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 flexible plans, high-touch account management, and increased employee engagement.
Large groups (101+)
A wide range of HMO, PPO, and other plan options help you manage costs while offering benefits that attract talent to your company. And both local and nationwide coverage ensures your employees have access to health care wherever they live or work.
Explore large group coverage
Discover Virtual Blue
A virtual-first plan available for fully insured small business & large group employers. $0 unlimited virtual visits, including mental health & specialty care, provided by AccoladeCare. In-person care available through our California and nationwide PPO networks (cost share applies).
Explore Virtual Blue
Small businesses (1 - 100)
Various options combine high-value coverage and simple administration for small businesses.
Explore small business coverage
Group Medicare
If your company offers retiree coverage, learn about our high-value Medicare continuity of coverage options.
Labor & Trust
Labor & Trust industries often have highly specific needs. We have extensive experience in building plans to address those needs.
Explore Labor & Trust
Have a question? Speak to one of our representatives to find the plan best suited for you.
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A new plan.
Made for your employees,
made for you.
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 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
ShowHide Transcript
Paula Lunde ( 00:08 ):
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 ( 00:40 ):
This holistic approach really produces great patient healthcare outcomes. You have people with different expertise that can address every aspect of what the member's going through.
Sabina Rosenstock ( 00:52 ):
Maybe they need some assistance with a support group or personal therapist or psychiatrist.
Cleo Mutebi ( 00:57 ):
It's really a white glove service where you don't have to do anything more than just make that one initial call.
Amy Togonon ( 01:03 ):
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. And it's different in 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 ( 01:23 ):
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.
Paula Lunde ( 01:31 ):
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.
Sabina Rosenstock ( 01:41 ):
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 ( 01:52 ):
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 a member and being able to address the concerns or barriers that they may be facing is extremely rewarding.
Paula Lunde ( 02:06 ):
We're proud of how our teams have really touched the lives of members and really improve the quality of life.
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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
Pharmacy: Integrated coverage for better value and outcomes
Looking for a smarter way to manage prescription drug costs? Our custom strategies and innovative cost management programs are designed with the highest quality care for your employees in mind—and offer savings of $16-24 per member per month.
Learn more about Pharmacy
Effective cost management solutions
- Robust formulary management
- Tailored plans that deliver better care at a better price
- Strategic partnerships to drive down costs via new generic and specialty drug programs
Simpler administration for employers
- Flexible, one-stop benefits shopping
- Streamlined administration with pharmacy and medical combined
- A proactive account management team ready to help
A better experience for employees
- Access to 68,000+ pharmacies nationwide, including all major chains
- Improved outcomes with coordinated pharmacy and medical care
- A single source of support for member questions
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.