Product cycle updates and benefit changes
Small Business (1-100)
Q1 2025 updates
Rates now available through your preferred quoting engine
We are pleased to announce Q1 2025 rate book is now available on the dedicated Rates page of Broker Connection. Our first-quarter 2025 rate action is a statewide average of 1.3%. Remember! The Employer Enrollment Tool lets you easily find quotes and provides a streamlined, digital experience for all your Q1 enrollments.
Rates, including closed rate books, can be found on Broker Connection Small Business rates.
Rates for closed Specialty benefits (dental and vision plans) are included in a variety of locations including:
- Rate book – includes Medical and Specialty (all regions: 1-19)
- Rate books 1-11
- Closed Rate Book – includes closed Specialty (all regions: 1-19)
January, February and March 2025 renewals
Groups renewing in January will be available to brokers through Shield Renewals on Tuesday, October 15* while group-level changes can be made using the newly launched Employer Enrollment tool for renewals starting Thursday, October 17*. Groups renewing in February and March will be available on Tuesday, November 12* while group-level changes will be available starting Thursday, November 14*.
View all your groups renewal information by visiting the renewal center page while logged into your unique broker portal. Accessing the Shield Renewals link will allow you to review and download renewal information, access your groups renewal microsite, consider buy up or buy down options by using the medical choice chart and many more to help ensure a streamlined renewal experience for you and your group. The employer enrollment tool now has the added functionality of managing your group-level changes. You can review this EET Renewals user guide for more information or visit the Employer Enrollment Tool resource page.
Don’t forget to bookmark or download your tool resources:
| Renewal Period | Download 60-day renewal kits from Shield Renewals | 60-day renewal notice mailed to Group Administrator (Employer) | Make group-level changes using Online Renewal |
|---|---|---|---|
| For below schedule, group and member level changes can be made using the Employer Enrollment Tool Renewals | |||
| January 2025 | October 15, 2024 | October 21, 2024 | October 17, 2024 |
| February 2025 | November 12, 2024 | November 15, 2024 | November 14, 2024 |
| March 2025 | November 12, 2024 | December 16, 2024 | November 14, 2024 |
*Dates subject to change
Medical plan updates
See below list for impacted PPO plans with cost share and name changes. There are no name changes within our HMO portfolio. You can view the full list of 2025 plan name changes here.
| PPO | |
2024 Plan Name |
2025 Plan Name |
Silver PPO 2000/60 |
Silver PPO 1700/60 |
Silver PPO 2350/65 |
Silver 2100/65 |
Silver PPO 2550/70 |
Silver PPO 2350/70 |
Gold PPO 1000/35 |
Gold PPO 1000/30 |
Bronze PPO 5500/65 |
Bronze PPO 4500/65 |
Mirror Bronze 60 PPO 6300/60 |
Mirror Bronze 60 PPO 5800/60 |
For a full list of 2025 plan changes and updates you can visit the ‘Changes To’ page on broker connection. To view exact terms and conditions of coverage for all 2025 plan offerings, refer to the Evidence of Coverage for the plan, or contact your Blue Shield account manager. You can also use the Plan Comparison tool to see plan updates across multiple years and compare plan benefits within the same plan family.
Making it easier to offer HMO to your groups
Effective January 1, 2025, you can now offer all 3 HMO (Access+, Local Access+, Trio) networks alongside each other, applicable to both new sales and renewals allowing for more simplification and growth.
Trio HMO now offering coordinated in-person and virtual care
A virtual provider option is now available in all counties that offer Trio HMO through Accolade Care offering primary, specialist, and behavioral care. Please note that referrals are required for specialty care.
Improved and equitable access to healthcare.
Providing improved accessibility to at-home care with DispatchHealth
Through DispatchHealth we are offering employers and their employees convenient and prompt at-home medical support post-hospitalization. Now available at $0 for all PPO members. A referral is needed by a case manager or a provider.
Our commitment to equitable access to health care
Effective January 1, 2025, we will be expanding our travel reimbursements program for eligible covered services, which currently includes abortion services, to also cover gender-affirming care. This program is designed to support members living in states that ban or restrict these services, providing them with access to necessary care.
Specialty Plans (Dental, Vision, Life)[1] update
Prepare for 2025 Dental PPO plan withdrawals
As part of our product transformation and portfolio simplification efforts, three DPPO plans will be withdrawn from our Specialty portfolio beginning January 1, 2025. See mapping grid for list of withdrawn plans and corresponding recommended available plans. You can also use the Plan Comparison Tool to compare benefits between a withdrawn plan and new available plan by using the compare year over year function. Plans being withdrawn:
- Smile℠ Deluxe 50/1500/Ortho/MAC
- Smile℠ Deluxe Gold 50/1500/Ortho/U85/NR
- Ultimate Dental Plus PPO for Small Business 50/2000/Ortho/MAC/NR
We will be providing written communication to your employer groups enrolled in any of these withdrawing plans 60 days prior to their anniversary. Please contact your blue shield account manager for more information.
Easily offer added specialty products with these enhanced programs
Bundled Savings discount program where groups will now receive a 10% discount on their dental or vision premium when added to their medical plan.
Quick Match ProgramSM Matching for small business life insurance plans has been enhanced. We can now match a current group's combined Basic Life/AD&D renewal rates at $0.08 per $1,000, for amounts between $15,000 and $200,000.
Pharmacy Updates
New 2025 pharmacy care model resources now available
You can now learn more about Blue Shield’s first-of-its-kind pharmacy solution by visiting this new pharmacy care mode resource page (authentication required). This page includes details about Blue Shield’s Pharmacy care model, Amazon Pharmacy for home delivery, new I.D cards and many more helpful information for you and your groups.
Updates to Member Pays Difference Penalty (MPD)
When the MPD penalty applies, your group’s employees will pay the difference in cost plus the applicable tier cost share of the brand drug. The MPD penalty will be expanded to brand drugs that have an available preferred biosimilar drug. An exception process continues to be available when the brand drug is medically necessary.
Changes to weight loss drug exclusions
Beginning January 1, 2025, upon group renewal the weight loss drug benefit exclusion will be reinstated to align with the market. Weight loss drugs will be excluded from coverage except when medically necessary. For exact plan coverage details please refer to the plan’s Evidence of Coverage.
Sell more, earn more with our various rewards programs
The small business incentive program will reward you for newly enrolled members and offer added bonuses when enrolling a new member in all three specialty products: dental, vision, and life. We are continuing to reward direct-selling brokers with our Direct Elite Rewards program. Each point you earn is equal to $1 available to both independent and individual brokers within an agency that has opted into a program. Learn more about enrolling in Producer Rewards here (authentication required).
Resources for a trusted advisor
For additional support and information your Blue Shield support team is available to you throughout the year. Contact Broker Services: (800) 599-5905 or email at producer.services@blueshieldca.com.
[1] Underwritten by Blue Shield of California Life & Health Insurance Company.
