2025 Elevance Early Look

• 115M total lives served
• 14 states or BCBS branded,  other 7 are various to round out at 21.
• New site – AgentPulse is where the first looks can be obtained.
• 26 locations with Medicaid Plans
• OH, KY, IN, MO, WI – HMO plans in these state share a network.
• #2 nationally in SNP market.
• 24 markets with Medicare Presence, 26 Medicaid markets.
• NEW: Partnering with BCBS of Kansas and BCBS of Kansas City
• Expanding DSNP plans with a simple combined allowance that includes Groceries, OTC*, Utilities and Assistive Devices
• DSNP plans with $0 Co pays in every county in their DSNP footprint
• Expanding MA footprint,  covers more than 3 out of 5 Eligibles nationally.
• Improving access to dental providers with OON dental benefits

CMS Final Rule

• SEP changes for DSNP and Declared disaster moving from quarterly to monthly.

Inflation Reduction Act

• 2025 changes:
  • Initial Coverage – New Drug manufacturer discount of 10% on brand drugs
  • Coverage Gap – Eliminated
  • Out-of-pocket – Capped at $2,000
  • Good for high utilizers,  negative for low.

Updated Prescription Drug Coverage

• Making Formulary Changes that reduce member cost and improve experience
  • Moving Key drugs to lower tiers (e.g. diabetes)
  • Increasing the number of drugs on Tier 2
  • Lowering generic copays on T1 and T2 – ensuring access

Everyday Options Allowances (EOA) – Embedded Benefits

• Single card for members to use across offerings (i.e. Groceries, OTC, Utilities and Assistive Devices)
• Combined Allowance increases options and provides greater flexibility
• Brand + Generic OTC* FL offers 3, OTC benefit is a separate benefit and not included in EOA
• Lead DSNP plans to include the expanded EOA

Key State Highlights – 4 out of 5 Medicare Beneficiaries prefer to buy from a broker/agent.

• California
  • Prime HMO plans in 5 more counties including expansion into Marion and Stanislaus
  • Lead DSNP plans with EOA and all RX at $0
  • Launch of Lung CSNP plans in 3 counties.
  • DSNP PPO offering with focused service area in 7 counties
• Florida
  • #1 CSNP Market Share
  • #3 DSNP and HMO Market Share
  • Fast growing state with 5M eligibles, ELV, FL grew 2x AEP24 market average at 4.6%
  • Robust portfolio including HMO, DSNP, CSNP & PPO
  • Maximum HMO Part B Giveback plans available
  • Designation as a Highly Integrated Dual Eligible Plan (HIDE)
  • All plans offer generous OTC, Vision, Hearing, and Enhanced Dental

• Georgia
  • $0 PPO expansion into 24 new counties
  • New Lead PPO plans to enhance product portfolio
    • Full and partial DSNP plans with EOA options and RX a $0
    • New MAPD and MA only PPO plans with up to $130 Part B giveback
    • $0 MAPD PPO embedded EOA for Groceries, OTC, Utilities, and Assistive Devices
  • Plan Consolidations to simplify product offerings
  • HMO-POS plans include OON Dental Coverage to improve access to dental providers
  • PPO plans provide OON access through BlueCard Network
  • Strong Commercial presence with over 50% market share,  offering a great opportunity for conversion
• Indiana
  • Over 130k MA members with 24% market share
  • 1 out of 4 beneficiaries are with Elevance.
  • Full, Partial and Integrated DSNP plans with EOA all RX at $0
  • $0 Premium plans include lower MOOPS and essentials Extras with groceries
  • Enhanced Chronic Care SNP in Marion County
  • HMO-POS Plans include OON Dental Coverage to improve access to dental providers
  • MA only PPO with a $70 Part B giveback

• Kentucky
  • Largest MA plan with over 140k MA members and 38% Market Share
  • All Counties, no pull outs this year.
  • YTD market growth leader (over 30k members)
  • New Lead Full Dual DSNP plan with embedded EOA and all RX at $0
  • MA only PPO with a $75 Part B giveback
  • Enhanced Chronic Care SNP in Jefferson County
• Missouri
  • New Full Dual DSNP plan with EOA and all RX at $0
  • Partial Dual DSNP plan available
  • MA Only PPO with a $70 Part B Giveback
  • NEW HMO with EOA, Groceries, OTC, Utilities and Assistive Devices available in 12 counties
  • HMO-POS plans include OON Dental Coverage improve access to dental providers
  • Simple and consistent Essential Extras Offering

• Ohio
  • Largest MA plan with over 300k members and #1 market share
  • 1  out of 3 members are on an Elevance plan.
  • New full Dual DSNP plan with embedded EOA and RX at $0
  • $0 HMO plans with Essential Extras provides grocery allowance option in every county
  • MA only PPO with $150 Part B giveback
  • Enhanced Chronic Care SNP in Cuyahoga, Franklin, and Hamilton Counties
• Wisconsin
  • Expansion of HMO and DSNP Statewide
  • MA only PPO with $95 Part B Giveback
  • Partial Dual DSNP available
  • HMO POS plans include OON Dental Coverage improve access to dental providers
  • New Full Dual DSNP plan with EOA for groceries, OTC, Assistive Devices, and all RX at $0
• Texas
  • DSNP plan options for partial and full dual eligibles
  • New Full Dual DSNP plan offering in San Antonio
  • Select HMO plans in Houston and San Antonio with simple and consistent Essential Extras offerings
  • Enhanced DSNP EOA in Dallas, Hidalgo, Houston, Nueces, and West Texas
  • Chronic Lung and ESRD CSNPs available with EOA for groceries and OTC
  • DSNP plan expansion in 15 counties and 71 newly marketed counties for the Full Dual DSNP plans matching the Medicaid Service area in Jefferson, Lubbock, Nueces, and West TX

• Virginia
  • #3 in total MA enrollment, over 95k MA members
  • New $0 HMO-POS plans featuring:
    • EOA for Groceries, OTC, Utilities and Assistive Devices for all members
    • OON Dental Coverage through point-of-service
    • Dental, Vision and Hearing Coverage
    • 31 county HMO-POS expansion in SW Virginia
  • MA only PPO with $80 Part B giveback
  • Service area all counties EXCEPT Accomack

Retention Strategies and Member Experience Improvements

• Elevance Loyalty team – 1,000 agents, 800k calls for 2024, and 47% of members stay.
• Migration Campaigns – Outbound calls to impacted members,  Elevance will keep the existing Agent of Record.
• CareGuide – 46% Reach Rate, Cancellations 10% decrease,  Disenrollments = 15% decrease.
• My Health Advocate – Elevance Customer Service Rep,  who goes above and beyond to personalize the experience for members.  Attempt to go to same rep each time a member calls in to alleviate members having to repeat themselves.  It is a holistic approach on relationship building.  

Medicare/Medicaid

• Members on unaligned plans can only make a change 1per year (AEP), Unaligned can enroll monthly.
• 2027 MA can only offer 1 DSNP
• New DSNP enrollees must be aligned
• 2030 DSNP = all DSNP members must be fully aligned.

Full Deck will be available in the coming days.

DISCLAIMERS

This document contains proprietary information intended for use only by our contracted brokers, agents and employer groups. It is not for distribution to the general public; nor for solicitation purposes. Any redistribution or other use is strictly forbidden.

The plans and benefits, premiums & formularies represented have been filed for 2025 and are not yet approved by CMS and are subject to change.

Elevance has NOT YET received approval from CMS to proceed.

All information in this presentation is CONFIDENTIAL. This is for internal use and external partners who have signed a non-disclosure agreement.

This is NOT to be used or shared with beneficiaries (members or prospective members). Disclosing information to beneficiaries (members or prospective members), other health plans etc. will result in a termination of appointment, and broker, agents, or employer group will be terminated with cause. If you have any question on content within the presentation, please email: readytosell@anthem.com