VA 2019 SG Guide

VA_2019_SG_Guide

User Manual:

Open the PDF directly: View PDF .
Page Count: 20

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 and Blue Shield is the trade name of Anthem Health Plans of Virginia. Anthem Blue Cross and Blue Shield, and its afﬁliate Healthkeepers, Inc., serving all of Virginia except for the City of Fairfax, the Town of Vienna,

and the area east of State Route 123, are independent licensees of the Blue Cross Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc.

107469VABENBVA 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.

Act Wise Consumer-Driven Health Plans

These new plans make it easier for employers to administer their health savings account because Anthem now manages both the medical

benef ts and spending accounts. Act Wise is streamlining everything – for you, employers and our members. It’s easy to get started andi

get one-stop support from a dedicated team at one customer service number. And members have one website and mobile app to review

claims in real time and access their benef ts and account information from the same place. i

Anthem Health Guide

This combination of customer service and health support offers members access to highly trained professionals (health guides) who

consult with them and provide comprehensive help. Backed by smart technology and analytics, guides are closely linked to health

professionals, such as nurses, health coaches, educators and social workers. Together, they can help members stay on top of their health,

get more value from their benef ts and navigate the health care system more eff ciently. Members can call, request a scheduled call back,ii

email or have an online chat on a computer or through our app.

Exclusive Provider Organization Health Plans

We’re offering a new suite of Exclusive Provider Organization (EPO) products in the platinum, gold and bronze levels on our KeyCare

network. EPO products can be offered at a lower cost because members enrolled in these products are required to receive care from in

network providers when in the service area. Members can also enjoy the convenience of visiting specialists without referrals. Plus,

members will gain access to in-network providers when outside of our service area through the BlueCard program®. BlueCard provides

access to an estimated 92% of doctors and 96% of hospitals throughout the country.

Home Delivery Choice for Mail Order Maintenance Drugs

New for 2019, your employees get up to two f lls of a drug they take on a routine basis at a retail pharmacy and after that they need toi

decide whether they want to continue using the retail pharmacy or start taking advantage of the Home Delivery Pharmacy. A

maintenance drug is a drug taken on a regular basis to treat or control a chronic illness, such as heart disease, high blood pressure,

epilepsy, or diabetes. Home Delivery Choice increases the usage of drug home delivery services and provides additional savings and

convenience for members.

Preventive Care Incentives

Our plans offer lots of ways to support members at every stage and we now we also offer incentives for taking steps to stay healthy. It’s

true that good health is its own reward. But getting something extra feels good, too. When members take steps to stay healthy, they’ll get

a Health Rewards card. It’s a reloadable debit card they can use anywhere major credit cards are accepted. As your employees earn

rewards, they’ll automatically be loaded to their current card. Your employees can cash in when they get a preventive wellness exam and

f u shot, complete a tobacco-free certif cation and complete an online health risk assessment. il

Enhanced Personal Health Care

We developed this leading patient-centered, value-based program to transform primary care practices across the country by rewarding

health care providers for managing and improving their patients’ overall health. By giving these providers (and their off ces) support, datai

and incentives, we work together to help them deliver improved care coordination that’s more eff cient and effective. By focusing on costi

saving strategies around chronic care and care management, this model also actively engages members to help them more eff cientlyi

manage chronic conditions and achieve better health.

If you'd like to know more contact your

Anthem representative.

For employer groups with 1-50 employees

Virginia

HIGHLIGHTS IN 2019

Working together to make health care easier for

everyone, everywhere

ANTHEM AND SMALL

GROUP

1 in 3 Americans are covered by a Blue

Cross and Blue Shield plan1

 More than 106 million employees

 96% of hospitals in the U.S. are in

our plans

 95% of providers in the U.S. are in

our plans

Local focus in 14 states



Our KeyCare network offers access to 97%

of service area doctors. Our

HealthKeepers network offers access to

93% of doctors.

 When using network doctors employees

save big! And we reward our doctors for

the quality of care they give not the

number of patients they see. So

employees get more attention and

better care.

Benef ts that travel i

Employees have access to medically necessary

emergency and urgent care across the country, and

around the world, with the BlueCard® and Blue Cross

Blue Shield Global Core program.

1 Blue Cross and Blue Shield Association website: About Blue Cross and Blue Shield Association

(accessed May 2018): bcbs.com.

We focus on helping people who live where

we do, our friends and neighbors of all ages.

AT THE HEART

OF VIRGINIA

Last year, we gave

$3.3 million to

support the health

of Virginians.

SOURCE: Anthem Corporate Responsibility Report: http://anthemcorporateresponsibility.com/cr/ .

Giving back to the communities we live in

$550,000 in associate (employee) donations

and Foundation match

7,045 in associate volunteer hours

$1.7 million in Foundation grants

$788,000 in volunteer programs

$821,000 in community relation programs

Within the United States

}

Outside of the United States

BLUECARD® MAKES

GETTING CARE EASY

ALMOST ANYWHERE

Employees take health care benef ts with them across thei

country and around the world.

The BlueCard® program gives employees access to

doctors and hospitals almost everywhere, giving them

peace of mind that they can f nd the health care provideri

they need no matter where they are in the world.

Employees have coverage for urgent and

emergency care. The Blue Cross Blue Shield

Global Core Program makes it easy for

employees to locate a preferred provider

through online tools and 24/7 Customer

Service.

Our PPO plans also include coverage for

nonemergency care across the U.S. and while

traveling abroad.

Employees are covered for medically

necessary emergency and urgent care in all

50 states, whether care is needed in a rural

or urban area.

When you see a network provider there are:

 No claims forms to complete

 No payment upfront for medical services

except for the usual out-of-pocket

expenses.

 Explanation of benef ts received from thei

employees’ plan.

Improving care while keeping costs down

Enhanced Personal Health Care (EPHC) holds providers

accountable for cost and quality outcomes. This

patient-centered approach:

Rewards doctors for managing and improving

overall patient health, meeting quality

standards and lowering costs.

Gives providers support, data and incentives to

help them deliver improved care coordination

that’s more efﬁcient and effective.

Improves the patient experience with 24/7

access to care, extended ofﬁce hours,

same-day and weekend appointments, and

better phone and email access to doctors.

$14.98 net savings per member per month1

18% decline in inpatient admissions1

8.3% savings in outpatient surgery costs1

1,017,003 attributed EPHC VA members2

The EPHC doctor-patient relationship

brings value to all of our plans, and with

some plans, members have lower copays

when they use EPHC providers.

1 Cost and utilization VA metrics based on a difference in preliminary analysis of members with

relationships to an EPHC provider compared to a matched sample control group. Data range from

4/1/13-9/30/16. Persistency is member attribution to the same provider group in the last six months

of consecutive performance years.

2 Data pulled from Tableau June 19, 2018 using the EPHC Provider Proﬁling workbook in

Payment Innovations.

The results

ENHANCED PERSONAL

HEALTH CARE

Why LiveHealth Online?

LIVEHEALTH ONLINE:

ACCESS TO CARE

ANYTIME, ANYWHERE

 Convenience. Access to care right from

the home or off ce. i

 Choice. Employees can select from a

range of doctors and therapists.

 Cost. Depending on the health plan,

employees pay $49 or less per visit1 to see

a doctor, and visits with a therapist or

psychiatrist cost about the same as an

off ce therapy visit. i

Employees can use LiveHealth Online to have video

visits with board-certif ed doctors from a computer withi

a webcam or mobile device. In minutes, doctors can

address common health issues such as colds, allergies

and headaches. They’ll then assess conditions, provide a

treatment plan and send prescriptions to a pharmacy, if

needed. Spanish-speaking doctors are available by

appointment from 7 a.m. to 11 p.m., 7 days a week using

Cuidado Médico.

LiveHealth Online also has professionals available to

address mental health, allergies, wellness, and some

that specialize in kids’ health. Employees can see a

licensed therapist or board certif ed psychiatrist in justi

a few days.1

Employees can register at

livehealthonline.com or download the

free mobile app.

1 Appointments subject to availabiity of the mental health professional.

Act Wise offers:

One-stop support from one implementation

team and one customer service number.

Easy set-up - whether it’s a new plan or a

renewal from another consumer-driven health

plan, it’s never been easier.

ACT WISE

CONSUMER-DRIVEN

HEALTH PLANS

Welcome to Anthem’s one team, one solution

consumer-driven health plan!

Act Wise makes it easier for your clients to administer

their health savings account because now Anthem

manages both the medical benef ts and the spendingi

accounts. We’re streamlining everything – for you, your

clients and even their employees.

One website and mobile app for employees to

review claims in real time and access benef ti

and account information.

Simple tools and messaging to help both

employers and employees understand their

coverage and manage their health benef tsi

and spending.

Health kits

Turnkey wellness campaigns focused on

important health topics.

Wellness calendar

A year of health education with monthly topics

that align with national health observances.

Workplace challenges

Fun wellness campaigns that motivate

employees to make simple, healthy changes.

Wellness on the Run

Monthly employer webinars that highlight the

latest workplace wellness tactics to help

motivate employees toward better health.

WORKPLACE WELLNESS

We’ll help your clients build a culture of health in their

workplace at no extra cost.

Time Well Spent® is our online communications toolkit

for workplace wellness campaigns. It includes step-by-

step guides and educational resources that can help

your clients build a wellness strategy. Go to

timewellspent.anthem.com to f nd: i

Healthy Workplace is a great online resource for

planning and evaluating a workplace strategy.

Your clients can just go to

anthem.com/healthyworkplace

HEALTHY WAYS TO

EARN REWARDS

Our plans offer lots of ways to support employees at

every stage and some provide incentives for taking

steps to stay healthy. Employees can earn up to $200 a

year in rewards with these programs available on

some plans. 1, 2

1 Must be 18 years of age or older to qualify.

2 An employee and their covered spouse or partner can each earn up to $200 in rewards a year.

* Health Rewards card = A reloadable debit Mastercard® that's automaticaly credited when members earn

rewards. Rewards can be earned by a member and their covered spouse or partner. Must be 18 or older

to earn rewards.

Preventive Care Incentives

 Get a preventive wellness exam and f u shot,l

get $100 on their Health Rewards Card*

 Complete tobacco-free certif cation, get $50i

on their Health Rewards Card*

 Complete online health risk assessment, get

$50 on their Health Rewards Card*

HELP EMPLOYEES BE

THEIR HEALTHY BEST

These resources help employees 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

employees offering suggestions to

improve health

Condition Care

 Support for employees with a

chronic condition

 Personalized plan from a nurse coach and

team of specialists

Case Management

 Proactive outreach to employees who are

hospitalized or have a serious illness

 Support from a nurse care manager and

other health professionals

Manage chronic conditions

Address medication gaps

Improve medication aherence

Save money

Our pharmacy data is delivered daily

Medical Pharmacy More effective and

affordable health care

The results speak for themselves

PHARMACY DRIVES

BETTER HEALTH

AND SAVINGS

Medical and pharmacy programs work together so

employees receive holistic, coordinated care that leads

to their better health and employer savings.

This helps us close pharmacy care gaps sooner

and increase engagement. It ultimately helps

employees:

 28% MORE gaps in care identif ed i

 32% MORE members are compliant with their

medications

 26% MORE care gaps closed within 12 months

 10% FEWER hospital stays

Care gap outcomes for MyHealth Advantage using our pharmacy data compared to carve-out pharmacy

data, compliance results based on 12-months clinical and cost-of-care programs for Commercial business,

and reduction in hospital visits based on Anthem 2014 integrated analysis.

PRESCRIPTION

DRUG PLANS

Select Drug List — Offers cost-effective drugs

and meets or exceeds the Affordable Care Act

(ACA) requirement.

Searchable Drug Lists — Employees can log

in to anthem.com to connect to their benef t-i

specif c drug list and search up-to-datei

information.

ACA Preventive Drug List — Under the

Affordable Care Act (ACA), pharmacy plans

must cover 100% of the cost of certain

preventive care drugs and products.

National Plus Retail Pharmacy Network —

Includes nearly 70,000 pharmacies across the

U.S. — 99% of all pharmacies.

Retail90 — Employees can get up to a 90-day

supply of drugs from participating local

pharmacies.

PreventiveRx Plus — Employees can get

certain drugs, used to treat and manage

conditions like asthma, diabetes, high

cholesterol and osteoporosis at a lower cost.

Home Delivery Choice — Employees choose

how prescriptions are f lled for maintenancei

drugs, at their local or home delivery

pharmacy.

Sharing data for whole-person care

Anthem Whole Health Connection brings together a

patient’s pharmacy, dental, vision, disability, behavioral

health and medical data. This allows us to use a

team-based approach to whole-person care. And that

results in savings.

With Whole Health Connection:

28% more gaps in care are found.1

37% more members use their drugs the

right way.2

Members have 10% fewer hospital visits.3

Anthem Whole Health Connection creates more

complete health proﬁles for our members thanks to

electronic health records. This helpful information is

sent to us by network dentists, eye doctors, primary

doctors and care coordinators.

Did you know eye doctors can detect early

signs of diabetes, high blood pressure,

heart disease and other health concerns?

1 Anthem internal data, based on 2015 clinical and cost-of-care program for enterprise, commercial and

exchange business: medical cost offsets based on medication review.

2 Care gap outcomes for MyHealth Advantage using our pharmacy data compared to carve-out pharmacy.

3 Compliance results based on 12-months clinical and cost-of-care programs for Anthem commercial

business, 2016.

ANTHEM WHOLE

HEALTH CONNECTION

VISION AND DENTAL

BENEFITS FOR WHOLE-

PERSON HEALTH

Anthem Blue View VisionSM offers employees 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 employees 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

employees in one of our medical care

management programs for certain conditions3

Retail and online partners

For a better start in life

Anthem’s Small Group medical plans include pediatric

dental and vision essential health beneﬁts for children

up to age 19.

Dental beneﬁts

Include preventive care, ﬁllings, orthodontia

and other services through the Anthem

Prime network.

In-network services offer 100% coverage for

diagnostic/preventive care, 60% for basic and

50% for major.

Diagnostic and preventive services do not

have a deductible.

Medically necessary orthodontia is included,

with a waiting period.

Beneﬁts have no yearly max amount.

Dental beneﬁts share a deductible and

out-of-pocket max with the medical plan.

Out-of-network coverage is 70%/50%/50%

and 50% for medically necessary orthodontia.

Include exams, glasses and/or contacts

through the Blue View Vision network.

Diagnostic and preventive services do not

have a deductible.

In-network services have a $0 copay for

routine exams and for lenses and frames once

per calendar year.

Vision beneﬁts

PEDIATRIC DENTAL AND

VISION ESSENTIAL

HEALTH BENEFITS

ADDED PROTECTION FOR

EMPLOYEES

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 employees 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.

PERSONALIZED,

EASY-TO-USE CARE

Our innovative approach helps provide one of the best

consumer experiences in the industry.

Enhanced Personal Health Care:

Team-based approach for personalized,

proactive, quality care.

LiveHealth Online: 24/7 doctor care, right

from a computer or mobile device.

Easy online tools: Employees can compare

provider costs and quality, review/rate

providers and get estimates on procedures.

Cancer Care Quality Program: Helps doctors

provide evidence-based care for employees

with fewer side effects

Quick care options: Helps employees

understand their options when they need care

right away.

Personalized customer service and care support

Our guides work closely with health care professionals

and offer support needed like:

Reminders for preventive and

follow-up care

Resources for comparing costs, ﬁnding

in-network doctors and more

Clinical alerts for care gaps and savings on

services and medications.

MEET ANTHEM

HEALTH GUIDE

With Anthem Health Guide, employees have access to

highly-trained professionals, backed by smart

technology and analytics. This helps them stay involved

in their health, get more value from their benef ts andi

navigate the health care system more eff ciently.i

Employees can call, request a scheduled call back,

email or have an online chat on a computer or through

our app.

Cancer support for employees, family

members and caregivers through treatment

Behavioral health support for employees or

family members with mental health, drug and

alcohol abuse or other personal issues

Check eligibility.

Request ID cards.

View Summary of Beneﬁts.

View, pay and download bills.

View transaction history.

EMPLOYERACCESS

MANAGING BENEFITS

HAS NEVER BEEN EASIER

EmployerAccess is a simple and secure tool on

anthem.com that gives your clients everything they need

to manage benef ts easily and quickly - 24/7. i

They can:

Enroll and cancel employees

and dependents.

Change employee personal information.

To get started today, clients can sign

up at employer.anthem.com.

1 Not available on all plans.

2 Available for iOs 9 and above and for Android versions 6 and above.

Access at-a-glance account information through

My Summary1.

touch authentication2.

Quickly ﬁnd providers or

urgent care centers.

Save their ID card to their phone or share, fax or

email an ID card directly to their provider.

Chat conﬁdentially with our Member

Services team.

Receive push alerts when there are changes to

claims or other updates.

MOBILE ANTHEM

ANYWHERE APP

The Anthem Anywhere app is better and faster than

ever, making it easy for employees to manage their

care and coverage right from their smartphone.

With a quick tap, employees can:

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 employees 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!

Employees 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.

Vision and hearing

Fitness and health

Family and home

Medicine and treatment

*All discounts are subject to change without notice.

SPECIALOFFERS@

ANTHEMSM FOR

HEALTHY SAVINGS*

With SpecialOffers@AnthemSM, employees get discounts

on products and services that promote better health and

well-being. Here’s a peek at the perks:

See the discounts

Employees can log in to anthem.com and select

Discounts.

 Jenny Craig®

 GlobalFit™

 FitBit

 SelfHelp Works

 1-800 CONTACTS®

 Premier LASIK

 Puritan’s Pride

 Allergy Control products

 WINFertility®

 Safe Beginnings®

 ASPCA Pet Health Insurance

Through our partnership with PayForward.

EMPLOYEES CAN EARN

CASH BACK WHEN

THEY SHOP

How does it work?

Employees can shop at 60,000 participating

retailers and earn 3 - 15% cash back with each

qualif ed purchase. They can shop online, swipei

their card or buy and use an e-gift card.

Is it free to join?

Yes! Employees just need to have an Anthem

medical plan.

How do employees sign up?

They can register at payforward.com, or

download the PayForward app from the App

Store or Google Play™.

Employees 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.

For more details:

 Check out payforward.com.

 Contact your Anthem account representative.

Here’s how it works:

Balance plans can be paired with any

major medical Small Group Affordable Care

Act (ACA) or transitional relief health plan, or

purchased as a stand-alone plan.

Beneﬁts can be used to pay for medical and

nonmedical costs like living expenses or

replacing lost wages.

NEW BALANCE PLANS —

MORE COVERAGE FOR

UNEXPECTED COSTS

Anthem has arranged with the IHC Group

(Independence Holding Company) to offer Balance -

complementary products designed to help

employees pay for high out-of-pocket costs due to

accidents and critical illnesses.

Employees pay a f xed amount for coverage. i

For additional details please contact

your Anthem representative or visit

anthem.com.

A great option that could save your clients money

Here’s how it works:

1. Your clients make a ﬁxed monthly payment

that covers all of their health care costs.

3. If they have higher than expected claims in

a year, the built-in stop loss coverage will

protect them from additional costs.

4. They’ll get monthly reports for

understanding beneﬁts, costs and how to

save money through smarter health

care decisions.

Groups also have the option to buy fully

insured dental, vision, life and disability plans.

ANTHEM BALANCED

FUNDING

Anthem Balanced Funding offers potential savings if

your clients’ claims aren’t too high. And, it can minimize

the impact of ACA mandates and state premium taxes

on their cost of coverage. Plus, with our Anthem

Balanced Funding Transition credit, we’ll help offset

their f rst year’s costs by giving them money back. i

Unlike fully insured plans, if they have a

healthier than expected year, they’re

rewarded with a premium credit.

For groups with 10-50 subscribers this could be a great

option.

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

Balanced Funding Medical product grid

Dental plan grid

Vision plan grid

Life & Disability plan grid