Employee enrollment
What is enrollment?
Enrollment is the process in which companies and employees select and
maintain their elected benefit options offered through Blue Shield. The
process has three major milestones:
Initial installation
When your company first elects Blue Shield coverage, company offerings are established, and employees enroll in coverage.
Annual renewal and open enrollment
The time when benefit coverage levels are adjusted or confirmed for the upcoming plan year.
The in-between moments
Special enrollment periods are created through qualifying life events, allowing new enrollments and changes outside of annual enrollment.
Electronic enrollment tools can help your organization save time and reduce administrative burden year-round. Blue shield offers employers two methods to manage enrollment electronically: through our benefits manager tool, or via an approved Electronic Data Interchange (EDI).
Manage enrollment online with the Employer Enrollment Tool
Built to be easier, faster, and dependable, enroll with confidence with the Employer Enrollment Tool. Blue Shield’s online enrollment resource guides you through submissions and automates backend processing for real-time installation. The result is a more intuitive and transparent experience with over two dozen enrollment types to give you the flexibility to maintain coverage online. With the tool, you can:
- View and download member rosters
- Process employee adds and cancels
- Process employee information changes
- View and change medical, dental, vision, and life insurance plans* in a single place
- View and download detailed reports for coverage and membership
- Download Blue Shield medical member ID cards
- Compare and quote Blue Shield Small Group medical, dental, vision, and life plans
*Underwritten by Blue Shield of California Life & Health Insurance Company.
Benefits Management Tool: Video tutorial resources
Navigation
- Employer homepage navigation (2:10 min)
- Group account page (2:56 min)
- Member account page (1:07 min)
- Document upload (0:57 min)
Member-level changes
- Enrolling new employees (6:29 min)
- Terminating employees (1:04 min)
- Adding and covering dependents (3:52 min)
- Federal COBRA enrollment (2:20 min)
- Update member demographics (1:25 min)
- Update member contact and class (1:56 min)
- Member plan changes – add (1:30)
- Member plan changes – cancel (1:17 min)
- Order member ID cards (0:37 min)
- Download ID card (0:48)
Group-level changes
- Group address (1:04)
- Cancel group (1:00)
- Class plans *Small Group only (0:33)
- Add products/plans *Small Group only (2:19)
- Cancel products/plans *Small Group only (1:46)
- Group name and structure change *Small Group only (0:41)
- Bill by department code *Small Group only (0:24)
Direct submissions:
Electronic Data Interchange (EDI) and Secure File Transfer Protocol (SFTP)
Employers who use third-party benefit administrators may want to establish a direct submission method of electronic enrollment. Blue Shield partners with BenefitFocus to manage ANSI 834 electronic files through their eExchange platform, which standardizes the intake process to provide increased accuracy and efficiency.
To use EDI/SFTP, please work with your Blue Shield Account Executive or submit an email requesting a new EDI Implementation to EDI834validation@blueshieldca.com.
As part of the implementation for a new ANSI 834 file, BenefitFocus will reach out regarding necessary steps. Implementation for a new ANSI 834 file takes approximately 30-45 days depending on the quality of the data sent and the number of testing iterations required.
Using EDI and the Employer Enrollment Tool together
Electric Data Interchanges and the Employer Enrollment Tool can be used together. We recommend using the enrollment tool while your EDI connection is being set up, or for access to care enrollments.
The EDI file is the source of truth and will overwrite changes only made to the Employer Enrollment Tool, and we will not allow open enrollment changes in the enrollment tool if you also use an EDI file.
Get help with our benefits management tool
For help navigating the benefits management tool or to report technical issues, call: (800) 325-5166 for Small Groups and (855) 747-5809 for Large Groups.
