For the 2020 benefit year, Anthem Blue Cross (Anthem) will continue to offer EPO Individual on-exchange and off-exchange plans in Covered California’s rating regions 1, 7, and 10, with expansion into regions 9 and 12, and are re-entering our HMO plans in regions 11, 15, 16, and 17. 

 

Below is a list of counties located in rating regions where Anthem will be offering individual on and off exchange EPO plans.

Region

County

1

Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Nevada, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolumne, Yuba

7

Santa Clara

9

Monterey, San Benito, Santa Cruz

10

Mariposa, Merced, San Joaquin, Stanislaus, Tulare

12

San Luis Obispo, Santa Barbara, Ventura


Providers in Regions 1, 7 and 10

If you are participating in the on and off exchange network located in one of these regions, you will continue to provide services to Anthem patients who have purchased coverage on and off exchange as you currently do under your Anthem provider agreement  

 

  • The 2020 EPO plans do not have out-of-network benefits except for emergent/urgent or authorized services only.

 

Providers in Region 9 and 12

If you participated in the on- and off- exchange network in 2017, we have reinstated your participation in the Individual EPO exchange network under your Anthem provider agreement.  We have further extended participation to several providers who previously did not participate in the Anthem Individual EPO exchange.  A communication has been sent to both previously participating providers and new providers in the EPO Individual exchange.

 

  • The 2020 EPO plans do not have out-of-network benefits except for emergent/urgent or authorized services only.

 

HMO Plans and Network

Starting with 2020 benefit year, Anthem is excited to re-enter rating regions 11, 15, 16 and 17 with our HMO Individual on exchange and off exchange plans.  The Anthem HMO network in these regions is considered a “narrow” network and providers have been selected and agreements executed.  Below is a list of counties located in the regions where Anthem will be offering 2020 Individual on and off exchange HMO plans.

Region

County

11

Fresno, Kings, Madera

15 & 16

Los Angeles

17

Riverside, San Bernardino


These changes do not impact Anthem California Individual “grandfathered” business. 

Anthem appreciates your partnership and continued participation in our Individual on and off exchange networks.  If you have any questions regarding this information please contact Anthem’s Network Relations department via email at CAContractSupport@Anthem.com.



Featured In:
December 2019 Anthem Blue Cross Provider News - California