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Small Group Health Plans
Small Group products from Anthem Blue Cross and Blue Shield
A small group is defined as having 1 to 100 employees.
We built our Small Group plans from the ground up – with the strengths you’ve come to expect from the Anthem product portfolio.
Our plans are well-positioned for the changing market. They cover all of the essential health benefits (EHBs) required by the Affordable Care Act (ACA or health care reform law), covering everything from emergencies to counseling services, to preventive care and more, including:
| Preventive, wellness and chronic disease management services|
| Outpatient care|
| Emergency services, including emergency room or urgent care|
| Hospital stays|
| Laboratory services|
| Prescription drugs|
| Mental health and substance abuse treatment|
| Maternity and newborn care|
| Pediatric services, including dental and vision care|
| Rehabilitative and habilitative services and devices |
| Gender discrimination prevention|
| Oral chemotherapy|
| Preferred Provider Organization (PPO) |
Allows members to go directly to any in-network provider. There is no need to choose a primary care physician (PCP) or get a referral to see other doctors.
| Health Maintenance Organization (HMO) |
Requires members to choose a PCP, and a referral is required to see other doctors.
| High Deductible Health Plan (HDHP)|
A high-deductible health plan that features higher deductibles than traditional insurance plans, which can be paired with a health savings account.
| Health Savings Account (HSA) |
A savings account for certain plans that members can fund with pre-tax dollars and use to pay for qualified health care expenses, including prescriptions. This is often used with a consumer-driven health plan (CDHP).
Preferred Provider Organization (PPO) Network Options
| PPO Network — Access to more than 15,200 doctors and specialists, and 76 hospitals, including most Colorado acute care hospitals|
| Pathway PPO Network — Access to 32 hospitals excluding St. Rose Dominican Hospitals (Siena, San Martin, and DeLima), more than 700 PCPs, and nearly 4,000 specialists|
Health Maintenance Organization (HMO) Network Options
| Pathway – Access to more than 10,900 doctors and specialists and 59 hospitals statewide|
| Mountain Enhanced — Community-based network across select mountain regions; for services not available within the service area, members have access to the greater HMO network and rates.|
Anthem Balanced Funding (ABF)
With Anthem Balanced Funding, businesses have predictable monthly payments and a limit to their financial responsibility. They also have the flexibility of a self-funded plan and can get money back if their claims experience is favorable.
A plan with the right combination of both fully insured and self-insured plan has these advantages:
| Fixed payments|
| No deficit carry-forward|
| A cap on financial responsibility|
| Savings for favorable claim experience|
| Plan design options|
| Savings on premium tax and future health care reform taxes|
The plan includes two kinds of stop-loss coverage and health and wellness packages too. Discover more by watching the demo
and reviewing our sales flyer
To learn more about the benefits offered by our health care plans, look at our product guides
and review the detailed summaries of benefits and coverage