Plan benefit design options are similar to those offered under a traditional, fully insured policy and are designed to be a solution for employers who require financial predictability and protection against high-cost claims.
Small Group Level Funded Plans
Blue Balance Funded℠ for Groups 10-50
Our administrative and stop loss coverage suite of services includes consistent monthly payments and comprehensive reporting. Employers can save up to 25% on average vs a fully funded ACA plan.
Blue Balanced Funded Plans
Predictable Payments1
A monthly invoice includes the employer cost for claims funding, administrative fees and stop loss premiums. Employers manage all three with an online billing system.
Stop Loss Coverage
Stop loss insurance provides protection for covered claims costs resulting from individual and aggregate claims exceeding the predetermined stop loss levels.
Analysis and Reporting
Transparent online analysis and reporting system for employers. With data, they track costs and trends, giving them opportunities to manage benefits better.
Possible Credit
After the yearly settlement, if the actual claims cost is less than the claims funding, your employer clients may be eligible for a credit toward future monthly payments.
Network Options
Included Products and Services
Employee Assistance Program
Members have access to clinical therapy sessions; family, legal and financial counseling; and online guidance resources.
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Well onTarget
The Well onTarget program gives members tools and resources to help them make healthy choices and rewards them for their hard work.
Learn more from member flyer
BlueCard Program
BlueCard links participating health care providers and the independent Blue Cross and Blue Shield Plans across the country through a single electronic network.
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Mental Health Hub
Digital one-stop-shop for mental health resources, recommended solutions, and access to behavioral health providers.
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Pharmacy Benefit Management
Prime Therapeutics is our pharmacy benefit manager. Prime handles prescription claims, pre-approvals, drugstore networks, and drug lists.
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Virtual Visits by MDLIVE®
MDLIVE's doctors and therapists can treat many non-emergency issues. Plus, virtual care may cost less than going to an urgent care clinic or the emergency room
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Cancer Care Support Hub
A one-stop shop for cancer care navigation that houses their benefits, program details and reources.
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Blue PointsSM
Members making smart health choices can access incentive programs to promote wellness.
Detailed member flyerGroup Eligibility Frequently Asked Questions
1 The amount of the monthly payment may fluctuate depending on the number of enrolled employees. It is recalculated each year and is subject to change. Employers are solely responsible for taxes, fees, and obtaining and paying for their own accounting and legal services.
2 We reserve the right to revise or withdraw the proposal if any of the requirements are not satisfied.