2020 Medicare Amounts
2020 Medicare parameters are now available.
2020 Medicare parameters are now available.
For 2020, Aetna has a new $0 premium MAPD plan, the Aetna Medicare Premier (HMO) H0628-005. Aetna also has a new 2020 Dual Eligible Special Needs Plan, the Aetna Medicare Assure (HMO D-SNP) H5337-001. Both plans offers your Northeast Ohio clients a strong provider network and impressive supplemental benefits!
The 2020 Aetna Medicare Premier (HMO) H0628-005 is available in Ashland, Belmont, Columbiana, Cuyahoga, Geauga, Harrison, Jefferson, Knox, Lake, Lorain, Mahoning, Medina, Morrow, Portage, Richland, Stark, Trumbull, Tuscarawas and Wayne counties. Benefits include:
The 2020 Aetna Medicare Assure (HMO D-SNP) H5337-001 is available in Belmont, Carroll, Columbiana, Coshocton, Cuyahoga, Franklin, Fulton, Guernsey, Lake, Lorain, Lucas, Mahoning, Medina, Montgomery, Morgan, Muskingum, Ottawa, Portage, Stark, Summit, Trumbull, Tuscarawas, Wayne and Wood counties. Benefits include:
For more information contact Cornerstone’s Jaime Lebron, Sales Director of NE Ohio.
Integrity Marketing Group, LLC (“Integrity”), the nation’s largest independent distributor of life and health insurance products, today announced it has entered into a definitive agreement to acquire North American Senior Benefits (“NASB”), an insurance marketing organization based in Lawrenceville, Georgia. As part of the deal, NASB Co-Founder Seixas “Chad” Milner III, Co-Founder and President Craig Harvey, and the other NASB equity partners will become owners in Integrity. Financial terms of the contract were not disclosed.
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NEW AND EXCITING:
New underwriting process and application tracker
Starting October 1, our underwriting process will give you faster decisions for underwritten Aetna Medicare Supplement applications. We have not altered our underwriting philosophy in any way. Most applications will have a decision within a few minutes. This exciting change also comes with an updated online application tracker, to give you clearer visibility to those decisions.
Changes: Point-of-sale telephone interview and voice signature option
To help make the underwriting process even easier for you, we’ll no longer require or offer a point-of-sale telephone interview as of October 1, 2019. We’ll also be discontinuing the voice signature option.
Our new underwriting process
Once we receive your Medicare Supplement electronic application, we will provide one of the following underwriting decisions within a few minutes:
We will also provide decisions on your paper applications once we have verified all required information has been included with the submission. This review may delay how soon the decision is displayed on the website.
MACRA 2020
Are you wondering how MACRA works and how it will affect you and your clients? I have attached a cheat sheet that will help you have a better understanding of MACRA.
Aetna has launched their MACRA 2.0 strategy in 15 states with more coming either later this year or early next year. Watch for your e-bulletins for more information.
August launches for MACRA 2020 – SC, IL, LA, AZ and TN
July launches – AL, GA, IA, MI and MS
September launch – FL
October launches – OH, NC, KS and PA
What does all this mean?
Aetna plan F rates will be on average within $15-$20 a month of our plan G rates and our plan F rates have been lowered. You will be able to offer a high deductible G with effective dates after 1/1/20
Why is Aetna putting out rates that are so competitive on plan F?
There are tens of millions reasons why. After 1/1/20 anyone on a Medicare Supplement currently or Medicare eligible by 12/31/19 will still be able to purchase plan C, F and HIF after 1/1/2020. These clients that would like to receive a very competitive plan F rate with us will need to go through underwriting so this with be a very healthy group of insureds which can mean lower rate increases.
Aetna has a new agent services phone number: 866-272-6630
New Quoting App!
Aetna has launched their new app for quoting all products. You no longer have to save the link to you home page. All you need to do is download our “quote on the go” app from the app store. You can quote every product Aetna offers in one easy format!
In Ohio, this effects only Dual Plan H5322-028 (Light Blue banded kit), which is now Closed to New Enrollment for 2020. Members on this plan can remain for as long as they like. Agents will continue their AOR status and be paid their renewal commissions.
The reason for this sanction is: the aggregate medical loss ratios of the 9 states included in this plan number, were less than the CMS required 85%. So in essence UHC didn’t lose enough money on that plan.
To note: Ohio was not a contributor to the low losses ratio, UHC had plenty.
UHC has replaced H5322 with H8125-002 for those 75 counties, so they can continue to serve Dual beneficiaries in the State of Ohio.
This does not affect the other Dual Plan H5253-059 (Purple banded kit) which serves Metropolitan 13 counties in Ohio.
All UHC Ohio Plans starting with: H5253 are all 4.5 stars plans and not effected!
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UnitedHealthcare is facing enrollment restrictions next year in one of its Medicare Advantage health plan contracts, regulators say, because the insurer hasn’t been spending a large enough share of revenue on the health care needs of enrollees.
The sanction from the Centers for Medicare and Medicaid Services (CMS) applies to just one of United’s many contracts with the federal government to sell Medicare Advantage health plans and doesn’t apply to coverage sold in Minnesota.
Minnetonka-based UnitedHealthcare, the nation’s largest health insurer, says it fell out of compliance due to federal legislation that reduced the insurer’s tax liability last year. The sanction applies to a health plan contract for coverage sold in nine states to less than 1% of the company’s roughly 6 million Medicare Advantage members. The states include Florida, Georgia, Kansas, New Hampshire, New Jersey, Ohio, Oklahoma, Texas and Virginia.
“CMS imposed enrollment sanctions on a subsidiary of UnitedHealthcare … because the organization did not meet a Medical Loss Ratio (MLR) of at least 85% for a third consecutive year,” CMS said in a response to Star Tribune questions.
“This enrollment suspension will be in effect for contract year 2020,” the federal agency said. The federal MLR rule “requires that a percentage of revenue should be used for patient care, rather than for other items [such] as administrative costs or profit.”
UnitedHealthcare is one of the nation’s largest sellers of Medicare Advantage plans, a newer form of Medicare coverage in which enrollees opt to receive federal health insurance benefits through a private managed care company. In 2019, roughly one-third of Medicare beneficiaries are opting for Medicare Advantage coverage, according to the Kaiser Family Foundation, as opposed to receiving benefits through the original Medicare program.
The federal government monitors the share of revenue that Medicare Advantage plans spend on patient care needs, vs. the amount spent on administration and kept as profit. This measure is called the “medical loss ratio,” and it’s a standard way for regulators and consumers to assess the profitability of health plans.
When a Medicare Advantage plan’s MLR drops below 85% for three consecutive years, the government can suspend new enrollment in the plan while letting current enrollees maintain the coverage. In a Sept. 11 letter to UnitedHealthcare, CMS said the medical loss ratio (MLR) was 71.3% in 2016, 83.9% in 2017 and 84.1% in 2018 for health plans within the contract that’s being sanctioned.
In a response to Star Tribune questions, UnitedHealthcare said the MLR last year fell below the mark — despite added benefits — because the company saw a financial benefit from the federal Tax Cut and Jobs Act, which became law in late 2017. The company says it subsequently factored the change into its calculations and anticipates achieving an MLR above 85% in 2019.
“While we won’t be enrolling new members in [this contract] for 2020, existing members will continue to receive the same level of care and support, including an increase in their coverage and benefits,” the insurer said in a statement. “UnitedHealthcare also has additional Medicare Advantage plans available in many of these markets.”
“We anticipate that we will achieve the MLR threshold in 2019 for [this contract], which will allow us to resume enrollment in these plans in 2021,” UnitedHealthcare said.
The health plan contract that’s being sanctioned primarily provides coverage for people who quality for benefits from both Medicare and the state-federal Medicaid program. UnitedHealthcare officials have said these products for “dually eligible” enrollees are an important growth area for the company.
If the MLR for a Medicare Advantage plan falls below the 85% mark for five years, the government can terminate its contract with the health plan. CMS says the regulatory action against UnitedHealthcare is the first time the agency has suspended enrollment in a Medicare Advantage plan due to noncompliance with the MLR rule.
AEP is in full swing and it’s important that Allwell keeps you, their brokers, informed and up-to-date on any and all information that will help you be more successful. Below are some hot topics Alllwell wanted to share with you.
Tip # 1: Administrative Payment Payouts
Don’t forget that when you initiate a VBE ($50) and Blue Button ($30) you will receive an extra $80 in administrative payments.*
VBE payouts have already started so make sure you are logging into your Allwell Broker Portal to keep track of your payments.
Blue Button payouts will commence as of November 20, 2019.
Administrative Payments are paid out on a weekly basis.
For any questions or concerns about your administrative payments please call Broker Services at 1-844-202-6811
Tip # 2: Special Enrollment Period (SEP) for Beneficiaries Affected by Severe Weather
If your client or client’s authorized representative has been affected by severe weather as documented by the Federal Emergency Management Agency (FEMA) and were not able to enroll, dis-enroll, or switch their Medicare health or prescription drug plan due to the disaster, they may be eligible for an SEP. If your client qualifies for an SEP they have four (4) full months from the day the disaster occurred to enroll, dis-enroll or switch their plan.
When enrolling your client for a weather related emergency or major disaster SEP within the Ascend online application you must make sure to use the correct election selection in the election period section of the application.
The election you need to choose is: “I was affected by a weather-related emergency or major disaster as declared by the Federal Emergency Management Agency (FEMA). One of the other statements here applied to me, but I was unable to make my enrollment because of the natural disaster.”
For more information about SEP please visit: https://www.cms.gov/AboutCMS/AgencyInformation/Emergency/Downloads/MedicareBeneficiaryDisasterEnrollmentQsandAs.pdf
For more information about areas that qualify as a disaster area please visit: https://www.fema.gov/disasters
Tip # 3: How do I Help my Client Locate their Medicare Beneficiary Identifier (MBI) Number?
It is important that you use your clients MBI number on the enrollment application when enrolling your client into an Allwell plan. If you don’t use your client MBI number the application process is slowed down considerably.
Your client can find their MBI number by:
If your client is new to Medicare and doesn’t have a Medicare card yet, they can get their Medicare number by logging into their Social Security Account
Tip # 4: Find Valuable Documents and Videos in the Ascend Resource Library
The online Ascend platform is so much more than just an online application platform. Once logged into the portal you can access the Resource Library where you can find valuable documents and videos to assist you in all your Allwell Sales. You will find documents such as Evidence of Coverage, Summary of Benefits, Sales Presentations, VBE training, Blue Button demo training and much more.
For More Information on Using the Allwell Online Application Platform, Ascend Check out Allwell’s FAQs
As a reminder, please be sure to submit termination requests to the appropriate email to ensure their timely processing. Click here to view the contact sheet.