Notice: Anthem Blue Cross and Enloe contract termination

To: Campus Community

From: Human Resources and Benefits Services

As of today, October 31, 2018, Enloe Medical Center and Anthem Blue Cross have failed to reach an agreement in their contract negotiations. With no resolution, it is anticipated Enloe will proceed with the planned termination of its contract with Anthem Blue Cross, effective tomorrow, November 1, 2018. This will affect all employees who are members of our PERS Select, PERS Choice, and PERS Care health plans. For those members, Anthem Blue Cross shared this message today:

As you know, Enloe Medical Center issued a notice to terminate its Contracting Hospital Agreement with Anthem Blue Cross. It is Anthem Blue Cross’s intent to reach reasonable contractual language and reimbursement rates that are beneficial to both organizations. Unfortunately, to date, Anthem Blue Cross and Enloe Medical Center have been unable to reach agreement and it appears that our commercial hospital contract with Enloe Medical Center may terminate effective November 1, 2018. While we still remain in a status of active negotiation, we wanted to ensure that you have reviewed the FAQ’s in the event we do not reach an agreement.

Within the updated Frequently Asked Questions (PDF), we have outlined the continuity of care procedures. California law provides for completion of covered services/continuity of care for certain medical conditions following a provider’s termination.  The current contract between Anthem Blue Cross and Enloe Medical Center has provisions that cover members for continuity of care/completion of covered services after the contract terminates. If a member began a course of treatment at Enloe Medical Center before the contract termination date, the member or his or her physician can request continuity of care by calling  your dedicated CalPERS customer service at  877-737-7776 PPO/ 855-839-4524 HMO.

A hospital’s emergency medical services do not require pre-authorization, regardless of where they are delivered. Enloe Medical Center must continue to provide services for members requiring emergency care. Coverage will be provided according to the member’s policy benefits. Anthem Blue Cross encourages members to make informed decisions about when to use urgent care as opposed to emergency room care. Urgent care is appropriate when a member needs a physician’s attention for a condition that is non-life threatening. 

For a comprehensive listing of urgent care centers please visit our website at www.anthem.com/ca/calpers.

In addition all Anthem CalPERS PPO and HMO members have access to our virtual urgent care Live Health Online.  Anthem members can have a video visit 24/7 with a board-certified doctor in minutes by using LiveHealth Online. If it’s needed, a doctor sends a prescription to your pharmacy. To access this program all members need is a smartphone, tablet, or computer with a webcam and it only costs the urgent care copay. For more information about this program please visit LiveHealth Online.

Should you have any questions or concerns, please contact Anthem Blue Cross Member Services at 1-877-737-7776, or contact the CSU, Chico Benefits team at 530-898-5436 or via email at benefits@csuchico.edu. We will update you regarding any additional information that is received.