6 months of cancellation of coverage. Employers should check their contract for further details.

Is Blue Shield allowing employer groups to change plan selections off-cycle to accommodate revenue and workforce reduction due to COVID-19?

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Blue Shield will allow a one-time buy-down (leaner plan design with lower premiums) change off-cycle for employers and employees to adjust their health plan selection to meet their current needs.

Note: rates for employees who choose a buy-down plan off-cycle will be based on the age of the member at the time of the change.

Learn more.

What is the “Premium Payment Plan” Program?

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Blue Shield has introduced a flexible payment program for the month of April, May and June for Individual and Family Plan and Medicare Supplemental plan members, and Small Business groups.

Learn more.

Are there any extensions to new group application deadlines?

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Yes. Check the Carrier Responses section of our COVID-19 resource page for the latest information.

Is there a special open enrollment period for individuals who have previously declined coverage?

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Employer groups may enroll new members off-anniversary through a Special Enrollment Period (SEP) through June 30, 2020, with July 1 as the latest effective date. This SEP is for employees who previously declined coverage for themselves or their dependents.

This applies to all fully insured Small Group (1-100) and Large Group (101+) employers, and includes enrollment for medical plans, dental plans, and vision plans.

See also: Can a group or employee change plans off-anniversary?

Learn more.

Is Blue Shield allowing employer groups to change plan selections off-cycle to accommodate revenue and workforce reduction due to COVID-19?

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Small Business (1-100): Blue Shield will allow a one-time buy-down (leaner plan design with lower premiums) change off-cycle for employers and employees to adjust their health plan selection to meet their current needs. Buy-down selections must be consistent with the current plan type offered by the group: PPO plan to PPO plan or HMO plan to HMO plan.

Note: rates for employees who choose a buy-down plan off-cycle will be based on the age of the member at the time of the change.

As a reminder, specialty benefits – dental plans, vision plans, and life insurance – may be added at any time.

Learn more.

If employees are required to work a reduced schedule (temporary layoff, furlough, reduction-in-hours, etc) will they remain eligible for coverage?

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Fully insured groups:

Blue Shield will continue to provide coverage through June 30, 2020 as long as premiums are received. Coverage must be offered on a consistent, non-discriminatory basis to all employees, and employee premium contributions must be the same or less as prior to the layoffs, furloughs or reduction of hours.

Options for continuing coverage for laid-off employees:

Learn more.