1/3/2025
California
Blue Shield of California’s Q2 2025 rates are now available, featuring a statewide average rate adjustment of 1.7%.
2025 Medical and Dental Updates: Q2 updates include improved deductibles and out-of-pocket maximums, added benefits, easier HMO pairing, and expanding access to care.
Impacted plans with cost share and name changes:
Expanded Access to Care: Trio HMO plans now include Accolade Care, offering seamless in-person and virtual care anywhere in California. Employees gain access to primary, specialist, and behavioral care through this coordinated solution.
Below are the plans being withdrawn:
2025 Medical and Dental Updates: Q2 updates include improved deductibles and out-of-pocket maximums, added benefits, easier HMO pairing, and expanding access to care.
Medical Plan Updates
For 2025, Blue Shield made minimal changes to their plans, including enhanced deductibles and out-of-pocket maximums.Impacted plans with cost share and name changes:
2024 plan name |
2025 plan name |
|
Silver PPO 2000/60 |
Silver PPO 1700/60 |
Silver PPO 2350/65 |
Silver PPO 2100/65 |
Silver PPO 2550/70 |
Silver PPO 2350/70 |
Gold PPO 1000/35 |
Gold PPO 1000/30 |
Bronze PPO 5500/65 |
Bronze PPO 4500/65 |
Mirror Bronze 60 PPO 6300/60 |
Mirror Bronze 60 PPO 5800/60 |
Expanded Access to Care: Trio HMO plans now include Accolade Care, offering seamless in-person and virtual care anywhere in California. Employees gain access to primary, specialist, and behavioral care through this coordinated solution.
Pharmacy Updates
- Price Check my Rx: Offers a personalized experience with real-time information from their formulary and benefits usage.
- Prescription Savings Program: Discounts on out-of-pocket costs for select medications and is designed to improve prescription drug affordability and medication adherence.
Dental Plan Updates
Effective January 1, 2025, three dental PPO plans will no longer be available. To explore new plans and available options, please refer to the plan mapping grid.Below are the plans being withdrawn:
- Smile℠ Deluxe 50/1500/Ortho/MAC
- Smile℠ Deluxe Gold 50/1500/Ortho/U85/NR
- Ultimate Dental Plus PPO for Small Business 50/2000/Ortho/MAC/NR
Vision Plan Updates
2025 Insight Discount with EyeMed Doctors: Members can take advantage of discounts with these three simple steps:- Locate an Eye Doctor: Members can choose from a wide network of independent eye doctors. Visit blueshieldca.com to find a provider.
- Schedule an Appointment: Members can call ahead or visit one of the many eye doctors that offer walk-in appointments.
- Use the Discount: When members arrive, they should inform the eye doctor that they have a discount plan through Blue Shield of California.
Updated Sales and Broker Marketing Materials/Tools
- Q2 2025 Medical Broker Sales Guide Updated
- Q2 2025 Specialty Broker Sales Guide Updated
- 2025 Plan Cheat Sheet
- 2025 Relaxed Participation flyer
Source: Blue Shield of California