welcome to the 2021 small business broker

INSERT IMAGE

Welcome to the 2021 Small Business Broker Roadshow!

Our presentation will begin in just a

few moments.

During the presentation, all lines will

be muted. Please also refrain from

using the raise hand feature.

Please submit any questions you

have using the Q&A button at the

bottom of your screen.

We will address questions at the end

of our presentation. We will follow up

via email to answer any questions we

can’t cover on this call.

Presenters

Jason Bleau

Vice President & GM

Tom Marshall

Area Vice President of Sales

Berylnn Bell

Area Vice President of Account Management

Mark Zeedik

Sales Manager, Specialty

2

Deana Perrin

Senior Director, Operations

Katherine Hast ings-Sierze

Small Business Account Executive

Sandi Eber

Senior Sales Manager – GA Channel - Statewide

Agenda

New Business Updates01.

Renewal & OE02.

Specialty benefits03.

Digital enhancements04.

Q&A05.

© 2021 Blue Shield of California. All Rights Reserved.

Closing remarks06.

Welcome from Jason Bleau



New business updates

Tom Marshall

Q4 Rating Action

6

• Consistent and sustainably affordable

Average HMO Rate Actions

Jan Apr Jul Oct YEAR

1.7% 1.8% 1.2% -1.8% 2.9%

0.7% 0.0% 4.0% 4.4% 9.3%

0.6% 0.0% 0.0% 2.8% 3.4%

0.0% 4.3% 0.0% -0.9% 3.4%

2.3% 1.0% 0.0% -2.1% 1.2%

0.9% 1.6% 3.8% 1.8% 8.3%

0.9% 0.0% 0.9% -1.2% 0.6%

0.0% 1.0% 1.2% 1.4% 3.6%

1.3%

Average PPO Rate Actions


6.5% 2.3% 2.5% -7.7% 3.1%

2.4% 0.0% 2.2% 0.0% 4.7%

1.1% 0.0% 0.0% 5.0% 6.2%

-0.2% 0.8% 0.0% 0.5% 1.1%

1.1% 1.9% 0.0% 0.7% 3.7%

1.3% 1.5% 3.3% 1.8% 8.1%

0.9% 0.0% 0.9% -1.2% 0.6%

0.0% 1.0% 1.2% 1.4% 3.6%

1.2%

Average Rate Actions for all plans


6.0% 2.2% 2.2% -6.3% 3.7%

1.9% 0.0% 2.8% 1.1% 5.9%

1.0% 0.0% 0.0% 4.5% 5.5%

-0.2% 1.6% 0.0% 0.2% 1.6%

1.4% 1.7% 0.0% 0.0% 3.1%

1.2% 1.5% 3.4% 1.8% 8.1%

0.9% 0.0% 0.9% -1.2% 0.6%

0.0% 1.0% 1.2% 1.4% 3.6%

2014

2015

2016

2017

2018

2019

2020

2021

2022

PPO Plans with rich benefit designs Continue to be the most popular; Demand varies regionally

#1 #2 #3

Rural North/Sierra Silver Full PPO 180/55 Bronze Full PPO 6850/65 Silver Full PPO Savings 2500/35%

Wine Country Platinum Full PPO 250/15 CCSB Gold 80 PPO 250/25 Platinum Full PPO 250/10

Greater Sacramento Bronze Full PPO Savings 6900 Gold Full PPO Savings 1750/15% Platinum Full PPO 250/15

San Francisco CCSB Gold 80 PPO 250/25 Platinum Full PPO 250/10 Platinum Full PPO 0/10

Contra Costa Platinum Full PPO 250/10 CCSB Gold 80 PPO 250/25 Gold Full PPO 1200/35

Alameda Platinum Full PPO 0/10 CCSB Gold 80 PPO 250/25 Bronze Full PPO Savings 6900

Santa Clara CCSB Gold 80 PPO 250/25 Platinum Full PPO 0/10 CCSB Platinum 90 PPO 0/15

San Mateo Platinum Full PPO 0/10 CCSB Gold 80 PPO 250/25 CCSB Platinum 90 PPO 0/15

Monterey Bay Gold Full PPO Savings 1750/15% Platinum Full PPO 250/10 Silver Full PPO 2300/45

Central Valley North Silver Full PPO 1800/55 Gold Full PPO 1200/35 Platinum Full PPO 250/10

Central Valley South Gold Full PPO 0/20 Silver Full PPO 1800/55 Gold Full PPO 750/30

South Coast Silver Full PPO 1800/55 Gold Access+ HMO 500/35 Gold Full PPO 750/30

Southern Desert Gold Access+ HMO 1000/35 Silver Full PPO 1800/55 Gold Full PPO 500/30

Kern Bronze Full PPO 6500/50% Silver Full PPO 1800/55 Gold Full PPO Savings 1750/15%

Los Angeles North CCSB Gold 80 PPO 250/25 Gold Full PPO 0/20 Gold Full PPO 500/30

Los Angeles South Gold Full PPO 500/30 Gold Full PPO 0/20 Platinum Full PPO 0/10

Inland Empire Silver Trio HMO 2350/65 Platinum Trio HMO 0/20 Silver Full PPO 1800/55

Orange Platinum Full PPO 0/10 Gold Trio HMO 0/30 Silver Trio HMO 2350/65

San Diego Silver Trio HMO 2350/65 Platinum Trio HMO 0/20 Gold Trio HMO 0/30

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Coming soon!New PPO & HMO plan offerings

• One Silver HMO offering

• One Bronze HMO offering

Two HMO plans

Two new Bronze PPO plans

New plans

Off exchange portfolio updates

• AV changes minimal

• Minor benefit changes to several plans

Underwriting updates 2022


Relaxed

participation

extended through

2022

Mirror plans can

now be sold

alongside

another carrier

Mirror plans can

now take

advantage of the

Relaxed

participation

promotion

Trio ACO HMO network expansion

City Zip Code

Carpinteria 93013

Carpinteria 93014

Goleta 93116

Goleta 93199

Goleta 93118

Goleta 93117

Santa Barbara 93110

Santa Barbara 93130

Santa Barbara 93160

Santa Barbara 93111

Santa Barbara 93103

Santa Barbara 93190

City Zip Code

Santa Barbara 93109

Santa Barbara 93102

Santa Barbara 93120

Santa Barbara 93121

Santa Barbara 93101

Santa Barbara 93140

Santa Barbara 93108

Santa Barbara 93107

Santa Barbara 93106

Santa Barbara 93150

Santa Barbara 93105

Santa Ynez 93460

Solvang 93463

Solvang 93464

Summerland 93067

Santa Barbara (partial county)


The following medical group will be

added to the Trio ACO network:

• Sansum Medical Clinic

The following hospital partner will be added to the Trio ACO network:

• Santa Barbara Cottage Hospital

• Santa Ynez Valley Cottage Hospital

• Goleta Valley Cottage Hospital

Trio ACO HMO network expansion


City Zip Code

Marina 93933

Monterey 93940

Monterey 93942

Monterey 93943

Monterey 93944

Pacific Grove 93950

Pebble Beach 93953

Seaside 93955

Monterey (partial county)The following medical group will be added to the Trio ACO network:

• Aspire Health plan

With network medical groups consisting of:

• Montage

• Salinas Valley Health System

The following hospital partner will be added to the Trio ACO network:

• Community Hospital of the Monterey Peninsula (CHOMP)

• Salinas Medical Center

Wellvolution

Largest digital therapeutics network

of any U.S. health plan, including 7

stress management programs.

myStrength

Self-service tools that can help with

stress, anxiety, depression, sleep

disorders, and mild substance

abuse.

Teladoc Mental Health

Nationwide virtual (phone or video)

coaching with a behavioral health

provider for members living in the U.S.

and while traveling.

Nurse help 24/7

Online chat or phone assistance. Can

give referrals to providers or county

mental health resources, and help

members access care.

Continual network enhancement

Our network continually evolves to

address the needs of members.

Inside California

Fully insured members have access to

Magellan’s provider network of over

15,000 behavioral health clinicians &

facilities (in person & virtual options).

Outside of California

Fully insured members have access to

over 34,000 behavioral health providers

through the national BlueCard network

(in person & virtual options).

Digital programs Virtual care and coaching In person

LifeReferrals 24/7

Confidential program of behavioral

health coaches, providing access to

financial & legal coaches, for

stressful circumstances (divorce,

adoption, budgeting, etc.)

Behavioral health

Mandates: No surprises


Consolidated Appropriation Act / Transparency in Coverage Final Rule

Blue Shield of California expects to meet compliance with all provisions by enforcement dates.

• No notifications regarding broker compensation to small business customers.

• Health plans already meet mental health parity requirements.

• Enhanced Continuity of Care policies in 2022.

• All members that meet the mandate specifications will receive new ID cards in 2022

• Updated federal guidance in August extended deadlines for several prov isions, however, Blue Shield teams continue to work on developing solutions for implementation and we will keep you informed.

Celebrating successful submissions with the Employer Enrollment Tool

Over the last year:

• You have submitted over 4,000 groups

and 34,000 members through the tool

• 9,500 quotes have been run to help your clients pick the coverage that’s right for

them

• The median average from when you start

an application to when you receive

member ID numbers is 2 hours

• We have accelerated processing time by

more than 41x


Broker bonus calculator

One sale, two reward systems to award your efforts, and a handy tool to help predict your bonus earnings!

• Sell more, earn more with our Small Group Incentive Program

• Get cash with Direct Elite Rewards

Earn more with our Small Business Incentive Program


Direct Elite Rewards


Renewal and open enrollment


Berylnn Bell

Coming 2022! Maintenance & renewal on the Employer Enrollment Tool

Spring 2022

• Group maintenance

• Member maintenance

• Book of business reporting

• Invoice and delinquency

visibility

• New profiles for agency sharing

& visibility

Summer 2022

• Renewal

• Recertifications


Changes Overview

What:

• IT design is enabling both digital and paper communications for ALL members* until they

register an account and opt-in to (or out of) paperless.

• Digital communications sent to members will include email notifications that members have letters or EOBs waiting for them in their online account, as well as an email encouraging

members to register online.*ALL members with an e-mail address on file, regardless of their communication preferences

Why:

• Enabling automatic digital communications introduces members to the ease and

convenience of online communications and prov ides members easier access to register their online account.

• Members today expect a digital experience!

When: • Digital communications have been enabled for Small Group on September 12.

What this means for you!

• We need your support to collect email addresses during the enrollment process and help

members receive the best experience available to them. • Please encourage your employer groups and their employees to register online accounts

and take control of their health care!

Auto digital opt-in at enrollment


Digital change is on the horizon!

New renewal microsite

• New download renewal PDF kit function

• Improved user experience

• New specialty page

• Updated the site’s look and feel

Making it easier for your group to renew!


Specialty benefits


Mark Zeedik

Introducing 22 new dental PPO plans

22 new dental PPO plans based on benefit levels

• Five DPPO categories to choose from

• DPPO Bronze / Bronze Voluntary

• DPPO Silver

• DPPO Gold

• DPPO Platinum

• DPPO Diamond

NEW FOR 2022

Simplified Portfolio

• Offer competitive benefit offering

• Streamlined naming conventions

• Ability to show buy-up / buy-downoptions with clear hierarchy

• Fewer plans with range of benefit options; voluntary, plan names that align with Medical

PRIMARY GOALS


Introducing 22 new DPPO plans

Existing "Marketed" DPPO plans will change to

"Non-Marketed" status

Renewing groups may continue to renew into their

same plan

New for 2022

Dental PPO plan status change


Dental HMO –Orthodontic in Progress

Takeover

• Available for eligible members

receiving “active orthodontic treatment” that will not be finished until

after BSC DHMO plan takes effect

• Available for new groups moving from

prior carrier’s DHMO plan to new BSC DHMO plan

• Takeover process is handled between member and provider. Provider will

submit required documents to dental claims team

Grid of orthodontic in progress takeover

by plans:

Dental benefit changes


Dental HMO – Enhanced Dental Cleaning

for Pregnant Women

• Allow third cleaning for pregnant

women to maintain good oral hygiene as shown in the sample summary of

benefit illustration below

Dental HMO/PPO/DINO –Dental Cleaning Frequency Change

• Benefit enhancement to allow dental cleaning frequency to twice per consecutive 12-month period vs. once every

6-months (current cleaning frequency)

• Value-added benefit to allow more member flexibility to maintain good dental hygiene


Dental benefit changes

Specialty benefit changes - Vision


This change will increase the elective contact lens benefit allowances to match the frame allowances.

In-scope:

• Vision plans with contact lens benefit

• Vision plans with frame allowance of $150

• Enhancement available for both new and renewing groups in 2022

MATCH ELECTIVE CONTACT LENS ALLOWANCE TO FRAME

ALLOWANCE

Benefit enhancement to include standard progressive lenses on plans without premium progressive lenses. These are a type of progressive lens with plenty of room at the bottom for your near vision.

In-scope:

• Offer competitive benefit offering

• Streamlined naming conventions

• Ability to show buy-up / buy-down options with clear hierarchy

• Fewer plans with range of benefit options; voluntary,

plan names that align with Medical

ADD STANDARD PROGRESSIVE LENSES

Digital enhancements


Deana Perrin

• Shop, quote and enroll using our employer

enrollment tool

• Check new group submission status and view your online client list

• Administer member level changes

• Order sales and marketing collateral

• Update your demographics, banking

information and manage email subscriptions

• Broker compensation, rewards and

commission

• Stay up to date on broker communications

• Group related questions

• Broker of record changes and book of

business transfers

• Billing inquiries

• Commissions questions

• New Small Group receipt verification

that requires escalation

• Questions regarding claims.

• Help you navigate our online tools and

resources

• Assists with renewal planning and

strategy

• Attends renewal open enrollment meetings to employees understand their

plan benefits

• Provides staff education including

specialty products

• Help you navigate our online tools and resources

• Unresolved escalated issues

Securely manage your BSC

book of business 24/7

(800) 559-5905

7:30am - 6:30pm M-F

For contact information, visit

blueshieldca.com/SMBcontact

SELF SERVICE PORTAL PRODUCER SERVICES ACCOUNT EXECUTIVE


Small business service supportThe Producer Services team and Sales/Account Management team are here to support you.

Exciting initiatives to improve the experience for you

• Addition of ~120 broker service agents for

quicker response

• Updated IVR aligning reason for call to a high skilled agent on that topic

• Simplified validation process on voice and digital channels to better protect your

information

• Agents empowered to handle your servicing needs reducing the amount of time taken to

address critical items

RECENTLY IMPLEMENTED

• End to end rev iew of all current processes for streamlining

• Expanded capabilities on digital including live chat with cobrowse, updated online client list, dynamic search, and notifications for key client information

• Enhanced content to help you service your clients easier

• Commissions transformation to simplify your payout and

associated reporting

COMING SOON


We are making changes to improve our service. Producer Serv ices has updated our phone

Interactive Voice Response (IVR) to make choosing your options easier. Once you enter your Tax ID as validation, you will be given 4 main options to get quickly to a representative skilled on your call type.

Self-serv ice options include member eligibility, benefits, PCP info, application status, ID cards,

billing information, or ordering forms. Just press 1.

If your questions are more complex and require a broker serv ices specialist, continue in the

menu. You will be asked to select your line of business and choose from the following options:

Press 1 for application support, benefits, eligibility, and broker eligibility.

Press 2 for billing, payments, PCP changes, plan changes, or to order ID cards and supplies.

Press 3 for commissions, bonuses, digital web support, or claims and appeals.

Press 4 for specialty benefits like- dental, v ision, or life.

Getting you the right answers fasterOur Producer Services menu options are improving.

Self service capabilitiesSimplifying the digital experience for ease of servicing


Questions & Answers


Closing remarksfrom Jason Bleau and the Small Business Team!


Thank you

welcome to the 2021 small business broker

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