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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


Networks Bigger Off-Exchange?

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Question: I just read today that in-exchange networks are different than off-exchange networks. For example, if I buy a plan from Blue Shield, they offer one network. If I buy the same plan with Blue Shield from Covered California, that network is much smaller. Is this true, and for what insurance companies?

Answer: No. Exchange carriers offer “mirrored” plans off-exchange that exactly match the Exchange plans including networks. Blue Shield offers only mirrored plans off-exchange. Anthem will offer alternative plans in addition to their mirrored plans off-exchange. Alternative plans are allowed by the ACA to foster innovation and and since they are not required to match exchange plans exactly some may offer broader networks.

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I spoke with our rep from Anthem Blue Cross and was told that all ACA compliant plans have the same Anthem network. Grandfathered and group are a different beast.

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