Anthem Ohio November 2020 AEP Updates & Reminders

Anthem communication from 11/2/20:

Slow & Steady Wins the Race!

We all know the old fable of “The Tortoise and the Hare.”  And, we’re all familiar with the moral of the story……. “Slow and Steady Wins the Race.”   Just like that fable, during AEP we must remember that slow and steady really is the key.  AEP is our Medicare Marathon; it is definitely not a sprint.  And, just like all experienced Marathon Runners, we should remember a few things to help keep us motivated and focused on our AEP success:  You Can Win with Small Consistent Steps  —  Don’t Compare Yourself with Others  —  Perseverance Will Always Yield Results.

With those strong AEP RESULTS in mind, we thought it would be a good idea to provide a quick refresher of some updates and enhancements we’ve rolled out over the last several weeks.  We suggest you keep this email handy to refer back to!

$50 HRA on DSNP

Great News! Beginning with 11/1/2020 effectives, Anthem Blue Cross and Blue Shield will reimburse Brokers $50 for their time and effort to complete and electronically submit Health Risk Assessments for new members enrolling in a D-SNP plan.  Completing a Health Risk Assessment (HRA) is an important part of helping Anthem connect your new D-SNP members with the support and care they need.  It’s fast and easy to submit your new D-SNP member’s application and Health Risk Assessment through mProducer!

Here’s How It Works:*

  • Each HRA must be completed and electronically submitted at the point of sale along with the application.
  • Reimbursement payments of $50 per HRA will be processed once the new D-SNP application is approved and the new member is active.
  • HRA completions for current members moving to or switching between D-SNP plans are not eligible for payment.
  •  Reimbursement payments will be included in commission statements.

*Reimbursement for HRA completion will be paid to the writing agent identified on the enrollment application within 60 days of the policy’s effective date. Reimbursement payments will only be paid for new D-SNP policies in participating plans sold with 11/1/2020 and beyond effective dates. Brokers associated with an FMO or MGA should consult with their agency regarding how and when reimbursement payments will be distributed


Care Guide Call  – MAPD Members

New Medicare Advantage plan members often have questions about their coverage.  We recognize the importance of quickly connecting with members to ensure they are taking FULL advantage of their new benefits.  The Care Guide Team includes experts who will reach out to your new Medicare Advantage members typically within the first 30 days of their approved enrollment

During this free call, the Care Guide Team will help your new members:
• Make sure they have received both their Welcome Kit (including their ID card) with the primary care physician of their choice and their OTC kit/card (where applicable).
• Review their plan benefits and answer questions about how those benefits work.
• Set up prescriptions for home delivery or pick up at a pharmacy.
• Register for online access to their plan information.
• Schedule their first doctor’s visit.
• Connect to community resources, and more.

Here’s How You Can Help: Let your new Medicare Advantage plan members know they can expect to receive a call from Anthem’s Care Guide Team typically within the first 30 days of their enrollment. Care Guide calls usually last about 20 minutes and will help your new members get off to a great start with Anthem!


EFT – Electronic Funds Transfer

When a member is interested in paying their premium using Electronic Funds Transfer (EFT), a voided check is no longer required!  As a direct result of your suggestions, this change was implemented and applies to Medicare Advantage Prescription Drug (MAPD) plans, as well as most Prescription Drug Plans (PDPs) submitted through mProducer.  Bank draft details entered on the screen during the enrollment process will now be passed to the plan electronically with the enrollment application. The EFT info will remain encrypted on the application PDF to protect our members. The document upload functionality will still be available if you choose to upload a copy of the voided check; however, it is no longer required.


Optional Supplemental Benefits (OSB) – Dental/Vision for MAPD Plans

Help your member complete their health care coverage with a dental and vision plan.  If members already have an MAPD plan in force, they have up to 90 days from the plan effective date to enroll!

Expanded coverage with:

  • One plan
  • One ID card
  • No waiting period

 OSB Plan information is included in every MAPD enrollment kit


Update to 2021 Plan Star Rating Fliers

The new 2021 Translated Medicare Advantage and Prescription Drug Plan Star Rating (PSR) fliers are now available on CustomPoint for downloading. The fliers are under the category “2021 PLAN STAR RATINGS.”  Also posted on CustomPoint is a versioning grid, titled “READ ME FIRST,” that will help you find the correct Star Ratings for a particular kit in those states with multiple contracts/Star Ratings.

A few items to note:

  • Old 2020 Star Ratings must be removed from Enrollment kits and replaced with the new 2021 Star Ratings by October 29, per CMS regulations. Please download and print the PSRs you will need. Once you select the PSR you need, use the “View or Print Document” link on the top right of the page for the PDF.
  • Please replace the Star Ratings fliers in kits you already have, rather than throwing entire kits away and re-ordering new ones.
  • All new Translated kits ordered through CustomPoint as of Monday, October 26th will automatically include 2021 PSRs with your order.


FREE 2022 AHIP Certification Training

Brokers who sell and retain 35 or more Medicare Advantage plans with 1/1/21 through 4/1/21 effective dates that are still enrolled as of 5/1/21, will earn FREE 2022 AHIP Certification Training!  Eligible NEW sales include all types of Medicare Advantage plans, PDP sales are not included.

Make sure rapid disenrollment doesn’t reduce your chances of earning Free 2022 AHIP Certification Training

 In an effort to help you meet your goals, we are offering a brief on-demand training session designed to help you avoid the most common Drivers of Rapid Disenrollment. It’s fast and easy to view or listen to this training session from your computer or mobile device.  AEP has already started so don’t wait!

Click the link below:


Updated Underwriting Guidelines – Medicare Supplement

In an effort to make us easier to do business with, we have added prescription drugs to our high level overview of the Underwriting Guidelines (UW) for brokers to use as a reference tool when writing Medicare Supplement (Med Supp) business.  We have designed an abbreviated list of prescription drugs that can be used in conjunction with the medical guide to assist brokers/agents during the application process.  Having this information on hand may reduce member abrasion by helping the broker understand when underwriting applies, what medical conditions or combination of prescription drugs would result in automatic denial of a submitted application and when the broker should consider other plan options that may be better suited for the prospect before submitting a Med Supp application.

**It is important to note that this is not a complete listing of all the medical conditions or prescribed medications that would result in a denial.  The attached underwriting and prescription guidelines are consistent across all states that require medical underwriting.  These guidelines are to be used as a broker tool ONLY and are not to be shared with members or prospects.

If there are questions about whether or not a Med Supp application would be approved or denied due to medical underwriting or prescription medications, brokers/agents should submit applications as they normally would and allow the underwriters to manage the underwriting review process.