Individual on and off exchange plans – 2019 benefit year update

For the 2019 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. As in 2018, for all other regions, Anthem will not be offering Individual health plans in 2019*. Below is a table showing the counties located in the regions where Anthem will be offering 2019 “non-grandfathered” EPO 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
10	Mariposa, Merced, San Juaquin, Stanislaus, Tulare

*There is no change for members covered under an Anthem Individual “grandfathered” plan.

 

Providers in Regions 1, 7 and 10

 

If you are participating in the on-exchange and off-exchange network located on one of these regions, you will continue to provide services to Anthem members who have purchased coverage on-exchange and off-exchange as you currently do under your provider agreement. Please ensure that if your Anthem patient from regions 1, 7 or 10 requires an authorization or referral, that it is to an Anthem on-exchange and off-exchange participating provider within regions 1, 7 or 10. The 2019 EPO plans do not have out-of-network benefits except for emergent/urgent authorized services only.