Dena News

Anthem Blue Cross has announced their Q2 Rate Action and Portfolio Update. Please read below for details on changes they are making for Q2, 2017 ACE Program Guidelines, extended promotional offers and general reminders.

Rate Update:

Good news! Anthem is offering a Rate Pass for all plans for Q2.

For those groups renewing in Q2, statewide averages for HMO plans are a 3.0% decrease, while the PPO plans will have a 1.1% increase. Please note that due to group demographics, member level rating, and actual plan selections, each groups’ renewal percentages can vary. Rates are available on HealthConnect now.

Portfolio Changes:

Anthem is not making any changes to their portfolio or any plan benefit changes for Q2.

2017 ACE Broker Program:

The ACE Broker program has been revised for 2017.  Anthem has downsized the program, from the top 400 brokers in 2016, down to 217 brokers in 2017.  Anthem has also instituted three levels to the ACE Broker Program:

 

ELITE: CHAMPION: ADVANTAGE:
  • Guaranteed attendance to annual ACE Broker event
  • Priority Enrollment Processing
  • Dedicated Small Group Account Manager
  • Service Support from Sales Support Specialists
  • Dedicated Small Group Account Manager
  • Service Support from Sales Support Specialists
  • Small Group Account Manager for renewal related support only

 

Each tier will also get a local Anthem sales team that understands the local market and will be able to participate in the Quarterly Rate Announcement Call.  Also, for groups with more than 50+ enrolled employees in Medical, they will receive a dedicated Small Group Account Manager and additional service support from Sales Support Specialists.

Underwriting Guidelines Extended:

Each of the below guidelines has been extended through the end of Q2 effective dates, with the exception of the All Plans promotion, which is only good through the end of Q1 effective dates currently.

Relaxed Participation Guideline:

The Anthem Reduced Participation Guide has been extended again for Q2 effective dates. Groups will need to meet 30% participation, with a minimum of 5 enrolled in order to meet participation guidelines.  This applies to medical and specialty lines of coverage.

DE9C not required for new group submission with 6 or more enrolled:

Effective immediately, Anthem is making it easier for you to do business with them, by continuing to simplify enrollment for small groups. You will no longer be required to submit a Quarterly State Tax Withholding Report (DE9C)* for groups with 6 or more enrolled employees, through Q2 effective dates.

New business submissions will need to include an agent quote, employer application, employee applications, and waivers from all employees not electing coverage, legal documentation, Statement of Understanding, Electronic Debit Payment Form, and a copy of last month’s prior carrier group premium statement for all products elected.

  • If employees are not listed on the prior carrier bill, the group will need to submit payroll records.
  • If the group is a startup company, they will need to submit a Conditions Enrollment/Start-up Companies form
  • If a new group does not have prior coverage, they will need to submit a DE9C or payroll records.

*Please note, while DE9C’s are not required for groups of 6 or more enrolled through this promotion, Anthem does reserve the right to request a DE9C to validate eligibility upon their discretion (e.g. variations in prior carrier bill and actual enrollment, future audits, etc.)

All Plans Promotional option for new Small Groups:

As of January 1, 2017, Anthem will allow clients to offer all plans for groups.  No more limitation of one HMO network and one PPO network.  This promotion is only good through March effective dates at this time. 

  • For new groups, simply indicate network option on the existing Employer Application.
  • For groups that have already renewed, your clients can submit an Anniversary Month Change Form.

Please note: any applicable rate changes will be applied to their request to change their anniversary month. (i.e. age rated for birthday, any address changes, etc.).

General Information & Reminders:

Q2 Renewals:

Renewals for 4/1 groups will start appearing in the Producer Toolbox on 1/20, with renewals for 5/1  and 6/1 groups available shortly after.  Group renewals for 4/1 groups will be mailed to the groups on 1/26/17 and will be available on the Employer Access portal on 1/30/17

Valid Waivers:

Individual coverage both on and off the Exchange is accepted as a valid waiver.

Electronic Member EOCs:

Starting 12/1/2016, members will receive electronic EOCs that they can access online under My Plan Documents. Groups will continue to receive paper copies for the plans they offer until further notice. They can request a paper copy by calling customer service.

ACA Fees suspended for 2017:

ACA fees have been suspended for 2017. Fees will be prorated for all renewal months, except January.