Choosing a group health insurance carrier is an important decision for any small business. Health benefits affect employee satisfaction, hiring competitiveness, and long-term budgeting. If you are evaluating Anthem group health plans for your business, this guide explains how these plans are structured and what to consider before enrolling.

At Veritas Risk Management, we focus on helping employers compare options clearly and objectively. Below is a structured overview of how Anthem group plans work and how to evaluate whether they fit your company’s needs. Health coverage should align with your broader business insurance strategy.

What Are Anthem Group Health Plans?

Anthem is a national health insurance carrier that offers employer-sponsored health plans. Like most large carriers, Anthem provides multiple plan types designed for small and mid-sized businesses.

Group health plans through Anthem may include:

• Medical coverage
• Access to provider networks
• Digital member tools
• Preventive care benefits
• Behavioral health coverage

The exact structure, network availability, and benefits vary by state and employer size, so reviewing local plan details is critical.

Common Types of Anthem Group Health Plans

Anthem typically offers several standard group health plan structures. Understanding these models helps employers compare flexibility, cost, and network access.

Preferred Provider Organization (PPO)

PPO plans generally provide broader provider access and allow members to see specialists without referrals. These plans often include:

• In-network and out-of-network options
• Greater provider flexibility
• Higher premiums compared to more restrictive models

PPO plans may appeal to employers who prioritize provider choice.

Health Maintenance Organization (HMO)

HMO plans typically require members to use a defined provider network and select a primary care physician. Referrals may be required for specialist visits.

HMOs are often designed to:

• Emphasize coordinated care
• Control costs through network structure
• Offer lower premiums compared to PPO plans

Network availability depends on the local market.

Exclusive Provider Organization (EPO)

EPO plans usually combine elements of PPO and HMO structures. Members must use in-network providers (except in emergencies), but referrals may not always be required.

EPOs often:

• Offer lower premiums than PPOs
• Limit coverage to in-network providers
• Require careful provider verification before enrollment

High-Deductible Health Plans (HDHPs)

High-Deductible Health Plans typically feature:

• Lower monthly premiums
• Higher deductibles
• Eligibility for pairing with a Health Savings Account (HSA), when structured accordingly

HDHPs may appeal to employers focused on premium control while offering employees tax-advantaged savings options (if HSA-qualified).

What Employers Should Evaluate Before Choosing Anthem

Rather than focusing only on brand name, employers should compare:

1. Network Fit

Confirm whether local hospitals, specialists, and primary care providers in the Tri-Cities area are included in the plan network.

2. Total Cost Structure

Review:

• Employer contribution strategy
• Deductibles and out-of-pocket maximums
• Copays and coinsurance

Premium alone does not tell the full story. 

3. Employee Demographics

Age mix, coverage tiers (single vs. family), and workforce size affect premium calculations under ACA small group rating rules.

4. Administrative Tools

Many large carriers, including Anthem, offer digital enrollment platforms and member tools. Ease of administration can significantly reduce HR workload.

Enrollment Considerations for Anthem Group Plans

While the specific enrollment process depends on group size and state rules, most small employers should expect to:

1. Confirm eligibility requirements
2. Select a contribution structure
3. Choose plan design options
4. Complete required employer and employee documentation
5. Conduct open enrollment for employees

Working with an experienced broker helps streamline this process and avoid administrative mistakes.

How Anthem Plans Compare Within the Broader Market

Anthem is one of several national carriers that offer:

• Multiple network options
• Different funding arrangements
• Standard ACA-compliant small group coverage
• Optional ancillary benefits, such as dental or disability

The best choice for your business depends less on the carrier name and more on:

• Local provider access
• Plan affordability over time
• Employee usability
• Renewal stability

For foundational education on plan structures, see our guide on health insurance basics.

How Veritas Risk Management Helps Employers

Veritas Risk Management works with businesses in:

• Abingdon
• Gate City
• Bristol
• Surrounding Southwest Virginia communities

Our advisory approach includes:

• Objective carrier comparisons
• Transparent cost breakdowns
• Network validation
• Enrollment support
• Ongoing renewal strategy

If you are considering Anthem or comparing multiple carriers, we can help you evaluate the full picture.

Frequently Asked Questions

Is Anthem a good option for small businesses?

Anthem is a well-established national carrier offering multiple group health plan structures. Whether it is a good fit depends on local network strength, plan pricing, and your workforce needs.

What is the difference between Anthem PPO and HMO plans?

PPO plans typically offer broader provider flexibility, while HMO plans usually require in-network care and may require referrals. Costs and structure vary by plan.

Are Anthem plans ACA-compliant?

Group health plans offered in the small group market are generally structured to comply with ACA requirements, including essential health benefit standards and rating rules.

Can small businesses offer Anthem plans with dental and disability coverage?

Many carriers, including Anthem, may offer ancillary benefits such as dental or disability alongside medical plans. Availability depends on state and employer eligibility.