Covered with an employer
Welcome to Blue Shield of California’s employer coverage page. You’ll find a variety of resources here to help you select a health plan that’s right for you. Simply scroll down the page to find the type of information that’s most helpful. If you need more specific information about the health plans your company is offering, please ask your employer.
Video: Understanding your health plan options
Is it your company’s open enrollment period? Or maybe you’ve had a major life change or have started a new job. No matter the reason why you need to select a health plan, watch our video for a useful overview of Blue Shield health coverage.
Healthcare 101 resources
HMO or PPO? What does a copay mean anyway? Look through our useful resources – including videos and tutorials – to gain a better understanding of everything health care.
Videos
Learn about HMO plans (2:05)
Learn about PPO plans (3:02)
What is Trio HMO? (0:38)
PDFs
HMO vs. PPO: Choosing the right plan (PDF 983 KB)
Understanding health plan terms (PDF 26 KB)
Why switch to Trio? (PDF 52 KB)
Compare the Tandem PPO plan with our Full PPO plan (PDF 1.4 MB)
Tutorials
Find a Doctor tutorials
Choosing the right plan: Things to consider
We know that selecting a new plan can feel overwhelming. Browse our health plan selection questions below to guide you through the process.
Are there specific doctors, specialists, or hospitals that you want access to?
If yes, you’ll want to make sure these providers are in the plan’s network. Narrow your plan options by eliminating those whose networks do not include these providers. To find out if your providers are in the Blue Shield network for the plans being offered to you, visit our Find a Doctor tool.
Is it important for you to have access to as many California specialists and hospitals as possible in case of illness or injury?
If yes, you may want to choose a PPO plan (if offered by your employer), as they offer you the most choice and flexibility. With a PPO plan, you can also see providers who are not in the PPO network. However, please be aware that you may pay more for non-network providers than you will for network providers.
Are you and your dependents healthy, and do you usually see your doctor for annual checkups only?
If yes, a high-deductible health plan (HDHP) might be right for you. HDHPs typically come with lower monthly premiums (but higher plan year deductibles) than other plans. This means that less will come out of your paycheck each month and you’ll only pay out of pocket for the care that you need. After all, why pay more for something you feel you will rarely use?
Do you or your family members have a chronic condition such as asthma, cancer, or diabetes?
If yes, you will want to compare plan coverage along with estimated copays and deductibles for specialists, hospital stays, medications, medical equipment, etc. Typically, you will have fewer out-of-pocket costs with an HMO plan than a PPO plan, but a smaller network of doctors and hospitals from which to choose.
Do you or any family members take prescription drugs on a regular basis?
If yes, be sure to review each plan’s prescription drug coverage, including drug copayment tiers and prior authorization and exception request processes. To learn about Blue Shield’s drug coverage, view our Drug Formularies.
Do you anticipate any medical procedures, treatments, or special services in the next year such as surgery, pregnancy, colonoscopy, etc.?
If yes, compare coverage for the specific medical care you may need such as specialists, hospitals, medication, etc. Typically, an HMO plan covers most of the costs but offers a more limited network of doctors and hospitals than a PPO plan.
Do you travel often for work or pleasure?
If yes, you may want to choose Blue Shield, as all our plans offer access to Blue plan providers across the country through the BlueCard Program, and around the world through Blue Shield Global Core. Also, with a Blue Shield plan, you are always covered for urgent and emergency care while on vacation or traveling for business anywhere in the world.
We have the experience you can trust. As a nonprofit health plan, we've been on a mission to ensure access to high-quality, affordable care for Californians since 1939.
Tandem may be the perfect choice if you want all the benefits of a regular PPO plan without the higher premium.
By enrolling in a Trio HMO or Tandem PPO plan, you'll get access to Shield Concierge – our team of personalized customer care assistants.
Trio HMO offers premiums that are typically lower than our other HMO plans. If Trio isn't available to you yet, don't worry – the network is growing each year.
To make it easier to take better care of yourself, we offer a wide range of wellness discount programs to help you save money and get healthier.
Sometimes you can’t wait for a doctor’s visit. And you don’t have to. A Blue Shield plan gives you access to many care options, so you can choose what’s right for you.
Wellvolution® is our suite of wellness programs available to all Blue Shield members. Get help to lose weight, be more active, quit smoking, and more.
Not sure which Blue Shield plans are available to you? Your employer or benefits manager can give you more information about your plan options. They may also have a Blue Shield enrollment website they can share with you.
