Anthem Medical Plans

UMG offers two medical plans through Anthem, the Co-Pay (EPO) and PPO plans, which are available to employees nationwide. These Anthem plans use the same network of providers, so the list of doctors and facilities does not change depending on the plan.

Anthem Co-Pay (EPO)

With the Anthem Co-Pay (EPO) plan, you don’t need to select a primary care doctor or referral to see specialists. You will experience comprehensive care with lower premiums and co-pays, but you must use in-network providers and facilities (except in true emergencies). This plan works well for those who prefer to stay within Anthem’s extensive network of providers.

Anthem PPO

The Anthem PPO plan provides more flexibility, covering both in-network and out-of-network providers (after you meet the out-of-network deductible). Like the EPO plan, it does not require a primary care doctor or referrals for specialists. However, it comes with higher premiums and coinsurance, and you may be responsible for any balance billing from providers. For those who anticipate seeing a provider that does not accept insurance or is outside of Anthem’s network, this plan provides that option.

Insurance cards

You will receive your medical ID card in the mail about 2-3 weeks after enrolling in benefits. You can access your insurance cards online using these instructions.

You can register for an account for online access to your ID cards, medical and Rx benefits, claims status, and more.

How to get care

You may find in-network providers on Anthem’s website and search for the provider you need. From there, you can contact providers and schedule an appointment with them directly.

If you see an out-of-network provider, you will be responsible for meeting the out-of-network deductible before the plan begins contributing, up to your coinsurance. You will also be responsible for any amounts the provider charges above the reasonable and customary (R&C) rate. You can submit your out-of-network claims using these instructions.

Hinge Health

Hinge Health is included in Anthem plans at no cost to provide exercise therapy programs at the tip of your fingers. To learn more, visit Hinge Health.

LiveHealth Online

LiveHealth Online lets you have a virtual consult with a doctor at no out-of-pocket cost for Anthem members. View more information here.

Anthem Digital Access – Sydney Health App

Get the Anthem Sydney Health app to have access to your digital ID card, see an overview of your account, and see plan details.

Traveling Internationally?

You can take your health benefits with you when traveling outside the U.S. through the BlueCard WorldWide program.

View more information on how to access care internationally here. You can visit the BlueCard Worldwide website to find doctors abroad.

AllClear Identity Repair Included with all Anthem Plans

AllClear Identity Repair is automatically available to all employees and covered dependents enrolled in an Anthem Medical Plan. No additional enrollment required.

Call AllClear ID at 1-855-227-9830 at any point while you’re an active medical health plan member if you need help.

Visit AllClear’s website and view AllClear FAQs here.

Out-of-Network Anthem Claims

Submit your claims online using the instructions at this link or submit your claim form via mail using this medical claim form or Rx claim form.

Anthem Resources

 

Have questions on your benefits?

Contact the UMG
Benefit Service Center
at (888) 526-2794
from 8 am – 5 pm PT.

Anthem (Policy #170167)
Phone: 800-690-0512
Website: anthem.com/ca

Medical plan comparison

Anthem PPO
Anthem PPO
Anthem Co-Pay
Kaiser HMO
Plan Features
In-Network
Out-of-Network
In Network Only
In Network Only
Annual Deductible
None
$750 per member
$2,000 per family
None
None
Annual Out-of-Pocket Maximum
$1,500 per member
$3,000 per family
$3,000 per member
$9,000 per family
$800 per member
$2,400 per family
$1,500 per member
$3,000 per family
Lifetime Maximum
Unlimited
Unlimited
Unlimited
Unlimited
Preventive Care
No co-pay
30% coinsurance*
No co-pay
No co-pay
Primary Care
$20 co-pay
Not covered
$20 co-pay
$15 co-pay
Telehealth
No co-pay (LiveHealth Online)
30% coinsurance*
No co-pay (LiveHealth Online)
No co-pay (Kaiser Video Visit)
Specialist
$40 co-pay
30% coinsurance*
$30 co-pay
$30 co-pay
Urgent Care
$20 co-pay

30% coinsurance*

$20 co-pay
$15 co-pay
Emergency Room
$100/visit (waived if admitted)
$100/visit (waived if admitted)
$100/visit (waived if admitted)
$100/visit (waived if admitted)
Mental/Behavioral Health (Outpatient)
No co-pay
30% coinsurance*
No co-pay
$15 co-pay
Mental/Behavioral Health (Inpatient)
10% coinsurance
30% coinsurance*
$200 co-pay
/admission
$100 co-pay
/admission
Inpatient Hospitalization
10% coinsurance
30% coinsurance* (lifetime maximum of $30,000/member)
$200 co-pay
/admission
$100 co-pay
/admission
Outpatient Surgery
10% coinsurance
30% coinsurance*
No co-pay
$30/
procedure
Infertility Services
10% coinsurance (lifetime maximum of $30,000/member)
No co-pay (lifetime maximum of $30,000/member)
Please review the SPD for specific services and coverage.
Lab & X-Ray
10% coinsurance
$142
No co-pay
No co-pay
Anthem PPO
Anthem PPO
Anthem Co-Pay
Kaiser HMO
Your 2025 Monthly Cost for Coverage**
Your 2025 Monthly Cost for Coverage**
Your 2025 Monthly Cost for Coverage**
Your 2025 Monthly Cost for Coverage**
Your 2025 Monthly Cost for Coverage**
Employee Only
$355
$355
$113
$137
Employee + Spouse
$333
$333
$250
$282
Employee + Children
$469
$469
$233
$237
Employee + Family
$328
$344
*30% coinsurance of plan allowed charges; out-of-network providers may balance bill for additional fees.
**Pre-tax payroll deduction.

Have questions about your benefits?

Contact the UMG Benefits Service Center at (888) 526-2794 from Monday to Friday 8 am – 5 pm PT.