Changes to health service open enrollment

October is open enrollment for medical plans. View the new rates.

There has been a lot of confusion about Blue Shield plans. Here’s what we know so far:

For Blue Shield, this is not a normal open enrollment process. This time, your plan might change if you do nothing. Faculty should look at the plans carefully and make educated decisions.

Blue Shield members have been in a plan called Access+. Now Blue Shield is introducing a new plan called Trio HMO. They say in their brochure: “Trio HMO has the same benefits and plan design as Access+, and access to many of the same hospitals and physicians, but with lower premium contributions.”

We’ve heard that some doctors and hospitals covered by Access+ are not covered by Trio. We do not know which doctors are covered and which are not. The only way to know for sure is to look at the Blue Shield website, which lists providers. You can search for doctors on these two lists:

Blue Shield’s brochure says: “Current Blue Shield members whose primary care doctors are Trio HMO doctors will be automatically enrolled in the Trio HMO plan, which is the lowest cost plan, unless you complete an SFHSS Open Enrollment form electing another plan.”

That means that if your primary care physician is in the Trio plan, you will be moved to the Trio plan by default. If you see specialists or other doctors in addition to the primary care physician, check to make sure they are covered under Trio.

We have asked the District to clarify with Blue Cross what these changes mean for various groups of Blue Cross participants. For example the District has no clear answer for what will happen to members whose primary care physicians are NOT covered by Trio. We will keep asking and we will let you know more as soon as we’re able to verify more details.

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