New for 2026: Alternative Health Plans
CalCPA Health is introducing Alternative Health Plans (AHPs) through the Anthem Blue Cross network, powered by Coupe Health. These new plans are designed to make your healthcare simpler, more affordable, and transparent.
With Anthem’s large provider network and Coupe Health’s easy-to-use tools, you’ll know your costs upfront, have more freedom to choose providers, and get personal guidance along the way.
- No deductibles*, no coinsurance, no specialist referrals
- Fixed easy-to-understand copays
- Access to Anthem’s Prudent Buyer PPO network – the largest in California
- Small Group and HSA-qualified options – a rare find in the market
How It Works
- Download the Coupe Health app and set up your account. Visit the Microsite noted below for instructions.
- Here you can find care, compare costs, see your out-of-pocket costs, and view your Explanation of Benefits (EOBs) – available 24/7
- Copay-only PPO plans – no deductibles or coinsurance on most plan designs.*
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Health Valet – a Coupe Health personal guide who helps you find care and understand your benefits and options.
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Cost transparency – see your out-of-pocket cost before your appointment, right in the Coupe Health app or member portal.
- Coupe Health’s tiered provider system (no Gatekeeper) – providers are grouped by data analytics, including quality, care efficiency, and patient experience. Tiering helps you make informed choices about your healthcare. Visiting a Tier 1 provider often results in lower out-of-pocket costs and these providers generally offer better care, which can lead to faster recoveries and fewer complications.
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Green (Tier 1) = Best quality and lowest copays – Represents high-quality and low-cost options. These providers are known for excellent patient outcomes and efficiency, which ultimately reduces overall healthcare costs.
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Yellow (Tier 2) = Moderate copays, good quality – Includes providers who meet standard quality metrics but may not consistently exceed them.
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Red (Tier 3) = Higher copays, meeting minimum standards – Comprises providers who meet minimum acceptable standards but may have higher costs or less efficient care practices.
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Criteria for Tiering
- Providers are evaluated based on several critical metrics:
- Medical board certification: Ensures providers meet high standards of practice.
- Patient outcomes: Examines the effectiveness of treatments and patient recoveries.
- Readmission rates: Lower rates indicate better initial care and fewer complications.
- Malpractice history: Tracks legal claims to assess risk and reliability.
- Operating efficiency: Measures how well providers utilize resources to deliver care.
- Physician years of experience: Considers the length of time providers have been practicing.
For more information and to search for in-network healthcare providers, visit our Microsite.
Benefits as a Member
- No deductibles* or coinsurance on copay-only plans.
- Access to Anthem’s largest statewide provider network of doctors, hospitals, and specialists.
- View your out-of-pocket cost for your medical service BEFORE making an appointment.
- Tiered provider rankings highlight quality and value to help you pick the right care for you.
- Comprehensive coverage – preventive care, urgent/emergency, specialty visits, pharmacy, maternity, behavioral health, and more.
- Convenient digital tools – check costs, coverage, and providers anytime, anywhere.
Benefits for Employers
- Premium savings opportunity – this alternative plan design can help lower overall healthcare costs.
- Employees make smarter healthcare choices when they can see costs up front.
- Meets employee expectations for transparency and convenience.
- Providing options for employees leads to higher retention.
By identifying top-quality providers, you will see the price for each medical service upfront—so there are no surprises. This transparency enables you to make confident, informed decisions about your care and select providers who offer the best value. It’s all designed to help you take charge of your health and become your own best advocate.
*Two AHPs are HSA-compatible HDHPs, which do include a deductible.