Sep 14, 2020
Anthem Blue Cross reports a statewide quarterly decrease of -3.7% for PPOs and -2.7% for HMOs. Anthem has made changes to plans and pharmacy networks, which we break down below.
New Plan Designs
- PPO Bronze 75/7300/40% (Full & Select) – Unlimited copays with the deductible waived for visits to PCPs and specialists. The Rx deductible is also waived for Tier 1 drugs
- PPO HSA Silver 2500/35% with PrevRx (Full & Select) – PrevRx stands for first-dollar coverage for preventive Tier 1 drugs before meeting the deductible. This is the only plan design denoted by PrevRx
Plan Enhancements
Anthem is embedding Dental and Vision for adults and children in seven popular plans. These “Whole Health” plans are denoted by a WH in the plan name. Keep in mind that Anthem is maintaining the same plans that do not include the WH. For example, Anthem will have both Gold PPO 35/500/25% and Gold PPO 35/500/25% WH versions.
- Anthem Bronze PPO 5600/45% with HSA WH
- Anthem Bronze PPO 6950/0% with HSA WH
- Anthem Gold PPO 35/1000/20% WH
- Anthem Gold PPO 35/500/25% WH
- Anthem Platinum PPO 5250/15% WH
- Anthem Silver PPO 45/1750/40% WH
- Anthem Silver PPO 55/2500/45% WH
Changes to Rx Networks and the Offer of Level 1 And Level 2 Pricing
Anthem will use the Rx Choice Tiered Network for all small group plans except SHOP plans. What differentiates this network is Level 1 and Level 2 pharmacy cost shares. Level 1 represents preferred pharmacies like CVS, Target, Walmart, Sam’s Club, and Costco. Members who use Level 1 pharmacies have lower copays across all tiers. Members who use Level 2 pharmacies, like Rite Aid and Walgreens, will pay higher copays across all tiers. SHOP plans will utilize Anthem’s Standard Network.
Benefit Changes
Changes include better copays for labs and x-rays, changes to deductibles, and better coverage for telehealth on Priority Select HMO plans – View the Plan Map.
Underwriting
- Promos extend through March 15, 2021
- IFP is a valid waiver
- 25% Relaxed Promo with 5+ enrolled
- No DE-9C for groups with 6+ enrolled
- Multiple Network Flexibility runs October 1, 2020 through March 15, 2021 – Mix and Match 2 HMO Network + 1 PPO Network OR 2 PPO Networks + 1 HMO Network
- Anniversary Date Change – Groups can change their anniversary date to January by submitting an anniversary date change form, which will be released along with SBC, SOB, and product guides on October 1, 2020.
Resources
- The Broker Plus App allows brokers to track commissions, view renewals and case status, and get notifications for the next steps. When you download the app, Anthem will donate 80 meals to help feed families!
- The Benefits Guide helps employers to navigate workplace issues.
We also want to let you know that renewals will be available on Producer Toolbox on October 19, 2020. Employers will receive renewals by mail on October 26, 2020 and online on October 28, 2020. Please reach out to your LISI Regional Sales Manager to help you with the heavy lifting.
