Blue Shield of California
  Members  |   Employers  |   Brokers  |   Providers

choice, confidence, and coverage start here.

We have a wide range of health plan options

Choose the option that best suits your business

Portfolio plans

You can choose from a variety of plan designs to meet your coverage needs. Use this tool to compare benefits from our standard portfolio plans. We’ll never stop working to find and pursue the best path forward for fulfilling our mission – making sure all Californians can access the care they deserve at a price they can afford.

 small business
 large group

Blue Shield offers two packages to small businesses outside of Covered California for Small Business. You can offer plans from the Off Exchange Package or the Mirror Package, but not both.

Off Exchange plans

The Blue Shield Off Exchange Package includes up to 74 plans, including PPO, HMO, Virtual Blue SM (superscript) and HSA-HDHP options. These plans are available at each metal level – Platinum, Gold, Silver, and Bronze – offering different levels of coverage.

Mirror plans

The Blue Shield Mirror Package includes a PPO plan at each metal level and our Trio HMO plans at Platinum, Gold, and Silver metal levels. The Mirror Package offers the same standardized plans that are offered on Covered California5 for Small Business.

PPO plan features and networks

expand

collapse

  • Our Full PPO Network is among the largest in California and includes more than 73,000 physicians and over 375 hospitals6.
  • Our Tandem PPO Network is a subset of our Full PPO Network, available statewide, with 67% of Blue Shield providers included. Tandem PPO plans7 provide the same plan benefits as the Full PPO plans at a lower price.
  • We also offer high-deductible health plans (HDHP)8, which are available on the Full PPO Network only. HDHPs come with the option of opening a health savings account (HSA) to help pay for qualified medical expenses.

expand

collapse

HMO plan features and networks

expand

collapse

Our HMO plans include all specialties and levels of care, access to over 320 hospitals, and are each available with one of three HMO provider network options:

  • Access+ HMO® Network provides access to more than 40,000 doctors in California.
  • Local Access+ HMO® Network15 provides access to more than 17,000 doctors in California.
  • Trio HMO® Network provides access to 10,000 doctors in 26 California counties. Trio HMO is a high-performance health plan that leverages ACO partnerships to provide more coordinated care and better outcomes for members. The name “Trio” represents our ACO program alliance between the medical group, hospital, and Blue Shield – an integrated network model that creates a community of care to support improved health outcomes for Trio members. Visit blueshieldca.com/ACO.

expand

collapse

Dental, vision, and
life insurance

Bundling offers savings plans for any size group

Dental

Add dental and save on premiums for all size groups. Blue Shield's dental PPO network10 has more than 45,000 provider access points in the state, our DHMO is the second largest in California. Many of our plans include orthodontia, including clear braces, implant coverage, extra cleanings for pregnant women, and additional fluoride treatments for children at risk for tooth decay.

Vision

Add vision and save on premiums for all size groups. We have the largest vision network in California with more than 14,000 access points11. Additionally, members have access to major retail chains with convenient evening and weekend hours (did you know that 15% of retail eyewear is purchased on Sundays?). Our plans provide generous allowances for lens extras (antiglare, bifocals, etc.).

Life insurance

We offer life insurance amounts between 15k and 300k. One-hundred percent employer paid12, flat amounts, multiples of salary, or graded class plans with guarantee issue amounts meaning no evidence of insurability is required. In addition, LifeReferrals 24/7SM offers care and support for family members who have suffered a recent loss of a loved one. Members have access to grief support, financial advice, and legal needs. Life insurance members also have access to Travel Assistance which offers members a broad range of worldwide travel, emergency, medical transportation and concierge services 24-hours-a day, 365-days-a-year.

Benefit summaries:

Dental benefit summaries

Vision benefit summaries

Life insurance benefit summaries

PPO plan features and networks

expand

collapse

Our PPO plans offer flexibility for members to see non-network providers. These PPO plans come with a wide range of deductible and cost-share options.

  • Our full PPO network is among the largest in California and includes more than 73,000 physicians and over 375 hospitals6.
  • Our Tandem PPO network is a subset of our full PPO network and available statewide, with 67% of Blue Shield of California providers included. Tandem PPO7 plans provide the same plan benefits as the full PPO plans at a lower price.
  • Exclusive provider organization (EPO) plans give members access to network providers in our full PPO or Tandem PPO network. Members have the flexibility to see any network doctors and specialists without a referral. Except for emergencies, EPO plans have no out-of-network benefits.
  • Our PPO savings plans are ideal for individuals who want to be actively in control of their healthcare expenses by saving tax-advantaged dollars for future medical expenses. These high-deductible health plans (HDHPs) can be paired with an HSA, HRA, HIA, FSA, LPFSA, or other financial accounts and are offered with full network coverage13. Each plan includes prescription drug coverage.
  • Our Active Choice® plans14 offer flexibility and greater management over routine health coverage spending. These plans are ideal for those who want comprehensive coverage but have low annual utilization.
  • Point-of-service (POS) plans are a great option for employers who would like the flexibility of having HMO and PPO benefits combined under one plan. With our Added Advantage POSSM plans, members can decide at the time they receive service whether they would like to pay less out of pocket with providers in the HMO network, pay higher and less predictable out-of-pocket costs using the larger PPO network, or pay even higher out-of-pocket costs using any licensed provider who is not contracted with Blue Shield of California.

expand

collapse

HMO plan features and networks

expand

collapse

Our HMO plans include all specialties and levels of care, access to over 320 hospitals, and are each available with one of three HMO provider network options.

  • Access+ HMO® Network provides access to more than 40,000 doctors in California.
  • Local Access+ HMO® / SaveNetSM Network15 provides access to more than 17,000 doctors in California.
  • Trio HMO® Network provides access to 10,000 doctors in 26 California counties. Trio HMO is a high-performance health plan that leverages ACO partnerships to provide more coordinated care and better outcomes for members. The name “Trio” represents our ACO program alliance between the medical group, hospital, and Blue Shield – an integrated network model that creates a community of care to support improved health outcomes for Trio members. Visit blueshieldca.com/ACO.

expand

collapse

Self-funded options

Blue Shield offers customizable and self-funded health plan options for businesses with 300 or more employees. Contact your Blue Shield representative for more information.

Access to care through large PPO networks in California

Blue Shield of California has one of the most expansive, diverse networks in California, offering access to hospitals, physicians, and specialty providers. Our PPO network includes more than 73,000 physicians and 375 hospitals6.

Network cost advantage

Blue Shield of California can help your clients with 300 or more employees customize a health plan, based on utilization and experience, to fit the needs of their workforce.

Custom plan designs, high-value stop-loss coverage16

  • Broad deductible range
  • Advanced funding when the deductible is reached – no waiting for reimbursements
  • Run-in and run-out contracts
  • Renewal rate cap options
  • Aggregate-specific arrangements
  • No employer disclosure and renewals
  • Top administrative partners to manage benefits and handle billings and claims
  • Care management through Shield Advocate, offering short- and long-term support to optimize your benefits, health, and quality of life.
Value-based benefit plans

Value-based benefit plans offer explicit plan incentives to encourage members with certain chronic conditions to use of high-value preventive health services. Removing financial barriers to care helps members lower their condition-related healthcare costs and promotes a healthy lifestyle. Visit blueshieldca.com/vbb for more information.

Dental, vision, and
life coverage

Bundling offers savings plans for any size group

Dental

Add dental and save on premiums for all size groups. Blue Shield of California's dental PPO network10 has more than 45,000 provider access points in the state and our DHMO is the second largest in California. Many of our plans include orthodontia, including clear braces, implant coverage, extra cleanings for pregnant women, and additional treatment for children at risk for tooth decay.

Vision

Add vision and save on premiums for all size groups. We have the largest vision network in California with more than 14,000 access points11. Additionally, members have access to major retail chains with convenient evening and weekend hours (did you know that 15% of retail eyewear is purchased on Sundays?). Our plans provide generous allowances for lens extras (antiglare, bifocals, etc.).

Life insurance

We offer life insurance amounts between 15k and 300k. One-hundred percent employer paid12, flat amounts, multiples of salary, or graded class plans with guarantee issue amounts meaning no evidence of insurability is required. In addition, LifeReferrals 24/7SM offers care and support for family members who have suffered a recent loss of a loved one. Members have access to grief support, financial advice, and legal needs. Life insurance members also have access to Travel Assistance which offers members a broad range of worldwide travel, emergency, medical transportation and concierge services 24-hours-a day, 365-days-a-year.

Benefit summaries:

Dental Summary of Benefits

Vision Summary of Benefits

Life insurance benefit summaries