Transcript Document

Anthem Blue Cross Offers
Solutions for Small Businesses
For businesses
with 2-50
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.
 Small Business Protections
 All Types of Coverage
 Cost Control & Savings
 Wellness Programs
 Why Anthem Blue Cross?
Small Business
Special Rights and Protections
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)
All Types of
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.
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
 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
 17 PPO Plans and 4 HMO plans
 Administrative ease
 Financial control
 75% employee participation
 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
 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
 Contributions start at 25% OR a flat $50
 60% participation
 On-line education and enrollment for the
employer and employees
PPO Dental Plans
 PPO Dental Plans Highlights
 Voluntary
 Flexible financing
 Broad network
New with our Silver, Gold and Platinum plans
no waiting periods.
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
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
 Supplemental Life (employer contribution not required)
Employer Contributions
Employer Contribution Options
Type of Coverage
Percentage 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)
50% to 100%
50% to 100%
$100 or more
50% to 100%
50% to 100%
$100 or more
25% to 100%
25% to 100%
$50 or more
50% to 100%
$15 or more
50% to 100%
Medical Plan Portfolios
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.
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.
Cost Control
& Savings
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
**SmileNetSM Dental Discount Program does not qualify
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)
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?
Wellness Programs
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 enewsletters 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
 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
 MyHealth Record
 Centers of Medical Excellence – Transplant and Bariatric networks
 Health Resource Center
 Behavioral Health Programs
 NextRx Resources
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
Why Anthem Blue Cross?
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
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
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
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
 Employers save a lot of money with our negotiated fees.
 Members get lots of free health and wellness programs as well as out-ofstate coverage – so they’ll feel better wherever they are.
Thank You for Joining Us