Transcript Document

CA Policies Sold Prior to 9/23/10
Anthem Blue Cross Life and Health
(regulated by the CDI)
Rate Action July 1, 2011
Benefit Action January 1, 2012
Rate and Benefit Action for Policies Sold Prior to 9/23/10
Individual Anthem Blue Cross Life and Health Insurance Company medical
policies (regulated by the California Department of Insurance - CDI) will receive a
rate adjustment effective July 1, 2011.*
Your clients on these policies will also see changes to benefits effective January
1, 2012.** See slide 7 for details.
For your Grandfathered clients, the benefit changes will not cause loss of
Grandfathered status.
Policy endorsements will be mailed in October, 2011. This mailing will serve
as a reminder of the benefit changes effective January 1, 2012.
•Basic PPO and CORE 5000 policy rate changes will be effective August 1, 2011.
** The following plans are not subject to benefit changes: ClearProtection, CoreGuard,
Premier, PPO Saver, Basic PPO, and CORE 5000
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CDI Grandfathered Policies Rate Change
The following Grandfathered* policies will be subject to a rate change:
Plan Name
Grandfather Contract Code
SmartSense
Z153, Z154, Z155, Z156, Z157, Z158, Z159, Z160, Z161, Z162, Z163, Z164, Z165,
Z166
CoreGuard
01C9, 01CA, 01CB, 01CC, 01CD, 01CE, 01CF
ClearProtection
00RN, 00RP,00RR
Lumenos CDHP (w/o Maternity)
Z126-Z152
Lumenos CDHP (w/ Maternity)
DX26, DX27, DX28, DX32, DX33, DX34, DX38, DX39, DX40, DX44, DX45, DX46,
DX47, DX48, DX49, DX53, DX54, DX55, DX59, DX60, DX62, DX63, DX644, DX68,
DX69, DX70, DX74, DX75, DX76, DX80, DX81, DX82
TONIK
DN13, DN14, DN15
HSA-compatible 3500 Deductible PPO,
500 Deductible PPO Plan
T160, R420
PPO Saver
NM31
PPO Share 500, 1000, 5000, 5000-R
1929, 1930, H062, PE27, Z829, Z830
RightPlan 40 (No Rx, Generic Rx, Full Rx)
RightPlan 500 (Generic Rx, Full Rx)
P958, PE48, PE49, 01LD, 01LE
* Policies sold prior to 3/23/10
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CDI Non-Grandfathered Policies Rate Increase
The following Non-Grandfathered policies will be subject to a rate change:
Plan Name
NGF Contract Code
SmartSense
069N , 069P, 069Q, 069R, 069S, 069T, 069U, 069V
Premier
01KU, 01KV, 01KW, 01LO, 01L1, 01L2
CoreGuard
069F, 069G, 069H, 069J, 069K, 069L, 069M
ClearProtection
069C, 069D, 069E
Lumenos CDHP (w/o Maternity)
07TH, 07TJ, 07TK, 07TL, 07TM, 07TN, 06AL, 06AN, 07TP
Lumenos CDHP (w/ Maternity)
06AM, 06AF, 06AG, 0AE1, 0AE2, 0AE3, 0AE4, 0AE5, 0AE6, 0AE7, 0AE8
TONIK
06AC, 06AD, 06AE
HSA-compatible 3500 Deductible PPO,
3500 Deductible PPO Plan
06AB, 06A5
PPO Saver
06A1, 06A2
PPO Share 500, 1000, 5000, 5000-R
06A3, 06AJ, 06AK, 06A4
RightPlan 40 (No Rx, Generic Rx, Full Rx), RightPlan
500 (Generic Rx, Full Rx)
06A6, 06A7, 06A8, 06A9, 06AA
* Policies sold between 3/23/10 – 9/22/10
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Serencsa Settlement
Your CDI clients who were active on 9/23/10 and have not changed to an
actively sold plan/policy are part of the settlement.
 They have a one-time opportunity to move any actively sold plan/policy
without medical underwriting, offered whenever Anthem increases rates
through 2013.
 These clients who move from a grandfathered policy to another
grandfathered policy (normal downgrade option) do not lose future
movement offers at rate increases to change to any actively sold
plan/policy without medical underwriting.
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Other movement options
Any of your CDI clients active on 9/23/10 who already took advantage
of another opportunity to change to an actively sold plan/policy with no
medical underwriting (e.g., March Open Enrollment) will not be eligible
to participate in the Serencsa open enrollment.
They will have the opportunity to move to an actively sold plan/policy of
equal or lesser value as determined by Anthem.
Reminder: Movement to an actively sold plan/policy will result in
loss of grandfathered status.
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Benefit Changes
We will implementing the following benefit changes:
 Increase Medical Deductibles
 Increase Brand/Specialty Co-pays*
 Increase Brand/Specialty Deductibles*
 Increase Coinsurance Maximum
 Increase Office Co-pays
*There will be no formulary changes.
The benefit changes apply to grandfathered policies (sold prior to 3/23/10) and
non-grandfathered policies (sold between 3/23/10 and 9/22/10).
The following plans are not subject to benefit changes: ClearProtection,
CoreGuard, Premier, PPO Saver, Basic PPO, and CORE 5000
See the Agent Guide on the agent website for a listing of all benefit
changes, by policy.
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Resources
 ChangeMyCoverage.com will be available for CDI members to view plan
options from 5/1/2011 – 6/30/2011.
 The Decision Tool shows all member plan options, including Serencsa options.
The tool is posted on the “Plan Option Tables” page of the agent website
 AgentServices for rate action client reports
“Rate/Benefit Changes (for Plans/Policies sold prior to 9/23/10” page on
agent website
Rates
Sample member communications
Agent Guide
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Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health
Insurance Company are independent licensees of the Blue Cross Association. ® ANTHEM is a registered trademark of Anthem
Insurance Companies, Inc. The Blue Cross names and symbols are registered marks of the Blue Cross Association.
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