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Anthem Blue Cross July 1st 2012 Plan Updates

2012 July 30
by Tim Thompson

 

The state of California required all health insurance companies to include coverage for maternity and autism beginning July 1st.  Anthem Blue Cross offered these benefits in only a handful of their plans, so they made changes to the rest of their health insurance plans to include these new benefits.  The net effect of these changes is that Blue Cross raised the rates on most plans in May to account for the July benefit changes, and dropped a few plans.

The Anthem Blue Cross portfolio of plans is very diverse and includes lower cost plans for rate conscious consumers as well as full featured plans for those willing to spend more to get the higher benefits.  The primary plans in the portfolio, along with a description of each, recommendations as to who the plans are good for, and a simple competitive analysis are outlined below.

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CoreGuard

The CoreGuard family of plans remains an enigma to me because it has never fit what the majority of people need in benefits or price.  The plans offer only free preventive services and then require that you meet the plan deductible before any further benefits are paid for by Anthem Blue Cross.  The family of plans offers the following deductible choices, 5000, 3500, 2500, 1500, and 750.

Click here to see more details about CoreGuard plans.

Because of limited benefits the CoreGuard family serves a small niche in the market. The Coreguard plans can be a good choice for someone that wants to have a low deductible and doesn’t need a full featured plan (typically using either the 750, 1500, or 2500).  The higher deductible versions of the CoreGuard family (3500 & 5000) really have no purpose because the ClearProtection 3300 plan is similar in price, yet offers more benefits.  Therefore the ClearProtection 3300 plan is a better choice.

ClearProtection

The ClearProtection 3300 plan is one of the most popular plans in the California marketplace.  The plan offers 2 office visits for a $40 copay and generic prescription coverage.  The 3300 deductible is the only remaining member of this proud family of plans.

Click here to see more details about ClearProtection plans.

For healthy individuals and families with teenagers this plan is usually a good choice, and it’s almost always lower cost than the CoreGuard family.

SmartSense

The SmartSense family of plans offer 3 office visits for copays, and provide generic prescription coverage.  The plan offers deductibles of 6000, 5000, 3500, 2500, and 1500.  There is an option to upgrade the prescription benefit to provide brand name coverage, and with this combination the SmartSense family is pretty competitive in the California marketplace.

Click here to see more details about SmartSense plans.

These plans are usually a good choice for families with children between the ages of 8-19, or for individuals that want to have lower costs and Brand name prescription coverage.

Premier

The Premier family of plans offer unlimited office visits for a copay, and provide both generic and brand name prescription coverage.  These are the Cadillac plans in the Blue Cross portfolio.   Within the family, you can choose deductibles of 6000, 5000, 3500, 2500, 1500, or 1000.

Click here to see more details about Premier plans.

These plans are a good fit for young children that need more office visits or are accident prone. Another group is people that have some medical conditions that require more frequent office visits and/or brand name prescription coverage.

PPO Share

The PPO Share family of plans is the granddaddy of the Anthem Blue Cross plans.  The family plan deductibles are 7500, 5000, and 3500.  These plans offer unlimited office visits for a copay, and provide both generic and brand name prescription benefits.  These plans changed very little because they have been the primary maternity plans for Blue Cross for many years.

Click here to see more details about PPO Share plans.

These plans are not really a good fit for anyone looking to get new insurance coverage, because the Premier plans tend to be lower cost and offer similar benefits.  These plans are commonly held by people that don’t want to deal with changing their health insurance, or have medical conditions, and they originally signed up for these plans many years ago.

Lumenos HSA

The Lumenos plans are the Blue Cross Health Savings Account (HSA) compatible plans.  These plans offer free preventive care just like the rest of the Blue Cross health insurance plans, but for all other benefits you must pay the plan deductible first.  Once you meet the deductible, Anthem pays 100% of all additional costs.  The Lumenos family offers the following deductibles 5950, 4500, and 3000 for individuals, and 11900, 7500, 5500, and 3500 for families.

Click here to see more details about Lumenos plans.

These plans are perfect for someone that wants to “self-insure” but make sure that there is a safety net in case something major happens.  The tax savings benefit is another reason people select HSA compatible plans (more details about HSA plans will be available soon).

Comparing Anthem Blue Cross Plans To The Marketplace

From a price and benefit standpoint, Anthem Blue Cross plans are still competitive in California.  In general, they are not the cheapest plans, nor are they the most expensive.  For most people, if they ask me to give them the 3 best plans for their needs, a Blue Cross plan would probably make it into that short list.

For maternity coverage, the best plan from Blue Cross is the Lumenos 3500 HSA with an expected total out of pocket maximum of $4900.  The remainder of the Blue Cross plans don’t really compare well against the top maternity insurance plans from their competition.  The Lumenos plan is the 5th best maternity plan in California.

The ClearProtection 3300 plan has its hands full trying to compete with the new Health Net plans in the low price end of the market.  The benefits of the Health Net plans are very similar to the ClearProtection plan, however they do have higher deductibles than the 3300 offered by Blue Cross and are much lower priced (see the analysis of the new Health Net plans).

The middle and high end of the market is where Anthem Blue Cross is very competitive at this point.  The SmartSense and Premier plans tend to offer a little bit better pricing than their competitors, Kaiser, Cigna, Blue Shield, and Aetna.

Summary

Earlier this year I raised the alarm that Anthem Blue Cross was becoming less competitive in the California marketplace based upon the price and benefit changes they made early in 2012.  The maternity and autism mandate appears to have evened out the playing field again, and Blue Cross is now one of the better positioned health insurance companies.

I expect that Blue Cross will maintain their market share lead, and will move further ahead of Aetna, Blue Shield, and Kaiser, while giving up some ground to Health Net and Cigna in certain parts of the market.

As we get closer to 2014 and the potential beginning of Health Care Reform’s “no underwriting” period, I expect we will see a surge of enrollments in the lower cost and medium cost plans, so Anthem Blue Cross should capture a good portion of those new applications.

Overall Anthem Blue Cross has a strong and broad portfolio of health insurance plans in California.  Their plans are priced competitively in most of the state and should be good solutions for many people.

See the recent analysis for the other major insurance companies by clicking on these links:
Health Net Analysis
Blue Shield Analysis

If you would like to discuss your specific needs with one of our advisors please call us.  If you want to see what health insurance plans are offered where you live, and what the pricing looks like, “click here” to get a health insurance quote.

Other Related Articles:

Health Net Rolls Out New Insurance Plans With Maternity Coverage
New Analysis Shows The Best Maternity Insurance In California Is…”
What Is The Best HSA Plan In California?
Blue Shield Of California Introduces New Plans For July 2012

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