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SHOP

The Small Business Health Options Program (SHOP) Marketplace makes it possible for small businesses to provide qualified health plans to their employees.

The SHOP Marketplace is open to employers with 50 or fewer full-time-equivalent employees (FTEs) and employers may also qualify for tax credits.  Not only does Capital BlueCross offer competitive medical options, but all the SHOP products also have Pediatric Vision embedded in the medical plan to be PPACA compliant. 

For more information about SHOP, please visit https://www.healthcare.gov/small-businesses/

For the different SHOP product plans Capital BlueCross offers, please choose from the tabs listed below. 

PPO
HMO
HMO Value Network
Why Choose CBC?
Employee Benefits
  • With Preferred Provider Organization (PPO) protection, health care is fully covered for your employees and their dependents.

    Members see the physicians of their choice, use the hospitals of their choice, and enjoy flat-rate copayments for routine office visits. PPO membership brings the value-added benefits of Capital BlueCross' unique mix of wellness programs, including Live Healthy, 24/7 Nurse Line, and access to the Search Save Center.

    PPO members have the reliability of our widely recognized BlueCard network when traveling.

    Our programs are designed with the goal of encouraging your employees to make better health care decisions and become savvy about health care spending.

    For more information, please view our brochure.

    PPO typically covers these services
    Physician office visits for illness or injury
    Preventive care (routine physical exams, annual gynecological exams, annual mammograms [women age 40 and over], childhood immunizations)
    Maternity and newborn care
    Disease management for asthma, diabetes, congestive heart failure and coronary artery disease
    Lab tests and x-rays
    Physical, occupational and speech therapy
    Home health care
    Skilled nursing facility
    Hospice care
    Outpatient and inpatient hospital services
    Emergency care
    Medical supplies and equipment
    Behavioral health services
    Substance abuse (drug and alcohol treatment)

    * Subject to applicable contract terms and exclusions

    PPO is issued by Capital Advantage Insurance Company®, or Capital Advantage Assurance Company®, Capital BlueCross subsidiaries.

  • With Keystone Health Plan Central Health Maintenance Organization (HMO), your employees select a PCP from our large, qualified provider network. PCPs provide treatment, refer members to specialists and hospitals, track feedback from specialists, and file all claims. The end result is a more complete picture of our member’s overall health care experience, which can significantly reduce costs. HMO members have the reliability of our widely recognized BlueCard network when travelling.

    For more information, please view our brochure.

    HMO typically covers these services
    Physician office visits for illness or injury
    Preventive care (routine physical exams, select screenings, annual gynecological exams, annual mammograms [women age 40 and over], well baby care, childhood immunizations)
    Maternity and newborn care
    Disease management for asthma, diabetes, congestive heart failure and coronary artery disease
    Lab tests and x-rays
    Physical, occupational and speech therapy
    Home health care
    Skilled nursing facility
    Hospice care
    Outpatient and inpatient hospital services
    Emergency care
    Medical supplies and equipment
    Behavioral health services
    Substance abuse (drug and alcohol treatment)

    * Subject to applicable contract terms and exclusions

    HMO is issued by Keystone Health Plan® Central, a Capital BlueCross subsidiary.

  • The HMO Value Network is a unique product only offered through SHOP to groups located in one of the eight counties listed below. There is no coverage outside of the eight counties unless it is for Emergency or Urgent Care services. The BlueCard network or Away From Home Care is only available when using providers outside Keystone’s standard 21 county service area.

    Since this product is only available in the eight counties it has a limited scope of participating providers. For a list of in network providers, please refer to the Search & Save Center.

    Berks Cumberland Dauphin Lancaster
    Lehigh Lebanon Northampton Perry

     

    For more information, please view our brochure.

     

    HMO Value Network typically covers these services
    Physician office visits for illness or injury
    Preventive care (routine physical exams, select screenings, annual gynecological exams, annual mammograms [women age 40 and over], well baby care, childhood immunizations)
    Maternity and newborn care
    Disease management for asthma, diabetes, congestive heart failure and coronary artery disease
    Lab tests and x-rays
    Physical, occupational and speech therapy
    Home health care
    Skilled nursing facility
    Hospice care
    Outpatient and inpatient hospital services
    Emergency care
    Medical supplies and equipment
    Behavioral health services
    Substance abuse (drug and alcohol treatment)

    * Subject to applicable contract terms and exclusions

    HMO is issued by Keystone Health Plan® Central, a Capital BlueCross subsidiary.

  • Service + Innovation + Variety + Flexibility + Value = Capital BlueCross!

    We have provided the people of our 21-county service area with maximum value in health insurance products since 1938. Our members in Central Pennsylvania and the Lehigh Valley know of our reputation for excellence in customer service and our commitment to offering a wide variety of easy-to-use, comprehensive and innovative health-care products for employer groups and our members.

    Learn More

    Benefits for You

    You have our commitment to work hand-in-hand with you to meet and exceed your goals and objectives. In addition to a robust selection of health coverage products - medical, dental, vision, prescription drug and more - we also provide you with the tools you need to help your employees live healthier lives and to make managing your employees' benefits as simple as possible.

    Learn More
  • Benefits for Your Employees

    Not only are we committed to helping you, our employer groups, meet your health coverage goals and objectives, we are also dedicated to your employees. We know how important health care services are to your employees and, of course, their families. To ensure they receive the most appropriate care, we offer many programs and services to help keep them healthy while making the management of their benefits as simple as possible.