Understanding Anthem's Network Options for 2025 Plans

Anthem offers 11 different plan designs in 2025 on a fully-insured basis to CT small groups:

• Bronze HSA 8000

• Silver HSA 4500

• Silver HSA 3500

• Gold HSA 2000

• Silver PPO 4500

• Silver PPO 4000 Value

• Gold PPO 2500

• Gold PPO 2000 Value

• Gold PPO 1500

• Gold PPO 25

• Platinum PPO 20

Groups purchasing level-funded coverage through Anthem will have similar choices in 2025.

The popular PPO 5000, PPO 4000, PPO 3000, and PPO 2000 plans from 2024 have all been migrated to similar options for 2025, such as the PPO 4500 and PPO 2500. The largest difference in 2025 is the size of the network associated with the plan. In 2024, each plan included in-network access to providers in Connecticut and throughout the country.

Each plan design in 2025 will have Pathway (Connecticut only) or Century Preferred (national) associated with it, indicating how much access is included. According to Anthem, roughly 85% of the claims they pay are to providers based in Connecticut. While Pathway options will include a local network, emergencies will be covered worldwide, and out-of-network benefits are still included. These are not HMO plans that require referrals.

Employers will be allowed to mix and match options. As an example, an employer can offer the Gold PPO 2500 with both network options. It will then be up to the employee to decide which of the two makes the most sense for them and their family. Along with that strategy, employers can subsidize the plans differently. The Pathway option may be the "core plan", allowing the employee to buy-up to the Century Preferred. Note that employees will not be able to change plans/networks mid-year in most instances.

Have questions about your options? Please contact the broker you are working with. If you are unsure of who to contact, email Benjamin Klein (bklein@tzedakah-house.com).