UHC: Changes coming for AARP Medicare Supplement Plan applications

Application changes are coming soon and may make the enrollment outcome more understandable for AARP® Medicare Supplement Insurance Plans from UnitedHealthcare® in:

Alabama, Arkansas, Iowa, Kansas, Kentucky, Louisiana, Maryland, Mississippi, Missouri, New Jersey, New Mexico, Ohio, Oklahoma, Tennessee, Utah, Virginia, Wisconsin, Wyoming.

For states with kits not yet available, please refer to the new rate pages on Jarvis or populated in LEAN™ when using the current kit.To find rate pages on Jarvis, go to  Knowledge Center > Product Overview > Medicare Supplement Plans > Rates & Underwriting and select a state from the drop down menu.

Get Ready for What’s Next

·         DO use LEAN for enrollments

o    Enrolling clients with LEAN means always having the correct application, plus less hassle managing Enrollment Kits

·         DO watch your email closely

o    Read emails to know when the new application will be implemented and new Enrollment Kits are available

·         DO NOT order large amounts of Enrollment Kits

o    Save the hassle of managing outdated kits you cannot use, as application changes are coming soon to Enrollment Kits in the impacted states

SureBridge: Benefit Change Option for Existing DVH Product

Sourced from SureBridge communication on 5/24/22:

We recently communicated about price adjustments on the SureBridge Prime DVH product for new business and in force policies with customers receiving an increase at 6 months in some states (AK, ALAZ, CA, CT, DC, GA, ID, IL, KS, KY, ME, MI, MN, MO, ND, NE, NV, OH, OK, PA, SC, TX, UT, VA, WI, WV, and WY).

Understanding some budgets may not allow for a rate increase, we are offering an option that may help. Customers who have been impacted by the 6-month rate increase and would like to lower their benefit level to make the premium more affordable, can contact Customer Service directly at 800-815-8535 or contact their agent to have the change made on their behalf.  We are allowing waiting period credits, accumulators, etc. to remain as they are at their current level with the move to a lower benefit. Those who received a 12-month rate increase notice already have the option to move to a lower benefit level.

Please note:

  • This change is only allowed within the existing DVH policy and does not allow customers to move to a standalone dental or vision.
  • A customer that exercises this option with their DVH policy does not trigger a new first year commission period or a commission advance.

CY 2023 Medicare Advantage and Part D Final Rule (CMS-4192-F)

CMS FACT SHEET: CMS is issuing a final rule that advances CMS’ strategic vision of expanding access to affordable health care and improving health equity in Medicare Advantage (MA) and Part D through lower out-of-pocket prescription drug costs and improved consumer protections.
An increasing number of Medicare beneficiaries receive services through MA and Part D plans. Over 27 million beneficiaries are enrolled in MA plans (including plans that offer Part D prescription drug coverage), and approximately 24 million beneficiaries are enrolled in standalone Part D plans. Additionally, an increasing number of beneficiaries who are dually eligible for both Medicare and Medicaid are enrolled in MA plans, Medicaid managed care, or both. About 4.1 million dually eligible beneficiaries currently receive their Medicare services through MA dual eligible special needs plans (D-SNPs).
The final rule revises the MA and Part D regulations related to marketing and communications; the criteria used to review applications for new or expanded MA and Part D plans, including compliance with MA provider network adequacy requirements; quality ratings for MA and Part D plans; medical loss ratio reporting; special requirements during disasters or public emergencies; how MA organizations calculate attainment of the maximum out-of-pocket (MOOP) limit for Parts A and B services; and the use of pharmacy price concessions to reduce beneficiary out of pocket costs for prescription drugs under Part D. This final rule also revises regulations for D-SNPs, and in some cases, other special needs plans, related to enrollee advisory committees, health risk assessments, and ways to improve integration of Medicare and Medicaid. Many finalized policies are based on lessons learned from the Medicare-Medicaid Financial Alignment Initiative.

CMS Marketing Changes

The marketing guidelines for Medicare Advantage and Prescription Drug Plans were updated on May 9, 2022. Among the provisions that apply directly to agents, the two most critical, which are to be in use by October 1, 2022, for Plan Year 2023, are a new required disclaimer and a requirement to record all sales calls with beneficiaries. While not comprehensive, the FAQ’s below will provide details. 

Required Disclaimer 

Disclaimer Language To Use:

“We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.” 

Who must use this disclaimer?

Any third-party marketing organization (which includes agents and brokers) must include this disclaimer. 

When and where do I have to have the disclaimer?

  • On all marketing materials: print (if possible, use a 12pt font), electronically, television, and radio
  • Within the first minute of all sales calls
  • Prominently displayed on TPMO websites
  • Verbally, electronically, or in writing, during any sales meeting with a beneficiary

What if I DO offer all plans in my area? 

While the regulation does provide a carve-out for TPMO’s that truly offer all plans in their area, it is exceedingly rare for an agent to truly be able to do this. In most areas, there are one or more plans that are offered only through captive agents, direct to consumer, or certain types of plans that agents and brokers cannot sell. Even if you do offer all plans in one county or service area, it is possible your marketing or referrals may extend to an area where that is not true, so the disclaimer would still be required. 

Requirement to Record Sales Calls

Under these new guidelines, all sales calls with beneficiaries and TPMO’s MUST be recorded and retained for 10 years, including enrollment calls. 

What constitutes a sales call? 

Any call that is related to what CMS calls the “chain of enrollment,” which has been defined as the events from a beneficiary becoming aware of an MA/PDP plan to the end of the enrollment process. This means that calling leads, scheduling appointments, collecting scopes of appointment (telephonically), presenting plans, collecting drug and doctor lists, and phone enrollments would all fall under this guidance. This list is not exhaustive, and other calls that contain marketing content will also need to be recorded and retained. 

How can I record and store calls? 

We recommend reaching out to your current phone provider to see if they offer call recording. If they do not, or it seems cost prohibitive, consider a VOIP phone system that can be used in the office or the field. Some common options are Ring Central, 8×8, and Vonage. For storage, you will need to develop a process for sorting and storing the calls either on a local drive or cloud-based storage. Since these calls contain sensitive data, most free storage accounts will not be HIPAA compliant. We are currently researching the best options for agents to compliantly store this data. 

What about in person appointments? 

In-person marketing and sales appointments do not need to be recorded, however, calls to set appointments or follow-up calls to answer benefit questions would require recording. Servicing questions about current plan business, such as claims, billing, and requesting in force plan documents, are not sales calls and would not require recording. 

I use my cell phone. How can I handle this? 

Most VOIP services have a mobile app version that would allow calls to be recorded from your mobile device. There are also recording apps that would allow for recording calls without VOIP. Be cautioned, however, as a stand-alone recording app will not include any disclaimers that may be required by your jurisdiction before recording, whereas most VOIP systems offer/include these options.

Please reach out with any questions to your team at Cornerstone Senior Marketing.  (614) 763-2255 |  [email protected]quirement to Record Sales Calls

Anthem Med Supp Update – Proof of Loss of Group Coverage Required

Anthem Producer Online News – May 5, 2022

Beginning May 14, 2022, proof of loss of group coverage must be provided for individuals moving from Employer Group medical coverage to a new Med Supp plan. This requirement is found in the Med Supp Guaranteed Issue Guidelines, Situation #2.

Guarantee Issue Situation #2 is described as having Medicare and an employer group health plan (including retiree or COBRA coverage) or union coverage that pays after Medicare and that plan is ending. Please review this GI Situation in the guidelines as the member may have additional rights under state law. The Med Supp Guaranteed Issue Guidelines are included with the Med Supp application for your convenience.

Beginning May 14, 2022, when submitting electronic Med Supp enrollment applications for GI Situation #2, you will receive a system prompt, indicating “Loss of Creditable Group Coverage” is required and must be included with the enrollment application submission. If you are submitting a paper application, you or your client must submit the documentation directly to the plan.

Acceptable documentation includes a loss of group coverage letter also known as a “Certificate of Coverage,” or letter from the former plan noting the dates the coverage started and ended. The “Certificate of Coverage” serves as proof of coverage. It is always possible to obtain a replacement copy from the employer or union.

  • If required proof is not submitted with the application, the application cannot be processed until loss of group coverage proof is received.
  • If the loss of group coverage proof is not received within seven calendar days, the application will be closed, and a letter will be mailed to the applicant letting them know the application will be re-opened for processing when it is received by the plan.

The application can be re-opened up to 180 days from the signature date on the application.

SureBridge: Billing Changes and New Customer Website for New Business Only

Sourced from SureBridge Broker Communication from 5/4/2022:

Starting on May 06, 2022, applications received for SureBridge supplemental products will have a new billing process and customer website for Alabama, Arizona, Connecticut, Florida, Indiana, Michigan, New Hampshire, Oklahoma, South Carolina, Utah and Virginia. These updates apply to NEW customers only and do not affect current customers. There are no changes for business dated prior to May 6th.

Click here for important details about the following items:

  • New customer billing draft date and pro-rated premium
  • New customer website (mysurebridgeinsurance.com)

We encourage you to become familiar with how billing for new business will differ from that of previous business sold in your state. We are excited about these changes and look forward to better serving you and our customers.