The two largest PBMs — managing pharmacy benefits for over 200 million Americans — are Express Scripts and Caremark. At the start of 2019, they removed over 90 medications from their formularies. Now, at the beginning of 2020, they are removing over 300 medications. Read the full article here.
DALLAS — January 28, 2020 — Integrity Marketing Group, the nation’s largest independent distributor of life and health insurance products, today announced the acquisition of Agent Pipeline. “Agent Pipeline’s choice to partner with Integrity is a game-changer for us in the way we serve the overall insurance marketplace and produce unrivaled results for our agents, agencies, and insurance carrier partners,” said Bryan W. Adams, Co-Founder & CEO of Integrity.
Centene’s full message regarding the Centene & WellCare combination:
We are pleased to announce that the combination of Centene Corporation and WellCare Health Plans is complete. The combining of Centene and WellCare has successfully created a premier healthcare enterprise focused on government-sponsored healthcare programs. No one company has brought a private sector focused approach to all facets of government healthcare – Medicaid, Medicare, the Health Insurance Marketplace and military services until today.
What does this mean for our Brokers?
- Stronger infrastructure leads to stronger tools and resources that Allwell will be able to provide to our brokers, agencies and field staff through this merger.
- Centene will continue to honor the relationships established independently by each of our two companies. No disruption to existing partnerships will take place at this time.
- There will be no changes to any existing broker or agency contracts or hierarchies during 2020 as a result of the combination.
- Our brokers and the role they play in our distribution structure will still remain our top priority for both organizations.
What does this mean for your clients?
This transaction has many benefits for your clients, our members.
- Immediately following the close, there are no changes to the Medicare member experience within WellCare or Centene.
- Centene and WellCare will build on both companies’ strong commitments to the communities in which our members live and work by offering competitive and comprehensive healthcare plans.
- The combined company will enhance its efforts to address the social determinants of health such as food insecurity, housing instability, homelessness, unemployment, lack of access to transportation and other non-medical barriers to health.
What’s the big picture?
This combination further reinforces our commitment to being the preeminent leader in the Medicare space. We value our partners, and look forward to continuing to provide healthcare solutions that meet the unique needs of the communities in each state. Most importantly, we are committed to our partnership and working together to continue providing access to the high-quality cost-effective healthcare solutions we have always provided.
Thank you for you partnership and continued support.
Allwell Medicare Advantage
Humana’s High Deductible Plan G are now available to sell in Ohio, Kentucky, and Indiana effective immediately. Click here to read more from Humana.
If you have any questions, reach out to your Cornerstone Senior Marketing representative.
Anthem’s amount of PDP applications that were written far exceeded expectations. However, with that being said, their billing partners are experiencing some backlog in the EFT queues. Here are a few helpful reminders:
- Is the EFT document going to the right place?
Some agents have been faxing in the payment option page (generally page 3) of the application along with the voided check to the new application fax number. While Billing is ecstatic that we are getting the voided check- this is not the correct protocol and could cause more member abrasion. WHY? Sending a 1 pager to the application queue with the voided check results in INCOMPLETE APP letters generating to members because the processors are trained to look for a full application in that queue.
What should agents do?- Please send the correct EFT form and voided check via fax to 800 833 8554.
- When will the Feb drafts pull?
The draft requests go out from Anthem on the 3rd of each month. Typically members will see drafts pulled from their accounts around the 5th or 6th, but this can vary based on the receiving bank or whether there is a weekend or holiday. It could be as late as the 9th. Remember: Anthem bills in advance (bill for Feb is sent in Jan), the drafts are pulled for the current month and any arrears. It could take up to 2 billing cycles for the draft to take effect. Members should be prepared to pay their bill if they want to avoid a double draft. Thank you for continuing to help set that expectation!
- Checking the status of an EFT set up during this backlog?
Billing is working the inventory in the order received to bring the draft requests current by the time the next scheduled draft runs. Anthem does want to be sure that billing has everything needed to get members squared away, multiple inquiries/submissions will not move these documents to the front of the line. Customer Service and Agent Services can confirm if the necessary documents are in queue and help avoid multiple submissions. The billing team will be focused on the queues vs email requests asking for status.
If you have any questions, contact your CSM service representative.
UPDATE ON EFT OPTIONS
We have been advised that both Anthem and WellCare have removed the EFT option from their enrollment forms on MedicareCenter. Both carriers are working to change and enable this functionality. For the time being, consumers can sign up for the coupon book and when they receive the materials members will have the option to sign up for EFT at that point.
If you have any questions or concerns reach out to your CSM rep.
SCHEDULED MAINTENANCE | SERVICE TEMPORARILY UNAVAILABLE
CSG Actuarial’s software systems and websites are scheduled to undergo maintenance on:
FRIDAY, JANUARY 17 AT 5:00 P.M. CST – SATURDAY, JANUARY 18 AT 12:00 P.M. CST
Please plan around this scheduled maintenance time as you will not be able to access any of the
Notifications will be posted on CSG Actuarial’s software systems and websites to notify users of the
This system maintenance will allow CSG Actuarial to continue improving the software and services they offer.
Recently, UHC was made aware of questions regarding the Walmart / Solutran Over-the-Counter (OTC) ancillary benefit. This issue has been escalated to leadership and are working diligently to improve the member experience.
Below is a list of the issues members are experiencing with best practices to help them work through them
Agents may need to assist members with the registration process.
- Member will need to authenticate the card received in the Welcome Packet in the portal so that they can order their products with the card number.
- The member will need to enter the 16-17 digit number from their order card.
- Members will receive a Welcome email upon registration.
Find additional information on the UnitedHealthcare® Toolkit; search Health and Wellness Catalog Benefit and click on the link to download.
All orders come with free shipping- no matter how much or how little the member orders
- The standard shipping is two days. Back ordered items will ship in two days once they’re in stock and the order is processed.
- UnitedHealthcare will pay the shipping charge if it is indicated that they are below the required purchase amount. The member will NOT be charged for shipping.
3. Price Changes:
- Generally, the catalog pricing will remain consistent with the website for the entire year. In certain cases, changes in market pricing for an item could impact a catalog item. A service representative can try to identify alternative versions of any products impacted by a price increase. The alternative item will be in line with or lower in price than the original item.
An Update on PDP Compensation
In April of 2019, we communicated that Prescription Drug Plan (PDP) commission payments would be paid on the 20th of each month. As such, the January renewal compensation for prior year plans (that were not replaced) was scheduled to be processed on January 20, 2020. Additionally, commission for plans issued during the 2020 Annual Enrollment Period (AEP) with effective dates of January 1, 2020, were also scheduled to be paid on January 20, 2020.
Due to unforeseen circumstances, the PDP January commission files will be delayed 2-weeks until February 7, 2020. The commission payment being made on February 7, will include 2020 renewals for the month of January as well as January 2020 new enrollments. We will resume regularly scheduled commission payments on February 20, 2020 and each month going forward. That is, the February commission file will run on schedule. Only the January process is impacted.
This is isolated incident and should not impact future PDP compensation. We apologize for any inconvenience that this may cause you and appreciate your patience.
READ MORE PDP Case Monitoring update PLUS Contact Information for MA and PDP