Blue Shield IFP Grandfathered, Off-Exchange and Dental HMO Plan Withdrawals
This week, Blue Shield of California will begin sending letters to members who are currently enrolled in a Blue Shield plan that will be discontinued as of December 31, 2017.
Blue Shield of California will withdraw the following plans from the Individual and Family Plans market. They will no longer be available as of January 1, 2018.
Grandfathered plans (impact: 1,610 members)
Being mission-focused means considering what is in the best interest of all our members and we are committed to offering your Blue Shield clients access to high-quality care at a price they can afford.
The membership of our grandfathered plans continues to get smaller every year. When a plan’s membership drops below 500 members, we need to review our portfolio and consider changes that benefit all Blue Shield members. Therefore, we are withdrawing the following Blue Shield of California grandfathered plans from the Individual and Family Plans market.
- Vital Shield Plus 2900-G
- Vital Shield Plus 400-G
- Vital Shield Plus 900-G
- Blue Shield Life PPO Plan 2000-G
- Vital Shield Plus 400 Generic RX-G
- Vital Shield Plus 2900 Generic RX-G
- Active Start Plan 35 Generic RX-G
- Shield Spectrum PPO 5500-G
Grandfathered plan members will NOT be automatically enrolled into another Blue Shield plan. These members will need to apply for a new plan for 2018. If they do not enroll in a new health plan, they will not have health coverage in 2018.
Off-Exchange Silver Seven 3750 and Bronze 5550 (impact: 38,151 members)
Due to rising health-care costs and high demand for medical services, we are streamlining our portfolio of plans. We will continue to provide options that offer the high-quality care your clients need. Our Bronze 5550 PPO and Silver Seven 3750 PPO plans will no longer be available starting January 1, 2018.
Members enrolled in one of these Off-Exchange plans will be automatically re-enrolled into a suggested/recommended plan as follows:
- Silver Seven 3750 PPO mapped to Silver 1850 PPO
- Bronze 5550 PPO mapped to Bronze 60 PPO
Members may want to think about a Trio HMO plan this open enrollment, which could help lower their monthly costs, but still offers access to board-certified doctors (available only for those who live in an area with approved Trio ZIP codes).
Dental HMO plans in 12 counties within three regions of California (impact: 6,724 members, limited withdrawal)
In 2018, we are discontinuing our Enhanced Dental HMO $0 and Dental HMO plans from 12 counties within regions 1, 2, and 12. This is because there are very few dental HMO dentists within these counties. Most of the affected membership in these two dental plans will be mapped to our Enhanced Dental PPO 25/500 plan. The waiting period listed on the Summary of Benefits for this plan will be waived for members with withdrawn dental plans.
Blue Shield is beginning to send letters to affected members notifying them about the plan withdrawals and their options for 2018. Those members who will not be mapped will need to select and apply for a new plan.