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Small Group Plans (2-50 employees)

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SimpleSelect – simple to choose, simple to use

AM Best Rating:  A
NCQA: Accredited

 

Available January 1, 2012

 
Introducing SimpleSelect, a comprehensive plan package, offering a wide range of healthcare coverage options. You can choose from 2 to 28 plans, including PPO, HSA-compatible high deductible health plans and HMO plan options. The ease and simplicity of SimpleSelect lets you  pinpoint the coverage they need at rates they can afford.

The new plan families have been designed with a logical price and benefit progression, making it easy to distinguish among the options. You can find a solution that's just right for your business – from plans with the richest benefits and low or no annual medical deductibles, to our leanest plans with affordable monthly rates in exchange for greater cost-sharing for members.
 

You can follow these easy steps:

1. Pick two or more plans that offer the right level of coverage for your employees.

2. Choose a monthly employer contribution option that works best for your business. Select either a minimum of:

$100 per enrolled employee   OR   50% of total employee rates

3.  Provide your employees with healthcare coverage they can trust!

SimpleSelect Plans
PPO plans
Premier PPO 5* Enhanced PPO 15*  Base PPO 30* Shield Spectrum PPOSM Plan 750 Value* 
Premier PPO 15*  Enhanced PPO 25*  Base PPO 40*  Shield Spectrum PPOSM Plan 1000 Value* 
Premier PPO 25*  Enhanced PPO 35*  Base PPO 50*  Shield Spectrum PPOSM Plan 1500 Value*
Premier PPO 35* Enhanced PPO 45*  Shield Spectrum PPOSM Plan 2500 Value* 
Premier PPO 45*     
 
HSA-compatible health plans  
Simple Savings 2500/5000* Simple Savings 4500/9000*
Simple Savings 3500/7000* Simple Savings 5500/11000*
 
HMO plans2:  
Access+ HMO® Premier 152 OR
Local Access+ HMO® Premier 152
Access+ HMO® Enhanced 152 OR
Local Access+ HMO® Enhanced 152
Access+ HMO® Premier 252 OR
Local Access+ HMO® Premier 252
Access+ HMO® Enhanced 252 OR
Local Access+ HMO® Enhanced 252
Access+ HMO® Premier 352 OR
Local Access+ HMO® Premier 352
Access+ HMO® Enhanced 352 OR
Local Access+ HMO® Enhanced 352 
Access+ HMO® Premier 452 OR
Local Access+ HMO® Premier 452
 
Note: You can select either Access+ HMO2 OR Local Access+ HMO2 plans
 
To learn more about the SimpleSelect package, download (PDF, 2.7MB) the brochure or order printed copies today.
*Underwritten by Blue Shield of California Life & Health Insurance Company. Pending regulatory approval.
1. SimpleSelect has a total of 36 plans, 8 of which are HMO plans with a choice of the Access+ HMO or Local Access+ HMO network. If you are an employer located in certain California counties whose eligible employees live or work in the Local Access+ HMO service area, you have the option of choosing any of the Access+ HMO  or Local Access+ HMO plans, but not both. The Local  Access+ HMO plans have the same benefits as our Access+ HMO plans. The service area for Local Access+ HMO plans in the Benefit Summary Guide (A16609).
2. If you are an employer located in certain California counties whose eligible employees live or work in the Local Access+ HMO service area, you have the option of choosing the Local Access+ HMO plans or the Access+ HMO plans, but not both. One HMO plan option must be selected; both options are not available to combine. The Local Access+ HMO plans have the same benefits as our Access+ HMO plans. The service area for Local Access+ HMO plans is described in the Benefit Summary Guide (A16609).

SimpleSync – simple by design
Available January 1, 2012

The new SimpleSync package offers simple, affordable, and flexible solutions foremployers. With a variety of options and benefit plans you can count on, SimpleSync is perfect for small groups that want to offer a Blue Shield plan alongside another carrier's HMO. You have up to nine plans to choose from, including comprehensive PPO plans, a high-deductible plan (HDHP) that is eligible with a Health Savings Account (HSA), and an HMO plan.

SimpleSync provides relaxed participation guidelines, so you will find it easier to qualify.

It only takes five enrolling employees with 65% enrollment in Blue Shield plans to qualify. And if you would like to offer SimpleSync alongside another carrier's HMO, in addition to the previously mentioned guidelines, at least 50% of the total number of employees must be enrolled in Blue Shield plan(s). For more information, download the SimpleSync brochure (PDF, 1.46MB). It contains a worksheet that will help you determine if you can enroll in the SimpleSync plans.

SimpleSync Plans

Plan
Premier PPO 20 Shield Spectrum PPOSM Plan 750 Value*
Enhanced PPO 30* Shield Spectrum PPOSM Plan 1000 Value*
Enhanced PPO 40* Shield Spectrum PPOSM Plan 1500 Value*
Simple Savings 3400/6800* Shield Spectrum PPOSM Plan 2500 Value*
Access+ HMO® Enhanced 40  
To learn more about SimpleSync package, download (PDF, 1.46MB) the brochure or order printed copies today.
*Underwritten by Blue Shield of California and Life Health Insurance Company. Pending regulatory approval.

 

 

 

Benefit Summaries (2-50 employees)

Premier PPO Plans Benefit Summaries Disclosures
Premier PPO 5* English (PDF, 92KB)
Revised November 3, 2011 
Spanish (PDF, 125KB)
English (PDF, 200KB)
Spanish (PDF, 211KB) 
Premier PPO 15* English (PDF, 94KB)
Revised November 3, 2011 
Spanish (PDF, 125KB)
English (PDF, 200KB)
Spanish (PDF, 211KB) 
Premier PPO 20 English (PDF, 93KB) 
Revised November 3, 2011 
Spanish (PDF,102KB)
English (PDF, 212KB)
Spanish (PDF, 213KB)  
Premier PPO 25* English (PDF, 93KB)
Revised November 3, 2011 
Spanish (PDF, 103KB)
English (PDF, 200KB)
Spanish (PDF, 211KB)
Premier PPO 35* English (PDF, 94KB)
Revised November 3, 2011
Spanish (PDF, 102KB)
Revised December 15, 2011
English (PDF, 200KB
Spanish (PDF, 211KB) 
Premier PPO 45* English (PDF, 92KB)
Revised November 3, 2011
Spanish (PDF, 103KB)
English (PDF, 200KB)
Spanish (PDF, 211KB) 
Enhanced PPO plans
The Enhanced PPOs offer a balance between the richest and most affordable PPO plans, and provide the flexibility of a PPO with affordable monthly premiums.
Enhanced PPO Plans Benefit Summaries Disclosures
Enhanced PPO 15* English (PDF, 91KB)
Revised November 3, 2011
Spanish (PDF, 102KB)
English (PDF, 200KB)
Spanish (PDF, 211KB)
Enhanced PPO 25*
English (PDF, 93KB)
Revised November 3, 2011 
Spanish (PDF, 103KB)
English (PDF, 200KB)
Spanish (PDF, 211KB) 
Enhanced PPO 30* English (PDF, 90KB)
Revised November 3, 2011 
Spanish (PDF, 102KB)
English (PDF, 200KB)
Spanish (PDF, 211KB) 
Enhanced PPO 35* English (PDF, 92KB)
Revised November 3, 2011 
Spanish (PDF, 101KB) 
English (PDF, 200KB)
Spanish (PDF, 211KB) 
Enhanced PPO 40* English (PDF, 92KB)
Revised November 3, 2011 
Spanish (PDF, 102KB)
English (PDF, 200KB)
Spanish (PDF, 211KB) 
Enhanced PPO 45* English (PDF, 92KB)
Revised November 3, 2011 
Spanish (PDF, 102KB)
English (PDF, 200KB
Spanish (PDF, 211KB) 
Base PPO plans
Base plans feature affordable PPO plan solutions with physician office visits* covered before the deductible is met. Base PPO plan premiums are generally lower than those for the Premier PPO and Enhanced PPO plans.
Base PPO Plans Benefit Summaries Disclosures
Base PPO 30* English (PDF, 92KB)
Revised November 3, 2011 
Spanish (PDF, 92KB)
English (PDF, 200KB)
Spanish (PDF, 211KB)
Base PPO 40* English (PDF, 92KB)
Revised November 3, 2011
Spanish (PDF, 92KB)
English (PDF, 200KB)
Spanish (PDF, 211KB)
Base PPO 50* English (PDF, 92KB)
Revised November 3, 2011
Spanish (PDF, 92KB)
English (PDF, 200KB)
Spanish (PDF, 200KB)
Value plans
Keep your ' budget in check with Blue Shield's PPO Value plans, which have some of the most affordable rates. Plus, they feature some of the most popular benefits.
Value PPO Plans Benefit Summaries Disclosures
Shield Spectrum PPOSM Plan 750 Value* English (PDF, 265KB)
Revised November 3, 2011
Spanish (PDF, 270KB)
English (PDF, 200KB
Spanish (PDF, 211KB)
Shield Spectrum PPOSM Plan 1000 Value* English (PDF, 263KB)
Revised November 3, 2011
Spanish (PDF, 279KB)
English (PDF, 200KB)
Spanish (PDF, 211KB)
Shield Spectrum PPOSM Plan 1500 Value* English (PDF, 263KB)
Revised November 3, 2011
Spanish (PDF, 279KB)
English (PDF, 200KB)
Spanish (PDF, 211KB)
Shield Spectrum PPOSM Plan 2500 Value* English (PDF, 235KB)
Revised December 9, 2011
Spanish (PDF, 245KB)
Revised December 9, 2011
English (PDF, 200KB)
Spanish (PDF, 211KB)
Optional Benefits for all PPO plans except Premier PPO 20
Substance Abuse
English (PDF, 47KB)
Spanish (PDF, 47KB)
Infertility
English (PDF, 36KB)
Spanish (PDF, 36KB
Optional Benefits for Premier PPO Plan 20
Substance Abuse
English (PDF, 47KB)
Spanish (PDF, 47KB)
Infertility
English (PDF, 36KB)
Spanish (PDF, 36KB)
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HSA-compatible health plans
Simple Savings HSA-compatible high-deductible health plans (HDHP)
Putting employees in charge of their own spending, the Simple Savings HDHPs allow them to open an HSA to pay for qualified medical expenses with tax-advantaged dollars. And once the deductible is met, employees can expect consistent out-of-pocket costs.
Download the optional benefit flyers for these plans.
HSA-compatible health plans Benefit Summaries Disclosures
Simple Savings 2500/5000*
English (PDF, 92KB)
Revised December 1, 2011
Spanish (PDF, 92KB)
English (PDF, 184KB)
Spanish (PDF, 187KB)
Simple Savings 3400/6800*
English (PDF, 92KB)
Revised December 1, 2011
Spanish (PDF, 92KB)
English (PDF, 184KB)
Spanish (PDF, 187KB)
Simple Savings 3500/7000*
English (PDF, 92KB)
Revised November 3, 2011
Spanish (PDF, 92KB) 
English (PDF, 184KB)
Spanish (PDF, 187KB)
Simple Savings 4500/9000*
English (PDF, 92KB)
Revised November 3, 2011
Spanish (PDF, 92KB)
English (PDF, 184KB)
Spanish (PDF, 187KB)
Simple Savings 5500/11000* English (PDF, 92KB)
Revised November 3, 2011
Spanish (PDF, 92KB)
English (PDF, 184KB)
Spanish (PDF, 187KB)
Optional Benefits for all Simple Savings plans
Substance Abuse
English (PDF, 47KB)
Spanish (PDF, 47KB)
Infertility
English (PDF, 36KB)
Spanish (PDF, 36KB)
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HMO plans
Access+ and Local Access+ HMO Premier plans
The Access+ HMO® and Local Access+ HMO® Premier plan family features brand-name prescription drug coverage without a deductible, a range of copayment amounts to choose from, and fixed hospital copayments to help members predict their costs.
Download the optional benefit flyers for these plans.
HMO Premier Plans Benefit Summaries Disclosures
Access+ HMO® Premier 15 English (PDF, 92KB)
Revised October 25, 2011
Spanish (PDF, 87KB)
English (PDF, 184KB)
Spanish (PDF, 187KB)
Access+ HMO® Premier 25 English (PDF, 92KB)
Revised October 25, 2011
Spanish (PDF, 87KB)
English (PDF, 184KB)
Spanish (PDF, 188KB)
Access+ HMO® Premier 35 English (PDF, 92KB)
Revised October 25, 2011 
Spanish (PDF, 86KB)
English (PDF, 184KB)
Spanish (PDF, 187KB)
Access+ HMO® Premier 45 English (PDF, 92KB)
Revised October 25, 2011 
Spanish (PDF, 84KB)
English (PDF, 187KB)
Spanish (PDF, 187KB)
Local Access+ HMO® Premier 15 English (PDF, 92KB)
Revised October 25, 2011
Spanish (PDF, 87KB)
English (PDF, 187KB)
Spanish (PDF, 184KB)
Local Access+ HMO® Premier 25 English (PDF, 92KB)
Revised October 25, 2011
Spanish (PDF, 86KB)
English (PDF, 187KB)
Spanish (PDF, 187KB)
Local Access+ HMO® Premier 35 English (PDF, 92KB)
Revised October 25, 2011
Spanish (PDF, 87KB)
English (PDF, 184KB)
Spanish (PDF, 187KB)
Local Access+ HMO® Premier 45 English (PDF, 92KB)
Revised October 25, 2011 
Spanish (PDF, 87KB)
English (PDF, 184KB)
Spanish (PDF, 187KB)
HMO Enhanced Plans Benefit Summaries Disclosures
Access+ HMO® Enhanced 15 English (PDF, 92KB)
Revised October 25, 2011
Spanish (PDF, 87KB)
English (PDF, 184KB
Spanish (PDF, 211KB)
Access+ HMO® Enhanced 25 English (PDF, 92KB)
Revised October 25, 2011
Spanish (PDF, 86KB)
English (PDF, 184KB
Spanish (PDF, 211KB)
Access+ HMO® Enhanced 35 English (PDF, 92KB)
Revised October 25, 2011
Spanish (PDF, 86KB)
English (PDF, 184KB
Spanish (PDF, 211KB)
Access+ HMO® Enhanced 40 English (PDF, 92KB)
Revised October 25, 2011
Spanish (PDF, 87KB)
English (PDF, 184KB
Spanish (PDF, 211KB)
Access+ HMO® Enhanced 45 English (PDF, 92KB)
Revised October 25, 2011
Spanish (PDF, 87KB)
English (PDF, 184KB
Spanish (PDF, 211KB)
Local Access+ HMO® Enhanced 15 English (PDF, 92KB)
Revised October 25, 2011
Spanish (PDF, 86KB)
English (PDF, 184KB
Spanish (PDF, 211KB)
Local Access+ HMO® Enhanced 25 English (PDF, 92KB)
Revised October 25, 2011
Spanish (PDF, 87KB)
English (PDF, 184KB
Spanish (PDF, 211KB)
Local Access+ HMO® Enhanced 35 English (PDF, 92KB)
Revised October 25, 2011
Spanish (PDF, 86KB)
English (PDF, 184KB
Spanish (PDF, 211KB)
Local Access+ HMO® Enhanced 45 English (PDF, 92KB)
Revised October 25, 2011
Spanish (PDF, 87KB)
English (PDF, 184KB)
Spanish (PDF, 211KB) 
Optional Benefits for all Access+ and Local Access+ HMO plans
Substance Abuse

English (PDF, 47KB)
Spanish (PDF, 47KB)
Infertility

English (PDF, 36KB)
Spanish (PDF, 36KB)
Chiropractic English (PDF, 52KB)
Spanish (PDF, 52KB)
  Chiropractic and Acupuncture English (PDF, 52KB)
Spanish (PDF, 52KB)
Access Baja HMO plan
If you want healthcare coverage in Baja California, Mexico, our Access Baja® HMO plans may meet your needs.
Access Baja HMO plans Benefit Summaries Disclosures
Access Baja HMO® Plan 10 English (PDF, 62KB)
Spanish (PDF, 64KB)
English (PDF, 238KB
Spanish (PDF, 228KB)
* Underwritten by Blue Shield of California Life & Health Insurance Company. Pending regulatory approval.
** Some limitations apply. Please refer to the Certificate of Insurance for further details.
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Ancillary Products

 

Enrollment Guidelines

Required Paperwork:

Employer Application (download)
Employee Application (download) for each employee and/or owner
SoleProprietor-Owner Statement (download)
Most recent DE9c (State quarterly payroll report)
Statement of Information (sample)
Copy of Articles of Incorporation
Business check for one month's estimated premium payable to the insurance company

Send to our office:

Health Plans Online, Inc.
31194 La Baya Dr. Ste. 201
Westlake Village, CA 91362

Submission timeline:

It is ideal to submit all completed forms two weeks before the requested effective date to provide ample time for the carrier to underwrite and provide a group number.