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October 2023 Broker Newsletter

Wednesday, October 11, 2023

Bon Secours Mercy Health Will Remain in Anthem's Network

Anthem Blue Cross and Blue Shield has reached a five-year agreement with Bon Secours Mercy Health (BSMH) that provides Anthem members with continued access to affordable care at all BSMH hospitals, outpatient care centers, and physicians through September 2028 without additional costs to employers.

This new contract also reinforces that access to affordable coverage for Anthem employer-based and Affordable Care Act plans was never interrupted and will now continue for an additional five years. With this agreement, Bon Secours Mercy Health will drop its lawsuit in Virginia.

In addition, all Anthem Medicare Advantage and Medicaid health plan members will have continued in-network coverage at Bon Secours Mercy Health. Both organizations have agreed that any services rendered when BSMH was out of the Anthem network will be reprocessed and paid at the in-network level.

If you have questions, please visit or contact your broker or account manager

Anthem to Discontinue all Individual Grandfathered Legacy Plans

Anthem is discontinuing all Virginia Individual legacy grandfathered plans, which means there are no legacy downgrade or legacy movement options available. ACA plans will be the only available options. The last day of coverage for these plans is December 31, 2023. Clients will be notified by mail with two separate notices. The first notice was mailed out on September 26, 2023, informing them that their plan is being discontinued after this year, effective December 31, 2023.

This second notice is targeted to be mailed out mid to late October by Anthem, pending final rate and contract approvals. It will suggest one of five new ACA POS plans utilizing Virginia's Pathway X Tiered Hospital network. Outside of Virginia, the plans will use the BlueCard PPO network. The plans include out-of-network coverage, but cost shares are higher except for urgent or emergency care. Please note the new ACA POS plans will use the Advantage Pharmacy Network with the Select Formulary. Clients must check if their pharmacies are in-network and their prescriptions are on the formulary.

Anthem is requesting that clients to affirm they want the new plan via the Acceptance of Health Plan Form that will be included in their second notice. Brokers can affirm the plan on behalf of their clients by calling Broker Services. Anthem will also inform clients that they can select another plan during Open Enrollment (November 1, 2023, through January 15, 2024) or during a Special Enrollment Period (SEP) from January 1 through February 29, 2024. The start date of the new plan will depend on when they enroll and make their first monthly payment. To avoid a coverage gap, they should enroll by December 15, 2023, for coverage to start on January 1, 2024.
Clients with a dental rider must purchase a new dental plan, as we will not automatically renew them into an ACA dental plan. The POS plan we suggest includes pediatric dental coverage for members up to age 19.

ACA plans do not offer supplemental accident riders. Therefore, coverage will end with the Virginia Individual Legacy grandfathered plan on December 31, 2023, for anyone with this rider.

Clients with a life insurance policy will be able to keep that policy at the same cost if they continue to pay the life premium. Impacted clients will receive a separate letter with details.

Clients who sign up for a high-deductible ACA health plan that is compatible with a Health Savings Account (HSA), can use our banking partner by calling Member Services or enrolling online. More information can be found here:

Here is how to identify your clients in the discontinued plans
1. Log in to your Producer Toolbox (PTB).
2. Navigate to Book of Business toward the top of the page and choose Clients.
3. Scroll down to Export Spreadsheet (below the graphs and filters).
4. Download your spreadsheet and filter out the data:
a. Column C – Markets: Filter out everything EXCEPT “Individual.”
b. Column J – Products: Filter out everything EXCEPT “Medical.”
5. In the remaining data, locate your impacted January 1, 2024, discontinuing members based on Plan Name in Column K.

Please contact Broker Support at 800-225-3611 or for more information