Blue Shield of California

 

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About Blue Shield of California

Blue Shield of California is the California’s third largest health plan. It has 2.6 million members and $6 billion in annual revenue. Blue Shield is a not-for-profit corporation with approximately 4,200 employees and more than 20 offices throughout California. Blue Shield of California is headquartered in San Francisco, California. According to Blue Shield of California, since 1939, when the company was founded, their priority has remained the same as it was more than 60 years ago: to listen to consumers and deliver the affordable, quality health coverage products that empower them to make intelligent decisions for themselves and their families.In an industry distinguished by rapid change, Blue Shield’s consistent ability to deliver the services Californians deserve and demand is a result of the people “behind the shield.” With a proven track record in building and growing successful health plans, Blue Shield’s executive team has the expertise, imagination and ingenuity required to reinvent the customer experience with a health plan.

 

Mission Statement

Blue Shield strives to make sure that high-quality health care is available to all Californians at a reasonable price.

 

Fast Facts about Blue Shield Health Insurance of California

Parent Company: California Physicians’ Service
Ownership Status: Not-for-profit (mutual benefit company)
National Affiliation: Independent Member of the Blue Shield Association
Year Founded: 1939
Service Area: California
Annual Revenue: $6 billion
Total Employees: 4,200

Plan TypeMembership (4/1/2003)
HMO1.3 million
PPO1.3 million
Total2.6 million

 

Physician Network (4/1/2003)HMOPPO
Primary Care Physicians10,12316,443
Specialists15,81428,973
Total25,93745,416

 

Hospital Network (4/1/03)
HMO Network296
PPO Network364

 

 

Accreditation

The National Committee for Quality Assurance (NCQA) awarded Blue Shield Excellent Accreditation (2003) for its HMO and Point of Service (POS) lines of business.

NCAA grants Excellent Accreditation to managed care organizations with systems to protect consumers and which provide high-quality medical care. The managed care organization’s operations must meet or exceed the high standards of NCQA. You can examine the NCQA Health Plan Report Card for Blue Shield of California at this web site: www.ncqa.org

 

Financial Ratings

Weiss Ratings named Blue Shield of California one of the strongest HMOs in the nation. AM Best gave the company an A- (excellent) rating from and Standard and Poors gave Blue Shield of California an A- (strong financial security) rating.

 

Individual Blue Shield Health Insurance

If you are considering individual health insurance in California, Blue Shield may be a good choice. As you can see from their membership above, they offer both HMO and PPO plans. It has an extensive network of HMO and PPO doctors and hospitals. As always, check to make sure that the doctors and hospitals that you want to use are in the provider network.

Currently, the only individual HMO health plan that Blue Shield offers has a $1,500 deductible for facility charges in the hospital. The HMO also has “Access plus” which allows patients to self-refer to certain specialists within a medical group without receiving an authorization from their primary care doctor. This means that if you have a rash, you can go to a dermatologist in your medical group without visiting your primary care doctor. You pay a higher copay, but you can receive care more easily with Access Plus.

Blue Shield offers many PPO plans and they have a very large network of PPO doctors. Their Health Savings Account (HSA) compatible PPO plans are very competitively priced. Congress established “Health Savings Accounts (HSA)” effective January 1, 2004. You may find that with an HSA compatible PPO plan you can pay a low monthly premium and obtain good medical care after you pay a high deductible. More information on California Health Savings Accounts.

One of Blue Shield of California’s most popular individual PPO plans is the Active Choice 600. This plan gives members a credit of $600 per calendar year ($1,200 family) to use for most medical treatments, except for prescription medicine and preventive care. Generic prescription medicine and preventive care are available with small co-payments. A subscriber can use the $600 for medical treatment in and out of the hospital. After the $600 ($1,200 family) is spent, the member would be responsible for the next $3,500 per calendar year in medical expenses ($7,000 family.) Blue Shield generally would pay all expenses after the $3,500 or $7,000 family co-payment. According to the insurance companies, 60-70% of people do not spend more than $600 per year on medical expenses. Accordingly, the $600 ($1,200 family) credit would cover these expenses. Also, any unused credit can be carried over to following years. This plan is popular because of the low monthly premium and the first dollar coverage it offers before the co-payment. Click here for information on HSA/MSA plans.

 

News & Articles

Blue Shield of CA to give Small Groups 18% Refund

Blue Shield Savings 3500 and 5200 HSA Compatible Health Plans with a Bridge Rider

Blue Shield Vital Shield 2900

Blue Shield California Individual Plan Rate Increase

Blue Shield Spectrum 2000 PPO- Good Option with Maternity

 

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