Deciding Between Anthem and Centivo During Open Enrollment: Budgie Can Help

Open enrollment begins November 11, and Guild members have a choice between two medical coverage providers for the upcoming year. A new tool is available to help determine whether Anthem or Centivo will be the best fit for members and their families.

Through Budgie Health, members can see side-by-side comparisons of costs between the two plans based on their own claims data from 2025. The cost comparison will include the annual premiums under both plans as well as the cost of care based on payments under the Centivo or Anthem plan structure. The comparison tool is available free of charge.

“If you have a choice between plans, you want to make sure people understand the nuances of each plan and what it’s going to cost them,” said Jillian Damaris, Budgie Head of Customer Success. “The goal is to be able to estimate the cost of your predicted utilization for 2027 based on your historic utilization so that you’re getting the most accurate representation of what plan could be best for you based on your anticipated needs.”

Starting November 1, members on PWGA coverage who log on to the Budgie site will find an account already set up for them based on information on file with PWGA Pension and Health Plans. Newer plan participants or those who didn’t submit claims in 2025 can build a profile in Budgie and ask the system to predict costs based on the medical needs they and their dependents expect to have in the upcoming year. Past claims data is encrypted and HIPAA-compliant to insure privacy.

If you’re managing a chronic condition, anticipating a surgical procedure or expecting a baby, for example, Budgie can run the numbers and give you the predicted costs from both Anthem and Centivo. Users can review deductibles, co-pays, and out-of-pocket maximums.

Members can also use Budgie to look up other relevant data including whether a doctor is in the Centivo network of medical providers. More information can be obtained through a virtual assistant or an appointment with a live Budgie Expert.

Since 2027 will feature a choice of two medical plans, PWGA administrators determined that a resource to help members understand the differences would be helpful. Members can use the tool both during the open enrollment period or throughout the year whenever they become eligible for medical coverage.

“The intention is to have this tool forever,” said PGWA CEO Jim Hedges. “So each year as people are making their decision on which medical plan to choose, they can use Budgie for cost comparisons.”

Enrollment opens Nov. 11 and ends Dec. 15. The chosen provider’s coverage and new terms will be effective starting January 1, 2027. Learn more.