Coverage Solutions: THE BLUE SHIELD DIFFERENCE

No matter what size your group is, Blue Shield of California offers you flexibility in plan building and nimble, responsive account management. Your members can expect one-stop service and a great experience that proactively engages them in their health journey.

All Blue Shield plans provide nationwide coverage; we tap into the same network of providers as other Blue plans across the country.

Discover leading-edge products, flexible plan building, nimble account management, and high employee engagement.

  • National accounts (3,000+)

    National accounts headquartered in California can take full advantage of the national Blue networks—and pair those networks with our flexible benefit plans and programs that keep employees healthy and engaged.

  • Large groups (101 - 2,999)

    A wide range of HMO, PPO, and other plan options give you the flexibility to manage costs while offering benefits that attract talent to your company.

  • Small businesses (1 - 100)

    Get the most out of your healthcare dollar with plan options that provide the perfect balance of coverage and value.

  • Coverage by industry

    Labor & Trust, public sector accounts, and other industries often have specialized needs. Blue Shield has extensive experience in building the right plans and programs for your organization.

  • Group Medicare

    Does your company offer retiree coverage? Our group Medicare options can provide continuity of coverage with high-value options.

  • Have a question? Speak to one of our representatives to find the plan best suited for you.

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  • Trio HMO: Coordinated, accountable care

    Trio is the next evolution of an HMO, built on accountable care and provider partnerships. Doctors, hospitals, and Blue Shield work together to coordinate care, including connecting members to community resources.

    21,000+ in-network doctors and 340+ in-network hospitals across 28 California counties

    $0 copay for virtual care from Teladoc® providers (including mental health care)

    Shield Concierge enhanced customer service

    Wellvolution(R) curated collection of life-changing disease-reversal apps

    Extensive pharmacy network, including major chains

    Assistance for healthy eating with the Healthy Savings® program

    • 12-15% average savings over full HMO
  • Tandem PPO: The right-sized PPO

    There’s an ideal middle ground between paying for a full PPO network and paying for just enough PPO network to fulfill the needs of your company or client. Tandem is a targeted PPO that delivers more savings and benefits—a “just right” solution for many.

    Tandem in-network doctors: 55,000+ (vs. 81,000+ in the full PPO network)

    Tandem in-network hospitals: 355 (vs. 382 in the full PPO network)

    Enhanced customer service with Shield Concierge, including access to RNs, pharmacists, and claims specialists; most issues solved in one call

    Members can see specialists without a referral

    $0 copay for virtual care from Teladoc® providers (including mental health care)

    Wellvolution suite of lifestyle medicine apps that provides $0 access to Ginger, Headspace, and more

    • 12% savings over broad PPO

Shield Concierge: High-touch services made personal

  • Shield Concierge service is included with Trio HMO and Tandem PPO plans. This personal, high-touch service gives employees a one-call source for answers. For employers, Shield Concierge helps reduce administrative responsibilities and improve employee satisfaction with benefits.

    Dedicated customer service that includes claims and coverage experts, nurses, pharmacy technicians, and social workers

    A single point of contact with high-quality interactions designed to resolve member issues in the first call

    90% member satisfaction rating, with 92% of all calls resolved within 30 seconds

  • ShowHide Transcript

    Paula Lunde: Healthcare can be scary and it could also be complicated. We help members navigate a system that isn't always easy to best meet their needs. Shield Concierge is one of our premium care models at Blue Shield, where we pair a designated customer care team with a designated clinical team, and they're working in lockstep to really deliver customized solutions for our clients. It's all about resolving a member's issues in one call and then working as a team to make sure that the member gets what they need.

    Cleo Mutebi: This holistic approach really produces great patient healthy outcomes. You have people with different expertise that can address every aspect of what the member's going through.

    Sabina Rosenstock: Maybe they need some assistance with a support group or personal therapist or psychiatrist.

    Cleo Mutebi: It's really a white glove service where you don't have to do anything more than just make that one initial call.

    Erin Casey: The concierge program is really incredible because the whole premise is that everybody has quick access to each other.

    Amy Togonon: Calling other health plans, you get transferred from person to person to person, and sometimes at the end of the call, you still don't get an answer. It's different at Shield Concierge because you call in, you speak to a customer service representative, and they're going to handle your call from beginning to end. They're going to be the one to call the different departments for you to take care of your needs.

    Sabina Rosenstock: When we support our members, we do our best to send them as much information as we can to reduce any homework that they might need to do on their own. A recent member that I worked with had a new diagnosis of cancer. We were able to discover that they could really use some extra emotional support, so I was able to connect them with a personal therapist as well as a cancer support group, and then also connect them with our registered nurse case managers to assist him with some referrals and authorizations to be able to coordinate with his providers and his treatment team.

    Melanie Zanze: Taking a member out of the middle, takes the responsibility of getting whatever they need off of them and back onto Blue Shield.

    Paula Lunde: We offer a really robust suite of clinical solutions that employers can get all in one place, and it's really a great way for employers to attract their employees.

    Erin Casey: It's a unique relationship that we get to build with our members, because even though I'm just a voice on the phone, I want you to get better. I want you to have access to your care. I want you to have the best possible outcome.

    Sabina Rosenstock: Blue Shield really cares about what their employees go through and how they feel and the resources and benefits that they need to be able to do their job effectively so that we can help our members and the community.

    Cleo Mutebi: My favorite part of my job is the impact that I make on a daily basis within Shield Concierge, being able to get on the call with the member and being able to address the concerns or barriers that they may be facing is extremely rewarding.

    Paula Lunde: We're proud of how our teams have really touched the lives of members and really improved the quality of life.

  • Self-funded/administrative services only (ASO) plans

    Our self-funded plans offer flexibility, control, and programs that promote a better member experience and better outcomes. These include Connect, our high-touch member advocacy support service.

    Customizable plans with whole person coverage available (disease management, Rx, dental, vision)

    80,000+ providers in California; national coverage with our extensive BlueCard® PPO network

    Member advocacy and service model that engages employees in their own health—with performance guarantees to back it up

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  • Specialty coverage

    Our specialty coverage supports total health and well-being with robust dental, vision, and life insurance options.

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  • Dental

    Your members will have access to the largest dental provider network in California and nationwide (as part of the Blue network).

  • Vision

    The largest vision network in California and nationwide includes doctors, specialists, and retailers like Costco, LensCrafters, Target, and Walmart.

  • Life

    Life insurance is an important way that companies can help employees protect their families.

Want to talk? Contact us to discuss your needs.