Business Plans - Excellus Prospect

A new, convenient way for our Care Managers to provide confidential, proactive, one-on-one, text-based outreach to members using a smartphone or tablet.

Introducing SimplyBlue Plus Dental, a dental plan option tailored specifically for small groups. See your account representative for more information.

Mental health and substance use disorders are now covered under the primary care physician cost share.

With three types of plans and multiple options, we have coverage that’s right for every group and every member. Our network gives you access to more of the best doctors, specialists, and hospitals in your neighborhood and around the globe than any other. We’ve also negotiated great rates with these providers, which means everyone pays less for a higher quality of care.

• Local 31-County Network: 100% hospital participation, 99% physician participation and more than 98% participation of hospital-based providers
• National Network: >1,300,000 providers, 96% hospital participation, and 93% doctor and specialist participation
• Global Network: 7,400 hospitals (including the U.S.), thousands of hand-picked doctors and dentists fluent in English, and providers in 190 countries

With Dental Blue Options, members get comprehensive dental coverage with the flexibility of choosing from a variety of coinsurance, deductible, and annual maximum options. Emphasizing on preventive care, Dental Blue Options help employees maintain their complete oral health, reducing the need for more costly dental care in the future.

With Excellus BCBS, members get:

• One-stop shop for comprehensive medical and dental coverage
• Flexible benefit options at competitive rates
• Easy access to a broad network of providers
• National network options through DenteMax
• 100% employee-paid options available

Introducing Dental Annual Maximum Rollover:

Regular dental visits can greatly reduce the occurrence of major oral health issues, saving money for both employers and employees. The Dental Annual Maximum Rollover from Excellus BlueCross BlueShield incentivizes preventive care by rewarding employees with funds they can roll over to use as needed in the future.

One of the ways we can help keep health care costs under control is by keeping your employees healthy with a wellness strategy. Our wellness team is comprised of clinical and degreed professionals who partner with you and your employees to provide targeted wellness programs tailored to meet each employee’s needs. The result: greater satisfaction and savings, and the best outcomes for your organization and your employees.

Our team of wellness consultants will work with you to develop programs that touch every aspect of wellness:

• Wellness toolkits for employers: Low-cost, high-return ideas you can implement right away.
• On-site biometric screenings*: Give your team the chance to get checked for common issues without making an extra trip.
• Tobacco cessation: Most people who smoke want to quit. They just need help.
• Rewards-based programs: HealthyRewards^® for large group members reward positive behaviors and lifestyle changes.
• Web-based wellness resources and education for members: From the Blue365^® discount program and advance care planning support to a wellness blog and helpful videos, we’re here to help in every way we can.

* Online available for experience-rated groups with 100+ employees.

When your team is healthier, your business runs more smoothly. That’s why our comprehensive approach to Population Health Management (PHM) is essential. With our system of programs, reminders, and education, we surround your employees with the help they need to stay on track with their health goals, live better, and work harder. Whether someone on your team is dealing with a chronic or complex condition, or just needs a reminder to go to the doctor once in a while, you can rest easy knowing someone is looking out for them—at no additional cost.

• Utilization Management: We connect members to the exact level of care they need to speed recovery and keep costs in check. We track and review each stage of care and leverage established national standards of care guidelines, evidence-based data, and partnerships with local providers to ensure the right level of treatment.
• 24/7 Nurse Call Line: Members can contact a nurse by phone anytime—24 hours a day, seven days a week—with general health questions. If ongoing support is needed, members may be referred to a member care manager so they’ll have the support that best fits their needs.
• The Wellframe^® app: Members can take advantage of a new, convenient way for our Care Managers to provide confidential, proactive, one-on-one, text-based outreach using a smartphone or tablet. Members can receive guidance, support, and tips to help achieve their health care goals and reduce costs.

Excellus BCBS provides access to virtual health care via our partner MDLIVE. Through a toll-free phone number, video conferencing via the web, or a secure mobile app, members have another option to receive care from Board-Certified providers for acute, non-life-threatening medical and behavioral health conditions.

Our telemedicine program:

• Addresses medical conditions like allergies, nausea and vomiting, cold and flu, and pink eye, as well as behavioral health conditions such as depression, addiction, stress and LGBTQ support
• Increases employee access to high-quality health care
• Helps reduce costs for both members and your company
• Decreases absenteeism and improves productivity by reducing visit times
• Promotes employee work-life balance by reducing in-person appointments that cut into valuable work and personal time
• Supports employers with a toolkit to educate employees on the benefits of telemedicine and motivate them to set up their accounts