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Open Enrollment 2022

Click a carrier below for company details:

• ANTHEM BLUE CROSS
  
• BLUE SHIELD OF CA - PPO
  
• BLUE SHIELD OF CA - TRIO ACO HMO
  
• HEALTH NET
  
• KAISER
  
• LA CARE COVERED
  
• MOLINA HEALTHCARE
  
• OSCAR
  
• SHARP
  

Health Plan Summary:
Platinum 90 - $0 Deductible

$15 Dr. Visit Copay / $30 Specialist

$15 Urgent Care          $150 ER Visit

$15 Lab / $30 X-ray
Rx: $5 Generic / $15 Tier 2 / $25 Tier 3

10% Outpatient Hospitalization
10% Outpatient Surgery

10% Inpatient Hospitalization

$4,500 Out of pocket maximum (2 max)

Gold 80 - $0 Deductible
$35 Dr. Visit Copay / $65 Specialist
$35 Urgent Care          $350 ER Visit
$40 Lab / $75 X-ray
Rx: $15 Generic / $55 Tier 2 / $80 Tier 3
20% Hospitalization
20% Outpatient Surgery
10% Inpatient Surgery
$8,200 Out of pocket maximum (2 max)

Silver 70- $3,700 Deductible / $10 Rx
$35 Dr. Visit Copay / $70 Specialist
$35 Urgent Care          $400 ER Visit
$40 Lab / $85 X-ray
Rx: $15 Generic / $55 Tier 2 / $85 Tier 3 (After Ded.)
20% Outpatient Hospitalization
20% Outpatient Surgery
20% Inpatient Hospitalization (After Ded.)
$8,200 Out of pocket maximum (2 max)

Bronze 60 - $6,300 Deductible
$65 Dr. Visit Copay (3) visits / $95 Specialist (3) visits
$65 Urgent Care (3) visits
$40 Lab / X-ray not covered until meet deductible
Rx: $15 Generic / 40% Tier 2 / 40% Tier 3 (After Ded.)
40% Hospitalization (After Deductible)
40% Outpatient Surgery (After Deductible)

40% Inpatient Hospitalization (After Deductible)
$8,200 Out of pocket maximum (2 max)

- Get the BEST VALUE

- Licensed CERTIFIED Agent

- 19 Years of Experience

Meet Marc Harris
Your Local Certified Insurance Agent

I have been helping clients since 1998 and was
one of the first agents to get certified with
Covered California and the CoveredCA.com
Exchange.  After reviewing the Blue Shield PPO options for this years open enrollment, I have concluded that they are going through a huge restructure and are unsure of their operations for this coming year. Some of our clients have seen upwards of a 40% rate increase.  What a "bait and switch" in my opinion.  Ready to renew your policy? We can help you today!  Complete our short Covered CA RENEWAL FORM and someone will contact you.

BLUE SHIELD PPO Info / Facts:
Founded in 1939 (78+ Years Ago)

Valued at $17 Billion (in 2014)       2016 Financials
# of Employees: 6,800 (4 million members) 
Privately Held: Non-Profit Health Plan
BBB Rated: NR (Click Here) - Started 8/31/1993
Wiki Link: Blue Shield of CA
website:BlueShieldCA.com
Customer Service Phone: (855) 836-9705
Payment Phone: (855) 634-3381    TelaDoc
In-Network:  Find a HOSPITAL   /  DOCTOR Search
Brochure Download: 2022 Plans-at-a Glance Summary

      
Notes (Advantages & Disadvantages):
- PROS: Solid PPO with very strong network
- In and out of network coverages, but very expensive..

- Freedom to travel outside of CA (Blue Card Network)
- TelaDocVideo or Phone Dr. visits - $5 copay
- General / Psychiatry / Etc. (8am - 5pm)   800-835-2362
- Abiility to self-refer to a specialist at any time

- CONS: Out of network max is $20,000 per member!
- One of the highest priced plans in the marketplace
- 20% to 40%+ rate increases per year are insane!

- All of the above is just our honest opinion.

$5 Urgent Care          $50 ER Visit

$8 Lab / $8 X-ray
Rx: $3 Generic / $10 Tier 2 / $15 Tier 3
10% Hospitalization
10% Outpatient Surgery

10% Inpatient Surgery (After Deductible)

$800 Out of pocket maximum (2 max)

Silver 87- $800 Deductible / $0 Rx
$15 Dr. Visit Copay / $25 Specialist
$15 Urgent Care
$20 Lab / $40 X-ray
Rx: $5 Generic / $25 T2 / $45 T3 (After Ded.)
20% Hospitalization
20% Outpatient Surgery
20% Inpatient Surgery (After Deductible)
$2,850 Out of pocket maximum (2 max)

Silver 73- $3,700 Deductible / $10 Rx
$35 Dr. Visit Copay / $75 Specialist
$35 Urgent Care
$40 Lab / $85 X-ray
Rx: $15 Generic / $55 T2 / $85 T3 (After Ded.)
20% Hospitalization
20% Outpatient Surgery
20% Inpatient Surgery (After Deductible)
$6,300 Out of pocket maximum (2 max)

We have done all of
the analysis for you!

  - Carrier Details & Phone #s

  - Information / Co. Facts

  - Pros & Cons of the Carrier

  - Hospital & Doctor Network

  - BBB Rating / Review Links

  - Wiki Links and more!

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BLUE SHIELD PPO

Marc's analysis of BLUE SHIELD PPO!

2020 Strategy:  Although you will see some plan design changes  and may see a smaller network of doctors and/or hospitals starting 1/1/20, Marc is recommending to stick with your current plan this year.  Have faith, and play the odds, if you need a doctor out of network, just pay cash!

Blue Shield Trio HMO:ACOs(Accountable Care Organizations) have saved over $440 Million to Members and Employers!

Starts 10/1/23 thru 1/31/24

Open Enrollment 2024

Income Attestation Form   2024 Plan Summary   Trio HMO  Payment   MEC