Q4 2022 Small Business Updates and Reminders From Blue Shield of California

7/14/2022
California

 

Relaxed Participation - Etended through 12/31/2022

Blue Shield is relaxing underwriting participation requirements for groups with five or more enrolled employees to just 25% for their medical, dental, vision, and life insurance plans.

Rules for the relaxed participation requirements promotion:
-Applies to new medical small business and specialty clients with off-exchange plans or mirror plans and effective dates of January 1, 2002 and later.


-At least 25% of the total number of eligible employees enroll in a Blue Shield healthcare plan with no fewer than five.
 

-Only one carrier can be written alongside a Blue Shield plan.
 

-EPO benefit-designed plans cannot be written alongside any Blue Shield medical products.
 

-When offering dental, vision, and life products, Blue Shield must be the sole carrier. Life insurance requires a minimum of two enrolled employees.
 

-Groups who contribute 100% of premiums for medical or specialty coverage must enroll 100% of eligible employees (except those waive due to other group coverage through another employer).


-Groups must meet the definition of a qualified small employer group.


-All normal eligibility and enrollment documents are required.


-Refusals are required for all eligible employees not enrolling in the Blue Shield plan(s).
[Relaxed Participation Flyer]     [Small Group Incentive Program Flyer]


Bundled Savings on Small Business specialty coverage groups of 1-100 employees
10% discount for small business specialty (dental and/or vision) is now available when added to medical. This applies to new business written on or after 1/1/19. The discount is applied directly to the monthly billing statement for dental and/or vision. 


Blue Shield of California Average Small Business Medical Rate Actions

Average HMO Rate Actions

Year January April July October Yearly Average
2013 2.0% 0.0% 0.0% 0.0% 2.0%
2014 1.7% 1.8% 1.2% -1.8% 2.9%
2015 0.7% 0.0% 4.0% 4.4% 9.3%
2016 0.6% 0.0% 0.0% 2.8% 3.4%
2017 0.0% 4.3% 0.0% -0.9% 3.4%
2018 2.3% 1.0% 0.0% -2.1% 1.2%
2019 0.9% 1.6% 3.8% 1.8% 8.3%
2020 0.9% 0.0% 0.9% -1.2% 0.6%
2021 0.0% 1.0% 1.2% 1.4% 3.6%
2022 1.2% 0.9% 2.4% 3.6% 8.3%


Average PPO Rate Actions

Year January April July October Yearly Average
2013 1.7% 3.3% 3.0% 0.0% 8.2%
2014 6.5% 2.3% 2.5% -7.7% 3.1%
2015 2.4% 0.0% 2.2% 0.0% 4.7%
2016 1.1% 0.0% 0.0% 5.0% 6.2%
2017 -0.2% 0.8% 0.0% 0.5% 1.1%
2018 1.1% 1.9% 0.0% 0.7% 3.7%
2019 1.3% 1.5% 3.3% 1.8% 8.1%
2020 0.9% 0.0% 0.9% -1.2% 0.6%
2021 0.0% 1.0% 1.2% 1.4% 3.6%
2022 1.2% 0.9% 2.4% 2.7% 7.4%


Note: The above are averages only; rate actions can vary significantly by plan and rating region. Each specific customer will also experience the customer-specific impact based on their demographics, in terms of the aging from one renewal to the next, as well as a possible increase in billable members for subscribers with more than three children, where one or more ages to 21 or over and starts being charged.
 

Blue Shield Average Small Business Specialty Rate Actions

Average Dental & Vision Rate Actions for 2022

January 2022 April 2022 July 2022 October 2022 2022 Yearly Average
2.5% 0.0% 0.0% -0.6% 1.9%



Life Rates for Q4 2022
Age banded rates – rate pass

Source: Blue Shield of California