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Office of the Chancellor

Anthem Plans and Dignity Health

July 21, 2021
Dear Colleagues,
 
We need to inform you that the contract between Anthem Blue Cross, the insurance carrier of the University of California’s commercial PPO (non-Medicare) plans, and Dignity Health, a health care provider that includes Mercy Medical Center Merced, ended effective July 15.

This affects members of the following UC PPO plans: UC Care, Health Savings Plan, and CORE.

This is deeply disappointing news, especially in the midst of a continuing pandemic.

We recognize that this contract termination and the resulting uncertainty of when and or if a resolution might be reached has significant impacts on many members of the UC Merced community and their families. We remain hopeful that Anthem and Dignity will come to agreement on mutually beneficial terms. Campus leadership is working closely with the UC Office of the President, which manages the systemwide benefits program, to develop guidance for affected UC PPO members.

We will communicate with you about this evolving situation as new information becomes available. Please contact UC Merced’s Benefits Office at benefits@ucmerced.edu for other questions you may have.

If you are a member of an Anthem PPO plan and received care from Dignity Health providers or Mercy Medical Center after 5 p.m. July 15:
  • Claims for services received will be processed at the out-of-network coverage tier.
  • Annual deductible amounts are higher for out-of-network care.
  • Higher out-of-network co-insurance rates, except for services pre-approved under the continuity of care rules described below, will be the patient's responsibility.
  • The patient may be responsible for the balance of costs above the allowed amount for care received from non-network providers.
  • Emergency medical services do not require pre-authorization regardless of where services are delivered. Members may go to any hospital for emergency services, including Dignity Health.
If you are currently receiving care:
Under California's continuity of care rules, some Dignity Health/Mercy Medical Center patients may continue to receive limited care from Dignity Health providers. Continuity of care must be requested by the member and is subject to approval by the medical plan. Anthem Blue Cross, at the enrollee's request, must provide for the completion of the following covered services:
  • For an acute condition
  • For a serious chronic condition
  • For the duration of a pregnancy
  • For the duration of a terminal illness
  • For the care of children between birth and 36 months
  • For surgery (or other procedures) that have been authorized by the plan or its delegated provider and is scheduled to occur within 180 days of the contract's termination date
To request continuity of care, patients should call the health plan number on the back of their UC PPO plan member ID cards or contact Anthem Health Guide to get help from your dedicated concierge team serving UC PPO members. 
  • Anthem Health Guide, toll-free, at (844) 437-0486.
  • Monday through Friday, 5 a.m. to 8 p.m. (Pacific). 
  • Pharmacy representatives are available 24/7.
You can find summaries of in-network and out-of-network summary charts linked below.
More information about your benefits is available at the UC PPO plan website.