Anthem PPACA Exchange Network Consolidations
As required by the Patient Protection and Affordable Care Act, we offer the same products, programs and plans (collectively Products) directly to consumers that we offer on Access Health CT (the State of Connecticut’s health care exchange). Members of these off-exchange Products are currently able to access, on an in-network basis, health care services rendered by providers and facilities participating in our BlueCare (HMO/POS) or Century Preferred (PPO) provider network, as applicable.
Beginning January 1, 2019, all members of our off-exchange Products will be required to utilize our exchange networks to receive in-network benefits. Specifically:
- Members of our small group off-exchange HMO Products must use the Pathway X HMO Exchange Network.
- Members of our individual off-exchange HMO Products must use the Pathway X Enhanced Exchange Network.
- Members of our small group off-exchange PPO Products must use the Pathway X PPO Exchange Network.
- Members of our individual off-exchange PPO Products must use the Pathway X Exchange Network.
For dates of service on and after January 1, 2019, you must participate in the applicable exchange network(s) listed above to render health care services on an in-network basis to members of off-exchange Products. Compensation for covered health care service rendered to members of off-exchange Products will be the amounts corresponding to the applicable Pathway network(s).
If you do not currently participate in our exchange network(s) and wish to, you may contact your Provider Relations Representative.
If you have any questions, please call the Provider Call Center at 800-922-3242. We thank you for your continued service and dedication to all our members.
June 2018 Connecticut newsletter