What if an agreement is not reached by July 31, 2025?
If an agreement is not reached, the ĢƵHealth Health System — including its doctors, its other health care providers, and facilities such as O’Bleness Hospital, Riverside Methodist Hospital and the Grant Medical Center — will be considered non-network providers after July 31, 2025.
If an agreement is not reached, Anthem will send patients utilizing the ĢƵHealth Health System letters alerting them to the change to non-network status and options patients may have regarding their care needs.
What is the impact on claims coverage if the ĢƵHealth Health System is considered non-network?
If the ĢƵHealth Health System is considered a non-network provider, medically necessary claims will be covered only up to the “allowed amount” determined by Anthem, and the non-network copays, deductibles, and out-of-pocket expenses of the University’s plan will apply. Any amounts above the “allowed amount” determined by Anthem will not be covered by the University’s health plan and will be the responsibility of the patient.
What are my options or next steps if I am a current utilizer of the ĢƵHealth Health System and/or am currently receiving care from the ĢƵHealth Health System?
If you are a current user of the ĢƵHealth Health System, we advise you to contact your physician’s office directly, alert them that you are covered by an Anthem plan, and request their assistance in reviewing your options, including assistance in transitioning your care to an in-network provider. You may also want to encourage them to reach an agreement with Anthem so that you can continue your care with them.
If you are currently receiving treatment for a serious or complex condition that will continue past July 31, 2025, please contact the Anthem Member Service Center at 1-844-995-1752 and request assistance regarding your care. You may be able to continue your care at ĢƵHealth for a limited time after that date if you are receiving certain types of care. Anthem may also assist you in transitioning your care to an in-network health care provider.
You may also call Health Navigator by Pinnacle Care, a cost-free service provided by the University’s EAP program, at 888-352-4969. Learn More About the Health Navigator Program
Health Navigator by Pinnacle Care may also be able to assist you in finding an in-network provider for your specific care needs. When contacting Health Navigator, let them know you are an ĢƵ University employee seeking assistance from Health Navigator to find in-network options for your care needs.
How do I find Anthem in-network providers?
You can search for in-network providers using .
You can search for care via the “Use Member ID for Basic Search” option and enter OHP as the ID number or prefix (first three values) requested.
What if I decide to continue using the ĢƵHealth Health System when they are a non-network provider?
If you decide to continue to receive care at ĢƵHealth when in-network benefits are no longer provided, all claims at an ĢƵHealth Health System provider or facility will be paid as an out-of-network claim. See the “What is the impact on claims coverage if the ĢƵHealth Health System is considered non-network” question listed above for details.
If Anthem and the ĢƵHealth Health System do not reach an agreement, will the university change health insurance companies?
The University is reviewing all its options, including whether to change insurance companies. The University’s current contract with Anthem is in place at least through June 30, 2026.
Where can I find any additional information regarding this issue?
Anthem has a website dedicated to its ongoing .
Please contact the HR-Benefits Office at 740.593.1639 if you have any additional questions or concerns.