Anthem Traditional PPO Plans - Indiana
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Our Anthem Commentary
We offer some perspectives on Anthem traditional PPO health insurance plans for Indiana residents:
Range of Benefit Designs
With five distinct plan groups, Anthem offers quite a menu to satisfy a wide range of benefit preferences.
There's Blue Access Plan 2, the costliest plan, providing generous benefits like those offered by many large employers.
For those looking to minimize their insurance premium, there's the Economy Plan, which also provides some generous benefits -- in moderation.
If you want something "in the middle," Anthem offers plenty of choices.
Long-term Rate Stability
Health insurance rate increases are a fact of life. However, because of Anthem's size, financial strength and risk pooling approach, we believe -- over the long run -- Anthem health insurance rate increases will tend to be more moderate than the rate increases required by most other health insurance companies.
Also, we're cautiously optimistic there'll be reduced rate increase trends for consumer-directed health insurance products.
Medical Underwriting
We view Anthem as an overall generous underwriter which strives, within their risk assessment guidelines, to offer health insurance to all applicants.
There are some areas where Anthem medical underwriting guidelines are rather stringent. For example, a person undergoing counseling for depression is going to be declined when applying for most Anthem plans.
On the other hand, an otherwise healthy person taking hypertension medication is likely to get -- in comparison to other health insurers -- a superior underwriting outcome from Anthem.
Favorable Rates for Smokers
Persons with medical conditions will not qualify for "preferred" rates and, depending on the specific situation, Anthem may not agree to provide comprehensive prescription benefits. Anthem's standard rate load for smokers is 20%, which is low compared to most other health insurers.
"Super Preferred" Rate Discount
If you provide favorable responses to the questions on Anthem's Healthy Lifestyles Questionnaire (included with Anthem Application forms), you may qualify for a 5% discount off Anthem's "Preferred One" rate that is typically quoted online.
No Condition-Specific Waivers
Unlike most other Indiana health insurers, Anthem will not place
condition-specific exclusion amendments in their policies.
These amendments, or "waivers," can -- for up to ten years -- exclude coverage for some pre-existing conditions.
These "waivers" are not always bad for the consumer, as they enable some people, who would not otherwise qualify, to obtain private health insurance. However, we're pleased Anthem doesn't engage in this underwriting practice, which is not, in our view, part of a long-term health care solution for Indiana residents.
Accommodates Pre-existing Conditions
Anthem will credit, against the 12-month pre-existing condition exclusion waiting period, time a member was covered by a prior qualifying health insurance plan. In doing this, Anthem follows guidelines of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), though HIPAA does not mandate health insurers to follow this procedure in administering individual polices.
You won't get this accommodation from most of the health insurance companies doing business in Indiana.
The Application Process
Anthem's handling of applications is relatively prompt,. This has something to do with Anthem making extensive use of phone interviews and medical-condition specific questionnaires. This reduces the need for medical record review -- a primary cause of delay in processing health insurance applications.
Customer Service
With sufficient staffing and knowledgeable representatives, Anthem Customer Service is good. Telephone hold times are generally short, and minor administrative problems are usually addressed quickly.
Summary
We have difficulty coming up with bad things to say about Anthem. Because of their size, they're occasionally a little ponderous and bureaucratic, but no more so than other large insurance companies.
Anthem is, by far, Indiana's largest health insurer -- and getting bigger. This wouldn't be occurring if Anthem weren't doing a lot of things right. Anthem operates with a fundamental cost advantage, and they've designed superior products satisfying a wide range of health insurance preferences.
In our view, Anthem senior management believes they have an important societal obligation to Indiana residents, and it shows in the way they conduct business.
