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2-99: Anthem's July 2012 Updates (Including Rate Passes on Some Plans)

Apr 18, 2012

Anthem Blue Cross 2-50 & 51-99 
July 2012 Benefit & Rate Adjustments

Anthem Blue Cross has announced a RATE PASS for some plans and a mild rate increase to some PPO plans. July 2012 quarterly rate adjustments to their 2-50 and 51-99 PPO medical plans average 0.6% statewide. Other news includes:
  • Medical Portfolio Benefit Changes
  • Plan Discontinuations
  • 24-Month RAF Guarantee
  • Specialty Updates
  • Quoting for July 1, 2012 effective dates is available now.

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 = 0.9%
  • 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 = 0.4%

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.
  • 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) 
  • April 2011 = 3.3%  
  • January 2011 = 4.7%
July 2012 Book Rates
Book rates area available below, on the b&p website and bpServ (iPad/iPhone app)


Effective July 1, 2012, ALL plans in ALL medical portfolios (EmployeeElect, EmployeeChoice and BeneFits) will experience benefit changes.
  • Expansion of Women's Preventive Care Mandates per PPACA
  • Maternity Benefits added to Elements and BeneFits Hospital plans per CA AB210 Mandates 
  • Autism Benefit added per CA SB946 Mandates 
  • Remove Healthy Check
  • Updates to the Solution 2500, 3500 and 5000 PPO plans 
  • EOC Language Updates
  • Click here to view before and after benefit grids. 

:::Expansion of Women's Preventive Care Mandates

Newly expanded benefits for women's preventive care through PPACA includes the following services, drugs and supplies paid at 100% in-network:

  • Breastfeeding support, breast pumps, supplies and counseling
  • Prescription contraceptives (birth control) and counseling for women
    • 100% coverage is limited to generic and/or single source brand contraceptives included in the plans applicable drug formulary
  • Permanent surgical contraception (sterilization) for women
  • Counseling for sexually transmitted infections
  • Counseling and screening for HIV
  • Counseling and screening for interpersonal and domestic violence
  • Screening for gestational diabetes
  • Human Papillomavirus (HPV) testing  

:::Maternity Benefits (California AB210

This bill requires that every group health insurance policy provide coverage for maternity services, including office visits. As a result, the Anthem Blue Cross Elements Hospital Basic and BeneFits Hospital Basic plans are being updated to comply with this legislation (also see Discontinued Plans).  

:::Autism Benefit (California SB946

This bill requires that all health plans and policies provide coverage for behavioral health treatment for pervasive developmental disorder or autism.

  • Preservice review will no longer be required for behavioral health outpatient professional services following the 12th visit; however,
  • Preservice review will be required for behavioral health treatment for pervasive development disorder or autism.
  • Benefits are not required to exceed essential health benefits as defined by PPACA.

:::Solution PPO Plan Updates

The Solution 2500, 3500 and 5000 PPO plans will experience benefit changes. To view the current benefits alongside the July 1, 2012 benefits, click here.  


:::EOC Language Updates

Updates to EOC language includes:

  • Change Mail Order references to Home Delivery Program
  • Add Tier 4 copay and benefit maximum (for eligible drugs) under Home Delivery Program 

Effective July 1, 2012, Anthem Blue Cross will eliminate two (2) medical plans from their portfolios.  Members will be migrated as listed below, unless the employer notifies Anthem Blue Cross of different plan elections:
  • Lumenos HIA Plus 500 will migrate to the PPO 1500/$35
  • Lumenos HIA Plus 750 will migrate to the PPO 1000/$25  

Effective October 1, 2012, Anthem Blue Cross will eliminate two (2) medical plans. Due to legislated benefit changes, the plan designs scheduled to be eliminated will closely mirror existing plans. As a result, members will be migrated to those plans.  

  • Elements Hospital Basic will migrate to Elements Hospital Plus 
  • BeneFits Hospital Basic will migrate to BeneFits Hospital Plus 

Beginning with July 1, 2012 effective dates, Anthem Blue Cross will introduce a revised Statement of Understanding. The new form will be required for all new and renewing groups. The broker and employer will both be required to sign the Statement of Understanding.

Anthem Blue Cross rolled out a 24-Month RAF Guarantee available for April 1, 2012 through September 15, 2012 new business effective dates for AB1672 qualified groups eligible for one of five (5) RAF offers. Click the link below for details.



With the exception of Prime & Complete Dental, all ancillary products will receive a rate pass for July 1, 2012 effective dates. Click here to learn about Anthem's 2012 Specialty Bonus Program.   



  • Prime & Complete = 1.23% 
  • All Other Dental PPO = Rate Pass
  • All DHMO = Rate Pass
  • No changes to benefits.
  • Rate pass and no changes to benefits.
  • Rate pass and no changes to benefits.

  • April 12th (approximate): July broker renewals were mailed. 
  • April 23rd (approximate): July group renewals will be mailed.
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