Anthem continues to offer EPO and HMO individual on and off exchange products

EPO Plans and Network

As a reminder, for the 2021 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, 9, 10 and 12. 

 

We are also very pleased to announce the expansion of our Individual EPO on and off exchange plans into rating regions 13 and 14.  Below is a list of counties located in those regions where Anthem will be offering 2021 EPO on and off exchange Individual 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
13 (NEW)	Imperial, Inyo, Mono
14 (NEW)	Kern

Providers in Regions 1, 7, 9, 10 and 12

If you are already participating in the Pathway (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. 

 

Providers in Region 13 and 14

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

  

HMO Plans and Network

 

Anthem Blue Cross (Anthem) is excited to re-enter rating region 18 with our HMO Individual on exchange and off exchange plans in addition to regions 11, 15, 16 and 17.  The Pathway HMO network providers have been selected and agreements executed.  Below is a list of counties located in the regions where Anthem will be offering 2021 Individual on and off exchange HMO plans.

Region	County
11	Fresno, Kings, Madera
15 and 16	Los Angeles
17	Riverside, San Bernardino
18 (NEW)	Orange

 

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

Anthem appreciates your partnership and continued participation in our Individual Pathway EPO and HMO networks. 

If you have any questions regarding this information, please contact Anthem’s Network Relations Department via email at CAContractSupport@Anthem.com.

972-0221-PN-CA