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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 email@example.com or 800.696.4543.Login To Prism
97% of employers expect their benefits broker to answer compliance questions, provide guidance, and ensure they are well informed about legislative changes, according to a recent Zywave survey. These expectations require that brokers know the Large Employer Mandate (also known as Play or Pay) and how employers will be impacted.
Large employers, those with 100 or more full-time (FT) employees plus full-time equivalent (FTE) employees, may already know they are subject to the Play or Pay Mandate, and have taken action. It’s the smaller employers, those with 50-99 FT plus FTE employees, that could be at risk because it isn’t always obvious if an employer is subject to the mandate.
To properly identify Applicable Large Employers (ALEs), it’s important to avoid conclusions based on a cursory employee count. Under the mandate, all employees of all businesses that are part of a controlled group and/or affiliated service group must be included in the determination of the group size. Hence, businesses with only a few employees can be subject to the mandate if the business is part of a controlled group and/or affiliated service group, and the number of FT and FTE employees combined for all businesses equals 50 or more.
It’s critical you know which employers are subject to the mandate, the compliance requirements and penalties, and how to address their needs. Use Claremont’s comprehensive ‘Play or Pay’ resources to understand the mandate and work closely with your employers to plan ahead and successfully manage the new requirements.
*Download and distribute these guides to your prospects and clients.Download One or All Exclusive Play or Pay Guides
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