Misuse of emergency rooms (ERs) for non-emergency medical concerns is a big cost driver for our clients and members. The average cost to go to the ER for a non-emergency is $1,200 (1). Yet 66% of members go to the ER whenever they (or someone they care for) are sick and the doctor’s office is closed.(2) And, 25% believe the best place to go is the ER, regardless of how sick or injured they are, no matter the time of day.(2) This not only costs members more – in terms of both time and money
Anthem has worked with the National Urban League, City of Hope and Pfizer, Inc., to launch Take Action for Health, a free, interactive website aimed at reducing some of the greatest health risks facing the African American community today, like breast cancer, heart disease and emotional well-being.
The Rx Choice Tiered Network is comprised of more than 70,000 retail pharmacy locations in all. The network is anchored in Anthem markets, where offered, by CVS, along with Target pharmacies, now owned and operated by CVS. Members have the option to pick pharmacies at other retail chains and big box stores, as well as many independent drugstores.
“Anthem is significantly disappointed by the decision as combining Anthem and Cigna would positively impact the health and well-being of millions of Americans – saving them more than $2 billion in medical costs annually,” said Joseph R. Swedish, Chairman, President and Chief Executive Officer, Anthem.
This Executive Order has no immediate impact on Anthem plans or our members’ benefits and coverage.
Existing Anthem Blue Cross member recently became eligible for Medi-Cal. Instead of moving to a new health plan, he or she can stay with the same plan and enroll in Anthem Blue Cross for Medi-Cal.
Beginning April 1, 2017, Anthem Blue Cross will adjust the base rates for existing business on all California Department of Insurance (CDI) grandfathered medical plans with an April 1, 2017 effective date. Members will also receive an adjustment for age changes. The base rates for members on Department of Manage Health Care (DMHC) grandfathered medical plans, that were effective April 1, 2016, are not scheduled to change in 2017. DMHC members will receive an adjustment for age changes.
As you know, for the 2017 benefit year, part of our contractual mandated requirements with CoveredCA, Anthem Blue Cross is required to assign all PPO/EPO members to a Primary Care Physician (PCP).
Individual grandfathered members enrolled in Anthem Blue Cross Life & Health Insurance Company (CDI regulated) policies at least one day in September of 2016 will be receiving a refund as a result of funds left over from a 2013 settlement of a class action lawsuit (Kreuzhage v. Anthem). This includes the majority of the grandfathered members. Members on Affordable Care Act (ACA) On and Off Exchange plans, and grandfathered members on Anthem Blue Cross (DMHC regulated) plans are not included.
The team determined with a high degree of confidence the identity of the attacker and concluded with a medium degree of confidence that the attacker was acting on behalf of a foreign government. Notably, the exam team also advised that previous attacks associated with this foreign government have not resulted in personal information being transferred to non-state actors.