Anthem ends relationship with Aspire Health, leaving 2,500 customers without local providers.

Approximately 2,500 Monterey County residents with Anthem Blue Cross HMO medical insurance got a shock earlier this month when they found out they will no longer have access to medical providers within the county as of March 1, about a month after Anthem announced it was terminating its relationship with Aspire Health Plan. Officials from both Aspire and Anthem confirmed the termination.

Those Anthem customers are now being reassigned to providers in Santa Cruz and Santa Clara counties. The only exceptions are for people who are currently pregnant or undergoing treatment for serious illnesses like cancer.

“That’s a lot of people who have to drive an hour or more to get health care,” says Judith Canner, who works at CSU Monterey Bay as chair of the Mathematics Department. She was recently informed that her new primary care physician will be located in Gilroy, a 50-minute drive from her home.

“I had just finally been able to establish with a new [local] primary care provider,” she says. “I learned there are literally no doctors available [in Monterey County].”

Tyler Munson, CEO of Aspire Health, said in a written statement that Aspire “provided a limited set of administrative services for this product,” since 2018. He cited “ongoing challenges in achieving long-term sustainability” leading to the termination by Anthem.

A written statement from an Anthem spokesperson states that anyone impacted was notified in advance “ensuring a smooth transition to alternate participating medical groups,” and that members who are not matched to current providers are being matched to a participating medical group “near their home.” The statement said that all benefits to members remain unchanged.

Canner’s insurance is made available through the California Public Employees’ Retirement System (CalPERS), which negotiates health insurance and retirement for state employees. Anthem Blue Cross, with Aspire administering the insurance, was one of her options during open enrollment last fall.

Within days of the insurance taking effect on Jan. 1, Canner and others received a letter from Anthem dated Dec. 31 stating that it was ending its relationship with Aspire.

“We understand the importance of maintaining the patient/doctor relationship,” the letter stated. “Every effort will be made to keep you assigned with your current primary care physician if he or she practices with another Anthem Blue Cross participating medical group. Otherwise, you will be assigned to a new participating primary care physician and medical group.”

The rub for Monterey County Anthem customers through Aspire is that there are no other participating groups. (Aspire is a partnership between Montage Health and Salinas Valley Health to provide Medicare and HMO plans.)

Canner was told by an Anthem representative that in an emergency she can go to a hospital in the county, but ongoing aftercare would have to be out of the county.

CalPERS officials said the employees’ only recourse was to write a “letter of consideration” to the agency to ask for permission to change insurance plans.