These are the companies that offer medical insurance to small businesses in California
Beware of Benefit Reductions
Some of the renewal rate reductions hide the fact that the insurance company has changed (reduced) the benefits on some of the plans. This means that patients will pay more for medical services when they receive care than they pay for those services on their current plan. As an example, the Anthem Gold HMO 35/20%/6600 (contract code 1K44) has changed to the Anthem Gold HMO 50/30%/6850 (contract code 1ZHR). The new 2016 plan is about the same monthly price (or “premium” in insurance-speak) as the old 2015 plan; however, the new plan requires a higher payment for doctor office visits ($50 vs. $35), higher co-insurance (30% vs. 20%) and a higher out-of-pocket maximum ($6,850 vs. $6,600). This means that while the monthly renewal premium increase is very little the amount people pay when they get medical care has increased. Accordingly, you should look closely at the renewal benefits in addition to the monthly rates.
Change in the Prescription Medicine (Rx) List of Approved Drugs for Anthem Blue Cross Small Groups
You should also be aware that beginning January 1, 2016, all of the Anthem California small business medical insurance plans will use the “Select” prescription medicine formulary vs. the “National” formulary that had been in place before. This change impacts all Anthem small groups when they renew in 2016. In a January 25, 2016 news release to insurance brokers and agents (see: sg-select-rx-news), Anthem wrote that “we expect that less than 5% of members will be impacted by the transition to the Select Drug List.” In that same news release, Anthem stated that “if a member’s doctor determines that an another option is not appropriate for treatment, the doctor can request an exception review.”
You can view the new Anthem Small Group Select Rx Formulary (List of Drugs) here: sg-select-rx-tier-4-2016
You can view the former Anthem National Rx Formulary (List of Drugs) here: rx-4-tier-natl-drug-list