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  • BlueShield of California

Blue Shield of California Individual and Family Plan, Small Business, and Large Group: Hoag & UC Health Negotiations Status

Admin
  • May 1, 2025
  • 2 min
Blue Shield of California is a nonprofit health plan that’s committed to working with their network providers to offer members and customers access to quality, affordable healthcare coverage. They are currently negotiating in good faith with both University of California Health (UC Health) and Hoag Clinic and facilities (Hoag) to reach agreements that ensure members continue to have access to these health systems at reasonable cost and reimbursement rates that are sustainably affordable.

Members can continue to access UC Health and Hoag through June 30, 2025, under the respective existing agreements. 

As required by regulators, Blue Shield will provide timely notifications to their members regarding UC Health and Hoag’s participation in the Blue Shield provider network:
May 1, 2025
60-day advance notifications to impacted commercial HMO members
May 16, 2025
45-day advance notifications to impacted Medicare HMO members with a Hoag PCP
May 30, 2025
30-day advance notifications to impacted Medicare members who have received care in the last 12 months at a UC Health or Hoag facility
July 2, 2025
Notifications to impacted commercial PPO members who have received care by a contracted Hoag or UC Health professional provider in the last 12 months
July 3, 2025

Notifications to HMO and PPO Individual and Family Plan, Small Business, and Large Group members who have received care in the last 12 months and/or commercial PPO members within a 15-mile radius of a UC Health or Hoag facility

Blue Shield’s online Find a Doctor tool will continue to include UC Health and Hoag through the end of the contract period, however, panels will be closed to prevent members from newly selecting these providers for primary care.

Blue Shield will keep you and their members informed of the outcome of negotiations. Should Blue Shield be unable to reach an agreement, they  will ensure a smooth transition for their members to in-network hospitals and providers in their community. Member communications contain information on continuity of care provisions, as applicable.

By standing firm on Blue Shield’s quality and affordability commitments in provider negotiations, Blue Shield is better able to provide their members with access to an extensive network of quality and more affordable facilities and providers throughout California.
 

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