Individual on and off exchange plans: 2020 benefit year update

EPO Plans and Network

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. 

 

We are also very pleased to announce the expansion of our Individual EPO on and off exchange plans into rating regions 9 and 12.  Below is a list of counties located in those regions where Anthem will be offering 2020 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

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 Blue Cross (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 CA 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.