Quick Reference Guide for Small Group and Individual Products Sold On and Off the Health Insurance Exchange
Effective January 1, 2016
Anthem Blue Cross and Blue Shield in New Hampshire
Please note: This document provides a list of small group and individual products sold on and off the Exchange only. Other products and prefixes may continue to be offered beyond January 1, 2016.
On Exchange
On Exchange Product Name
Product
Type
Network Name
Alpha
Prefix
Market
Segment
PCP selection
required?
PCP referrals
required?
Anthem Bronze Pathway X Enhanced HMO
Anthem Silver Pathway X Enhanced HMO
Anthem Gold Pathway X Enhanced HMO
Anthem Catastrophic Pathway X Enhanced HMO
Anthem Blue Cross and Blue Shield Silver DirectAccess, a Multi-State Plan
Anthem Blue Cross and Blue Shield Gold DirectAccess, a Multi-State Plan
Anthem Gold Pathway X HMO
Anthem Silver Pathway X HMO
Anthem Bronze Pathway X HMO
Anthem Bronze Pathway X HMO with HSA
Anthem Silver Pathway X HMO with HSA
Anthem Gold Pathway X HMO with HSA
HMO
HMO
HMO
HMO
HMO
HMO
HMO
HMO
HMO
HMO HSA
HMO HSA
HMO HSA
Pathway X Enhanced
Pathway X Enhanced
Pathway X Enhanced
Pathway X Enhanced
Pathway X Enhanced
Pathway X Enhanced
Pathway X
Pathway X
Pathway X
Pathway X
Pathway X
Pathway X
YGQ
YGQ
YGQ
YGQ
YGT
YGT
YGP
YGP
YGP
YGP
YGP
YGP
Individual
Individual
Individual
Individual
Individual
Individual
Small group
Small group
Small group
Small group
Small group
Small group
No
No
No
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
Off Exchange
Off Exchange Product Name
Anthem Bronze Pathway HMO
Anthem Silver Pathway HMO
Anthem Gold Pathway HMO
Anthem Catastrophic Pathway HMO
Anthem Bronze Matthew Thornton Blue HMO
Anthem Silver Matthew Thornton Blue HMO
Anthem Silver Matthew Thornton Blue HMO
Anthem Gold Matthew Thornton Blue HMO
Anthem Silver Access Blue New England HMO
Anthem Gold Access Blue New England HMO
Anthem Silver HMO Blue New England Choice
Anthem Gold HMO Blue New England Choice
Anthem Bronze Access Blue New England HMO with HSA
Anthem Silver Access Blue New England HMO with HSA
Anthem Gold Access Blue New England HMO with HSA
Product
Type
Network Name
Alpha
Prefix
Market
Segment
PCP selection
required?
PCP referrals
required?
HMO
HMO
HMO
HMO
HMO
HMO
HMO
HMO
HMO
HMO
HMO
HMO
HMO HSA
HMO HSA
HMO HSA
Pathway
Pathway
Pathway
Pathway
Matthew Thornton Blue HMO
Matthew Thornton Blue HMO
Matthew Thornton Blue HMO
Matthew Thornton Blue HMO
Access Blue NE HMO
Access Blue NE HMO
HMO Blue New England
HMO Blue New England
Access Blue NE HMO
Access Blue NE HMO
Access Blue NE HMO
YGO
YGO
YGO
YGO
YGB
YGB
YGN
YGN
YGE
YGE
YGL
YGL
YGE
YGE
YGE
Individual
Individual
Individual
Individual
Individual
Individual
Small group
Small group
Small group
Small group
Small group
Small group
Small group
Small group
Small group
No
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
Yes
Yes
No
No
Yes
Yes
No
No
No
12-7-15 Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of New Hampshire, Inc. Independent licensee of the Blue Cross and Blue Shield Association ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names
and symbols are registered marks of the Blue Cross and Blue Shield Association.
Off Exchange
Off Exchange Product Name
Anthem Bronze Matthew Thornton Blue HMO with HSA
Anthem Silver Matthew Thornton Blue HMO with HSA
Anthem Gold Matthew Thornton Blue HMO with HSA
Anthem Silver Preferred Blue PPO
Anthem Gold Preferred Blue PPO
Anthem Bronze Preferred Blue PPO with HSA
Anthem Silver Preferred Blue PPO with HSA
Anthem Gold Preferred Blue PPO with HSA
Anthem Bronze BlueChoice New England POS
Anthem Silver BlueChoice New England POS
Anthem Bronze Blue New England HMO
Anthem Silver Blue New England HMO
Anthem Gold Blue New England HMO
Product
Type
Network Name
Alpha
Prefix
Market
Segment
PCP selection
required?
PCP referrals
required?
HMO HSA
HMO HSA
HMO HSA
PPO
PPO
PPO HSA
PPO HSA
PPO HSA
HSA-POS
HSA-POS
HMO
HMO
HMO
Matthew Thornton Blue HMO
Matthew Thornton Blue HMO
Matthew Thornton Blue HMO
Preferred Blue PPO
Preferred Blue PPO
Preferred Blue PPO
Preferred Blue PPO
Preferred Blue PPO
Blue Choice NE POS
Blue Choice NE POS
HMO Blue New England
HMO Blue New England
HMO Blue New England
YGN
YGN
YGN
YGR
YGR
YGR
YGR
YGR
YGI
YGI
YGL
YGL
YGL
Small group
Small group
Small group
Small group
Small group
Small group
Small group
Small group
Small group
Small group
Small group
Small group
Small group
Yes
Yes
Yes
No
No
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
Yes
Yes
Yes
Sample ID Card for Plans Sold On or Off the Health Insurance Exchange
[Product Name]
Health Insurance Marketplace/ACA Plans Contact Information
•
•
•
Provider Call Center: 855-854-1438
Utilization Management/Pre Authorization: 800-531-4450
Claims Submission (electronic filing is preferred)
By mail:
Anthem Blue Cross and Blue Shield
P.O. Box 533
North Haven, CT 06473