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CA Policies Sold Prior to 9/23/10 Anthem Blue Cross Life and Health (regulated by the CDI) Rate Action July 1, 2011 Benefit Action January 1, 2012.

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Presentation on theme: "CA Policies Sold Prior to 9/23/10 Anthem Blue Cross Life and Health (regulated by the CDI) Rate Action July 1, 2011 Benefit Action January 1, 2012."— Presentation transcript:

1 CA Policies Sold Prior to 9/23/10 Anthem Blue Cross Life and Health (regulated by the CDI) Rate Action July 1, 2011 Benefit Action January 1, 2012

2 2 Rate and Benefit Action for Policies Sold Prior to 9/23/10 Individual Anthem Blue Cross Life and Health Insurance Company medical policies (regulated by the California Department of Insurance - CDI) will receive a rate adjustment effective July 1, 2011.* Your clients on these policies will also see changes to benefits effective January 1, 2012.** See slide 7 for details.  For your Grandfathered clients, the benefit changes will not cause loss of Grandfathered status.  Policy endorsements will be mailed in October, 2011. This mailing will serve as a reminder of the benefit changes effective January 1, 2012. Basic PPO and CORE 5000 policy rate changes will be effective August 1, 2011. ** The following plans are not subject to benefit changes: ClearProtection, CoreGuard, Premier, PPO Saver, Basic PPO, and CORE 5000

3 3 CDI Grandfathered Policies Rate Change Plan NameGrandfather Contract Code SmartSenseZ153, Z154, Z155, Z156, Z157, Z158, Z159, Z160, Z161, Z162, Z163, Z164, Z165, Z166 CoreGuard01C9, 01CA, 01CB, 01CC, 01CD, 01CE, 01CF ClearProtection00RN, 00RP,00RR Lumenos CDHP (w/o Maternity)Z126-Z152 Lumenos CDHP (w/ Maternity)DX26, DX27, DX28, DX32, DX33, DX34, DX38, DX39, DX40, DX44, DX45, DX46, DX47, DX48, DX49, DX53, DX54, DX55, DX59, DX60, DX62, DX63, DX644, DX68, DX69, DX70, DX74, DX75, DX76, DX80, DX81, DX82 TONIKDN13, DN14, DN15 HSA-compatible 3500 Deductible PPO, 500 Deductible PPO Plan T160, R420 PPO SaverNM31 PPO Share 500, 1000, 5000, 5000-R1929, 1930, H062, PE27, Z829, Z830 RightPlan 40 (No Rx, Generic Rx, Full Rx) RightPlan 500 (Generic Rx, Full Rx) P958, PE48, PE49, 01LD, 01LE The following Grandfathered* policies will be subject to a rate change: * Policies sold prior to 3/23/10

4 4 CDI Non-Grandfathered Policies Rate Increase Plan NameNGF Contract Code SmartSense069N, 069P, 069Q, 069R, 069S, 069T, 069U, 069V Premier01KU, 01KV, 01KW, 01LO, 01L1, 01L2 CoreGuard069F, 069G, 069H, 069J, 069K, 069L, 069M ClearProtection069C, 069D, 069E Lumenos CDHP (w/o Maternity)07TH, 07TJ, 07TK, 07TL, 07TM, 07TN, 06AL, 06AN, 07TP Lumenos CDHP (w/ Maternity)06AM, 06AF, 06AG, 0AE1, 0AE2, 0AE3, 0AE4, 0AE5, 0AE6, 0AE7, 0AE8 TONIK06AC, 06AD, 06AE HSA-compatible 3500 Deductible PPO, 3500 Deductible PPO Plan 06AB, 06A5 PPO Saver06A1, 06A2 PPO Share 500, 1000, 5000, 5000-R06A3, 06AJ, 06AK, 06A4 RightPlan 40 (No Rx, Generic Rx, Full Rx), RightPlan 500 (Generic Rx, Full Rx) 06A6, 06A7, 06A8, 06A9, 06AA The following Non-Grandfathered policies will be subject to a rate change: * Policies sold between 3/23/10 – 9/22/10

5 5 Serencsa Settlement Your CDI clients who were active on 9/23/10 and have not changed to an actively sold plan/policy are part of the settlement.  They have a one-time opportunity to move any actively sold plan/policy without medical underwriting, offered whenever Anthem increases rates through 2013.  These clients who move from a grandfathered policy to another grandfathered policy (normal downgrade option) do not lose future movement offers at rate increases to change to any actively sold plan/policy without medical underwriting.

6 6 Other movement options Any of your CDI clients active on 9/23/10 who already took advantage of another opportunity to change to an actively sold plan/policy with no medical underwriting (e.g., March Open Enrollment) will not be eligible to participate in the Serencsa open enrollment. They will have the opportunity to move to an actively sold plan/policy of equal or lesser value as determined by Anthem. Reminder: Movement to an actively sold plan/policy will result in loss of grandfathered status.

7 7 Benefit Changes We will implementing the following benefit changes:  Increase Medical Deductibles  Increase Brand/Specialty Co-pays*  Increase Brand/Specialty Deductibles*  Increase Coinsurance Maximum  Increase Office Co-pays The benefit changes apply to grandfathered policies (sold prior to 3/23/10) and non-grandfathered policies (sold between 3/23/10 and 9/22/10). The following plans are not subject to benefit changes: ClearProtection, CoreGuard, Premier, PPO Saver, Basic PPO, and CORE 5000 See the Agent Guide on the agent website for a listing of all benefit changes, by policy. *There will be no formulary changes.

8 8 Resources  ChangeMyCoverage.com will be available for CDI members to view plan options from 5/1/2011 – 6/30/2011.  The Decision Tool shows all member plan options, including Serencsa options. The tool is posted on the “Plan Option Tables” page of the agent website  AgentServices for rate action client reports  “Rate/Benefit Changes (for Plans/Policies sold prior to 9/23/10” page on agent website  Rates  Sample member communications  Agent Guide

9 9 Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross names and symbols are registered marks of the Blue Cross Association.


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