Plan Features & Highlights

Anthem Health Guide 

This enhanced customer service for PPO participants will replace Anthem’s traditional member services. Anthem Health Guides are trained in medical plans and benefits and will be able to refer you to various point solutions such as Carrum, Hinge or Progyny along with other Anthem programs that might be helpful to you. The member services phone number will remain the same for Anthem Health Guide: at (800) 284-2466.

All Anthem participants will receive a new Member ID Card for the 2024 plan year in December.

Anthem’s Carelon Rx

Pharmacy benefits under the Anthem PPO plans are leaving MedImpact and returning to Anthem’s internal Pharmacy Benefit Manager (PBM), known as Carelon Rx. The copay structure is the same, and the retail pharmacy network is extensive. The formulary list is similar, but some drugs may be covered at different copay amounts or may be excluded. Prescriptions currently covered under MedImpact will be grandfathered-in and covered for 90 days following the January 1, 2024 effective date. Prior authorizations and step therapy already completed will be provided to Carelon Rx for their records. Outreach letters will be sent to participants if certain medications have tier changes or are no longer covered. More information regarding this change in the prescription drug benefit will be sent by Carelon Rx to your home in late November and December. To check your prescription medication coverage, please click the link below. Anthem PPO/CDHP Prescription Drug Formulary

Hinge Health Virtual Physical Therapy for Anthem PPO

Hinge Health will provide a well-rounded virtual physical therapy program for acute or chronic conditions. Benefits include live video visits with a physical therapist, visits with a certified health coach to address underlying causes, and/or a tablet with sensors to provide feedback on movements during therapy. 

Click on the Hinge Health Overview Video or see the Hinge Health Flyer to learn more about this benefit.

Carrum Health for Anthem PPO

If you ever need surgery in the future, please remember to check out the Carrum Health Benefit. This optional surgery benefit for Anthem PPO participants provides a second opinion and, if surgery is needed, travel for you and a companion to the top surgeon at a world-class surgical facility. Learn more at carrum.me/acwajpia , watch this video, or view the Carrum Flyers.

Hear Carrum Health Testimonials and Knee Replacement Testimonials.

Oncology Guidance for Anthem PPO

Carrum Health, JPIA’s concierge and second opinion surgery partner, has expanded to offer oncology services. Oncology Guidance will provide those newly diagnosed with cancer with a registered oncology nurse to guide them through their journey for up to 48 months.  Click on the Carrum Oncology Webinar for more information

Breast Cancer Treatment for Anthem PPO

Carrum Health's journey further into the oncology space has led to their partnership with the world-renowned City of Hope Cancer Center. Comprehensive treatment bundles include coordinated care, radiation, chemotherapy, and surgery.  See the Carrum Health Flyer for more information about this benefit. 

Modern Health 

Members of Kaiser HMO, Anthem PPO,  and Anthem HMO medical plans are eligible for Modern Health. This mental health and wellbeing benefit through Modern Health makes mental healthcare accessible in a timely manner, with appointments typically available within 48 hours. Modern Health offers one-on-one therapy, coaching, live group sessions, meditations, and other educational content on your smartphone or tablet. This benefit is available to all employees and retirees enrolled in ACWA JPIA Anthem and Kaiser medical plans. Dependents are also eligible, regardless of enrollment. Learn more with this short video. Register today at https://my.joinmodernhealth.com


 Plan Provider Flyers

Kaiser Flyers: Click Here
Anthem Flyers: Click Here
MetLIfe Flyers: Click Here
United Healthcare Flyers: Click Here