Q1-2025 Updates

Blue Shield of California continues to deliver comprehensive health benefits tailored to the needs of small businesses and their employees. Here's a summary of the changes for 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%. 

Renewals

• January groups will be available October 15th.
• February and March groups will be available November 12th.

Medical Plans

• Minimal changes were made to the plan portfolio. Most include improved deductible and out-of-pocket maximums.
• All 3 HMO networks (Access+, Local Access+ and Trio) can be sold alongside each other, effective January 1, 2025.

Other Highlights

• All Trio HMO members can now access virtual health services through Accolade Care.
• At-home medical support post-hospitalization is now available at $0 for all PPO members through DispatchHealth.
• Dental PPO Plans unavailable as of 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

Bonus Programs and Relaxed Participation Promotion

• New Small Business Incentive Prorgam is in effect from February 1, 2025 through January 31, 2026. The current Small Business Incentive Program runs through January 31, 2025.
• Specialty Bundled Savings Program is a perpetual program.
• Relaxed Participation promotion has been extended through December 31, 2025.

Get the details and access the resources. Contact us today for a Blue Shield of CA quote.

2025 Small Business Broker Roadshow Recording

Miss the Q1-2025 Blue Shield Small Business Broker Roadshow? Watch it on demand for valuable insights and updates to help you during the upcoming open enrollment period. Highlights Include:

• Competitive rate adjustments.
• Actuarial trends impacting 2025 healthcare costs.
• Digital portal enhancements and more!

Watch the Broker Roadshow recording.

Q1-2025 Updates

CaliforniaChoice has announced the following Q1-2025 updates:

Rates

• Q1 plans are now available through PRISM, our free and easy online quoting system.
• There are new rates for all health plans.

Medical Plans/Networks (Effective January 1, 2025)

• Cigna + Oscar will be exiting the small group market.
• These plans will no longer be available:
  • Anthem Blue Cross: Silver HMO C, Gold PPO F, Gold PPO G
  • Health Net: Bronze HMO A, Silver HMO C, Silver HMO D, Gold HMO F, Platinum HMO D
  • Kaiser Permanente: Bronze HMO B

Reminders

• Anthem Platinum HMO B (includes the Vivity network) became available on September 1, 2024.
• CaliforniaChoice is offering a streamlined underwriting process for groups with Cigna + Oscar direct coverage. This promotion applies to new business effective dates from 7.1.24 to 12.1.24. Get the details and contact us for assistance.

Learn more and contact us today for a CaliforniaChoice quote.

Q1-2025 Updates

ChoiceBuilder has announced the following Q1-2025 updates:

Rates

• Q1 plans are now available through PRISM, our free and easy online quoting system.
• Dental: Ameritas and MetLife Platinum Plus PPO plan rates have changed. There are no rate changes for the other carriers.

Benefits

• Ameritas Dental: Employer Sponsored and Voluntary Plans
  • Platinum Plus PPO option added, effective 1.1.25 and later.
  • $3,000 annual maximum.
  • Orthodontic takeover credit now 5+ eligible employees.
  • Pre-existing conditions (missing tooth) coverage.
• Delta Dental: Employer Sponsored and Voluntary Plans
  • Congenital missing tooth coverage.
  • No waiting periods for major and orthdontic benefits.
• MetLife: Employer Sponsored and Voluntary Plans
  • Dental:
    - All Plans: The orthodontic take over credit has changed from “Does Not Apply” to “Automatic.”
    - Platinum Plus PPO (employer sponsored only): The annual maximum benefit has changed from $2,500 to $5,000 for (IN) and from $2,000 to $2,500 for (OON).
  • Life: EAP provided through TELUS Health is now included at no additional cost (employer sponsored plans only).
• Landmark Healthplan: Chiropractic/Acupuncture Employer Sponsored and Voluntary Plans
  • The New Patient Evaluation & Management benefit has changed from $65 to $80 per visit.
  • Benefits that have changed from $50 to $65 per visit:
    - Established Patient Re-Examination & Management
    - Modalities
    - Therapeutic Procedures
    - Chronic Manipulative Treatment
    - Special Services

Learn more and contact us today for a ChoiceBuilder quote.

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As always, we'll keep you informed about healthcare issues and news affecting you and your clients. Our knowledgeable team is here to help you succeed.

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