What coverage is available for out-of-state employees through Covered California for Small Business?

The Blue Shield Bronze PPO 60 plan, with out-of-state coverage through the Blue Card, is available to out-of-state (OOS) employees IF the employer is located in the service area where the plan is offered. Below is the list of counties and/or partial counties where the Blue Shield Bronze PPO is offered.

Normally, employers can only offer two tiers of coverage (Silver and Gold, for example), however, if an employer located in one of the above service areas needs to accommodate OOS employees, Covered California for Small Business (CCSB) will permit the employer to offer the Blue Shield Bronze PPO 60 to OOS members. If the employer is not located in one of the above service areas, then other coverage would need to be considered for these employees.  For instance, the employer can opt to offer the eligible OOS employee coverage through the SHOP in that employee’s primary out-of-state worksite.

Note: CCSB had sold plans from Health Net that provided coverage to OOS members, however, in April 2016 Health Net announced that they would no longer cover OOS members. For groups that have existing OOS members on the Health Net plan, they can stay on the plan until the group comes up for renewal. For groups that did not have existing OOS members, they would not be able to add any OOS members after April 2016 so other coverage would need to be considered.

At the group’s renewal, the OOS members do have the option to move to the Blue Shield Bronze PPO 60 plan IF the employer is located in one of the service areas where the plan is offered (see above).