Anthem 2020

Anthem will become Miami's health plan administrator beginning January 1, 2020. This transition will also include a change from OptumRx pharmacy to IngenioRx for pharmacy benefits. 

See more about Anthem in 2020!

FAQ About the Change to Anthem

Why did Miami make the change?

Miami completed a “request for proposal,” or RFP, earlier this year to explore opportunities for enhanced services, network management and other resources to offer greater value to employees and their families. Miami offers comprehensive benefit package to attract and retain employees and employee health benefits are important. 

What health plans will be offered?

Miami will continue to offer the PPO and the High Deductible Health Plan (HDHP) with an HSA.

What do I need to do to enroll?

You will receive open enrollment information by mail to your home in mid-September. Review the changes that Anthem brings and other available benefits. Then, enroll in your health plan during open enrollment period between October 7 and October 31.

If you choose not to complete open enrollment by 5 pm on October 31, you will continue in the plan (PPO or HDHP) you are in today with the same tier (single, employee plus, or family) in 2020,  and your new ID cards will come from Anthem in mid-December.

When will I receive my new Anthem ID card?

New ID cards will be mailed to your home address in mid-December. Confirm and/or update your mailing address in BannerWeb prior to October 31.

Will I have to change my doctor?

Most likely, no. There is a 99.2% provider match from UMR to Anthem, which means most employees and their covered family members will not need to change providers to stay in-network. Anthem will be on campus during the Benefits and Wellness Fairs on October 2 and 3 to answer any questions. Additionally, Anthem's physician finder is an excellent tool for you and your family.

What if I am in the middle of a specific treatment?

Transition of care (TOC), also known as continuation of care, allows members who are in treatment for conditions like maternity, dialysis, or chemotherapy to continue that care until it is complete. If you or a covered dependent will be in the middle of a specific treatment going into January, and believe that you will need the TOC, please complete this online Request for Information form. We can then let Anthem know to send you the information that you will need to process the TOC before December 20.

If your physician is in both the UMR and Anthem network, you need only present your Anthem ID card to your provider in January so that your record can be updated and future claims will be directed to Anthem.

Will I have to change my health savings account (HSA)?

No, your HSA will continue to be administered through Chard Snyder. New debit cards are issued when your current card expires.

What tools and support will Anthem offer to help me manage the changes?

On October 1, employees will have access to the Anthem Health Guide (1-833-995-1483) which is  a team of dedicated customer service representatives that can be reached by phone as well as an online provider finder tool. Until January 1 when our plan goes into effective, the Health Guide will only be able to answer questions about network providers. Anthem representatives will also be available at the Benefits and Wellness Fairs on October 2 and 3.

Beginning in the spring of 2020, Anthem will offer an online transparency tool called Engage. This is an integrated online health platform that creates a personalized member experience by connecting health plan and benefits data with individual data and information pulled from health and wellness apps. Engage will also help you make better cost and quality decisions when accessing care. 

What will happen to my health insurance?

Miami employees will continue to have access to the same health plan options as in 2019: the preferred provider organization (PPO) or high deductible health plan (HDHP). As part of Miami’s commitment to offer high-quality and affordable health care benefits, the premium calculations for Anthem’s PPO and HDHP plans will remain the same in 2020.

The employee contribution is calculated from a percentage of the employee’s annual salary, plus the plan and coverage level the employee selects. While the percentage of salary used to calculate the premium will not change, employees who saw their pay increase as of October 2019 will see only a corresponding change in their health care premium contribution effective January 2020. For those employees who enroll in the HDHP, Miami’s contribution to employees’ health savings accounts (HSA) will also remain the same. To figure your premium amount use our online health premium calculator.

Will my asthma drugs and diabetes supplies and drugs be covered at a discount or zero copay?

Yes, tier 1 and tier 2 asthma, diabetes drugs, and diabetic supplies will continue to be covered at 100%. Those in tier 3 or 4 will fall under the associated copay or deductible.

Will hospitals be tiered?

Yes, but instead of the 3 tiers in-network that we had with UMR, there will only be 2 tiers in-network, with coverage of 90% for a tier 1, and 80% for a tier 2 facility. The penalty for using tier 3 hospitals under UMR will be removed. The chart below indicates the facilities under each of the tiers beginning January 1, 2020.

Tier 1 and Tier 2 Facilities

Tier 1 (90% coverage)

Tier 2 (80% coverage) Out of Network

Dayton Children's Hospital

TriHealth Hospitals

Bethesda North Hospital
Good Samaritan Hospital
Bethesda Butler Hospital
TriHealth Evendale Hospital
McCullough-Hyde Memorial Hospital

Kettering Hospitals

Fort Hamilton
Grandview Medical Center
Greene Memorial
Kettering Medical Center
Soin Medical Center
Southview Medical Center
Sycamore Medical Center
Troy Hospital

Ohio State University Med Center

The Christ Hospital

Cincinnati Children's Med Center

Mercy Health Hospitals

Anderson Hospital
Clermont Hospital
Fairfield Hospital
West Hospital
The Jewish Hospital

Premier Health Hospitals

Atrium Medical Center
Miami Valley Hospital
Miami Valley Hospital North
Miami Valley Hospital South
Upper Valley Medical Center

UC Health Hospitals

UC Medical Center
West Chester Med Center
Drake Rehabilitation
Lindner Center of HOPE

Reid Hospital (IN)

Network facilities outside OH

All other non-network facilities

Anthem Resources

  • Call Anthem Health Guide at 1-833-995-1483 to find in-network providers
    • In Ohio, Blue Access Options PPO
    • Outside of Ohio, National PPO (Bluecard PPO)
  • Search for a provider at Anthem.com
    • Under "Find a Doctor: search by plan
      • Choose Medical
      • Choose the State you are searching in
      • Type of plan is Medical (Employer-Sponsored)
      • Plan/Network is Blue Access Options PPO
  • The Health Guide will be available beginning January 1 for specific plan questions
  • View the Anthem PreventiveRx Drug List