Anthem BCBS networks for a small employer in CO with remote workers
I work for a very small employer in Colorado and I've been tasked with setting up small group health insurance for our company. Most of our employees are here in CO, but we also have remote workers (in New York currently) and expect to add more in other states.
I've been working with our broker and he's provided us quotes for a big range of plans with an even bigger range of networks. As of right now, we're pretty focused on Anthem plans as they seem to offer the best bang for the buck. Understanding coverage for in-state is easy – the different networks are kind of tiered in price, with different groups of providers, depending on the cost of the plan.
My big question relates to remote workers that live out of state. I'm trying to understand which networks would allow them to see their local providers as in-network.
It seems like the Anthem PPO network is pretty rock-solid on that. I think that with those plans an out-of-state remote worker could have in-network coverage at most BCBS providers.
But I've been told different things about the Anthem Pathway EPO – by the broker and by documentation I've found online. So, I've reached the point where I'd like some outside input. When I called Anthem directly they said they can't answer any questions since I'm already working with a broker.
In my research, I've been consulting these two documents:
CO Networks at a Glance
CO Networks Overview (for Providers)
Some example plans that are identical other than network:
Anthem PPO Bronze – 6U9Y
Anthem Pathway EPO Bronze – 6U78
Based on initial conversations with the broker (and on my understanding from the CO Networks Overview document) it seemed like the Pathway EPO network would allow the remote workers to access the standard Anthem PPO network when out of state (though they'd need to use the Pathway-specific providers when in state). However, last time I spoke with the broker he said that the rules changed and that now Pathway EPOs can NOT be used out-of-state.
Is anyone familiar with this really niche Colorado/Anthem/Remote Work specific question? I'm struggling here and hoping to be able to offer plans by April 1.
submitted by /u/asset_mgmt
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