Anthem Blue Cross EPO Health Plan Offers A Great Provider Network For Small Companies In California

July 2, 2024by mycalchoice

Anthem Blue Cross EPO Plan Offers Flexibility & A Great Provider Network For Small Companies In California

If you and your employees want access to a great provider network and competitive rates, an Anthem Silver or Bronze Exclusive Provider Organization (EPO) plan, available through the CaliforniaChoice private exchange, may be something you will want to consider.

What is an EPO? An EPO is a sort of hybrid plan that offers some of the flexibility of a Preferred Provider Organization (PPO) plan and the cost savings of a Health Maintenance Organization (HMO) plan. With an EPO, you don’t need to choose a Primary Care Physician like with an HMO; instead, you can directly connect with a specialist when you need care as long as you choose a provider from the EPO network. With the Anthem Blue Cross EPO, you get access to the Anthem Prudent Buyer Network – the largest network in the CaliforniaChoice portfolio. Plus, there are no more out-of-network provider charges when using an in-network hospital (if your coverage is effective July 1, 2017, or later). The Anthem Blue Cross Silver EPO A plan even offers no deductible on prescription drug benefits. (As you probably know, since the Affordable Care Act (ACA) was enacted, health plan benefit levels are divided into four metal tiers: Bronze, Silver, Gold, and Platinum.) With Anthem Blue Cross EPO coverage through CaliforniaChoice, from north to south and from the Pacific Ocean to the borders of Nevada and Arizona, enrolled groups can access some of California’s most sought-after providers.

In Orange County, the Prudent Value Network includes:

  • Hoag Memorial Regional Medical Center
  • Mission Hospital Laguna Beach
  • Mission Hospital Regional Medical Center in Mission Viejo
  • Joseph Hospital in Orange
  • Jude Medical Center in Fullerton
  • Saddleback Memorial Medical Center in Laguna Hills
  • University of California Irvine Medical Center.

In the Inland Empire, CaliforniaChoice members enrolled in an Anthem EPO plan enjoy access to:

  • Community Hospital of San Bernardino
  • Desert Regional Medical Center, Palm Springs
  • Desert Valley Hospital in Victorville
  • Eisenhower Medical Center in Rancho Mirage
  • Loma Linda University Medical Center
  • Riverside Community Hospital
  • Mary’s Medical Center in Apple Valley

In San Diego and Imperial counties, the Anthem Blue Cross Prudent Buyer Network includes:

  • Rady Children’s Hospital, San Diego
  • Scripps Memorial Hospital in Encinitas and La Jolla
  • Sharp Memorial Hospital in San Diego
  • University of California San Diego (UCSD) Medical Center

In Los Angeles and Ventura counties, providers in the Anthem Blue Cross EPO include:

  • Cedars-Sinai Medical Center, Los Angeles
  • Community Memorial Hospital of San Buenaventura in Ventura
  • Glendale Adventist Medical Center
  • Huntington Memorial Medical Center in Pasadena
  • Keck Hospital of USC, Los Angeles
  • PIH Hospital Health in Downey
  • Providence Little Company of Mary in Torrance
  • Providence Saint John’s Health Center, Santa Monica
  • Ronald Reagan/UCLA Medical Center in West Los Angeles
  • Valley Presbyterian Hospital, Van Nuys
  • Ventura County Medical Center in Ventura

In Northern and Central California, the Anthem Prudent Buyer network includes a roster of premier facilities stretching from the Bay Area to Sacramento County, San Joaquin County, Stanislaus County, Santa Clara County, and south to Fresno County.

Among others, the Anthem Blue Cross EPO providers in Northern & Central California include:

  • Alta Bates Summit Medical Center;
  • California Pacific Medical Center;
  • Good Samaritan Hospital;
  • Mercy General Hospital, Sacramento;
  • Mills Peninsula Medical Center;
  • NorthBay Medical Center;
  • O’Connor Hospital, San Jose;
  • Saint Agnes Medical Center, Fresno;
  • Stanford Health Care;
  • Sutter Medical Center (and other Sutter facilities);
  • UCDavis Medical Center;
  • UCSF Benioff Children’s Hospital Oakland.

The Anthem Prudent Buyer Network gives employers and employees access to more than 60,000 doctors and specialists and 330 hospitals. The appeal of Anthem’s EPO plans is reinforced by the fact that 96 percent of claims are processed in-network. Of course, an EPO is just one of a variety of great health plan options you and your employees can choose with the CaliforniaChoice private health insurance exchange. If you want like to learn more about EPO choices or the Anthem Blue Cross provider network, or if you want to learn about the CaliforniaChoice private exchange, talk with your employee benefits broker.

If you don’t already have a broker, we’ll help you find a CaliforniaChoice broker to speak with about your group’s health insurance choices.

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This guide compiles a list of common questions you may have before you start offering health insurance coverage.