September Anthem News Updates
Helping Employees Protect Themselves and Their Loved Ones
Life insurance is a key part of an employee’s overall financial wellness. This September is Life Insurance Awareness Month—and a good time for your clients to remind their employees of the importance of protecting their family members if they, unfortunately, face a loss.
You can guide your clients by reminding them of the life insurance provisions that can help their employees receive the coverage they need, even if they were to lose their job or have their hours reduced:
- Continuation of coverage: If an employee is not working due to a layoff, leave of absence, or disability, their employer can continue to pay their premiums for a period of time — usually 1 to 3 months.
- Conversion: If an employee leaves or loses their job, they can convert their group life coverage to an individual life policy and pay the premiums directly to Anthem.
- Portability: If an employee leaves or loses their job, they may be able to keep their voluntary or supplemental life plan by paying the premiums directly to Anthem.
Cancer Care Navigator Program
Anthem’s new Cancer Care Navigator program helps fully insured and ASO members understand their cancer diagnosis and treatment plans, make sense of benefit options, and connect to helpful resources in their community.
Cancer Care Navigators serve as the central point of contact at Anthem for members and their cancer care teams across the care experience. They work to reduce the burdens facing many members with cancer by:
- Supporting member and caregiver needs.
- Connecting the member to critical Anthem and community resources.
- Reinforcing treatment plans and medications, and providing education about possible side effects.
Updates to ACA Preventive Care Drug List
Anthem is removing Annovera, Balcoltra, Falessa Kit, Lo Loestrin FE, Natazia, Slynd, Taytulla, and Twirla from the ACA Preventive Care Drug List January 1, 2021, for fully insured and ASO members with women’s contraceptive benefits. Members will pay their plan’s cost share for these branded drugs. Anthem will continue to cover generic contraceptives at no cost to members.
Anthem is sending letters to affected members and their prescribing doctors on October 1, 2020, to allow time to explore options and provide new prescriptions for their patients. Letters to health care professionals will include some generic contraceptive alternatives that our plans cover at no cost to members.
Mental Health Trends Webinar
Anthem is offering another opportunity to learn about important topics for your business.
Please join Anthem leaders at 2 p.m. (ET) on Monday, September 21, 2020, as they share the latest information on COVID-19, including legislative and clinical updates. They’ll focus on regulatory and mental health trends and resources.
REGISTER NOW and save the event to your calendar.
GM/Legacy Renewals for January 1, 2021
The average rate increase for the entire Renewal Block is 6 percent. Anthem also has about 80 percent of the block coming in at less than a 10 percent rate increase! There will obviously be some outliers, but they believe this will give your groups’ some relief during these uncertain times. Also, the GM/Legacy renewals will be released in mid-September.
Dental PPE Reimbursement Extension to October 31, 2020
Many dental providers are charging an additional $10 per visit to help them cover the cost of the Personal Protective Equipment (PPE) for their staff. Anthem will reimburse members for this additional charge up to $10 per patient per visit to in-network PPO providers through October 31, 2020.
Telehealth Cost Share Changes
As of September 30, 2020, Anthem member cost share waivers for video only telehealth visits will expire.
Starting October 1, 2020, Anthem members will pay their usual cost shares for visual telehealth visits with in-network providers. Anthem will continue to cover in-network telephone only visits at no cost share through December 31, 2020. Starting October 1, 2020, LiveHealth Online visits will require member cost shares.
Eligibility Requirements Continue to Be Relaxed to the End of the Year
Anthem’s requirement for employees to be actively working in order to be eligible for coverage will be relaxed through December 31, 2020, as long as the monthly premium payment is received.
Anthem will allow employees that have a reduction in hours (work less than 30 hours per week) to continue coverage through December 31, 2020, as long as the monthly premium payment is received.
SBC Template Updated for 2021
CMS released an updated 2021 SBC Template, Instructions, Uniform Glossary and Guide, Narratives (Maternity, Diabetes and Foot Fracture) and Calculator for coverage examples. The AI/AN zero cost sharing template is now also available for use.
As a reminder, group health plans and health insurance issuers will be required to use the 2021 SBC template and associated materials beginning on the first day of the first open enrollment period for any plan years (or, in the individual market, policy years) that begin on or after January 1, 2021, with respect to coverage for plan or policy years beginning on or after that date.
Contact your Cornerstone representative to learn more.
