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.
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.
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.
Get the most out of your healthcare dollar with plan options that provide the perfect balance of coverage and value.
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.
Does your company offer retiree coverage? Our group Medicare options can provide continuity of coverage with high-value options.
Today, employees expect more. Virtual Blue delivers with anytime, anywhere virtual care, $0 copays for AccoladeCare virtual visits, and in-person care when they want it. A collaborative approach to care delivers better outcomes and elevates employee satisfaction, driving value for businesses of all sizes.
Collaborative approach to care integrating primary, behavioral health, and specialty care
A personalized experience with a dedicated virtual care team for each employee
Easy access to care via our California and nationwide PPO networks.
The Virtual Blue plan is available to fully insured small business employers (1-100 employees) and large group employers (101-2,999 employees).
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 |
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 |
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 |
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.
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 |
Blue Shield’s integrated approach to pharmacy and medical benefits gives you a smarter way to manage prescription drug costs. Our custom strategies and innovative cost management programs — all designed with the highest quality care for your employees — will save $16-24 per member per month.
Robust formulary management. Tailored plans that deliver better care at a better price. And strategic partnerships to drive down costs via new generic and specialty drug programs.
One-stop benefits shopping. Streamlined administration. And a proactive account management team ready to help. See how our flexible, value-driven, service-oriented approach can work for you.
With coordinated pharmacy and medical care, members get the answers they need and prescriptions they can afford. They’ll also have access to 65,000+ pharmacies nationwide , including all major chains.
Our specialty coverage supports total health and well-being with robust dental, vision, and life insurance options.
Your members will have access to the largest dental provider network in California and nationwide (as part of the Blue network).
The largest vision network in California and nationwide includes doctors, specialists, and retailers like Costco, LensCrafters, Target, and Walmart.
Life insurance is an important way that companies can help employees protect their families.