Anthem Blue Cross Small Group

Anthem Logo
 Administration, FormsWellness,  Employer Portal, Customer Service & Renewal  Information & Tools

Anthem Blue Cross 
Group #Administrator Manual  9/2022 ONLINE

View in pdf

Anthem Group Administrator Manual

Blue Cross #Underwriting Rules 2023 

Blue Cross Anthem Underwriting Rules

Explanation of Blue Cross PPO – HMO, #Network, etc. options

from their official brochures.

 

HMO Network Comparison Guide 7/2023  

blue cross hmo network comparison guide

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 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.
 
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 

Optional PCP Selection for PPO can help improve

employees’ health and lower costs

A strong relationship between your employees and a primary care physician (PCP) is important to promoting wellness, improving health and reducing costs. Optional PCP Selection lets your employees choose a PCP.

Why designate a PCP?

When members choose an EPHC doctor from their health plan as a PCP, they’re helping Blue Cross help them. Blue Cross can keep their doctors in the loop when they have an ER or hospital visit. Blue Cross can reach out to that doctor about tests and services a member may need. Blue Cross also can share other resources that will help doctors emphasize wellness with members. The goal is to have everyone work together so your employee's overall care makes the best sense. And when employees choose an EPHC doctor as their PCP, that doctor can more quickly take over the responsibility of coordinating the member’s care.

Encourage your employees to designate a PCP

Developing a relationship with a PCP is all about improving health care quality, outcomes and affordability. That’s why we’re encouraging members in open access plans to designate a PCP as part of the Optional PCP Selection. They also can call customer service or have you, their employer, complete the selection through Employer Access.

More information, resources & links

#Find a Anthem Blue Cross
Doctor, Physician, Dentist Hospital and other Providers
 

Anthem Blue Cross provider doctor search

 

EAP  Employee Assistance Program

Anthem’s Employee Assistance Program (EAP) provides quick and easy access to confidential counseling and referral services to help you deal with daily work and life challenges. It’s employer-sponsored, so it’s available at no cost to you, your dependents or household members.
EAP addresses a variety of issues, including:

  • Child care and parenting
  • Helping aging parents
  • Financial issues
  • Legal concerns
  • Work and career
  • Emotional well-being
  • Addiction and recovery
  • Wellness and prevention
  • Life events
  • Coping with stress and change
  • Relationship issues
  • Resources to support work/life
    balance
  • Dealing with traumatic events
As news of COVID-19 continues to evolve, you may find yourself growing increasingly concerned about dependent care, personal finances or even your family’s preparedness to whether the storm.  If so, rest assured you’re not alone. Remember, your Employee Assistance Program (EAP) is here to provide you and your household members support during challenging times.
Need support?  Reach out to the EAP today!

With your EAP you’ll have no-cost, confidential access to1:
Telephonic support.  Available 24/7 at 800-999-7222.  Talk to a counselor for in-the-moment support or a work/life specialist who can assist you in identifying resources to meet your individual needs.

  • Counseling visits.  Get a referral for in-office or LiveHealth Online video visits to manage stress, anxiety, and other issues.  Call 800-999-7222 for a referral.
  • Child and Eldercare resources.  Conduct your own search for local resources for full, part-time and back-up care at anthemeap.com (log in: My EAP CA.)
  • Financial consultations.  Meet telephonically with a certified financial professional who can discuss your short and longer term financial concerns.
  • Legal consultations. Speak to an attorney for a no cost consultation to discuss your legal questions.2
  • Website. At anthemeap.com (log in: My EAP CA) you’ll find tips, tools and resources for COVID-19, a critical event center, and more.

In accordance with federal, state law, and professional ethical standards.
Excludes benefit and employment matters. A per issue per 12 month period benefit.

Blue Cross

#Wellness & Health Resources

When you use your health care services, there are some important things to know that could save you time and money, and keep you feeling your best. Here, on Blue Cross’s website you’ll learn about the best place to get care when you have a basic, urgent or emergency medical need. You’ll learn the best ways to prepare for your doctor’s appointment, and you can even get a personalized set of preventive care milestones with our Preventive Health Calendar.

Blue Cross Rx #Prescription Coverage & Information

 

Anthem Pay #Forward
Get Paid to Shop

15% Cash Back

Visit Anthem Pay Forward Website

FAQ’s

Flyer

Learn More @ anthem.payforward.com

Pay Forward VideoPay Forward Video

How does Medicare pay  for #SkilledNursing Homes - 10153 11359

Our Introductory You Tube VIDEO based on this manual

video medicare skilled nursing

Anthem Logo

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.

 

3 comments on “Administrative, Renewal & Wellness Tools

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.