Window shopping for Individual and Family 2025 Open Enrollment starts soon on anthem.com. Open Enrollment starts November 1, 2024, and runs through January 15, 2025.
We’re here to help you connect your clients to a health plan that offers the savings and care they need. Benefits include $0 preventive care,1 $0 virtual care visits,2 $0 for many brand and generic prescription drugs,3 and rewards for healthy behaviors. Plus, our Sydney Health app gives members their health information, resources, and well-being support in one convenient place.
Important update for 2025
Members who qualify and are enrolled in 2024 bronze plans may be enrolled in a 2025 Silver plan by the Marketplace. If they prefer to keep their bronze plan or choose another plan, they must enroll in the preferred plan by December 15, 2024.
2025 Open Enrollment Renewal materials
Your clients will receive their personalized Open Enrollment renewal packets by mail. The cover letter includes information on how members can find out if they qualify for financial help or make sure they receive all the savings available to them. Visit Producer Toolbox, select Book of Business, then select Renewals to view the Renewal Letter link for a specific client.
Discontinued plans for 2025
Anthem is discontinuing Blue Preferred POS plans for on- and off-exchange plans in select counties effective January 1, 2025. Anthem will not offer POS plan options in Rating Areas for 8 exiting counties starting in 2025. Members will be notified by mail of this POS product plan withdrawal and directed to shop for a different plan during open enrollment or special enrollment period. These members will qualify for a Special Enrollment Period (SEP) of 60 days from January 1 to March 2, 2025.
Impacted members can choose a different medical plan during Open Enrollment or a Special Enrollment Period. Because their plan is ending on December 31, 2024, members qualify for a Special Enrollment Period and may enroll in a new plan from January 1 through March 2, 2025.
Rating Areas, Existing County Names, and Codes:
- 4 – Dunn (033)
- 6 – Trempealeau (121)
- 10 – Portage (097)
- 11 – Fond Du Lac (039)
- 13 – Oneida (085)
- 14 – Jefferson (055)
- 15 – Juneau (057)
- 16 – Marinette (075)
Heart Healthy Plans and Benefits
2025 plan names will include “Heart Healthy.” Related benefits include office visits to cardiologists with copays the same as those for primary care physicians, and nutritional counseling. Certain heart tests will be covered at no cost, including Cardiac Calcium Scoring, Carotid Intimal Medial Thickness, and High Sensitivity C-Reactive Protein, which can range in cost from $8 to $350. Heart-healthy benefits will be communicated at renewal to appeal to existing members, improve health, avoid heart disease, and identify risks.
Standard Silver Plans low-cost options
Members enrolled in 2024 Standard Silver plans were renewed into 2025 Standard Silver plans. Members will be eligible to renew into an alternative lower-cost option in 2025.
Primary Care Provider
Primary Care Providers (PCPs) are mandatory for HMO/POS ACA plans in 2025. PCPs will be automatically selected during renewals for mandatory PCP benefit changes. Members can change PCPs at any time.
Tips & tools to help you and your clients
- Members can review their personal information, premium, and whether they qualify for financial help on myanthemchoices.com.
- Members must pay the full amount of their January bill on time, including any past-due amount, to make sure their 2025 coverage begins January 1, 2025.
- Enrollment-Renewal Reference Sheet includes helpful enrollment and renewal information.
- Our Wisconsin map shows current coverage areas.4
- View ACA rate sheets and generate client reports in Producer Toolbox.
We’re here to help you connect your clients to affordable Anthem health plans. If you have questions, please contact Broker Services at 833-864-0133, or agency.services@anthem.com.
Thank you for your partnership and dedication to your Anthem clients.
1 Nationally recommended preventive care services received in-network have no copay and no deductible requirement.
2 Virtual care visits, including medical chats and video visits using the Sydney Health app are at no cost to members for most plans. Those enrolled in High-Deductible Health Plans associated with a Health Savings Account must first meet their deductible. Virtual care visits refer to medical chats and/or video consultation, as deemed appropriate by a licensed physician. In addition to using a telehealth service, members can receive in-person or virtual care from their own doctor or another healthcare provider in their plan’s network. If members receive care from a doctor or healthcare provider not in their plan’s network, their share of the costs may be higher. Members may also receive a bill for any charges not covered by their health plan. Sydney Health is offered through an arrangement with Carelon Digital Platforms, a separate company offering mobile application services on behalf of their health plan.
3 Some commonly used prescription drugs are available at no cost to members. Contact us for more information.
4 Individual Marketing collateral for plan year 2025 will be available to access on October 1, 2024.