Presentation on theme: "Health care plans provided by Anthem Blue Cross. Insurance plans provided by Anthem Blue Cross Life and Health Insurance Company. Anthem Blue Cross is."— Presentation transcript:
Health care plans provided by Anthem Blue Cross. Insurance plans provided by Anthem Blue Cross Life and Health Insurance Company. Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensees of the Blue Cross Association. ® ANTHEM is a registered trademark. ® The Blue Cross name and symbol are registered marks of the Blue Cross Association. Anthem Blue Cross Offers Solutions for Small Businesses For businesses with 2-50 Employees
2 Agenda Small Business Protections All Types of Coverage Cost Control & Savings Wellness Programs Why Anthem Blue Cross?
4 Special Rights and Protections AB1672 Small Group is different from Individual coverage, and many business owners may not know these basics: Guarantee Issue – as few as two! Rate Protections (RAF’s +/- 10% of the standard rate) Reasonable participation and cost sharing 60 - 75% participation 25 - 50% defined contributions Tax Advantages – employer contributions may be 100% tax deductible (as a general business expense)
6 Anthem Blue Cross Offers One-stop shopping for Medical, Dental, Vision, Life and Workers’ Compensation* coverage – plus discounts and savings when purchased together Several Medical plan portfolios: Each portfolio offers at least five and up to 21 different plans Flexible employer contribution options to help employers control bottom line cost * Workers’ Compensation coverage through Employers Compensation Insurance Company, a separate entity that does not offer blue branded products or services.
7 Anthem Blue Cross Offers 12-month initial rate and benefit guarantee for medical and dental; 24-month initial rate and benefit guarantee for vision One of the largest provider networks in California with negotiated prices Free wellness programs to help members develop healthy lifestyles
8 Choice MEDICAL – start with a strong foundation DENTAL – add even more value VISION – build a clearly superior benefits package LIFE – provide security and peace of mind WORKERS’ COMPENSATION – fulfill state requirements and save money at the same time
10 EmployeeChoice 5 popular Anthem Blue Cross plans (4 PPOs and 1 HMO) Option for employer to offer another HMO from another carrier (would count as a valid waiver) At least 5 employees must enroll in Anthem Blue Cross plans 75% employee participation required
11 BeneFits Four targeted PPOs, one HSA-compatible plan and one HMO - #1 plan, BeneFits Preferred, has Dental and Vision benefits built-in More affordable rates – guaranteed for 12 months Contributions start at 25% OR a flat $50 60% participation On-line education and enrollment for the employer and employees
12 PPO Dental Plans PPO Dental Plans Highlights PPO HMO Voluntary Flexible financing Broad network New with our Silver, Gold and Platinum plans no waiting periods.
13 Blue View Vision Convenient network: includes independent ophthalmologists and optometrists as well as LensCrafters, Target Optical etc. Fast delivery of eyewear 15 - 40% retail savings beyond plan benefits Frame allowance – covering up to 70% of manufactured frames
14 Life Coverage Basic Term Life coverage $15,000 to $250,000 automatically includes AD&D benefits Guarantee Issue – vary by size (no medical questions) EAP at no charge for groups offering 25k or more of Life Dependent life coverage option (employer contribution not required) Supplemental Life (employer contribution not required)
15 Employer Contributions Employer Contribution Options Type of CoverageTraditionalPercentage Plan*Fixed Dollar (percentage applied to all plans employees are enrolled in) (Percentage based on the price of one designated plan) (dollar amount, in $5 increments applied to all plans employees are enrolled in) Medical Plan Portfolios EmployeeElect50% to 100% $100 or more EmployeeChoice50% to 100% $100 or more BeneFits25% to 100% $50 or more Dental 50% to 100%N/A$15 or more Vision 50% to 100%N/A Life 25% Minimum Employer Contribution * Percentage & Plan option: only available for Medical; premium price of the Basic PPO Plan from Anthem Blue Cross Life and Health Insurance Company cannot be designated as the basis for the employer’s contribution.
16 Workers ’ Compensation Anthem Blue Cross and EMPLOYERS ® have joined forces to integrate Medical coverage and Workers’ Compensation in one convenient, cost-effective program One managed care provider network for both personal health and Workers’ Compensation coverage Employees’ network family physicians can treat both personal illness and work-related injuries * Employers Compensation Insurance Company is a separate entity that does not offer blue branded products or services.
18 Save on Life and Dental When purchasing Anthem Blue Cross Dental and Life coverage with Medical, groups save: Up to 1% on their Medical premium* - purchase $25,000 or more of Group Term Life Insurance along with Medical 6% on their Life premium and another 6% on their Dental premium** - purchase both $25,000 or more of Life and any of our insured Dental plans at the same time *.90 is the best Risk Adjustment Factor available **SmileNet SM Dental Discount Program does not qualify
19 Integration with Medical Easy administration through one consolidated bill and point of contact Integrate and Save 10% savings automatically on the Workers’ Comp portion of an integrated bill Potential additional savings on the Medical portion of an integrated bill if they qualify (underwriting is required)
20 Save on Taxes Employer premium contributions can be tax-deductible, and can: Reduce payroll taxes with a Premium Only Plan (P.O.P.) P.O.P. allows employees to use pre-tax dollars to pay their monthly health coverage premiums Employers win with reduced payroll taxes… employees win with increased take-home pay We’ve arranged with Ceridian Benefits Services to set up and administer P.O.P.s at a cost of only $125 per year. Did you know that Workers’ Compensation rates can be lowered based on these tax advantages?
22 360° Health ® offers 4 levels of added support and engagement to Anthem Blue Cross members: Health Resources – Access to health and wellness information Healthy Living powered by WebMD – daily health tips, alternative medicine and mental health information Wellness Information – eating healthy, healthy habits, Women’s health e- newsletters and more AudioHealth Library Health Extras – Tools and Health Discounts Healthy Living – health risk assessment, LEAP fitness program, depression and anxiety screens, physician pre-visit questionnaire and more Staying Healthy Reminders Health Discounts – Vitamins and OTC medications SpecialOffers program (formerly Healthy Extensions) The Last Cigarette Program for adults and adolescents Wellness
23 Health Guidance – Get help when you are in need of care Future Moms – Formerly Baby Connections 24/7 Nurseline – access to registered nurses Childhood obesity Decision support tools – at your fingertips when you have questions MyHealth Record Centers of Medical Excellence – Transplant and Bariatric networks Health Resource Center Behavioral Health Programs NextRx Resources Wellness
24 Health Management and Coordination ConditionCare – Asthma, diabetes, coronary artery disease, heart failure and chronic obstructive pulmonary disease ComplexCare Comprehensive Medical Management – utilization management case management Medical Review Unit (MRU) transition Assistance Comprehensive behavior health management Neonatal intensive care unit Transplant program Bariatric program More Online Resources – at www.anthem.com/ca Wellness
26 HMO Plans Anthem Blue Cross HMO plans provide: Comprehensive health care coverage Unlimited lifetime benefits for covered services Low, predictable out-of-pocket costs Immediate (no deductible) benefits for generic drugs and office visits Self-referral for OB/GYN care DirectAccess and SpeedyReferral: Programs that provide specialty-first consultations without prior approval for specialties
27 PPO Plans Anthem Blue Cross PPO plans provide: In-network access to over 53,000 doctors and specialists and nearly 400 hospitals in California Negotiated in-network fees that can save members 30-40% Out-of-network access as desired - at a higher member cost Immediate (no deductible) benefits for generic drugs and office visits on most plans Payment at 100% for most in-network covered services after meeting annual out-of-pocket maximum
28 Trusted Partner We aim to help more groups offer coverage: Innovative solutions for different types of businesses, including several plan portfolios and programs Industry-first options to expand coverage opportunities for part-time workers and household staff groups Dedicated Small Group Customer Service Easy Online Administration The best Independent Anthem Blue Cross Agent partnership
29 So....Why Anthem Blue Cross? It’s nice to know that we’ll be there when we are needed: We’ve been helping people all over California get covered and stay covered for nearly 70 years! Our wealth of experience, stellar reputation and financial stability work together – for your clients. Members have access to one of the largest provider networks in California. Employers save a lot of money with our negotiated fees. Members get lots of free health and wellness programs as well as out-of- state coverage – so they’ll feel better wherever they are.