2019 PPO Blue Shield Benefit Summaries

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Individual and Family Plan medical Summaries of Benefits (SOB) are effective January 1, 2019, and must be accompanied by the Important Legal Information booklet (PDF, 2.5MB)Spanish  (PDF, 2.1MB)

In addition to the Summary of Benefits, the Evidence of Coverage/Policy (EOC) and Summary of Benefits and Coverage (SBC) forms provide your clients with an easy-to-understand overview of what our IFP plans cover.

PPO Plans
Summary of Benefits Evidence of Coverage/Policy (EOC)
Blue Shield Platinum 90 PPO English (PDF, 2MB)
Spanish (PDF, 2MB)
Evidence of Coverage/Policy (EOC)
Blue Shield Gold 80 PPO English (PDF, 2MB)
Spanish (PDF, 2MB)
Blue Shield Silver 70 PPO English (PDF, 2MB)
Spanish (PDF, 2MB)
Silver 70 Off Exchange PPO English (PDF, 2MB)
Spanish (PDF, 2MB)
Silver 1850 PPO English (PDF, 2MB)
Spanish (PDF, 2MB)
Blue Shield Bronze 60 PPO English (PDF, 2MB)
Spanish (PDF, 2MB)
Blue Shield Bronze 60 HDHP PPO English (PDF, 2MB)
Spanish (PDF, 2MB)
Blue Shield Minimum Coverage PPO English (PDF, 2MB)
Spanish (PDF, 2MB)

We offer six Silver cost-sharing reduction plans through Covered California for clients whose income is between 138% to 250% of the federal poverty level (FPL). These plans are available only through Covered California.

Cost-Sharing Reduction Plans Summary of Benefits
Blue Shield Silver 73 PPO English (PDF, 2MB)
Spanish (PDF, 2MB)
Evidence of Coverage/Policy (EOC)
Blue Shield Silver 87 PPO English (PDF, 2MB)
Spanish (PDF, 2MB)
Blue Shield Silver 94 PPO English (PDF, 2MB)
Spanish (PDF, 2MB)

 

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2018 Blue Shield

Historical
Summary of Benefits

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Covered CA process to change broker.

 

Trio HMO Plans Historical
PPO Plans  Benefit Summaries   More Information  
Blue Shield Platinum 90 PPO English (PDF, 498KB)
Spanish (PDF, 498KB)
  Important Legal Information booklet  *  Spanish
Blue Shield Gold 80 PPO English (PDF, 498KB)
Spanish (PDF, 498KB)
 FAQs
on new format
Blue Shield Silver 70 PPO English (PDF, 498KB)
Spanish (PDF, 498KB)
 Evidence of Coverage/Policy (EOC) and blueshieldca.com/policies
Blue Shield Silver 1850 PPO English (PDF, 498KB)
Spanish (PDF, 498KB)
Mirrored Plans?
Blue Shield Silver Seven 3750 PPO English (PDF, 498KB)
Spanish (PDF, 498KB)
Blue Shield Bronze 5550 PPO English (PDF, 498KB)
Spanish (PDF, 498KB)
Blue Shield Bronze 60 PPO English (PDF, 498KB)
Spanish (PDF, 498KB)
Blue Shield Bronze 60 HDHP (formerly Bronze 60 HSA) English (PDF, 498KB)
Spanish (PDF, 498KB)
Blue Shield Minimum Coverage PPO English (PDF, 498KB)
Spanish (PDF, 498KB)
Enhance Silver – Cost Sharing Reduction Plans
Blue Shield offers three PPO Silver cost-sharing reduction plans through Covered California for clients whose income is between 138% to 250% of the federal poverty level (FPL). Income Chart *

These plans are available only through Covered California.  We are certified agents and can help you at no extra charge.

Historical

Blue Shield Silver 73 PPO English (PDF, 498KB)
Spanish (PDF, 498KB)
Blue Shield Silver 87 PPO English (PDF, 498KB)
Spanish (PDF, 498KB)
Blue Shield Silver 94 PPO English (PDF, 498KB)
Spanish (PDF, 498KB)
Click here to view sample email.

In 2018, out-of-network deductibles and out-of-pocket maximums are significantly increasing for subscribers who continue to visit a doctor or specialist not participating in their plan’s network.

  • To keep out-of-pocket expenses down, we strongly urge  clients to see doctors who are participating in their plan’s network.
  • If a service isn’t covered, your clients will be responsible for all billed charges from out-of-network providers.
  • The Find a Doctor tool will help your clients find a doctor in our network.

 Click Here to Enroll and get quotes from Blue Shield

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Blue Shield ONLINE Instant Enrollment & Quotes
Blue Shield ONLINE Instant Enrollment & Quotes

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Related Pages in  Blue Shield CA Information & New Enrollment  Section

 

7 comments on “2019 PPO Benefit Summaries

  1. How come completed my boyfriends Covered CA application for Blue Shield yet you simply gave me the direct affiliate link above asked me to do everything on my own with the application process for Blue Shield direct. This process has been anything but convenient.

    • One reason we get so involved in Covered CA applications, is that Covered CA wants you to wait on hold and call them directly. Their process for one to select an agent is not what they promised us at their mandatory training. Your boyfriend had already partially completed an application with us a few years back. We can also be of more help during the year… The last day of open enrollment is not a good day to expect a lot of personal attention.

      When you use OUR affiliate link, we get notified of the progress of your application. If you just go to Blue Shield’s website, we are not your agent, nor do we know anything about your application. If you want us as your agent… got confused as to which link to use… Not Covered CA etc. we can send you a Broker of Record letter to send to us, then we will send to Blue Shield.

      The Blue Shield ONLINE application above, is rather simple, no income or medical questions. We already discussed the plans with you. You didn’t want Medi-Cal, nor did you qualify for subsidies at your income level. IMHO the complex part is the time and effort selecting a plan, going over coverages and definitions. The hardest part of the application is reading the disclosures and putting in your credit card information. Our website is full of intricate policy details. We feel we can help our clients with that, better than filling out your name and address and going over 16 digit credit card numbers.

      The next thing is that as a Blue Shield member, you can get a member portal to give you instant 24/7 information on your policy, claims and premiums.

  2. It looks like health Net Silver 70 Enhanced Care PPO and Blue Shield Silver 70 PPO offer the exact same benefits.

    However, Health Net is $593.48 and Blue Shield is $740.13.

    Is that correct?

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