Blue Shield is leading in the fight to contain COVID-19
Blue Shield of California President and CEO, Paul Markovich, is working directly with Governor Gavin Newsom as co-chair of a new task force to increase COVID-19 testing in California which will enable health officials to help contain the spread of the virus.
“This is a critically important project to help keep Californians safe and healthy,” said Markovich. “We need to test extensively and effectively to contain this virus, and we need to speed up the turnaround times so we know the full scope of the problem and how to control the risks.”
For more information on these efforts, please read the press release
posted in our news center.
Leadership is essential to the success of any organization, but especially so in times of crisis. Blue Shield of California Chief Human Resources Officer, Mary O’Hara provides perspectives on supporting employees during this challenging time, outlining four fundamental ways employers or business leaders can support their employees.
Read the press release
posted in our news center.
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New steps to remove barriers to access care for COVID-19
Blue Shield of California is taking additional steps to remove barriers and help its members receive the health care they need during the coronavirus (COVID-19) pandemic, announcing it will cover members’ coinsurance, copayments and deductibles for COVID-19 medical treatments through May 31, 2020. Read the full release
. Last month, Blue Shield also announced coverage for cost-sharing for testing and screening for COVID-19.
This recent announcement applies to customers who are covered under Blue Shield’s fully-insured employer group plans and union insured plans (as well as Individual and Family Plans, Medicare Supplemental plans, Medicare Advantage plans). Blue Shield will also administer the waiver for self-insured and flex-funded group health plans that choose to participate. Account teams are reaching out to confirm decisions by April 10.
Questions answered, specific to the cost-sharing waivers for COVID-19 treatment, here
Special Enrollment Period
Blue Shield is also enabling employer group members off-anniversary enrollment through a Special Enrollment Period (SEP), with July 1 as the latest effective date. This SEP is for employees who previously declined coverage for themselves or their dependents. Note: For small group (1-100) – 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.
- For an April 1, 2020, effective date, enrollment request must be received no later than April 15.
- For May 1, June 1, and July 1 effective dates, enrollment requests must be received on or before the first of the month for which enrollment is being requested.
This is available to all fully insured small group (1-100) and large group (101+) employers. Self-funded plan sponsors typically determine eligibility of group coverage, which is described in their Plan Document.
Supporting our providers who care for our members
We are also extending financial support to providers, hospitals, and health professionals who are on the front lines fighting the coronavirus (COVID-19) pandemic. We will be making advance payments to providers to assist with anticipated healthcare costs and help get them through the next six months. Read the press release
Blue Shield also has been working on a patient billing solution with San Francisco-based technology startup OODA Health and northern California providers such as Hill Physicians and Dignity Health. The payment pilot program was launched in the Sacramento region last year.
Blue Shield has taken several other steps to support providers and the public since the pandemic began. For information on what we are doing to support our members, brokers, and employers please see our COVID-19 response Fact Sheet
Help while sheltering-in-place: $0 Teladoc visits extended to behavioral health
Today’s shelter-in-place mandates, social distancing, and disruptions to routines may cause mental health issues to arise or become more acute. Telehealth visits offer a way for members to get help from the comfort of their homes. Early in our response to the COVID-19 outbreak, Blue Shield announced $0 copays for Teladoc Health medical visits, whether or not related to COVID-19, through May 31. We are now extending the Teladoc Health $0 copayment benefit to include behavioral health visits, also through May 31
. Learn about Teladoc behavioral health service
Expanded Teladoc coverage for mental health services is available to members enrolled in a wide range of Blue Shield health plans, outlined below. Members can log in to their accounts at www.blueshieldca.com
to confirm benefit coverage and to schedule an appointment. Fully insured plans with Teladoc
These members can take advantage of expanded coverage and access to Teladoc behavioral health services with $0 copayments through May 31, 2020. ASO plans (self-funded, Shared Advantage, Shared Advantage Plus) with Teladoc
These members will obtain expanded coverage and access to Teladoc behavioral health services through May 31, 2020.
ASO plans (self-funded, Shared Advantage, Shared Advantage Plus) without Teladoc
- For ASO plans that have both Teladoc general medical and Teladoc behavioral health, Blue Shield is covering member copays through May 31, 2020. The group remains responsible for their current cost share.
- For ASO plans with Teladoc general medical only, Blue Shield is adding Teladoc behavioral health through May 31, 2020. Blue Shield will cover both member copays and group cost during this time.
If an ASO group does not have Teladoc today, they can purchase it (Blue Shield is not providing coverage for such groups unless they buy up).
Other covered benefits for Blue Shield members to support mental health and well-being, include mental health services available through our Mental Health Services Administrator (MHSA) network, Magellan, LifeReferrals 24/7, and Wellvolution. We will share more additional information on these benefits in upcoming employer communications to share with your clients.
Telehealth visits: We’re adding more platforms
We are working in partnership with state and federal regulatory agencies and our provider network to expand our ability to deliver covered services to Blue Shield of California and Blue Shield of California Promise Health Plan members via phone or video conferencing.
We are strongly encouraging our providers to use HIPAA-compliant platforms. However, we know that some providers are not set up to conduct HIPAA-compliant telehealth.
During this public health emergency, providers may offer care via widely available communication apps such as FaceTime or Skype. Members with existing provider relationships should contact their provider to find out how they can access services without leaving their homes.
- All credentialed and contracted behavioral health providers are now permitted to conduct telehealth video sessions.
- Providers can now use Skype, FaceTime, Zoom and other non-HIPAA–compliant platforms to conduct telehealth video sessions; however, we strongly encourage our providers to continue to use a HIPAA-compliant telehealth platform that includes both audio and video whenever possible. Providers may not use public-facing services, such as Facebook live, Twitter, Twitch, or TikTok.
- Outpatient providers can also conduct telephone-only (no video) sessions if it is impossible for a member to do a face-to-face telehealth video session.
- We are covering these sessions during the COVID-19 public health emergency as benefits for members in the same way we would if they visited their healthcare provider in person.
For further details, visit telehealth services
Stay up to date
Blue Shield is closely monitoring the trajectory of COVID-19, including state and federal policy. We will continue to keep you informed of policy changes affecting your employer groups.
Comprehensive FAQs on Blue Shield’s response to COVID-19 are updated and re-formatted for easier searching, available here
, and always posted on our resources page on Employer Connection
. An overview of Blue Shield’s response is shared in this COVID-19 Fact Sheet
We will continue to explore ways to meet the needs of our members through this challenging time, and will continue to keep you informed. Stay up to date with Blue Shield on our News Center
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