Network Explanation 

• Small Business (1-100)
  Off-Exchange plans
  • Our flagship package, featuring a range of healthcare options including PPO, HSA compatible HDHP, and HMO plans. Not available for purchase on Covered California for Small Business (CCSB) online marketplace, these plans can be purchased from Blue Shield through a broker. Customers can choose among any plans in the package, or select our PPO plans to offer alongside HMO’s from another carrier. Plans from this package can be sold individually, but cannot be offered alongside plans from any other Blue Shield package.
• Mirror plans
  • This package includes several HMO and PPO options that can be purchased from Blue Shield through a broker. Plans from this package may be sold individually. These plans are also available for purchase on Covered California for Small Business (CCSB) online marketplace. Plans from this package can be sold individually, but cannot be offered alongside plans from any other Blue Shield package.
• PPO networks
  • Our Full PPO Network is among the largest in California and includes more than 80,000 physicians and over 380 hospitals (in-network).
  • Our Tandem PPO Network is a subset of our Full PPO Network, available statewide with 55,000 providers included and 350 hospitals. Tandem PPO plans provide the same plan benefits as the Full PPO plans at a lower price. Visit blueshieldca.com/Tandem to see what makes Tandem such a great choice.
    All off-exchange PPO plans offer the flexibility to visit a doctor or specialist with a referral. PPO members can also see non-network providers but may incur higher costs.
    HSA-compatible high-deductible health plans (HDHP)
    Many small businesses opt for high-deductible PPO plan coverage for their employees. Deductibles are higher, but monthly rates are lower, and the plans come with an option of opening a health savings account (HSA) to help pay for qualified medical expenses.
    Our HSA-compatible plans are offered on both the Full PPO network and Tandem PPO network.
• HMO networks
  • Our eight off-exchange HMO plans for small business are each available with one of three HMO provider network options: Access+ HMO, Local Access+ HMO, or Trio HMO.

• • Plan designs are identical, and all specialties and levels of care are included.
  • Access+ HMO plans give members access to more than 44,000 doctors and 370 hospitals.*
  • Local Access+ HMO plans give members access to more than 32,000 doctors and 330 hospitals.t
  • Trio HMO plans are available in 26 counties and gives members access to 17,000 doctors from the Access+ provider network.‡ Trio HMO plans come with valuable bonus features not included with other HMO plans. Visit blueshieldca.com/aco to learn more about Trio HMO features and coverage areas.
    You may offer Trio HMO plans alongside Access+ or Local Access+ plans, but Access+ cannot be offered alongside Local Access+. A business must be located in the plan’s service area to offer an Access+ HMO, Local Access+ HMO, or Trio HMO plan, and eligible employees must live or work in the service area.
• Learn more about Blue Shield’s Small Group medical coverage with the Plan Comparison Tool.
  • This interactive tool features our product portfolio (medical, dental, and vision) with a variety of resources at your fingertips. You can view a single plan, compare multiple plans side by side, or review a plan year-over-year.
  • Looking for a specific doctor?
    • Use our Find a Doctor tool to search for doctors in your network
• Source

Employer Enrollment Tool Manual

Blue Shield CA Employer Group #Dental HMO & PPO Plans 

Dental coverage is the benefit most requested by employees after medical coverage.  With Blue Shields affordable dental plans and access to some of the largest dental provider networks in the country¹,  you’ll add value to your employees’ benefits package and help them better manage their oral and overall health.  Plus, offering access to preventive oral care can help keep employees happier and more productive at work.

Brochure including HMO  

What Blue Shield Offers

Blue Shield dental plans are available with or without a Blue Shield medical plan. They  offer a variety of benefit levels, plan flexibility, no waiting periods² and one-source administration. For added flexibility, voluntary dental plans require no minimum employer contribution.

Dental  INO  Smile  ^SM  plans

The Smile^SM In-Network Only (INO) dental plan portfolio³ pays benefits on a coinsurance basis, but with no out-of-network coverage¹. The INO network includes all the same providers as the dental PPO network. Members can access covered services from any provider in the INO network, giving members access to over 25,000 providers in California and over 218,000 nationwide¹. The INO plan lets you tailor dental coverage for your employees by selecting options from these three key components:

• Voluntary or contributory
• Endodontics and periodontics coverage level (either a 50% or 80% coinsurance level)
• Orthodontia coverage (can be included or excluded)

Additional features:

• $1,500 annual benefit maximum
• Orthodontic coverage of $1,000 per calendar year available, for children and adults
• Oral cancer screening covered as a diagnostic and preventive service
• Covered diagnostic and preventive services covered at 100%

Dental  PPO  Smile ^SM  Plans

With our dental PPO plans, you and your employees have access to a nationwide dental network of more than 25,000 providers in California and 218,000 PPO providers nationwide.¹

Your employees save money and get the most out of their benefits by choosing a provider from our large network of general and specialty dentists. They can also receive care from any licensed dentist of their choice, covered as an out-of-network benefit.

• No waiting periods so employees have access to benefits on the first day of coverage.
• 100 percent coverage for diagnostic and preventive services from network providers.
• Enhanced dental services for pregnant women.
• Orthodontic coverage options for children and adults with some plans, with up to a $1000 orthodontic benefit per member, per year.
• Choices for low annual deductibles and calendar year maximums.

Dental  HMO  Plans

Dental HMO plans help your employees and their dependents take control of their dental costs with the network dental provider of their choice. We’re now introducing four new dental HMO plans to offer coverage for basic and major services, while delivering lower out-of-pocket costs for employees.

Our dental HMO features include:

• Over 16,000 HMO providers in California¹
• $5 office visit copayments
• No deductibles, claim forms or calendar-year maximums
• No charge for diagnostic and preventive services
• Select plans have orthodontia benefits for adults and children.

Dual  Option  Dental

Give your employees a choice between any two dental plans, including voluntary plans.
Find a Provider or call member services at (888) 702-4171 for dental PPO/INO plans, or at (800) 585-8111 for dental HMO plans. Call center hours are Monday through Friday, 5 a.m. to 8 p.m. (PST).

• Dental Plans & Benefits  
  • More complete coverage
• Pediatric dental & vision FAQ’s
  • Cavities – Caries Risk Management Assessment
• Guide to Orthodontic Coverage
• Guide to managing your dental plan online
• Guide to Implant Coverage
• Dental Networks Map
• Competitive Highlights
• Manage your dental plan ONLINE
• Implant Coverage
• Dental Networks at a Glance
• How to find Dentists
• Rate Charts  BROKER ONLY
• 2021 brochure

Recommend a Dentist

If your employee’s dentist is not in the provider network, they can nominate a dentist  to join the network.

¹ Dental providers in and out of California are available through a contracted dental plan administrator.
² Voluntary dental PPO and INO plans have a 12-month waiting period for major services.
³ Underwritten by Blue Shield of California Life & Health Insurance Company (Blue Shield Life) and pending regulatory approval.  Copied from Blue Shield CA.com