Grandfather Plan Rate Change April 1, 2017 Blue Cross Anthem

Grandfathered plans are not affected by the 2018 withdrawal from 16 CA Regions

April 1, 2017 rate action for California Individual Grandfathered plans

Beginning April 1, 2017, Anthem will adjust the base rates for existing business on all CDI grandfathered medical plans with an April 1, 2017 effective date. Members will also receive an adjustment for age changes. The base rates for members on DMHC grandfathered medical plans, that were effective April 1, 2016, are not scheduled to change in 2017. DMHC members will receive an adjustment for age changes. Click here for a copy of the updated Grandfathered Rate Sheet. It includes the plan names, contract codes and base rates effective April 1, 2017 for CDI plans and effective April 1, 2016 for DMHC plans.

Later this month, we will begin notifying impacted grandfathered clients of their new rate and the date it will go into effect (the effective date will be April 1, 2017 for the majority of these clients). This mailing will provide the required 60-day advance notification to your clients.

In addition, any of your Dental clients entering a new age category will also be notified of their dental rate change.

Sample Communications

CDI Member Letter 2.2017 Version
DMHC Member Letter (sent 60-days prior to their age change increase)
Dental Member Letter
- Dental Insert
Centers for Medicare and Medicaid Services (CMS) Notice: This notice of renewal is required by the Department of Health and Human Services.
- CMS Member Letter
CA DOI says rates are not reasonable, but Blue Cross will use them anyway – Sample Letter
SB 908 Premium Rate Notice attached to change application

Please remember, because this notification overlaps the current Open Enrollment and as outlined in the letters, any of your grandfathered clients have the option to change their coverage by:

Downgrading to another Grandfathered Anthem Individual Health Plan if available
Choosing a New Non-Grandfathered ACA compliant Individual Health Plan during the Open Enrollment or a Special Enrollment Period (SEP)
- Learn more about the difference between ACA-ObamaCare Plans and Grand Fathered Plans
  - Chart
Grandfathered members (CDI and DMHC) qualify for a SEP on their 2017 renewal. If they wish to change to an ACAplan due to this qualifying event:
- They should select the “non-calendar renewal” qualifying event on the 2017 application
- They may apply up to 60-days before or 60-days after the effective date of their rate change
- And they need to submit a copy of their grandfathered rate action/renewal notice as documentation of their qualifying event