Anthem Blue Cross of California is a popular option for small employers. Blue Cross of California is for-profit company and the largest subsidiary of Anthem, Inc. which is a publicly traded corporation that is headquartered in Indianapolis, Indiana. Anthem, the parent company, operates in 14 different states and is the second largest health insurance company in the United States and number 29 in the Fortune 500 list of America’s largest companies.
The most recent data available from 2015 show that Anthem Blue Cross provides medical insurance to about 18 percent of small businesses in California (Source, see page 23 of the California Health Care Almanac: California Health Insurers: Two Years After Reform, by the California Health Care Foundation.)
Large Provider Networks: Anthem’s largest PPO network for small group employers (called the “Prudent Buyer PPO” network) includes most of the doctors and hospitals in California and it is a favorite among many business owners and others who desire the greatest freedom to see a specific doctor. Anthem also offers a full/large network HMO plan (called the “California Care HMO” network) that can be offered alongside their smaller/narrow “Select” network HMO plans.
Flexible with Start-Ups: Anthem also seems to be very flexible when qualifying new, start-up companies by requiring only two weeks of payroll records with the understanding that the group will submit four additional weeks of payroll records after the coverage is in force. Many other insurance companies require months of payroll records or follow the state guidelines that require an employer to have “one non-owner W-2 employee for fifty percent of the preceding quarter.” (See California Insurance Code Section 10753(q)(1)(A)) Anthem’s flexibility allows start-ups who have recently hired at least one W2 employee who works a minimum of 30 hours per week to offer coverage right away.
Low Participation Requirements: Anthem recently reduced their underwriting requirements so that employer groups with five or more enrolling employees only need 30 percent of the eligible employees to enroll. Most insurance companies require a minimum of 70 of the eligible employees to enroll. Anthem’s underwriting flexibility means that your company may qualify with Anthem where they may not qualify with other companies. An added plus for Anthem is that they consider individual coverage to be a valid waiver. This is probably more detail that you need, but the result is that Anthem is very lenient when determining who must enroll in your group’s plan. Give us a call and we can help you out 800-746-0045.
Anthem has full and narrow (Select) network HMO and PPO plans, however, a small group employer can only offer one PPO network – full (Prudent Buyer) OR narrow (Select), not both. An employer can offer both HMO networks to employees.
Also, Anthem doesn’t offer a Bronze level HMO plan so you’ll need to find a Bronze PPO if you want to offer a bare bones plan.