Anthem Blue Cross Switches Covered California Plans To Model With No Out-Of-Network Coverage

On January 1, 2017, Anthem Blue Cross transitioned its Covered California health insurance marketplace plans from a preferred provider organization (PPO) structure to an exclusive provider organization (EPO) structure. Unlike a PPO plan, the EPO plans provide no coverage for out-of-network services. About 500,000 Anthem members in the state are affected by the change in plan structure.

On November 1, 2016, Consumer Watchdog sued, seeking a restraining order to prevent Anthem from making the switch. Consumer Watchdog said that Anthem’s renewal notices to its members were misleading about the nature of the change. People could have . . .