UHC Ohio Medicaid Updates: Verification & Emergency Assistance Changes

Ohio Medicaid Verification Update via PHD, Jarvis, Mira
UnitedHealthcare has recently learned that the state of Ohio Medicaid verification system is undergoing a transitional stage that will prevent agents from verifying Medicaid in our state. Jarvis, Mira and the Producer Help Desk (PHD) are impacted by this change and currently do not have a workaround to verify eligibility.

What you need to know:

The state system will likely go down at 5 pm tomorrow, Tuesday, Jan. 31. This outage could potentially last for several days.
• You are able to continue writing new business during the outage, but you may need to ask additional questions of your prospects to verify their status & eligibility (ask if or who’s paying their Part B premium, are they part of MyCareOhio, do they have a local JFS office case worker they work with re their benefits, etc.)
• Please submit enrollment applications as soon as possible before the blackout window to avoid any potential delays.
• There may be a delay for applications being approved for Feb. 1 and March 1 effective dates.

At this time, UHC is unable to determine how long this outage will be. UHC will keep brokers updated as they receive additional information. UHC is working with the state of Ohio to get this resolved as quickly as possible.


Ohio Medicaid – Emergency Assistance Changes

Beginning in April, Medicaid expansion is set to begin unwinding across each state that took part in the COVID pandemic related Medicaid coverage increases. This will result in a county by county effort by local JFS offices to contact over 1 million Ohio Medicaid recipients letting each person know they need to reenroll.


This is very likely to cause confusion & frustration among clients & prospects at the low income venues and organizations you partner with. At the same time, this becomes an OPPORTUNITY for each of you to provide additional service and assistance and value to the locations you visit each week.


For additional information, please see this recent local TV video report from the local Columbus NBC station: Changes approaching for Medicaid recipients | NBC4 WCMH-TV (nbc4i.com)


The Health Plan: New OTC Vendor – InComm

Sourced from THP Broker Communication from 1/19/23:

The Health Plan has a new OTC vendor, InComm.  Enclosed is an instructional video “How to Access and Navigate My Benefits Center” that may help you communicate this benefit to your THP Medicare Advantage members.

Please advise your members that this benefit / Visa Card is already activated upon receipt and ready-to-use for their OTC purchase needs.  DSNP plan members can also use it for healthy foods and utility bill assistance, as instructed in the video. Every member who earns rewards & incentives for getting their annual physical, mammogram and / or colonoscopy will access their rewards through this card as well.

Click here to view the instructional video.

Please direct your members to contact The Health Plan’s Customer Service department with any questions at: 1-877-847-7907, M-F 8:00 am – 8:00 pm

If you have any questions, please reach out to your CSM Service Rep

Biden Administration Releases Timeline IRA Medicare Provisions

Biden Administration Releases Timeline for Implementation of Inflation Reduction Act Medicare Provisions

The administration released a timeline for implementation of certain Inflation Reduction Act (IRA) provisions, including provisions related to Medicare drug price negotiations.

As we have mentioned previously, the IRA grants the secretary of HHS the ability to negotiate the prices of certain drugs for the Medicare program with new prices beginning in 2026. Ten Part D drugs will be negotiated in 2026, with an additional 15 Part D drugs in 2027, 15 Part B or D drugs in 2028, 20 Part B or D drugs in 2029, and 20 more drugs each year beyond that. The bill dictates that the secretary can only negotiate prices on costly single-source drugs, those among the highest-spend products in Part B or Part D that do not have competing small-molecule generics or biosimilars that are both FDA-approved and marketed. The legislation also exempts “small biotech drugs” from negotiation until 2028….




Mutual of Omaha 2022 1099’s Coming to SPA

Great news, 2022 1099s will be available through Sales Professional Access (SPA) for all producers.

Please note: if the producer has a Compensation PIN assigned for SPA already, they will not be able to view their 1099 without their compensation pin. We wanted to give all of you the heads up before we send a general announcement in February.



SureBridge Cancelation Requests System Issue

System Issue: Cancelation requests through the SureBridge branded Self-Service Tool not processed
We recently identified a system issue with the SureBridge Self-Service tool (myportal.surebridgeinsurance.com) that prevented policy cancelation requests made through the portal from being processed between Nov. 23, 2022 and Jan. 7, 2023. This issue is isolated to cancelation requests only and updates have been made to correct the issue. The tool should be working as expected again.

The policies affected are being identified and will be processed accordingly.  Any refunds that may be due could take up to 10 days to be processed.  This email is for information purposes only and requires no action by the agent.

If you have list of customer cancelation requests that were made during this timeframe and would like to check status, please email producersupport@surebridgeinsurance.com instead of calling Customer Service.

We apologize for the inconvenience this may have caused you and your customers.



Report: CVS Considering $10B Purchase of Oak Street Health

Georgia Market – OEP 2023 D-SNP Sales Incentive Program  – Learn More! 

Aetna is excited to announce to all brokers in Georgia that we have a NEW SALES INCENTIVE to help support you during Lock-In.

The top three D-SNP producers will be able to access marketing dollars in the form of traditional co-op or funds through our Medicare Marketing Studio, marketing collateral to support community events, and local Aetna support to host community events throughout the year.

Producer Rewards & Qualifications

Top 3 Producer Rewards:

#1 Top Producer
• $5,000 in marketing co-op dollars in Q1 Only
• Aetna Swag
• Event collateral (banners, table runner, flags)

#2 Top Producer
• $3,000 in marketing co-op dollars in Q1 Only
• Aetna Swag
• Event collateral (banners, table runner, flags)

#3 Top Producer
• $1,500 in marketing co-op dollars in Q1 Only
• Aetna Swag

Sales Incentive Details & Qualifying Criteria:

• New to Aetna D-SNP sales for February 1- April 1 effective dates (CMS issued sales only).
• Final sales numbers will run in early May. Winners will be announced at that time.
• Cancelled applications and rapid disenrollments will be removed from final counts.
• To qualify for the contest, the broker must have a minimum of 10 New Sales
• Top three winners will be announced in each of the following markets:
Atlanta Metro/North Georgia
Macon/Columbus/South Georgia

***NOTE: Plan replacement is excluded***


The Qualifying Plans Include the Following:
• Aetna Medicare Dual Choice Plus Plan (PPO Full D-SNP)
• Aetna Medicare Dual Preferred Plan (HMO Full D-SNP)
• Aetna Dual Choice Plan (PPO Partial D-SNP)
• Aetna Medicare Dual Select Plan (HMO Partial D-SNP)

The Aetna Medicare FULL D-SNP plans are available in 78 counties in Georgia. Our plans offer competitive benefits and includes many extras:

• Extra Benefits Card: $600 combined quarterly allowance on a prepaid debit card for OTC and healthy foods. No pre-qualifying conditions required.
• $0 Rx copays on all tiers at standard and preferred pharmacies.
• Dental: up to $4,500 allowance that covers preventive comprehensive care, including dentures and implants (excluding cosmetic services).
• Eyewear: up to $500 allowance.
• Transportation: up to 60 one-way trips (100 Mile radius) to medical appointments, pharmacies and SilverSneakers locations through SafeRide.
• LifeStation Personal Emergency Response: $0
• Hearing aids: up to $1,250 allowance per ear.
• Fall Prevention: $150 for home/bath safety devices.
• Plus … earn an extra $110 service fee when you complete the HRA via electronic submission.

CMS Med Advantage Reminder: Addition of Race and Ethnicity Data Fields on Enrollment Transactions for 2023

SUBJECT: Model Individual Enrollment Request Form to Enroll in a Medicare Advantage Plan (MA) or a Medicare Prescription Drug Plan (Part D), and Advance Announcement of January 2023 Software Release – Addition of Race and Ethnicity Data Fields on Enrollment Transactions


The Centers for Medicare & Medicaid Services (CMS) implements software changes to the enrollment and payment systems that support Medicare Advantage Prescription Drug (MAPD) programs. The purpose of this memorandum is to announce the addition of race and ethnicity data fields on the model Individual Enrollment Request Form to enroll in an MA or Part D plan, OMB No. 0938-1378 and provide high level advance notification of the associated system changes scheduled for release in January 2023. These new fields are required to be included on the enrollment form; however, applicant response to these questions is optional. When provided by an applicant, MA and Part D plans will submit these data to CMS as part of the enrollment transaction. If a plan receives a rejected transaction reply code (TRC) 394 or informational TRC 396 (see attachment C), the plan must send a subsequent corrected transaction code (TC) 92 to rectify. CMS expects plans to submit the beneficiary response to the race and ethnicity field, including confirming if the beneficiary did not provide the optional data. Until all race and ethnicity data are accepted by CMS, including annotating that the beneficiary did not answer the question, the field is not considered complete.