We’ve represented Blue Shield for 40 years and have been quite happy. There is no charge for you to have our expertise as Blue Shield pays us. It helps them too!
Check out the brochure to the right if you have a full size monitor or below if you are on a smart phone. See the buttons to enroll, set a Zoom meeting or ask us a question.
Try turning your phone sideways to see the graphs & pdf's?
Trio ACO’s are a new family of limited network HMO plans: these plans are focused on delivering choice, affordability, and access to high-quality care with lower premiums.
The Trio ACO HMO plans are designed to help break down barriers, enhance care coordination, reduce duplication of services, and improve the member’s overall experience.
Trio plans are designed to help:
- Link members to the right services
- Create cross-organizational focus on patients with complex needs
- Improve discharge processes and programs to reduce hospital readmissions
Just scroll down our page
An accountable care organization (ACO) is a network of doctors and hospitals that shares responsibility for providing coordinated care to members and limiting unnecessary spending. As with a traditional HMO plan, each member’s care is centered around a primary care physician.
Learn More===> Section 3022 ACA
Blue Shield’s ACO framework is based on a proven record of delivering integrated care to more than 200,000 Californians.
Be sure to enroll on our Blue Shield affliate website. Blue Shield pays us to help you, at no cost to you, as it saves them time and $$$.
Print a temporary ID card and more – Member Services Center and Registration
Picking a PPO Primary Care Physician PCP – MD
PPO members for all Covered CA plans and maybe all? plans will now have a central point of contact PCP – Primary Care Physician, in the health system for receiving long-term, comprehensive, coordinated care for most health needs. PPO members are able to switch PCPs at any time. There is no action for members to take. Blue Shield will provide additional details on this new feature in the coming weeks.
Members of non-grandfathered PPO plans will continue to have the freedom to choose specialists and other providers – without referrals inside or outside the network – as they do now.
PPO Primary Care MD – member communication from Covered California
- What is a primary care physician?
- Why is it important to have a PCP?
- How did we select your PCP match?
- When will I receive information about the PCP that I was matched with?
- I’ve been matched with a PCP. Now what?
- What should I consider when evaluating my PCP?
- How do I change my PCP?
- I already have a doctor that I like. How do I know if my preferred PCP is part of my plan’s network?
- I can’t find my preferred PCP in the Exclusive PPO Network. What do I do now?
- Will my PCP appear on my ID card?
- What happens if I make a change to my PCP?
- How often can I change my PCP?
- Provider Finder
- Finding or changing MD with Trio Plan VIDEO
- Blue Shield Exclusive PPO Your new ppo * PPO Primary MD FAQ’s * has 50k+ doctors and 320 hospitals statewide, plus Blue Card benefits out of state & country. 2020 Agent Guide * Member Outreach Bulletin *
- How to use the Finding a provider tool above VIDEO
- Understanding Your Plan pdf
- Nurse Help 24/7, Heal and Teladoc save on prescriptions ER vs. urgent care.
- Get the most from your health care plan VIDEO
- Use your online account to review claims, copays or deductibles and take advantage of other member benefits.
- Explanatory VIDEOS on everything... from Blue Shield
- Medicare Advantage Provider Print Directories BROKER ONLY
- Late Bloomers – Medicare – VIDEO
- Enroll and get full details on our
- Pharmacy networks
- Drug formularies
- Member resources
- Pharmacy FAQs
- Our other webpages on Rx
- General Information on Rx Coverage - with extensive FAQ's
- Medicare Information including Shop & Compare
- Medical Loss Ratio - Insurance Companies can't break the bank
Blue Shield offers affordable and comprehensive dental plans available to clients with and without a Blue Shield health plan.1
Blue Shield’s dental provider networks are among the largest in the state. The dental PPO plans include nearly 47,000 providers in California and nearly 400,000 nationwide. The dental HMO network includes more than 22,000+ providers in California. Check out the dental network map for an overview of county coverage.
- No waiting period for diagnostic or preventive services
- Covered diagnostic and preventive services, such as X-rays and routine cleanings, do not count toward the annual coverage limit for dental PPO and Specialty Duo dental plans, providing more coverage for other services before reaching the annual limit
- A wide range of dental benefits, including most diagnostic and preventive services and oral cancer screening, at no additional cost when using a dental network provider
- Implants coverage available in our dental PPO plans with a $1,250 calendar-year benefit maximum
- Orthodontic benefits are available for both children and adults
- Choice of $25 or $50 deductible per member, per calendar year
- Choice of a $500, $1,000 or $1,250 calendar-year benefit maximum per member
- Coverage even when your clients use a non-network dentist. Our plan reimburses your clients up to an allowed amount for covered services, and your clients pay the remaining balance of the total billed charges.
- No deductibles and no calendar-year maximums
- Orthodontic services available with or without a 12-month waiting period, for both children and adults
- Affordable fixed copayments for basic and major services
- Specialty care available with a referral from a primary dentist
Dental Benefit Summaries
|Dental HMO||English (PDF, 250KB)|
|Dental Standard HMO||English (PDF, 155KB)|
|Plan name||Benefit summaries|
|Dental PPO||English (PDF, 2MB)|
|Specialty DuoSM Dental||English (PDF, 2MB)|
|Enhanced Dental PPO 25/500||English (PDF, 145KB)|
|Enhanced Dental PPO 50/1250||English (PDF, 145KB)
|Enhanced Dental PPO 50/2000||English (PDF, 2MB)
Spanish (PDF, 1.7MB)
|Enhanced Dental PPO 50/2000/Lifetime Ortho 1500||English (PDF, 2MB)
Spanish (PDF, 1.7MB)
|Plan name||Benefit summaries|
|DMHC Disclosure||English (PDF, 2MB)|
|CDI DisclosureImportant Legal Information Booklet (||English (PDF, KB)|
Broker Page for Dental on Blue Shield Site
Importance of Dental Coverage
Dental & General Health
- Why Buy Dental Insurance? VIDEO
- What dental Insurance... should I buy???
VIDEO the dentist attempts to give you some guidance about things to consider before buying a dental insurance plan, finance plans available, negotiating with your dentist
- Sacramento Truck driver sudden dealth from tooth infection Sacramento Bee 1.31.2017
- Health Savings Accounts?
- Video - how bad sugary drinks are for you
Resources, More Info & Links
More detailed information – dental benefit summaries.
| Specialty DuoSM
If any of the above links require a password, email us and we will send you the brochure.
Member #Portal Account
Benefits of creating-registering for a Member Portal Account
- Easily search and view benefit information
- Member Website Overview pdf
- Change methods of payment for paying premiums
- See claims by family member
- Track deductibles and co payment amounts
- Change PCPs and medical groups
- Renew your plan BlueShieldCA.com/Renew
- Print member ID cards – anytime, anywhere!
- Members can follow three easy steps to print a new ID card:
- Register for an ONLINE Member Portal
- Go to Member Overview and add New Member ID number (required).
- Click View . . . and Print ID.
The ID card will work at the doctor’s office as soon as your client’s membership becomes effective. The plastic ID card will arrive in seven to 10 business days.
- Explanatory Videos on everything… from Blue Shield
- Ask A Question – FAQ’s
Many of your issues can be resolved for our clients by emailing us [email protected] and we can help immediately or in a few days via email rather than calling and waiting on hold with Blue Shield. Here’s the form to appoint us as your broker with Blue Shield, no extra charge!
Customer Service (800) 393-6130
mail: P.O. Box 272540 Chico, CA 95927-2540
Provider – Pre Authorizations Website
Pre-admission (800) 541-6652
More Contact Info
Tech Support (800) 393-6130
Website Technical Support 877 932-3375
Get a Member Portal