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Blue Shield of CA – Q1-2025 Updates

Oct 14, 2024, 3 Minute Read

Blue Shield of California continues to deliver comprehensive health benefits tailored to the needs of small businesses and their employees – offering healthcare that is accessible, affordable, high quality, and universal. Here’s a summary of the changes for 2025.

Q1-2025 Rates

• Q1 plans are now available through PRISM, our free and easy online quoting system.
• The Q1-2025 rate action is a statewide average of 1.3%.
• View the medical and specialty rate tables.
• More information can be found on Broker Connection.

Q1-2025 Renewals

• January groups will be available Tuesday, October 15th.
• February and March groups will be available Tuesday, November 12th.
• The Employer Enrollment Tool (EET) renewal solution has replaced the Small Group Online Renewal (SGOR) tool.
• Visit the Renewal Center page on Broker Connection for more information and resources.
• Product updates and materials are available on the Product Cycle Updates page.

Medical Plans

• Minimal changes were made to the plan portfolio. Most of the changes include improved deductible and out-of-pocket maximums.
• Additional information on the benefit changes is available on the Plan Name Changes for 2025.
• Effective January 1, 2025, all three HMO networks (Access+, Local Access+ and Trio) can be sold alongside each other. This will be applicable to new sales and renewals.
• Q1-2025 medical cycle changes can be found on the Q1-2025 Blue Shield Medical Sales Guide.

Other Highlights

• Accolade Virtual Providers
  All Trio HMO members can now access virtual health services including primary care physician visits, behavioral health, and specialty care through Accolade Care.
• DispatchHealth At-Home Care
  At-home medical support post-hospitalization is now available at $0 for all PPO members.
• 2025 Dental Plan Updates
  • Blue Shield is withdrawing three dental plans effective January 1, 2025:
    • Smile℠ Deluxe 50/1500/Ortho/MAC
    • Smile℠ Deluxe Gold 50/1500/Ortho/U85/NR
    • Ultimate Dental Plus PPO for Small Business 50/2000/Ortho/MAC/NR
  • For more information, refer to the Q1-2025 Blue Shield Specialty Sales Guide.

New Small Business Incentive Program

• The new bonus program is in effect from February 1, 2025 through January 31, 2026.
• Brokers can earn points for each new member as follows:
  • 25 points per new enrolled medical member on all 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.
  • 2x points for each new member enrolling in all three: dental, vision, and life (40 points total).
• The current Small Business Incentive Program is good through January 31, 2025. It includes the following:
  • 100 points per new enrolled member in a Tandem PPO or 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.

Specialty Bundled Savings Program

The 10% specialty discount is a perpetual program that is applied to the dental and/or vision premium when a dental and/or vision plan is added to a new or existing small business medical group. Learn more.

Relaxed Participation

The Relaxed Participation promotion has been extended through December 31, 2025.

Contact us today for a Blue Shield quote.

Get a Quote

Resources

• Q1-2025 Medical Sales Guide
• Q1-2025 Specialty Sales Guide
• 2025 Medical Plans Cheat Sheet
• 2025 Medical Plan Names
• Basic Life Insurance Quick Match Program
• Underwriting Guidelines
• Relaxed Participation
• Small Business Incentive Program
• Specialty Bundled Savings Program
• Blue Shield News Center
• Product Cycle Updates
• Employer Connection Plus (EC+)
• Employer Enrollment Platform Resources
• Broker Connection
• Plan Comparison Tool and Network Comparison Tool
• Wellvolution Mental Health
• Broker Bonus Calculator

COVID-19 Resources

• COVID-19 Member Resource Page
• California Coronavirus Response Website
• DMHC COVID-19 Response and Guidelines

Contact us today for a Blue Shield quote.

Get a Quote

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

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