blue cross california employer small group plans

Blue Cross California Small Group Health Insurance

Blue Cross / Anthem has long been one of the major health insurance carriers for California small group employers.
This page is meant to help employers, employees, and families understand where Blue Cross may fit, how to review
provider networks, and where to find plan documents when more detail is needed.

The most important question is usually not just “What is the cheapest plan?” For many employers and employees, the
better questions are: Are my doctors in the network? Are my hospitals accepted? What happens if an employee lives
outside the main service area? How does Blue Cross compare with Kaiser, Blue Shield, Health Net, or other California
small group options?

Questions this page helps answer:

  • Is Blue Cross a reasonable option for a California small business?
  • How do I check whether doctors, hospitals, or medical groups are in the network?
  • Where can I find Blue Cross small group brochures, applications, and plan documents?
  • How should an employer compare Blue Cross with other California carriers?
  • When should I ask for broker help instead of trying to interpret a 50-page booklet myself?
  • Do you already have Blue Cross and need help on administering your plan? 

Provider and hospital access matters.

Many visitors are really trying to answer a provider question. They may want to know whether a particular doctor, medical group, or hospital accepts a Blue Cross plan. Always verify directly with the carrier and the provider before enrolling, because networks can change and provider offices sometimes give incomplete answers.

You may also want to review related provider and hospital pages on this website, including:
Provider Finder and Network Help

Plan documents and brochures:

Carrier brochures, applications, benefit summaries, and enrollment guides are important, but they should not be the only thing an employer reviews. The official documents explain the details; a broker helps interpret how those details apply to your company, employees, doctors, and budget.

Some documents may be hosted here for convenience. Others may link directly to Anthem / Blue Cross or other official sources. If a document is time-sensitive, always confirm that you are using the current version before making an enrollment decision.

For employers:

A small group health plan decision usually involves more than the monthly premium. Employers should also think about employee contributions, waiting periods, dependent coverage, participation rules, Section 125 premium-only plan options,
and whether employees are better served by a group plan or by individual coverage through Covered California.

Related employer pages:
Small Group Health Insurance
Small Group Special Enrollment Periods
Section 125 Premium Only Plan
California Health Insurance Carriers

For employees and families:

If your employer offers Blue Cross, compare the plan carefully before enrolling. Check your doctors, prescriptions, hospitals, deductible, copays, coinsurance, and out-of-pocket maximum. If you are also considering Covered California, Medicare, COBRA, or Medi-Cal, the rules can overlap and the right answer may depend on your household situation.

Related individual coverage pages:
Individual and Family Health Insurance
Covered California Help
Medicare Information
COBRA Information

Bottom line:

Blue Cross may be a good fit for some California small groups, but it should be compared against the employer’s actual needs: doctors, hospitals, employee locations, prescriptions, budget, and administrative requirements. The brochures are
useful, but the real value is knowing what to look for before you enroll.

Want More Details? (Optional)
Supporting documents, rules, and deeper explanations are below if you want them — most people don’t need them.

Networks & Provider Finder

Anthem Wellbeing Solutions 

Help your employees meet their health goals Anthem.com 

Anthem Wellbeing Soluctions

Contact us via email or use the form below

#Contact Us - Ask Questions - Get More Information - Schedule a Zoom Meeting

Email Us [email protected]

By submitting the information below , you are agreeing to be contacted by Steve Shorr a Licensed Sales Agent by email, texting or Zoom to discuss Medicare or other Insurance Plans as relevant to your inquiry. This is a solicitation for Insurance

 

 

  • PPO plans have large provider networks and give employees more choices than an HMO plan, but monthly premiums and deductibles are usually higher.
    • No primary care physician (PCP) is needed.
    • No referrals for other in-network doctors are required.
    • Choosing doctors, hospitals and other covered medical services that are not in-network might cost employees more out-of-pocket.
    • Prudent Buyer PPO network — Access to nearly 60,000 California doctors and specialists, and more than 330 hospitals
  • Select PPO plans give employees access to the same high-quality providers as a PPO, but usually the network is smaller.
    • The monthly premiums and deductible options offer greater value than the standard PPO.
    • No PCP Primary Care Physician  is needed and no referrals for other in-network doctors are required.
    • Access to more than 40,000 California doctors and specialists, and more than 300 hospitals
  • Note: Employers may choose only one PPO network.     Flyer  
 
  • HMO plans offer network provider choices similar to a PPO, but members must select an in-network primary care physician (PCP) to coordinate their care.
  • Referrals are needed to see other doctors.
  • The monthly premiums and out-of-pocket medical costs are generally lower than other plans.
  • CaliforniaCare HMO network — Access to more than 42,000 California doctors and specialists, and more than 330 hospitals
 
  • Select HMO plans work like a standard HMO, but usually the network is smaller.
  • The monthly premiums and out-of-pocket costs are generally lower than most other plans, offering greater value than the standard HMO.
  • Members must select a primary care physician (PCP) to coordinate their care.
  • Referrals are needed to see other doctors.
  • Access to more than 26,000 California doctors and specialists, and nearly 250 hospitals
  • Note: Employers may choose only one HMO network
 
Employers must select a network for each plan type.   For example, the employer may offer employees plans  available in the Select HMO network  alongside the Prudent Buyer PPO network. Not all network options are available in every area. Anthem.com *
 
 
 
 
 
 
Links – References 

How does it work if you want to #offer more than ONE Health plan?

 

Let's take a look at the Employer Application

 

Choose what plans you want to offer from our Quote Engine and/or the Anthem/Blue Cross Guides

 

Choose plans to offer

  Contribution must be the same for all similarly situated Employee's and Owners

Contribution Amount

Waiting periods to enroll must be the same for everyone.

 

Pick waiting period

 

Our webpage on waiting periods

We can also double check links to other pages on our website, cited below, Blue Cross Administrator Manual and their underwriting rules 

One comment on “Blue Cross – Anthem – Employer Health Plans

  1. Thanks for your efforts, you are top notch at what you do.
    I was so amazed at how much you know about your industry, how efficient you are and how you handled all my needs with a smile and such a caring attitude!
    You didn’t create any extra stress during one of the worst periods of my life.
    Lots of blessings of success to you Steve and the strength to care about the people around you.

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