Anthem Blue Cross and Blue Shield

Anthem Blue Cross is the business name of better known Blue Cross of California.  It is an autonomous licensee of the Blue Cross Blue Shield Association established in Thousand Oaks, California. ANTHEM is a listed trademark of Anthem Insurance Companies, Inc.  The Blue Cross title and sign are registered characters of the Blue Cross Association. It is a secondary firm of insurance giant Anthem Inc. Anthem has more or less 800,000 clients and has personal policyholders in California than any other insurance company.

Evolution of the Anthem Blue Cross or Blue Shield

Blue Cross of California was WellPoint Health Network Inc.’s forerunner. In 1982, Blue Cross of California was created by the alliance of Blue Cross of Northern California which was established in 1936 and Blue Cross of Southern California that was established in 1937.

Later in 1992, WellPoint was shaped to run Blue Cross of California’s managed care business.1993 was the year when Blue Cross of California turned off its managed care business into an isolated publicly merchandised unit named as WellPoint Health Networks Inc. Blue Cross of California retained 80% of the business and had “approximately all” of the company’s voting stocks. In 1996, Blue Cross of California finished changing all its business to for-profit status, subsequent in a rearrangement that elected WellPoint Health Networks Inc. as its parent organization. Afterward, WellPoint Health Networks Inc. initiated heavy spreading out.

In 1996, Anthem initiated to entirely emphasis on healthcare benefits. Anthem then added 850,000 policy holders with its buying of Blue Cross and Blue Shield firms in New Hampshire, Colorado, Connecticut, Maine, and Nevada. Later in 1997, Anthem acquired Blue Cross and Blue Shield of Connecticut and Anthem Group traded According to a cluster of private financiers. In 1999, they acquire Blue Cross and Blue Shield of New Hampshire and Blue Cross and Blue Shield of Colorado and Nevada and the same year Anthem Group’s income had developed to $6.3 billion. Between its client sources were 2.4 million PPO enrollees and 964,000 with HMOs. Later in 2000, it acquires Blue Cross Blue Shield of Maine.

It was October 2001 when Anthem transformed from a mutual insurance firm in public held stock firm, which dragged it to the 4th largest public managed health care company in America. 2002 was the year when Anthem acquires Trigon Healthcare of Virginia, a Blue Cross and Blue Shield strategy in Virginia, the main insurer in Virginia, for $4.04 billion. Associated Insurance extended 11.9 million fellows.

In 2008, WellPoint had $2.49 billion of net income and $4.7 billion in 2009. In January 2008, Leslie Margolin was Anthem Blue Cross’s company president and too was chief executive officer of the company’s Life and Health associate. Joseph Swedish is presently chief executive officer of the firm.


When was the name Anthem revised?

In December 2014, WellPoint transformed its trade name to Anthem Inc. and its NYSE ticker sign from WLP to ANTM. Anthem Inc. proclaimed that it was to obtain Just Healthcare Holdings, Inc., a chief Medicaid and Medicare managed care company in Florida. Later in June 2015, Anthem declared a deal to obtain Cigna, a global health insurance service company, for more or less than $47 billion in cash and investment, July of the same month Anthem and Cigna declared that they have passed in into a conclusive agreement, worth the transaction at $54.2 billion on an enterprise source.

Later in June 2015, Anthem declared a deal to obtain Cigna, a global health insurance service company, for more or less than $47 billion in cash and investment, July of the same month Anthem and Cigna declared that they have passed in into a conclusive agreement, worth the transaction at $54.2 billion on an enterprise source.

In February 2017, a US District Court reigning jammed the Cigna merger on monopolistic grounds, then Cigna Corp. canceled its $48 billion union contract with Anthem Inc., with Anthem affirming it would remain to impose its rights below the merger contract and remains devoted to closing the deal

How Anthem Blue Cross benefit people?

It is the company natives of California have trusted for straight 70 years to help guard their health and financial security. Actually, Anthem shields 8.3 million Californians, more than any other insurer in the state. As a crew of caring characters who finance our best thoughts and efforts to make inventive health coverage resolutions that are nearby to all Californians. Anthem Blue Cross delivers customers with matchless choice and elasticity in meeting their health plan desires. These choices are frequently fine-tuned to improve

Insurance plans of Anthem Blue Cross.

Anthem Blue Cross delivers customers with matchless choice and elasticity in meeting their health plan desires. These choices are frequently fine-tuned to improve the entrance to reasonable, quality health care.

Exclusive products offered in the separate, small and large group, senior and MediCal marketplaces take in a full series of combined medical and specialty products. Their products consist of:

-BeneFits – the innovative portfolio with distinct provisions and an exclusive education and registration site for small businesses.

-Dental, vision, life and incapacity coverage.

-360o Health Management Program, is a remarkable set of wealth, programs, tools and services to aid our Small  Group associates to achieve their own individual healthy best.

Accreditations of Anthem Blue Cross

-Anthem Blue Cross HMO/POS is known as a Brilliant Certification status from the National  Committee for Quality Assurance (NCQA).

-Anthem Blue Cross PPO is the first and remains to be the only PPO in California to have received a Full Accreditation from the NCQA5. Full Accreditation is the uppermost level reachable for a PPO.

-In 2008 Anthem Blue cross launched the Zagat Survey online platform, which will permit clients to share their physician experiences with others people. The survey and consequences will be obtainable free of any fee to members via their health plan’s website.

How does Anthem Blue Cross focus on quality?

-Anthem Blue Cross funds many research studies at California universities, reaching from the efficiency of initial cancer screenings to growing immunization charges between children and the aged.

– To state California’s increasing variety, Anthem is also creating healthy living more reachable to the Hispanic municipal through, our revolutionary Web site.

-We are pleased to venture with the California Governor’s Council on Physical Health and Sports via the “Live like a Champion” and Kids in Charge of Kalories programs.

What is the Provider Network Education plan of Anthem Blue Cross?

The Provider Network Education team of Anthem Blue Cross presents quality educational packages and tools specially planned for the office staff of physicians, hospitals, and medical groups, auxiliary and other health care specialists. These free programs deal ‘blended learning’ via face-to-face and web-based knowledge chances entirely for our contracted provider network. For a whole agenda of the sessions, webinars, on-demand e-courses, and education solutions keep viewing their website.


Chances for Anthem Blue Cross staff to encounter with you face-to-face and debate extremely valuable info that can help streamline your communication with Anthem Blue Cross. We inspire all office managers, promoting and processes staff at physician offices, facilities, ancillary and other healthcare specialists to join.

For viewing the plan and register for an occasion in your area. The booklet will deliver details of the content that will be covered in these conferences.


Live and communicating conferences through the internet and eased by the Provider Network Education team and Subject Matter Specialists. You can also register yourself for more than one session.

Webinar Recordings aka “Listening Library”

You can listen to a recorded webinar assembly through the internet assisted by the Provider Network Education team. They offer a range of topics, so at your ease, you just need to simply click the subject of your choice, then look out and listen to the recording! The audial will come via the speakers on your computer; you will require headphones to hear the audio.

How to request a Copy Webinar Recordings?

If you need a copy of a recorded webinar conference, you need to select a topic from the list and send an email request, containing your topic, too: [email protected]

The topics include:

  1. Behavioral Health Practitioner & Office Staff Orientation
  2. BlueCard (Out-of-Area) Refresher
  3. Provider Manual Overview (Professional)

Supplemental Education Materials (SEMs)

SEMs are self-service orientation tools that deal a broad library of numerous topics relevant to Anthem Blue Cross corporate processes. These SEMs are obtainable in pdf layout – easy to outlook, download, or print and share.

The Provider Home of Anthem Blue Cross

You can submit Inpatient and Outpatient precertification applications online with Interactive Care Reviewer – and make inquiries on earlier submitted cases.

The Interactive Care Reviewer (ICR) presents an efficient precertification procedure. Obtainable to ordering and examining physicians and services requesting inpatient and outpatient medical and social health services for many participants covered by Anthem Blue Cross. You also can ask to find info on a request previously submitted by phone, fax, ICR or other online devices.

Controversies against Anthem Blue Cross

The insurance as of other businesses was a talk of the town for many controversies:

Giving for uninsured

It was 2007 when WellPoint assured to expend $30 million over three years, by means of the company’s charitable establishment, to aid the uninsured. So in March 2010, the Los Angeles Times stated that WellPoint’s tax histories and website displayed that the business gave only $6.2 million until 2009. The company was dubious that, saying that the foundation did accomplish its $30-million pledge by mid-2009, but deteriorated to deliver any economic details to support its position.

Policy cancellations

The California Department in 2007 Managed Health Care (DMHC), a California national controlling agency, inspected Anthem Blue Cross’s strategies for rescinding (revoking) health care insurance plans. The DMHC unsystematically selection of 90 examples where Anthem Blue Cross gave up for lost insurance of policyholders who had been identified with expensive or life-threatening diseases, to discover how many of these annulments were permissible. The agency decided that all these annulments were unlawful. “In all 90 files, there was no indication that Blue Cross, before annulling coverage, inspected or recognized that the candidate’s omission/perversion was deliberate,” the DMHC report said.

Anthem Blue Cross in July 2008, decided to a settlement with the California Department of Managed Health Care. To finish the claims of inappropriate policy rescissions (annulments), WellPoint funded $10 million and restored 1,770 policy-holders whose plans they had annulled. They also settled to deliver benefit for any medical debts experienced by these policy-holders in the intervening time. Though, WellPoint did not legitimately confess obligation.

Then in April of 2010, a report in Reuters suspected that Wellpoint “by means of a computer procedure, recognized women lately identified with breast cancer and then singled them out for annulment of their policies plans.” The fact not only triggered substantial public atrocity, but the then Secretary of Health and Human Services, Kathleen Sebelius, and President Barack Obama, to demand on WellPoint to conclude the exercise.

Anthem Blue Cross in 2011 initiated withdrawing policies of participants who had been paying payments with credit cards, from time to time without calling or emailing the fellow ahead of time.

Resistance to health care reforms.

The WellPoint’s previous Vice President for Public Policy and External Affairs, known as Elizabeth Fowler, is the High-ranking Counsel to Max Baucus, the chairman of the Senate Finance Committee and a chief rival of the public choice in health care reform.

However, in August 2009, WellPoint’s Anthem Blue Cross unit, the major for-profit guarantor in California, communicating its staffs and advise them to get involve in competing with Congress’ plan for health care reform. Consumer Watchdog, a non-profit making watchdog association in Santa Monica, requests California Atty. Gen. Jerry Brown to examine its right that WellPoint had unlawfully strap workers to write to their elected politicians.

Gen. Jerry Brown to examine its right that WellPoint had unlawfully strapped workers to write to their elected officials, appear in town hall meetings and recruit family and friends to guarantee an repair that matches the company’s interests. As of the Consumer Watchdog, California’s employment code straight away forbids forced communications, containing neglecting bosses from regulatory, forcing or influencing employees’ political doings or associations. WellPoint had not been communicating by the California attorney general and had not seen any objection.

While in 2010 and 2011, WellPoint senior executives encountered once-a-month with officials of other main health guarantors to dull the result of the health care reform law.

2009 premium growth in Maine

Anthem Health Policies of Maine, a WellPoint subsidiary, take legal action in the state of Maine for the right to raise premiums more. In the meantime Maine licenses insurance firms by the means of its Department of Insurance, Anthem would require the state’s approval to promotion rates. The Law Court differed with Anthem and discovered that different other methods of insurance, the Maine Insurance Code do not involve the Supervisor to think through the profits at all.

2010 premium growth in California

Later in February 2010, WellPoint declared that some Anthem Blue Cross discrete plans in California would get a rate rise as great as 39%. This statement gives rise to in an inquiry by the US Federal and California government watchdogs. For the reason that of this, Anthem Blue Cross extended internationally by media consideration and developed a poster child for the trick of increasing US health charges, when it declared that it was rising charges on certain discrete plans holders by as far as 39% as of March 2010. The ratio rise comes from one year later Anthem had raised rates 68% on discrete plan holders. This statement resulted in an inquiry by the US Federal and California government watchdogs.

To describe the newest rate growths, several which were four times the ratio of medical inflation, Anthem suppose the company has qualify a death spiral, as jobless and decreasing salaries led healthy clients to leave their insurance, the residual risk pool develops sicker and more costly to insure, and, in order, rates are enforce up and push more individuals out of the market.

In reaction to the atrocity from politicians and clients, Anthem suspended the ratio growth till May 1, 2010. Particular Anthem’s rate growth policies, Senator Dianne Feinstein, Democratic Senator from California, has planned to give the federal government authority to block protection premium climbs measured to be “baseless”.

Reclassifying expenditure

It was 17th March 2010, when WellPoint declared it was reclassifying several of its managerial costs as medical care costs in order to encounter new loss ratio desires below the health care law, which entails guarantors to devote at least 80% or 85% of client premiums on health care facilities, dependent on the sort of policy.

2009-10 security breach

Then in June 2010, Anthem Blue Cross sent mails to 230,000 clients in California cautioning them that their private data might have been retrieving online. Afterward a routine upgrading in October 2009, a third-party merchant specified that all safety processes had been appropriately restoring, whereas in actual fact they had not. As an outcome, private info of thousands of coverage candidates who were below the age of 65 was uncover in the open. Afterward, a Los Angeles-area female discover that her request for coverage was openly accessible, she filed class-action litigation contrary to Anthem Blue Cross. Although collecting proofs for the case, the woman’s trial lawyer copy some private client info from Anthem’s website and warns Anthem about the opening. According to the statement of lawyers, private information had lingers out in the expose for five months.

Denying benefits

After the security breach in May 2014, Anthem Blue Cross rejected to compensate for the hospitalization of a Sonoma Region, California man suffering from stage four cancers, even though he had funded Anthem over $100,000.00 in payments. Anthem concluded up paying for treatment following a public uproar.

2015 medical data breach

The last controversy took place on February 4, 2015, Anthem Blur Cross, Inc. revealed that felonious hackers had wrecked into its servers and possibly stolen more than 37.5 million records that comprise individually recognizable information from its servers. According to Anthem, Inc. statement, the data breach prolonged into numerous brands Anthem, Inc. uses to advertise its healthcare policies, containing, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Georgia, Empire Blue Cross and Blue Shield, Amerigroup, Caremore, and UniCare. Healthlink states it was also a prey. Anthem declares the medical info and financial data was not give in.

Anthem has presented free credit observing in the wake of the breach. Bloomberg News states China may be answerable for this data breach. Michael Daniel, chief mentor on cybersecurity for President Barack Obama, thought he would be altering his own PIN. The New York Times publish that around 80 million business records were hack, and there is the terror that the embezzle data will be use for identity theft. Later on February 7, 2015, in USA Today Elizabeth Weise pens that the give in information was restrict to names, birthdays, medical IDs, social security numbers, street addresses, e-mail addresses and employment information, as well as revenue data only.