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.
Explore national coverage
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.
Explore large group coverage
Small businesses (1 - 100)
Get the most out of your healthcare dollar with plan options that provide the perfect balance of coverage and value.
Explore small business coverage
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.
Explore coverage by industry
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.
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
Learn more about Trio 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
Learn more about Tandem 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
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 Engagement Point<sup>SM</sup>, our digital platform that can incorporate your third-party vendors, and 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
Specialty coverage
Our specialty coverage supports total health and well-being with robust dental, vision, and life insurance options.
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.