Explore your plan options

Every Blue Shield plan is designed to help you discover the healthiest version of yourself. Choose from the options below to get started on your path to better health. If you need help choosing a plan or learning more about programs and services offered by Blue Shield, watch this video below or visit . blueshieldca.com/employercoverage.

Medical

Silver Trio HMO 2300/70 OffEx

Our Trio HMO plan is typically more affordable than other plans. It features a select network of local providers who closely coordinate your care and a concierge service to help you with everything from benefit questions to scheduling doctor’s appointments. When you enroll in the Trio HMO plan for the first time, you must choose a primary care physician (PCP) for yourself and your covered dependents. Each member of your family can choose a different physician and medical group/Independent Practice Association (IPA).

To enroll in the Trio HMO plan, you must live or work within the Trio service area.

Gold Trio HMO 500/35 OffEx

Our Trio HMO plan is typically more affordable than other plans. It features a select network of local providers who closely coordinate your care and a concierge service to help you with everything from benefit questions to scheduling doctor’s appointments. When you enroll in the Trio HMO plan for the first time, you must choose a primary care physician (PCP) for yourself and your covered dependents. Each member of your family can choose a different physician and medical group/Independent Practice Association (IPA).

To enroll in the Trio HMO plan, you must live or work within the Trio service area.

Gold Trio HMO 0/30 OffEx

Our Trio HMO plan is typically more affordable than other plans. It features a select network of local providers who closely coordinate your care and a concierge service to help you with everything from benefit questions to scheduling doctor’s appointments. When you enroll in the Trio HMO plan for the first time, you must choose a primary care physician (PCP) for yourself and your covered dependents. Each member of your family can choose a different physician and medical group/Independent Practice Association (IPA).

To enroll in the Trio HMO plan, you must live or work within the Trio service area.

Silver Full PPO 2000/60 OffEx

Our PPO plans offer a broad physician and hospital network, and the flexibility to see any doctor in, or out, of the plan’s network. However, PPO plans may include a deductible, which is the amount you must pay before your insurance kicks in. After you’ve met your deductible, you’ll usually pay a percentage of the cost, which is called coinsurance. Staying in network will mean you usually pay lower out of pocket costs than if you choose to go out of network.

Gold Full PPO 750/30 OffEx

Our PPO plans offer a broad physician and hospital network, and the flexibility to see any doctor in, or out, of the plan’s network. However, PPO plans may include a deductible, which is the amount you must pay before your insurance kicks in. After you’ve met your deductible, you’ll usually pay a percentage of the cost, which is called coinsurance. Staying in network will mean you usually pay lower out of pocket costs than if you choose to go out of network.

Bronze Full PPO 6250/65 OffEx

Our PPO plans offer a broad physician and hospital network, and the flexibility to see any doctor in, or out, of the plan’s network. However, PPO plans may include a deductible, which is the amount you must pay before your insurance kicks in. After you’ve met your deductible, you’ll usually pay a percentage of the cost, which is called coinsurance. Staying in network will mean you usually pay lower out of pocket costs than if you choose to go out of network.

Bronze Tandem PPO 7500/65 OffEx

Our Tandem PPO plan offers the flexibility of a PPO plan but is typically more affordable due to a select network of providers. That said, the network includes over 65% of doctors and 90% of hospitals from our broad PPO network. This plan also offers concierge support services to help answer your questions about benefits, claims, and more.

Bronze Full PPO Savings 5700/40% OffEx

High-deductible health plans offer lower monthly premiums than our other PPO plans, but have a higher deductible. These plans qualify you for the option of opening a tax-advantaged HSA account to help save and pay for qualified medical expenses. Money added to an HSA is yours to keep and there is no use it or lose it penalty.

Resources

Health programs and services
Acupuncture services

Visit any participating acupuncturist in the American Specialty Health Plans of California, Inc. (ASH) provider network without a referral from your PCP.

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Care away from home

You are covered for emergency and urgent care services across the United States and around the world through the BlueCard® and Blue Shield Global Core programs.

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Care away from home

Through the BlueCard® and Blue Shield Global Core programs, you have access to care across the United States and urgent and emergency care around the world. You can receive urgent or emergency care from any provider. However, using a BlueCard provider can be more cost-effective.

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Chiropractic services

Visit any participating chiropractor in the American Specialty Health Plans of California, Inc. (ASH) provider network without a referral from your PCP.

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Coverage for students or families living apart

The Away From Home Care program offers students, long-term travelers, workers on long-distance assignments and families living apart access to health care from Blue Shield and Blue Cross plans across the country. HMO benefits vary by state.

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Health savings account (HSA)

An HSA offers a useful way for you to save for medical expenses.

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ID theft protection

Protecting your financial well-being is as important as protecting your health. This is why we offer identity protection services. These include credit monitoring, identity repair assistance and identity theft insurance. To sign up, visit experianidworks.com/blueshieldca. Use code BCBSCALI22 when setting up your account. Or call (866) 274-3891, Monday to Friday from 8 a.m. to 8 p.m. and Saturday and Sunday from 8 a.m. to 5 p.m.

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LifeReferrals 24/7

Part of the Small Group life insurance program, LifeReferrals offers experienced professionals who can help beneficiaries with grief counseling, financial coaching, and legal assistance.

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Mental health and substance use disorder care

You have access to virtual, inpatient and outpatient care for issues such as depression, alcohol/substance use disorder and mental illness. Find network providers now.

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MyStrength (New for 2021)

Get help managing stress, sleeping better, and more with this digital mental health treatment tool.

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NurseHelp 24/7

Registered nurses are available to answer your health questions at any time, every day.

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Maternity program

Blue Shield of California members can access Maven, a program designed to give you and your partner digital and virtual support for your pregnancy and  postpartum needs – at no extra cost. You can also get support if you have experienced a pregnancy loss.

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Preventive care

Take charge of your health. Find out what screenings, services, and immunizations are recommended for you and your family.

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Shield Concierge

Get support managing your health needs for a wide range of conditions from a team specially trained on the specific health benefits and programs available to you. You’ll also receive personalized service for everything from finding a doctor to understanding benefits and claims.

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Teladoc

Speak to a licensed doctor or mental health professional online, via a mobile app or phone. You have a $0 copay per consult.

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Wellness Discount Programs

Get help saving money and living healthier with a wide range of discount programs* including fitness club memberships; acupuncture, chiropractic services and massage therapy; eye exams, frames and contact lenses; and LASIK surgery

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Wellvolution

This program offers in-person programs and online programs to to help you achieve your well-being goals.

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Pharmacy benefits
CVS mail service prescriptions

Receive up to a 90-day supply of covered maintenance drugs, delivered directly to you with no charge for shipping.

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Contact Blue Shield

HMO and PPO Member Services

Phone: (888) 319-5999

8 a.m. to 5 p.m. PST, Monday through Friday


Shield Concierge

For all Trio HMO plans call

Phone: (855) 664-5577

7 a.m. to 7 p.m. PST, Monday through Friday


Shield Concierge

For all Tandem PPO plans call

Phone: (877) 806-7589

7 a.m. to 7 p.m. PST, Monday through Friday


Summary of Benefits and Coverage

The Summary of Benefits and Coverage (SBC) documents that follow are available as required by the Affordable Care Act. The linked SBC documents that appear below are in English. We provide descriptions of the Summary of Benefits (SOB) plans in Spanish to make it easier to understand the benefits of a plan. You can find the descriptions by selecting the name of the plan in the "Medical" section above.

Silver Trio HMO 2300/70 OffEx

Gold Trio HMO 500/35 OffEx

Gold Trio HMO 0/30 OffEx

Silver Full PPO 2000/60 OffEx

Gold Full PPO 750/30 OffEx

Bronze Full PPO 6250/65 OffEx

Bronze Tandem PPO 7500/65 OffEx

Bronze Full PPO Savings 5700/40% OffEx

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