New guidance from the federal government about the Affordable Care Act allows Anthem individual members and small group employers who have not moved to an ACA-compatible plan to keep their current health plans (and network of doctors) for another year. This offer will be extended to individuals and small groups with renewals starting July 1.
Prior to this ruling, Anthem had been mailing ‘transition’ notices to individual members and ‘discontinuance’ notices to small group clients informing them that their current legacy plan would be discontinued upon their 2014 renewal date and that they would be automatically transitioned into an ACA-compliant plan upon their renewal. Anthem is mandated to mail such notices 90 days in advance of the renewal date; therefore, the notices for July and August clients have already been mailed. However, it’s important for you to know that those individuals and small group clients (with a July-December renewal) do not have to transition into an ACA-compliant plan and are therefore eligible to grandmother their current plan.
If your clients choose to stay on their current plans, they may experience a rate increase at renewal. But their plan will be exempt for another year from the ACA product changes that went into effect January 1, 2014. Clients also will gain more time to understand how health care reform may work for them.
Your clients will get more details when Anthem mails them their renewals. For your reference, here are sample letters for individual members and small group employers explaining the new offer. The communication
also includes this required notice from the Centers for Medicare & Medicaid Services (CMS) for individual members and small group
employers.
The list of your affected Individual clients will be located in the legacy Broker portal in AgentServices under the Renewal Report tab. As a way to differentiate your clients that are being allowed to stay on their non-grandfathered plan, they will be loaded with a “5th of the renewal month” date. Anthem is not changing their actual renewal date, but using that date as a way to easily differentiate between your affected clients and other renewing clients listed on your report.
To access your Anthem renewal reports, simply follow these instructions:
- Go to Anthem.com. Click on Producers under “Other Anthem Websites” at
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the top of the homepage.
- Log in using your user name and password.
- At the bottom of the Producer Toolbox home page, click on your state Legacy Portal.
- On the MyAnthem Broker home page, select My Services and then Agent Services.
- Select the Renewal Report tab to view or download your report.
What if a client wants a different plan?
Clients who want to change
their plans at renewal (to an ACA-compliant plan) need to notify Anthem before their annual renewal. For both small group clients and individual members, Anthem needs to know their decisions at least 15 days in advance of their renewal effective date. Small group clients will be required to sign and return the ACA-Compliant Renewal Request Form attached to their renewal cover letter. Otherwise, Anthem will assume they want to accept the option to stay on their current plans. Individual members can access ChangeMyCoverage.com via your AgentConnect link or you can do a quote and comparison for them via the Producer Toolbox if they choose to make a change to an ACA plan. They can also go to the Health Insurance Marketplace to determine if they may be eligible for a subsidy. If your clients choose to switch from their current plan, they will not be able to switch back at another time.
PLEASE NOTE: Due to this, the renewals for July will not be available until the middle of May.
