Blue Shield Links on Grandfathered Plans
Renewing your Grandfathered Plan
Blue Shield will be sending letters to to those who are currently enrolled in a Blue Shield plan that will be discontinued as of December 31, 2017.
Blue Shield of California will withdraw the following plans from the Individual and Family Plans market. They will no longer be available as of January 1, 2018.
- Grandfathered plans (impact: 1,610 members)
Being mission-focused means considering what is in the best interest of all our members and we are committed to offering your Blue Shield clients access to high-quality care at a price they can afford.The membership of our grandfathered plans continues to get smaller every year. When a plan’s membership drops below 500 members, we need to review our portfolio and consider changes that benefit all Blue Shield members. Therefore, we are withdrawing the following Blue Shield of California grandfathered plans from the Individual and Family Plans market.
- Vital Shield Plus 2900-G
- Vital Shield Plus 400-G
- Vital Shield Plus 900-G
- Blue Shield Life PPO Plan 2000-G
- Vital Shield Plus 400 Generic RX-G
- Vital Shield Plus 2900 Generic RX-G
- Active Start Plan 35 Generic RX-G
- Shield Spectrum PPO 5500-G
Grandfathered plan members will NOT be automatically enrolled into another Blue Shield plan. These members will need to apply for a new plan for 2018. If they do not enroll in a new health plan, they will not have health coverage in 2018.
- Off-Exchange Silver Seven 3750 and Bronze 5550 (impact: 38,151 members)
Due to rising health-care costs and high demand for medical services, we are streamlining our portfolio of plans. We will continue to provide options that offer the high-quality care your clients need. Our Bronze 5550 PPO and Silver Seven 3750 PPO plans will no longer be available starting January 1, 2018.Members enrolled in one of these Off-Exchange plans will be automatically re-enrolled into a suggested/recommended plan as follows:
- Silver Seven 3750 PPO mapped to Silver 1850 PPO
- Bronze 5550 PPO mapped to Bronze 60 PPO
Your clients may want to think about a Trio HMO plan this open enrollment, which could help lower their monthly costs, but still offers access to board-certified doctors (available only for those who live in an area with approved Trio ZIP codes).
- Dental HMO plans in 12 counties within three regions of California (impact: 6,724 members, limited withdrawal)
In 2018, we are discontinuing our Enhanced Dental HMO $0 and Dental HMO plans from 12 counties within regions 1, 2, and 12. This is because there are very few dental HMO dentists within these counties. Most of the affected membership in these two dental plans will be mapped to our Enhanced Dental PPO 25/500 plan. The waiting period listed on the Summary of Benefits for this plan will be waived for members with withdrawn dental plans.
We are beginning to send letters to affected members notifying them about the plan withdrawals and their options for 2018. Those members who will not be mapped will need to select and apply for a new plan.
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Grandfathered withdrawal notices going out in June
Blue Shield will be sending notices to 2,062 Grandfathered plan subscribers to inform them that their current Blue Shield of California health plan will no longer be available after December 31, 2016. To ensure a smooth transition for these subscribers, we will automatically enroll them into an ACA-compliant plan with the most benefit coverage for the lowest monthly premium on January 1, 2017, unless they choose to enroll into a different plan. These plans are being withdrawn from the market due to low membership.
If you wish to keep your new plans, just simply continue paying the new monthly premium. Those who wish to change their plans must do so before December 15, 2016 for coverage to start on January 1, 2017.
You do not have to take any action at this time. You will receive details about the new plans, our 2017 Exclusive PPO network (Provider Finder) and 2017 open enrollment as the open enrollment period approaches.
It is important that you check to see if their current doctors are in the Exclusive PPO network because if they choose a provider outside of the 2017 Exclusive PPO Network, they could end up paying a higher share of the cost for any covered services. Members can start searching for 2017 network providers using the find-a-provider tool.
We are withdrawing the following 11 California Department of Insurance (CDI) and six Department of Managed Health Care (DMHC) plans in 2017:
Starting on January 1, 2017, these subscribers will have a special enrollment period that gives them the option to remain in their new Blue Shield plan or switch to another health plan carrier until March 1, 2017, 60 days after their current coverage ends. Blue Shield will also provide information to subscribers about financial assistance that may be available through Covered California.
Grandfathered plan withdrawals
Blue Shield is withdrawing 11 California Department of Insurance (CDI) grandfathered plans and six Department of Managed Health Care (DMHC) grandfathered plans effective Jan. 1, 2017. This change affects 2,062 members. On June 20, 2016, Blue Shield mailed a notice to members in CDI grandfathered plans informing them that their current Blue Shield of California health plan will no longer be available after Dec. 31, 2016. Members in DMHC plans will receive their notifications in September.
To ensure a smooth transition, we will automatically enroll these members into an Affordable Care Act-compliant plan with similar benefits and lowest monthly premium effective Jan. 1, 2017. If they approve of our recommendation, the only action they need to take is to pay their January premium when the bill comes in December. If they want to select a different plan, they must do so by Dec. 15, 2016 for the change to be effective on Jan. 1, 2017.
Starting on Jan. 1, 2017, these members will have a special enrollment period that gives them the option to remain in their new Blue Shield plan or switch to another health plan carrier.
They have until March 1, 2017, 60 days after their current coverage ends, to make a decision.
You and your clients will receive details about the new plans and our 2017 Exclusive PPO network as the 2017 open enrollment period approaches.