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3 Important Anthem Updates: Special Enrollment, Downgrades & Eligibility

Anthem Blue Cross announced three important updates regarding a new Special Enrollment Period, plan downgrade options, and extended eligibility flexibility.


Special Enrollment Period through July 31st for an 8/1 effective date

Anthem will provide both Fully insured and Self-funded groups, excluding Life and Disability*, an option to offer a Special Enrollment Period to enroll employees who previously did not elect to enroll in coverage at the time of open enrollment. This Group Special Enrollment Period will last from June 8, 2020 to July 31, 2020 and is available to both Large and Small groups. Coverage would be effective no later than August 1, 2020. State eligibility guidelines will apply. Employers should consult their legal counsel regarding the tax treatment of employee coverage elections made through this SEP. 


Plan downgrade option available for 7/1 and 8/1 effective dates

Anthem will also allow currently covered employees to switch to a lower priced medical plan when one is offered. This option is available for July 1, 2020 and August 1, 2020 effective dates. Anthem will not allow currently covered employees to switch to a more expensive plan absent a qualifying event as described in the benefit booklet or certificate or as mandated by HIPAA.


Extending flexibility on eligibility requirements until 9/30

Anthem is relaxing their requirement for employees to be actively working in order to be eligible for coverage through September 30, 2020 as long as the monthly premium is received. This applies to employees that were laid-off, furloughed or moved to part-time. Coverage must be offered on a uniform, non-discriminatory basis to all employees and employee premium contributions must be the same or less than what they were prior to the layoffs. This flexibility was set to expire on July 31, 2020, but in an effort to be keep members covered, Anthem is extending it to September 30.


Download Anthem’s latest COVID-19 FAQs for more information and complete details.


Anthem also provided two flyers on a return-to-the-workplace strategy with Sydney Care:


For questions, please contact a member of your B&P Sales Team – 888.722.3373.



*For Anthem’s Fully Insured Group Life and Fully Insured Group Disability groups, the Special Enrollment Period will not apply. The existing enrolled Disability and Life population shall remain covered, subject to the all other terms of the policy.