6/1/2021
California
Expanding portfolio of medical plans to consider
The newest additions for 2022 are designed for groups seeking lower cost options that meet their health plan needs.
Below are some updates for 2022.
The newest additions for 2022 are designed for groups seeking lower cost options that meet their health plan needs.
- PPO Savings Embedded Deductible 6350 100%
This plan design is available on either the Full PPO or Tandem PPO network. - EPO 25-1500 80
- EPO 25-2500 80
These plan designs are available on either the Full PPO or Tandem PPO network. - Active Choice Classic & Active Choice Plus
The plans below were made available in the market earlier this month and are effective for 2021.- Active Choice Plus 1000 80/60
- Active Choice Plus 1000 20 80/60
- Active Choice Plus 300 80/60
- Active Choice Plus 300 20 80/60
- Active Choice Classic 850 80/60
- Active Choice Classic 600 80/50
- Active Choice Classic 850 70/50 w/ 1000 Deductible
Below are some updates for 2022.
- Maximizing PPO Savings coverage
Peak flow meter and glucometer benefits will be available to members prior to meeting their deductible in accordance with IRS Notice 2019-45.- Portfolio plan cost shares
- For standard PPO Savings plans glucometer and peak flow meter cost shares equal DME.
- For PPO Savings plans w/ $0 HDHP Preventive Drugs glucometers and peak flow meters are available at no charge.
- Custom plan fully insured cost share options:
- For custom PPO Savings plans without $0 HDHP Preventive Drugs, glucometers and peak flow meters can be either no charge or have a cost share matching durable medical equipment (DME).
- For custom PPO Savings plans with $0 HDHP Preventive Drugs, glucometer and peak flow meter must be no charge.
- ASO cost share options:
- ASO plans may set glucometer and peak flow meter to no charge, equal to DME or not covered regardless of HDHP Preventive Drug cost share.
- Portfolio plan cost shares
- Active Choice benefits clarified
Both medical and behavioral health Teladoc benefits will be moved to Category 2 to clarify that those services are available at no charge. Active Choice plans are also reintroducing first dollar allowance rollover and access to family first dollar credit for members on a family plan, with language updates to clarify these plan features. - Physician Visit Cost Shares
Physician Office Visit and Physician Home Visit cost shares are now equal for the three Portfolio plans for which this was not the case:- EPO Admit 10-250 (Full PPO / Tandem PPO)
- Added Advantage POS 300-100/90/70
- Added Advantage POS 500-100/80/60
Source: Blue Shield of California