Small Group products from Anthem Blue Cross and Blue Shield
A small group is defined as having 1* to 50 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 or out-of-network provider. Members pay substantially less out of pocket when they use a provider in the PPO network. There is no need to get a referral to see a specialist.
| Health Maintenance Organization (HMO) |
A HMO only covers services from providers in the HMO plan network. Members must choose a PCP in the network. If a specialist is needed, the PCP provides a referral.
| Consumer-Driven Health Plan (CDHP)|
A health plan that features higher deductibles than traditional insurance plans. They can be paired with a health savings account. CDHPs are available as an HMO or a PPO.
Health Savings Account (HSA)
An employee-owned savings account that employees can fund with pre-tax dollars and use to pay for qualified health care expenses, including prescriptions.
A variety of options
Chamber BlueOptions is for small businesses with 2-50 employees. It offers different health plans with different levels of coverage:
| Only 60% of your eligible employees need to enroll (most health plans require 75%). |
| Each employee can choose the plan that best meets his or her family’s needs. |
| Every plan includes coverage for doctor visits, preventive care, hospitalization, emergency care and outpatient care. |
| Plans come with easy-to-use online tools for you and your employees. |
| Blue Choice PPO —Access to 100% of hospitals and more than 96% of doctors in Maine as well as access to any Blue Cross and Blue Shield network provider nationwide.** |
| Pathway HMO – Access to nearly 1,000 primary care doctors and more than 3,000 specialists in Maine.** |
Now your clients can offer their employees a choice of five plans, thanks to Chamber BlueOptions®. Chamber BlueOptions is a package of small business health plans created just for Maine’s state, regional and local chamber members.
Anthem Balanced Funding (ABF)
Available for Small Groups with 25 or more enrolled employees
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
To learn more about the benefits offered by our health care plans, review the detailed summaries of benefits and coverage
or contact your Anthem sales representative.