Jul 10, 2019
With the recent launch of Priority Select, Anthem Blue Cross is offering groups more affordable price points with a continued focus on coordinated care. They continue to reposition their presence in the market to stay relevant.
Groups have one of two Dual HMO options:
1) Full HMO can be paired with Select HMO
2) Select HMO can be paired with Priority Select HMO
Here are key things for you to know, specific to Q4:
• Anthem Blue Cross rates look good. Their statewide quarterly average for PPO and EPO plans hover around 0.3%. Their Full HMO reports a slight increase of 1.3% while their Limited HMOs report a 2.2% increase.
• Tier 1 will no longer split into Tier 1a and Tier 1b copays. Groups and members will receive a letter, advising them that Tier 1a and Tier 1b will now just be Tier 1. SBCs, SOBs, and EOCs are being updated.
Anthem will update two plans highlighted in the table below:
|
2019 Replacement Plan (Core Contract Code) |
Changes Include |
| Anthem Silver HMO 2250/40% (5144) Anthem Silver Select HMO 2250/40% (5145) |
Increase specialist (SPC) copay by $10 from $100 to $110 and all services that map to SPC (i.e. office surg, home health) Change plan name New contract code |
| Anthem Silver PPO 40/1750/40% (514A) Anthem Silver Select PPO 40/1750/40% (5153) |
Increase deductible from $1,500 to $1,750 Change plan name New contract code |
Underwriting promotions are extended through December 15, 2019. Briefly, they are:
• 25% relaxed participation for groups with 5 or more enrolled employees
• IFP is considered a valid waiver
• No DE-9C required for groups with 6 or more enrolled employees
• Dual HMO
We will continue to provide you with updates. Reach out to your LISI Regional Sales Manager to see where Anthem lies in your book of business.
