CA 2019 SG Guide
CA_2019_SG_Guide
User Manual:
Open the PDF directly: View PDF 
.
Page Count: 12
YOUR TIME MATTERS.
So we’re making everything work harder for you.
�
New, more affordable plan designs for your clients
�
Simplified electronic process, from quoting through enrollment, for you
Small Group product guide I Effective January 1, 2019
This policy has exclusions, limitations, and terms under which the policy may be continued in force or discontinued. For costs and complete details of coverage, contact your Anthem representative.
* Non-ACA compliant plans may may not qualify for single bill when combined with other coverages.
Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensee of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc.
107469CABENABC 05/18
HELPING CHOOSE THE RIGHT PLAN FOR YOUR CLIENTS SHOULDN’T KEEP YOU UP AT NIGHT
Your clients want their employees to have the right plan for their needs, while balancing the cost. We get it. We created a wider range of plan
options with everything your clients and their employees need to make smarter health care choices, save time and manage costs. And our plans
work together – medical, pharmacy, dental, vision, life, disability and behavioral health. You and your clients should feel good with that choice.
� More plan choices to meet more budgets
� A lower cost of care because of the strength and quality of our
networks, so members can see doctors who deliver the most
effective, efficient care
� Expanded medical and pharmacy portfolios:
—ACA-compliant medical and pharmacy plans offering
a wide range of member cost share options
—Integrated Act Wise consumer-driven health plans
that manage the medical benefits and the
spending accounts
� A 5% discount on specialty premiums (dental, vision, life and
disability) when clients purchase dental for the first time along
with vision, life and/or disability
—Members get whole-person coverage. Because our products
are connected, doctors can work together behind the scenes
to see a person’s overall health, leading to earlier detection of
possible health issues
� Better health and engagement for members – our digital health
care platform integrates benefit information, clinical and claims
data, and other digital tools to create a more personalized
member experience
MAKING IT ALL EASIER. YOU SPOKE, WE LISTENED.
We know it hasn’t always been easy to work with us. From complicated and inconsistent processes to long implementation times, you’re
frustrated and we hear you. We’ve been working hard to invest in, and develop, market-leading tools and technology with one goal in mind:
to streamline, so you can save time and worry. The changes you’ll see:
� Reimagined Producer Tool-box where you can do it all—in one
place, no more going back and forth between portals
� Simplified quoting so you can easily show your clients the cost
of any combination of our medical, dental, vision, life and
disability coverage
� Online enrollment submission for your clients and their
employees that drastically reduces implementation times; no
more paperwork
� Full transparency on your clients’ status in the implementation
process – no more guessing games
� Integrated EmployerAccess makes it easier for you to perform
maintenance on all of your clients with a single sign-on
But we didn’t change everything. You will continue to enjoy the support from the service teams you know and trust. And we’ve made their jobs
easier with streamlined processes that are consistent across our company and technology that’s flexible so they can quickly answer your
questions. It’s the best of both worlds so you can rest easy.
PharmacyMedical Dental DisabilityLifeVision Behavioral Health
MAKING IT EASIER
FOR YOU AND YOUR CLIENTS
Your time should be focused on supporting your clients, consulting with them on the right health plan
for their unique needs. What if it could be easier? Instead of paperwork, what if you could focus on
building your business?
WELCOME TO A BETTER WAY.
>
Great Products, Service and More on Tap for 2019
Anthem’s California Small Group Team is continuously enhancing our products and programs. Check out the latest for 2019!
New Product Naming
Plan names have been modif ed to an attractive naming structure you’ve been asking for. i
- Out of pocket maximum (OOPM) has been removed from all plan names
- PCP copay has been added
- Only the PCP copay will be listed for HMO "no deductible" plans
New Products
New EPO product - Designed to direct the member to a physician for care.
- Features new PCP selection program - Member selects a PCP at enrollment, referral to specialist is not required
- Two new and simple Gold EPO plan design that applies deductible/coinsurance on most medical and pharmacy services
- Offering in-network coverage using the full PPO network for in-state and BlueCard network for out-of-state
- No Out of Network Coverage
New Silver HMO 55 - Copay-based plan option in the Silver metal tier designed with no medical deductible or coinsurance.
Product Updates
Bronze PPO plans with limited visits – Copays (such as off ce visit, therapy, emergency room, mental health) have been greatlyi
modif ed to meet AV requirements with also a change to a combined medical/pharmacy deductible that provides a very competitivei
plan design.
Copays, coinsurance, out of pocket maximum, deductibles and pharmacy cost shares have been adjusted as needed to provide the
variety and price point that employers are looking for in Anthem’s portfolio – check it out!
Program Updates
LiveHealth Online- just got easier with a $0 copay for f rst 3 visits! i
Anthem Act Wise – Anthem HSA plans are now offered on our own Anthem branded solution called Anthem Act Wise – it is a
consolidated experience, coordinated medical benef ts paired with an optional integrated HSA…making saving easier than ever i
Future Moms now enhanced with Breastfeeding Support– through LiveHealth Online visits with lactation consultants or registered
dietitian at no charge!
Contact your Anthem representative to
learn more.
For employer groups with 1-100 employees
California
WHAT’S NEW IN 2019
GET QUALITY CARE WHEN
AND WHERE YOU WANT IT
Off ce. Online. Home. i
In the doctor’s off ce i
From PPO to HMO and from narrow to full, Anthem’s network
provides its members with access to f t your needs. We havei
8.3 million members in California alone, and a statewide
network of:
- 45,000+ physicians and over 400 hospitals for HMO plans
- 62,000 physicians and over 400 hospitals for PPO plans
Online 24/7
Using LiveHealth Online, members can visit with a doctor
using their smartphone, tablet or computer with a webcam at
home, the off ce or anywhere in between. LiveHealth Online isi
available for basic doctor visits, behavioral health, lactation
consulting and care for kids.
In Your Home
HEAL helps members see a doctor at home, on-demand and
on their schedule. HEAL is available across California — in Los
Angeles, Orange County, San Diego and the San Francisco
Bay Area.
For more information visit anthem.com/ca or
contact your sales representative.
2
Through our partnership with PayForward.
MEMBERS CAN EARN
CASH BACK WHEN
THEY SHOP
How does it work?
Members can shop at 60,000 participating
retailers and earn up to 15% cash back with
each qualif ed purchase. They can shop online,i
swipe their card or buy and use an e-gift card.
Is it free to join?
Yes! Members just need to have an Anthem
medical plan.
For more details:
Check out payforward.com.
Contact your Anthem account representative.
How do members sign up?
They can register at payforward.com, or
download the PayForward app from the App
Store or Google Play™. When 30% or more
members sign up, PayForward will raff e off $50,l
$25, or $10 incentives that will go straight to their
Anthem health wallets.
Members can use incentives to:
Spend any way they choose.
Save to a Health Wallet, PayForward
account or bank account.
Share with friends, family and charities.
3
VISION AND DENTAL
BENEFITS FOR WHOLE-
PERSON HEALTH
Anthem Blue View VisionSM offers members access to
one of the largest networks in the nation — along with
signif cant savings. i
1 Except when discounting of non-covered services is prohibited by state law.
2 Based on the Blue View Vision plan with $10 lens copay and $130 frame allowance for glasses, or
$130 contact lens allowance.
3 Applies to Anthem Dental Essential Choice members who are actively engaged in an Anthem Care
Management program for the following conditions: cancer, pregnancy, diabetes, certain heart
conditions, organ or bone marrow transplants, stroke, end stage renal disease (kidney disease), and
suppressed immune systems (HIV/AIDS).
38,000 doctors and 27,000 locations
40% off an additional pair of glasses from
providers in the plan1
63% average retail savings for Blue View
VisionSM members using network providers 2
Our Dental benef ts i offer members easy access to a
large number of dentists. That includes discounts and
services to help them keep up their dental health and
prevent long-term problems.
127,000 dentists and 385,000 places to
get care
35% average discount on covered dental
services when using a dentist in the plan
Extra cleaning or periodontal maintenance for
members in one of our medical care
management programs for certain conditions3
Retail and online partners
4
ADDED PROTECTION FOR
MEMBERS
Dedicated team of disability case managers,
nurses and health coaches.
Personalized claim support and stay-at-work
programs help those with disability claims get
back to work quickly and safely.
Resource Advisor offers counseling on
emotional, f nancial and legal concerns, andi
identity theft recovery.
Travel assistance with emergency medical
assistance covers members when traveling more
than 100 miles from home.1
Benef ciary Companioni offers support for
handling estate details.
Disability claims processing time is 7.3 days
or less with 99.8% accuracy.
These benef ts can be offered on a voluntary basis toi
help your clients save on premium costs
Your clients can offer 100% employee-paid voluntary
dental, vision, life and disability plans. They pick the
plan design and their employees pay premiums at
affordable group rates.2
Life and disability benef ts are easy to add, easy toi
manage. Here's a sample of what's included:
1 Travel assistance available to clients with life benef ts. i
2 Minimum voluntary participation requirements: dental/vision = 5 enrollees, life/disability =
10 enrollees.
5
HELP MEMBERS BE
THEIR HEALTHY BEST
These resources help members get support for every
life stage.
24/7 NurseLine
Round-the-clock answers to health questions
Help deciding where to go for care
Future Moms
Education and support during pregnancy
Assessments to help f nd risks i
Nurses on call for questions and follow-up
throughout pregnancy
Breastfeeding support through
LiveHealth Online
MyHealth Advantage
Claims reviewed for gaps in care and
health risks
Conf dential MyHealth Note sent toi
members offering suggestions to
improve health
Condition Care
Support for members with a
chronic condition
Personalized plan from a nurse coach and
team of specialists
Case Management
Proactive outreach to members who are
hospitalized or have a serious illness
Support from a nurse care manager and
other health professionals
6
Search for doctors, specialists, hospitals,
urgent care centers and other providers in
their plan.
Rate a doctor’s service and review ratings from
other members.
CARE & COST FINDER:
BETTER CARE AT A
BETTER COST
Anthem’s Care & Cost Finder tool gives members what
they need to make smart health care choices.
And it’s easy! They can f nd a doctor, compare costs andi
look up quality ratings — all in one place. This online tool
lets them:
Use it anywhere!
Members can register or log in at anthem.com or use
our Anthem Anywhere app to start using the Care &
Cost Finder tool.
Search for pharmacies or link to Anthem
pharmacy benef ts information. i
See cost estimates for over 400 common
medical procedures (based on their health
plan) to know how much they may pay.
7
LET’S DO THIS, TOGETHER
Choosing a health plan isn’t easy, but we want it to be. The plans you’re about to see have been
created to be easy for you to quote and administer and easy for your clients and their employees
to use.
Select the links below to view Anthem’s products for 2019.
As you view our portfolio, you’ll see all types of plan designs that are as unique and different as
your clients.
Medical plan grid
Dental plan grid
Vision plan grid
Life & Disability plan grid
YOUR TIME MATTERS.
So we’re making everything work harder for you.
�
New, more affordable plan designs for your clients
�
Simplified electronic process, from quoting through enrollment, for you
Small Group product guide I Effective January 1, 2019
This policy has exclusions, limitations, and terms under which the policy may be continued in force or discontinued. For costs and complete details of coverage, contact your Anthem representative.
* Non-ACA compliant plans may may not qualify for single bill when combined with other coverages.
Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensee of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc.
107469CABENABC 05/18
