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2-99: Anthem Announces October 2012 Updates

Jul 24, 2012

BenefitChangesAnthem Blue Cross 2-50 & 51-99  
October 2012 Benefit & Rate Adjustments
Anthem Blue Cross has announced a RATE PASS for most plans and a small rate increase on some PPO plans. October 2012 quarterly rate adjustments to their 2-50 and 51-99 PPO medical plans average 1% statewide. Other news includes:
Average statewide rate increases by portfolio and product are provided below. Since increases vary by plan and region, any member of your b&p Sales Team will be able to provide plan specific rate increases.

  • 2-50 & 51-99 HMO = RATE PASS 
  • 2-50 & 51-99 PPO = 1.5%
    • Solution PPO plans = 5.3%
    • GenRx PPO plans = 1.9%
    • Elements Hospital plans = 1.8%
    • All other PPO plans = RATE PASS 
  • 2-50 & 51-99 CDHP = RATE PASS 
  • Please note that the 51-99 (including 2-50 MHP compliant plans) quarterly increase is the same as 2-50; however, book rates are slightly higher for the 51-99 portfolio. 
EmployeeChoice = 0.7%

BeneFits = 0.7%

Quarterly Rate Adjustments
Anthem Blue Cross Small Group has issued the following quarterly rate adjustments. It should be noted that these rate adjustments are averages and vary by plan and by region.
  • July 2012 = 0.0% (the original rate increase was rolled back)
  • April 2012 = 5.0% 
  • January 2012 = 2.1% (with a CDHP rate pass) 
  • October 2011 = 3.2% (with several plans receiving a rate pass) 
  • July 2011 = 0.6% (with a CDHP and HMO rate pass)
October 2012 Book Rates
Book rates are available below.
Effective October 1, 2012, the ACO 20 and ACO 30 plans will have the following benefit changes when these services are obtained through a Preferred Participating Provider (PPAR):
  • Chemotherapy and Radiation Therapy will be covered at the PPAR office visit copayment amount instead of the In-network coinsurance amount.
  • Home Infusion Therapy will be covered at the PPAR office visit copayment amount instead of the In-network coinsurance amount.
  • Outpatient Medical Services will be covered at the In-network coinsurance level instead of the current dollar copayment amount.

Updated ACO 20 and ACO 30 benefit summaries should be available by the end of this month.

Effective October 1, 2012, Anthem Blue Cross will introduce a new limited HMO network in Southern California. The eight (8) current HMOs in the EmployeeElect and 51-99 portfolios will also be available in the new Priority Select HMO network. 
Keep in mind that a Group can only buy the Full HMO network or the Select HMO network or the new Priority Select HMO network. They cannot be sold alongside each other. 
  • Click here for the Priority Select HMO network County listing.
  • The benefit summaries for these new plans can be found on our website (login required).

Please note that Anthem Blue Cross intended to roll out new Select PPO plans for October 1, 2012 effective dates but they did not receive regulatory approval in time.  Currently, they are pending until January 1, 2013 effective dates. 


Since Anthem Blue Cross received news of the delayed approval after creating October renewals, details on these plans were already included in the packets mailed to your clients.  Please notify your clients to disregard any information pertaining to the Select PPO plans. 


Effective October 1, 2012, Anthem Blue Cross will eliminate three (3) medical plans. Due to legislated benefit changes, the Elements & BeneFits plans scheduled to be eliminated will closely mirror existing plans so members will be migrated to those plans on renewal.  

  • Elements Hospital Basic will migrate to Elements Hospital Plus. 
  • BeneFits Hospital Basic will migrate to BeneFits Hospital Plus. 
  • Premier PPO $20 Copay (EmployeeChoice portfolio only) will migrate to PPO $30 Copay.   
Anthem Blue Cross revised their 24-Month RAF Guarantee available for October 1, 2012 - December 15, 2012 new business effective dates for AB1672 qualified groups eligible for one of five (5) RAF offers.
Starting in October, any Group with more than 5 employees enrolling in the Solution PPO plans will not qualify for the .90 RAF Guarantee. Click the link below for details.

All ancillary products, with the exception of Prime & Complete Dental plans, will receive a rate pass for October 1, 2012 effective dates.  In other great news, Anthem Blue Cross announced a new Small Group Prime & Complete 5+5+5 Bonus Program for August 1, 2012 - December 15, 2012 effective dates. Click here for the details on that new bonus program. Click here to learn about their other 2012 Specialty Bonus Program for Small and Large Groups.   



  • Prime & Complete Plans: 1.23% with no changes to benefits.
  • Other Dental Plans: Rate pass


  • Rate pass and no changes to benefits.
  • Rate pass and no changes to benefits.
  • July 20th (approximate): October broker renewals will be mailed. 
  • July 30th (approximate): October group renewals will be mailed.
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