Health Insurance Marketplace / Affordable Care Act
Quick Reference Guide
Health Insurance
Marketplace
for Missouri plans effective January 1, 2015
The Affordable Care Act (ACA) compliant plans only apply to Individual and Small group business
Difference between plans purchased: “On the Exchange” or “Off the Exchange”
•
On the Exchange - refers to Individual and Small Group plans purchased through the Health Insurance
Marketplace.
•
Network Names
Alpha Prefixes for
Health Insurance
Marketplace / ACA
plans
Off the Exchange - refers to Individual and Small Group plans purchased through other channels such as a
broker, sales agent, or directly through a health insurance company
Network Name for plans sold ON Exchange:
• Pathway X, Pathway X with Dental, Blue Preferred
Network Name for plans sold OFF Exchange:
• Pathway, Pathway with Dental, Blue Preferred, Blue Access, Blue Access Choice
On Exchange
Alpha Prefix Health Plan Benefit Option
Product Type Network Name
(which will appear on Member ID card)
YCH
Individual
PPO
Pathway X
JWZ
Individual
PPO
Pathway X
JWU
Small Group
PPO
Blue Preferred
Off Exchange
Alpha Prefix
JWY
YCB
YCC
YCD
YCE
Sample Member ID
Cards
Health Plan Benefit Option
Product Type
Individual
Small Group
Small Group
Small Group
Small Group
PPO
PPO
PPO
PPO
PPO
Network Name
(which will appear on Member ID card)
Pathway
Blue Preferred
Blue Access
Blue Access Choice
Blue Preferred
Front of member ID card (sample)
Product Name
Note: This sample
is from 2014, as
2015 sample cards
are not available
yet.
The templates will
be the same with
the exception of the
Product Names and
Network Names will
be updated with
the new naming
convention.
Back of member ID card (sample)
Missouri 4-15
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Naming Structure:
Health Insurance
Marketplace/ACA
plans Contact
Information
•
•
Provider Services for Exchange plans: 1-855-854-1438
UM Pre Authorization: 1-800-992-5498
Claims Mailing Address:
Anthem Blue Cross and Blue Shield
PO Box 187
Atlanta, GA 30348
Anthem Blue Cross and Blue Shield is the trade name of: In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Missouri
(excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT
and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide
administrative services for self-funded plans and do not underwrite benefits. In Ohio: Community Insurance Company. In Wisconsin: Blue Cross Blue Shield of Wisconsin
(BCBSWi), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation (Compcare), which underwrites or administers
the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees 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 the registered marks of the
Blue Cross and Blue Shield Association.
Missouri 4-15
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