CalPERS Committee Recommends Anthem for New PPO Contract
On Tuesday, the CalPERS Pension and Health Benefits Committee recommended Anthem Blue Cross for a new contract to manage the pension fund's PPO program for five more years, the Sacramento Bee reports.
Anthem holds the current contract for the PPO program, which serves 357,000 CalPERS beneficiaries (Kasler, Sacramento Bee, 3/20).
The new contract will begin in January 2014 and run through December 2018.
CalPERS Compares Insurers
According to CalPERS, Anthem earned a better composite score on its PPO than Blue Shield of California, the other finalist for the contract.
A score sheet released at the committee meeting shows that the biggest gaps between the two insurers' PPO plans involved:
- Pricing and performance guarantees;
- Pharmacy benefit services; and
- Member disruption.
Kathy Donneson -- chief of the health plan administration division of CalPERS -- said the pension fund was concerned about the number of primary care providers in Blue Shield's narrow network plan.
She added that there also was a significant difference between Anthem and Blue Shield's administrative fees and projected increases over the next five years.
Response to Decision
Tom McCaffery -- vice president of Blue Shield -- told committee members after the decision, "We are disappointed with the outcome. But win or lose, the bidding game gives feedback for a better position at a future go-round."Anthem officials declined to comment until the decision is approved by the CalPERS Board of Administration this week (Robertson, Sacramento Business Journal, 3/20). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.