SPOUSE FIRST NAME> <SPOUSE LAST NAME>
SPOUSE CARE OF>

SPOUSE ADDRESS LINE 1>

SPOUSE ADDRESS LINE 2>

<CITY>, <STATE> <ZIP CODE>

Your health benefits are ending– you’ll need topick a newplanfor 2018!

Spouse First Name>,your plan is only available for members up to age 30 and will end on December 31, 2017 – unless you qualify for a hardship exemption. Go to HealthCare.gov to find out. You’ll need to provide proof of your hardship and then re-apply for your health benefits.

Other members of your family younger than age 30 will stay covered on this plan in 2018, <2017 CAT plan name>.^ More info about options for your family members will be sent separately.If you have dental and/or vision benefits with us, we’ll also send you that renewal information separately.

Open Enrollment is November 1, 2017 through December 15, 2017 –you can pick a new plan for 2018 during this time.If you need help choosing a new health plan for 2018, give us a callor visit MyAnthemChoices.com during Open Enrollment — we might have another onethat suits your needs.Call our Health Plan Advisors at 1-844-590-9350from 8 am – 7 pm ET or contact your broker. Go to HealthCare.gov to contact the Marketplace.

Need this info in another language? The last page explains how to get help.


Sincerely,

Harry Hayes, Director, Small Group and Individual Sales

Anthem Blue Cross and Blue Shield in Kentucky

^May not reflect a recent 2017 plan change.

It’s important we treat you fairly

That’s why we follow federal civil rights laws in our health programs and activities. We don’t discriminate, exclude people, or treat them differently on the basis of race, color, national origin, sex, age or disability. For people with disabilities, we offer free aids and services. For people whose primary language isn’t English, we offer free language assistance services through interpreters and other written languages. Interested in these services? Call the Member Services number on your ID card for help (TTY/TDD: 711). If you think we failed to offer these services or discriminated based on race, color, national origin, age, disability, or sex, you can file a complaint, also known as a grievance. You can file a complaint with our Compliance Coordinator in writing to Compliance Coordinator, P.O. Box 27401, Mail Drop VA2002-N160, Richmond, VA 23279. Or you can file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights at 200 Independence Avenue, SW; Room 509F, HHH Building; Washington, D.C. 20201 or by calling 1-800-368-1019 (TDD: 1-800-537-7697) or online at Complaint forms are available at

Under the ACA or health care reform law, health coverage plans for individuals sold on and off the exchange are “guaranteed issue” plans. This means you cannot be denied coverage due to any pre-existing health condition. If you need help getting coverage, contact a certified exchange enrollment facilitator or your licensed agent, broker or carrier.

Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Kentucky, Inc. Independent licensee of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

6009_05395KYMENABS_KY_CVR-CAT-C-OFF 04/17