Our portfolio of clinical management and advocacy products provides comprehensive options for employers’ needs in clinical management, advocacy, navigation, behavioral health and utilization management.
Large Group Health Insurance Plans
Discover a complete portfolio of standard to customizable, end-to-end health care solutions for large employer groups (151+) from Blue Cross and Blue Shield of Texas.
Popular Plans for Large Businesses
The following network products1 are available for local, labor/municipal, and national groups with 151+ participants for both types of funding arrangements: fully insured and self-funded (aka Administrative Services Only or ASO). Exceptions noted.
| Plan Type | Blue Premier℠ | Blue Premier Access℠ | Blue Essential℠ | Blue Choice PPO℠ |
| Type | HMO | HMO | HMO | PPO |
| Cost Saving | 13% relative to broad PPO2 | 12% relative to broad PPO2 | 9% relative to broad PPO2 | 9% relative to broad PPO2 |
| Key Features | Cost-effective network, value-based care model with PCP-guided care | Cost-effective network, no PCP selection or referrals required | Cost-effective network, standard HMO model with PCP-guided care | Cost-effective network, value-based care model with PCP-guided care |
| Availability | 20+ counties in Dallas Fort Worth, Austin, San Antonio and Houston | Statewide | Statewide | Statewide |
Health Management & Advocacy
Health Advocacy Solutions
This solution gives employees access to health advocates. They provide hands-on navigation and care support. Employers get a full suite of digital wellness resources tailored to the employer.
Benefits Value Advisor
Benefits Value Advisors help employees understand their health care benefits, find in-network doctors and facilities, schedule doctor visits, get prior authorizations and more.
Wellbeing Management
Employees work with an advisor and multidisciplinary team to address complex care. The team can include behavioral, pharmacy, maternity and oncology clinicians to help guide members to evidence-based care.
Enhanced Oncology
This program identifies and supports members navigating the complexities of cancer care. They take the lead in helping members through this difficult time, from the initial diagnosis to recovery.
Enhance Your Coverage Today
Easily Boost Medical Benefits with Ancillary
We can combine our medical coverage with some of the most popular ancillary benefits in one quote. Package pricing3 combines medical coverage with other ancillary benefits and allows for a reduction in medical premium.
Group Dental Insurance
Blue Cross and Blue Shield of Texas can build the ideal dental plan for any employer.
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Group Vision Insurance
Boost your client's Blue Cross coverage with flexible, cost-saving vision benefits.
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Life Insurance
Life insurance protects loved ones financially in case of an untimely death.
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Short-Term Disability
Short-Term Disability plans provide income when illness or injury prevents work.
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Long-Term Disability
Long-Term Disability insurance secures your income, protecting your family during hardships.
Learn MoreIntegrated Pharmacy: An Approach That Delivers
Our strategy links pharmacy and medical benefits to lower overall health care costs, improve health outcomes and deliver an unrivaled member experience. Our solution uses real-time data to drive real-time results. Here's how we do it.
Better Outcomes
Clinical programs backed by real time, integrated data support providers in optimizing care management and improving member health. The result: 7-16% lower overall risk for diabetes related vision loss and kidney disease and 15% less inpatient utilization.4
Member Engagement
Programs leverage real time pharmacy and medical data to engage members, leading to lower costs and better outcomes. Our study showed a 42% improvement in member engagement rates with connected benefits.5
Lower Costs
Programs target adherence, manage utilization, and leverage real-time medical and pharmacy data to drive down costs for chronic conditions. Examples: Medical cost savings for Crohn’s disease ($1,452 PMPY) and chronic kidney disease ($1,104 PMPY).5
Aligned Incentives
Our flexible an innovative solutions across dispensing channels support the goals of an employer group and the needs of their employees. While others maximize profits for shareholders, we maximize value for our customers.
1 Blue Premier, Blue Premier Access and Blue Essentials provide coverage within stated regions with the exception of emergency room and emergency procedures.
2 Our book of business analysis of Texas based employers (151+) indicated that employers benefit from about 13% in cost avoidance by using Blue Premier relative to the broad PPO, about 12% in cost avoidance by using Blue Premier Access relative to the broad PPO, and about 9% in cost avoidance by using Blue Essentials relative to the broad PPO. Savings will differ based on each employer’s population (demographics and location).
3 Ancillary product package pricing is available to mid-market (51-150) and large group market segments (151+) with up to 3,000 eligible employees when combining medical with qualifying ancillary options. Multiple Employer Welfare Arrangements, small groups (1-50), Blue Balanced FundedSM, student health plans, select large group segments, Minimum Premium Plans and ASO groups with percent-of-claims arrangements are excluded from this program.
4 Integrated Diabetes Study 2023
5 2023 Study on Condition-Specific Integration Results