Blue Shield of California
COVID-19 Resource Center for Employers, Plan Sponsors, Brokers and Consultants

B2B General

October 08, 2020 - 2 min read

Blue Shield is extending enrollment accommodations through the end of the year


Employees with reduced work hours, or who have been furloughed or laid off, can remain on a group plan.


Our group service agreements allow for continued coverage for members who are impacted by a temporary suspension of work or work hours. Assuming the employer continues to remit premium payments for workforce that is laid off and not actively at work in the same manner as prior to COVID-19 crisis, there would be no change in coverage.

If an employee was laid off, furloughed, or had reduced work hours below eligibility requirements during the COVID-19 outbreak, and premiums were not paid during this time, reinstatement for coverage is possible without the standard waiting period (if re-enrolled within six months of when coverage ended).

Plan selection downgrades for Small Groups will be allowed through December 31, 2020

To help provide options for our employers concerned about the impact of COVID-19 on their financial situation, Blue Shield will offer the ability to downgrade to a leaner plan design off-anniversary.

Buy-down selections must be consistent with the current plan type offered by the group: PPO plan to PPO or HMO plan to HMO. If a group changes plan selections, employees can choose from any of the plan offerings as long as they are choosing a downgraded plan. The rates for employees who choose a buy-down plan off-cycle will be based on the age of the
member at the time of the change.

The option to buy-down to leaner benefits applies for medical plans, dental plans, and vision plans.

To change plan offerings, please contact your Blue Shield representative.


The Special Enrollment Period (SEP) has been extended through December

Blue Shield will continue allowing Special Enrollment Period (SEP) for COVID-19 through December for small businesses. Self-funded plan sponsors typically determine eligibility of group coverage, which is described in their Plan Document.

Notes:

  • This special enrollment for small groups applies only to employees who previously waived coverage for themselves and/or their dependents, allowing enrollment without any of the standard qualifying life events.

  • Enrollment requests must be received on or before the 1st of the month for which enrollment is being requested.

  • This applies to all enrollment for medical plans, dental plans, and vision plans.

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