Blue Shield Employer Small GROUP Plans

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

Our other pages on Dental Coverage

We don't put a lot of effort into selling dental coverage.  Generally it's a wash on paying premiums vs getting back claims payments.  Unless it's employer group.  Then the premiums are tax deductible under IRS  Section 106.

Here's more information on how we feel about dental.  Here's our page on implants, where we get lots of inquires, but few sales.  Most people only seem to want dental coverage, after they've been told they need a lot of dental work.  Not profitable for Insurance Companies.  See our other pages for details & explanations.   See our page on Medical Loss Ratio.  Insurance Companies need to take in $1 to pay 80c in claims.

Medicare Plans

• Blue Cross Dental & Vision
• Blue Shield Dental & Vision
• Original Medicare Dental under Medicare is very limited

Individual & Family Plans

• Blue Cross Dental
• Blue Shield Dental & Vision
• Health Net Dental & Vision
• Dental & Vision for Adults and Mandatory Pediatic as an essential benefit

• Child Dental & Vision
• Covered CA & More
• FAQ’s – Explanations – Technical Info
  • Dental Implants
  • No Coverage – Big Claim – Buy Coverage now???
• Vision

Dental For Everyone,
has an excellent  website with full brochures, Instant online quoting and enrollment

One of our colleagues on how Dental for Everyone Works..

Employer Group Plans

• Anthem Blue Cross Dental
• Blue Shield Dental
• SHOP – Covered CA for Small Business

• Dental

Dental, Vision, Supplemental

• Group Supplemental
• Vision