Blue Shield Adds a Silver Insurance Plan to the Covered California SHOP

Posted: July 25, 2016

by John Hansen

Covered California for Small Business Gets a Blue Shield Silver Obamacare Health Plan

In 2017, Blue Shield will be adding a Silver Insurance Plan to their Covered California for Small Business (formerly SHOP) plan offerings. Consumers have been frustrated that Shield has not included a silver health care plan on the California Exchange for groups. It has made SHOP less appealing, and it has made Blue Shield less attractive to consumers considering enrolling in group health insurance for California through the State Exchange.

This Was a Drawback to Getting Blue Shield in the SHOP.

With 63% of consumers choosing silver insurance, these plans have been the most popular in the market. Whether people went with Covered California Blue Shield or with another carrier, the silver health care plan was most often the plan of choice.

Many small businesses were a bit disenchanted with the California Health Exchange when they found out there was no Blue Shield silver insurance plan offered. This often led them to go with another carrier (like Anthem Blue Cross) or to purchase coverage outside of the California Health Exchange. If a small group qualified for a tax credit through Covered California and they really wanted a Blue Shield silver health care plan, then they were in a bind.

Starting Jan 1, 2017, Blue Shield will offer all the metal tiers including the silver insurance plans. All plans will include the full Blue Shield network, which is one of the most extensive, quality medical networks in California.

Why didn’t Blue Shield offer silver insurance plans in the shop to begin with?

Jeff Smith, Vice President of Individual and Family Lines for Blue Shield, commented, “We read the risk and were too conservative.” Blue Shield of California considered offering the small group silver insurance plans on the exchange, but they were concerned they might lose money. So they offered all the other metallic tiers, but not the silver health care plans.

Blue Shield was not the only California health plan concerned about the risks of selling health insurance in the new world of Obama Care, the ACA and Health Care Reform. All carriers in the state were concerned about taking on too much risk. They were re-evaluating all of their products, not just the Obamacare silver insurance plans. Carriers were trying to calculate risk factors and carefully ease into a market that was radically changing.

It was not surprising that a lot of carriers were very cautious with the passage of the Affordable Care Act. Health plans like United Health Care waffled regarding whether or not they wanted to be in the exchange at all. Other health insurance companies, like Blue Shield of California, questioned offering silver health care plans. They looked at what plans they wanted to include in their product line and whether or not they wanted to include all metallic tiers. 

Fears of high risk pools bankrupting health insurance companies caused many medical plans to tip toe carefully into Obama Care in California. Carriers re-evaluated all metallic plans, including silver insurance plan offerings. They assessed pricing, exchange options, and they questioned whether they would include these offerings on the individual and family side or on the small business group side of their product lines.