Blue Shield Small Business Health Plans California

Network Explanation – Definitions

• PPO vs HMO
  • One of the most important decisions for an employer is choosing between a PPO and HMO network.
  • PPO Plans generally allow employees to see specialists without referrals and may provide some coverage outside the network.
  • HMO Plans generally require members to use network doctors and medical groups, but often have lower monthly premiums.
  • The best choice usually depends on whether employees want maximum flexibility or lower monthly costs.

• Tandem PPO
  • Tandem PPO is one of Blue Shield’s most popular cost-saving options. It uses a narrower network than the Full PPO network while maintaining the same basic PPO plan structure.
  • Many employers select Tandem PPO when employees can keep their preferred doctors and hospitals while reducing monthly premiums.
  • Brochure, Flyer, Map, # of providers 

• Trio HMO
  • Trio HMO is Blue Shield’s lower-cost HMO option. It is built around selected medical groups and providers and is often chosen by employers looking to reduce premiums while maintaining quality coverage.
  • The most important question is whether employees’ doctors, hospitals, and medical groups participate in the Trio network.
    • Trio Network Guide 

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• HSA Compatible High Deductible Plans
  • Many employers choose High Deductible Health Plans (HDHPs) because they generally have lower monthly premiums and allow eligible employees to contribute to a Health Savings Account (HSA).
  • Blue Shield offers HSA-compatible plans on both the Full PPO and Tandem PPO networks.

• Find a Doctor Before Choosing a Plan
  • Before selecting any Blue Shield plan, verify that employees’ doctors, specialists, hospitals, and medical groups participate in the specific network being considered. Provider participation can vary significantly between Full PPO, Tandem PPO, Access+, Local Access+, and Trio HMO networks.
  • Blue Shield Plan & Network Comparison Tool
  • Blue Shield Find a Doctor

Treatment Cost Estimator 

• Member flier
• Member step-by-step flier
• Employer flier
• Blog – Insure Me Kevin.com
• FAQs

Blue Shields Website
Forms & Applications

• Rates  |
• Renewal Center  |
• Evidence of Coverage (EOCs)  |
• Changes To  |
• Underwriting Guidelines  Broker ONLY
• Benefits and Coverage Plan Documents  |
• Sales Resources and Collateral  |
• Document Library  |
• Small Business Producer of Record Form