Coverage for Midsize and Large Businesses
What’s New for 2023*
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Bright Beginnings – Upon renewal in 2023, the Healthy Baby Connection program, previously available to Large Groups, will be enhanced and called Bright Beginnings. While many aspects of the previous program will stay the same, the 2023 program will embrace a more proactive outreach strategy to engage members sooner. Our Care Management team will continue to provide support to members as they navigate the health care system, with a focus on early intervention, prenatal education, and personalized support during and after pregnancy. In 2023, the Bright Beginnings program will also be available to Small Groups.
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Active&Fit ExerciseRewards™ – We will be updating our Active&Fit ExerciseRewards program to count a fitness center visit as two points. Members that track their steps will continue to earn one point for 10,000+ steps in a day. Members are rewarded once they earn 100 points each 6-month period for working out at a qualifying fitness center or on their own** through their tracked steps. Maximum of two points per day will be allowable.
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Dental Annual Maximum Rollover and Account Fund Matching – Groups enrolling in an Excellus BlueCross BlueShield Dental Blue Options plan with the Annual Maximum Rollover benefit will now be able to keep any accrued rollover account funds from another plan. We will match the funding members have with a competitor up to the Rollover Account Maximum.
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REMINDER! Blue Simplicity Plans are Available to all Large Groups – Introduced last year, Blue Simplicity plans give groups the predictability of a copay plan – without the higher premiums. With transparent copay levels, first dollar coverage with no deductibles and coinsurance, free preventive care from day one, and much more! Blue Simplicity is available to all Fully Insured and Self-Funded groups.
* Subject to DFS approval.
** At-home workouts will not count as a workout; only the steps tracked during a workout may count toward rewards.
Medical Plans
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: >1,700,000 providers, 96% hospital participation, and 95% 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
Also, we know that going to the doctor’s office isn’t always an option, so our plans allow employees to access care and support right from home through telehealth, telemedicine, and the Wellframe® app. Learn more about these convenient tools in Tools & Resources.
Blue Simplicity
The simplicity and predictability of a copay plan - without the higher premiums. Blue Simplicity is a new way for employers to offer an easy-to-understand copay plan at a lower price point. It works just like a traditional copay plan, only with additional copay levels that help businesses keep expenses in check while still providing a simple copay plan employees love.
- Six copay levels so costs are always transparent and predictable.
- No deductible or coinsurance to figure out.
- Copays go toward the out-of-pocket max.
- Preventive care is covered in full from day one.
- All plans are FSA and HRA compatible.
Medicare Solutions
We can also help you with Medicare Advantage, Part D, and Supplement Plans for retirees and employees working past age 65. View Group Medicare Options.
Member Health Management
When your team is healthier, your business runs more smoothly. That’s why our comprehensive approach to Member Health Management is essential. With our system of clinical 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 feel confident knowing someone is looking out for them—at no additional cost*.
Some highlights of our comprehensive roster of Member Health Management services include:
- Utilization management
- Care management
- Disease management
- Behavioral health management
- Wellbeing and incentive programs
Tools & Resources
We’re dedicated to making health care more convenient for greater employee engagement. That’s why we offer free self-service support tools that make it easier than ever to get care.
- Online Member Accounts: From viewing their member card and benefits to viewing claims, tracking their deductible and out-of-pocket spending, and more, members have more visibility into their plan than ever before.
- Calm® App: Members receive a 12-month premium subscription to the Calm app, a digital experience to help members build resilience and manage stress through better sleep, mindfulness, and meditation.*
- Telemedicine: For non-emergency conditions and emotional wellbeing needs, telemedicine gives members convenient access to medical and behavioral health care 24/7/365 from the comfort of their home. In-network telehealth services provided by a member’s physician or our partner, MDLIVE®, are covered in full (subject to deductible where applicable).
- Wellframe® App: Wellframe is a convenient way for members to receive confidential, text-based, one-on-one outreach from our care managers using a smartphone or tablet. Members can receive guidance, support, and tips to help achieve their health care goals and reduce costs.
- 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.
- Find a Doctor & Estimate Medical Costs Tool: Members are more in control of their care with the ability to quickly and easily find their most affordable local, national, and global care options with our online tools.
*Included in Fully Insured Large Group plans; Buy-up for Self-Funded and Minimum Premium groups. Calm is an independent company that provides a mobile app for sleep, meditation, and relaxation to Excellus BCBS members.
Voluntary Benefit Services
When you integrate services like dental, administrative services and stop loss with medical benefits, Excellus BlueCross BlueShield can support employees with a more complete view of their health. Leading to more proactive support to help keep employees healthy and costs of care down.
Large Group Dental Packages (more than 50 eligible employees)
With Dental Blue Options, groups 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 helps 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
- Large network of dental providers with plans including National Dental GRID+ DenteMax
- 100% employee-paid options available
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 BCBS incentivizes preventive care by rewarding employees with funds they can roll over to use as needed in the future.
NEW! Groups new to enrolling in our dental plan will now be able to keep any accrued rollover account funds from another plan when they enroll in a dental plan that includes the annual maximum rollover benefit. We will match the funding members have with a competitor up to the Rollover Account Maximum.*
*Subject to DFS approval. Proof of rollover account funds will be required upon enrollment.
Simply Vision Plans
Vision and eye health are essential to overall wellbeing. That’s why group vision plans with low out-of-pocket costs are now available from Excellus BCBS.
All Simply Vision plans include:
- Low-cost eye exams
- Fully covered and low-cost on-trend frames options through the Exclusive Collection
- Competitively priced plan options and multiple contribution options
- Access to great discounts on lens add-ons, additional pairs of eyeglasses, LASIK services and other great extras*
Through our partner, Davis Vision, members also enjoy convenient coverage, with access to a large network that includes nearly 900 provider locations in the local Excellus BCBS network area and 100,000+ points of access nationwide.
*Not all providers participate in Davis Vision Discounts, including the fixed lens option pricing. Members should contact their provider prior to scheduling an appointment to confirm if discount and fixed lens options are offered.
Davis Vision is an independent company providing vision benefit management services and access to their network.
As the largest regional pharmacy benefits manager, we oversee every aspect of care on a member-by-member basis to keep costs low and keep businesses and their employees safe. Plus, we regularly connect with local physicians to stay current on new medications that can lower costs even further.
With integrated benefits from Excellus BCBS, you get the complete package:
- One member card
- Zero claims integration fees, hidden costs for utilization management, or reporting fees
- Local, dedicated pharmacy, sales, and customer service team for more responsive service
- Real-time formulary management to identify the most effective drugs at the lowest cost —based on real member data (not national statistics)
- Access to 28 on-staff pharmacists and 16 medical directors
- 4-6% reduction in overall medical costs*
* Health Plan Data
We’re in the business of protecting local businesses from catastrophic claims
We treat stop loss as an important part of our business, not a commodity. It’s a conviction that goes back more than 30 years and one we plan to keep. So you get the timely support and payments you need, when you need them most.
- An Integrated Approach to Care
By rolling stop loss in with medical and pharmacy coverage, we can use real-time member data to help prevent catastrophic events. The result: pricing consistently below the industry’s average stop loss trend.
- Reimbursements When They Matter Most
With wire transfer availability, we can make deposits directly into health plan accounts — with funds immediately available. We can also provide credit to claim billing for extraordinary, large reimbursements.
- Administration Without the Frustration
One point of contact for billing and customer service. Direct access to underwriters. And one consolidated bill for ASO administrative fees and stop loss payments when you also have medical through us — with no need to verify enrollment between carriers.
Health insurance administration is complicated. We can help connect you with workplace management solutions to help ensure regulatory compliance while improving efficiencies and bottom lines. Meaning your business can save more by focusing on other business priorities.
You can get administrative support for things like:
- Fully integrated reimbursement accounts
- Compliance services
- Full COBRA administration
- Nondiscrimination testing
Talk to an Excellus BCBS sales representative to learn more.
Excellus for Business
Infographics, videos and more: See how we can help keep your team healthy and costs under control.
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