Oct 11, 2021
Blue Shield is pleased to announce Q1 2022 rates are now available for quoting. First-quarter 2022 rate action is a statewide average of 1.2%.
Portfolio Updates
Heading into Q1, you’ll find minimal changes to the existing medical portfolio. This is due to decreased out-of-pocket maximums in many plans, no actuarial value calculator changes resulting in minimal cost share changes, and Blue Shield’s focus on providing more plan options with a greater value for their members.
Underwriting Updates
- Relaxed participation promotion has been extended through 2022 – and mirror plans can now take advantage of this promotion!
- Mirror plans can now be sold alongside another carrier.
Enrollment Forms
Blue Shield has released 2022 versions of the below enrollment forms. These are required for January 1, 2022 and later effective dates. No exceptions will be made.
For new 2022 effective groups:
- Employer Application
- Employee Application
- Refusal of Coverage
- Express Enrollment Spreadsheet (coming soon)
For existing groups making a change in 2022:
Sales Material
Trio Network Expansion
Starting in January 2022, the Trio ACO network will expand to include parts of Santa Barbara and Monterey.
Santa Barbara County
The following medical group will be added to the Trio ACO network in Santa Barbara (partial county): Sansum Medical Clinic.
The following hospital partners will be added to the Trio ACO network in Santa Barbara:
- Santa Barbara Cottage Hospital
- Santa Ynez Valley Cottage Hospital
- Goleta Valley Cottage Hospital
Zip codes now in service area:
- Carpinteria: 93013, 93014
- Goleta: 93116, 93199, 93117, 93118
- Oak View: 93022
- Ojai: 93023, 93024
- Santa Barbara: 93110, 93130, 93160, 93111, 93103, 93190, 93109, 93102, 93120, 93121, 93101, 93140, 93108, 93107, 93106, 93150, 93105
- Santa Ynez: 93460
- Solvang: 93463
- Summerland: 93067
- Ventura: 93001
Monterey County
The following medical group will be added to the Trio ACO network in Monterey (partial county): Aspire Health Plan
With network medical groups consisting of:
- Montage
- Salinas Valley Health System
The following hospital partner will be added to the Trio ACO network in Monterey (partial county):
- Community Hospital of the Monterey Peninsula (CHOMP)
- Salinas Medical Center
Zip codes now in service area:
- Marina: 93933
- Monterey: 93940, 93942, 93943, 93944
- Pacific Grove: 93950
- Pebble Beach: 93953
- Seaside: 93955
Renewing Groups
Group renewal packets include an options census for quick quoting that displays the current and renewing rates, along with several plan options with 2022 rates. This options census includes Trio HMO and Tandem PPO plans comparable to a group's current Access+ HMO or Full PPO plan selections. You may find Trio HMO and Tandem PPO plans can reduce your clients’ costs without requiring their employees to change providers. The statewide average rate difference between Trio HMO and Access+ HMO is 19%, and there is a 10% difference between Tandem PPO and Full PPO.
- Groups renewing in January will be available to brokers through Shield Renewals on Friday, October 8* while group-level changes can be made using Small Group Online Renewal (SGOR) beginning Thursday, October 14.
- Groups renewing in February and March will be available to brokers through Shield Renewals on Wednesday, November 10* while group-level changes can be made using Small Group Online Renewal (SGOR) beginning Tuesday, November 16.
Groups will receive an email notification and a mailed one-page letter. The letter will direct them to their renewal microsite for complete renewal information. Full renewal printed packets will only be mailed to groups if these sites are not visited on or before the dates outlined below.
- January renewals:
- Employer notifications sent October 22.
- Access site by November 12.
- February renewals:
- Employer notifications sent November 19.
- Access site by December 10.
- March renewals:
- Employer notifications sent December 17.
- Access site by January 7.
