About Anthem Blue Cross

Anthem Blue Cross offers the health insurance coverage and choices you – and your employees – want and need. You can select from a variety of plan types, including HMO, PPO, EPO, and Health Savings Account-compatible plans. Anthem has the largest provider network in the nation (and in California), so you’re likely to find that your preferred doctor is already in-network – saving you money and time.

Don’t forget about Anthem’s smart tools designed to help employees make the most of their group health benefits. It’s easy to find a doctor, access your virtual ID card, or get plan information, claims data, and other info with the Anthem Anywhere mobile app. Click below to explore the details on any of the Anthem plans available through CaliforniaChoice.

Quick Plan Highlights

Here are some of our most popular Anthem Blue Cross health plans along with a high level snapshot of plan coverage and out-of-pocket costs. To view a complete list of Anthem Blue Cross coverage options, click Download All Plans below to see the most current plan information.

These plans are effective as of: 1/1/19

Bronze EPO A

Network	Prudent Buyer - Small Group
Calendar Year Deductible	$5,600 / $11,200¹
Out-of-Pocket Max Ind/Fam:	$7,350 / $14,700²
Dr. Office Visit (PCP):	$65 Copay (first 3 visits)³ 60%
Urgent Care:	60%
Emergency Room	$400 Copay - 60%

Silver PPO A

Network	Advantage PPO
Calendar Year Deductible	In Network $1,250 / $2,500	Out of Network² $2,500 / $5,000
Out-of-Pocket Max Ind/Fam:	$7,350 / $14,300¹	$14,700 / $29,400
Dr. Office Visit (PCP):	$40 Copay (ded waived)	50%
Urgent Care:	$40 Copay (ded waived)	50%
Emergency Room	$350 Copay - 60%	$350 Copay - 60%

Gold PPO A

Network	Advantage PPO
Calendar Year Deductible	In Network $500 / $1,500	Out of Network⁹ $1,000 / $2,000
Out-of-Pocket Max Ind/Fam:	$6,000 / $12,000¹	$12,000 / $24,000¹
Dr. Office Visit (PCP):	$30 Copay (ded waived)	50%
Urgent Care:	$30 Copay (ded waived)	50%
Emergency Room	$250 Copay - 80%	$250 Copay - 80%

Platinum HMO A

Network	Select HMO
Calendar Year Deductible	None
Out-of-Pocket Max Ind/Fam:	$2,000 / $4,000⁹
Dr. Office Visit (PCP):	$10 Copay
Urgent Care:	$10 Copay
Emergency Room	$100 Copay

Bronze EPO A

Network	Prudent Buyer - Small Group
Calendar Year Deductible	$5,600 / $11,200¹
Out-of-Pocket Max Ind/Fam:	$7,350 / $14,700²
Dr. Office Visit (PCP):	$65 Copay (first 3 visits)³ 60%
Urgent Care:	60%
Emergency Room	$400 Copay - 60%

Silver PPO A

Network	Advantage PPO	Out of Network²
Calendar Year Deductible	$1,250 / $2,500	$2,500 / $5,000
Out-of-Pocket Max Ind/Fam:	$7,350 / $14,300¹	$14,700 / $29,400
Dr. Office Visit (PCP):	$40 Copay (ded waived)	50%
Urgent Care:	$40 Copay (ded waived)	50%
Emergency Room	$350 Copay - 60%

Gold PPO A

Network	Advantage PPO	Out of Network²
Calendar Year Deductible	$500 / $1,500	$1,000 / $2,000
Out-of-Pocket Max Ind/Fam:	$6,000 / $12,000¹	$12,000 / $24,000¹
Dr. Office Visit (PCP):	$30 Copay (ded waived)	50%
Urgent Care:	$30 Copay (ded waived)	50%
Emergency Room	$250 Copay - 80%

Platinum HMO A

Network	Select HMO
Calendar Year Deductible	None
Out-of-Pocket Max Ind/Fam:	$2,000 / $4,000⁹
Dr. Office Visit (PCP):	$10 Copay
Urgent Care:	$10 Copay
Emergency Room	$100 Copay

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Footnotes

*) All services are subject to the deductible unless otherwise stated. Family Deductible: For any given Member, cost share applies either after he/she meets their individual Deductible, or after the entire family Deductible is met. The family Deductible can be met by any combination of amounts from any Member; however, no one Member may contribute any more than his/her individual Deductible toward the family Deductible.

1) Family Out-of-Pocket Limit: For any given Member, the Out-of-Pocket Limit is met either after he/she meets their individual Out-of-Pocket Limit, or after the entire family Out-of-Pocket Limit is met. The family Out-of-Pocket Limit can be met by any combination of amounts from any Member; however, no one Member may contribute amy more than his/her individual Out-of-Pocket Limit toward the family Out-of-Pocket Limit.

2) Family out-of-pocket Limit: For any given Member, the out-of-Pocket limit is met either after he/she meets their individual out-of-pocket limit, or after the entire family out-of-pocket limit is met. The family out-of-pocket limit can be met by any combination of amounts of any Member; however, no one Member may contribute any more than his/her individual out-of-pocket limit toward the family.

3) Office visits are per Member and combined for primary care physician, specialist, other provider, Retail Health Clinic Visit, Counseling (including Family Planning, Nutritional), Mental Health and Substance Abuse, and Telehealth. These Office Visits have a Co-payment with deductible waived for in-network providers which, applies to any combination of services for the first three visits during the Benefit Period. Starting with the fourth visit, you pay Deductible and Coinsurance instead of a Co-payment. Always check the setting above to determining your payment responsibility for other services and Providers, if applicable. Benefits are based on the setting in which, Covered Services are received. If the service is available (and you obtain the service) in a setting other than the one listed above, your Co-payment /Coinsurance will be based on the setting in which, you receive the service. Please see those settings to determine your cost share.

9)Family Out-of-Pocket Limit: For any given Memeber, the Out-of-Pocket Limit is me either after he/she meets their individual Out-of-Pocket Limit, or after the entire family Out-of-Pocket Limit is met. The family Out-of-Pocket Limit can be met bt any combination of amounts from any Member; however, no one Member may contribute any more than his/her individual Out-of-Pocket Limit toward the family Out-of-Pocket Limit.

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