Humana’s High Deductible Plan G Now Available

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 EFT Backlog Update

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.

UHC’s Update Regarding Walmart/Solutran OTC Benefit

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

  1. Registration:

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.

2. Shipping:

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.

CLICK TO VIEW UHC’S OVER THE COUNTER FAQ DOCUMENT

Mutual of Omaha Update – PDP commissions delayed, and more.

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

UHC’s Medicare Med Supp Deep Dive Trainings in Ohio

UHC will be covering topics ranging from the new rates, At Your Best by UnitedHealthcareTM (including Renew Active for AARP Medicare Supplement Plans) and the Authorized to Offer program, among MUCH more!

 

Register to John Herbut @ johnherbutfromthedeskof@uhc.com, for the session that best accommodates your schedule.

        *MUST REGISTER VIA EMAIL BECAUSE SPACE IS LIMITED! 

Can’t make any of these sessions?

Fret not, because WebEx meetings are coming soon! And John from UHC will be back in Ohio the week of February 24th in Dayton, Toledo and Akron- more info to come!

 

Tuesday, January 14, 2020

10:00 AM – 12:00 PM ET

Holiday Inn Independence

6001 Rockside Rd.

Independence, OH 44131

REGISTER TO JOHN HERBUTplease indicate which training date you will be attending

 

Wednesday, January 15, 2020

10:00 AM – 12:00 PM ET

Hilton Garden Inn

6165 Levis Commons Blvd.

Perrysburg, OH 43551

REGISTER TO JOHN HERBUTplease indicate which training date you will be attending

 

Thursday, January 16, 2020

10:00 AM – 12:00 PM ET

Hilton

8700 Lyra Dr.

Columbus, OH 43240

REGISTER TO JOHN HERBUTplease indicate which training date you will be attending

Anthem’s 2020 Updates & Important Info

MA/PDP Bank Drafts:

A voided check has always been required to set up EFT on these contracts. It could take up to 2 billing cycles for the draft to go in effect so members can expect a bill the first month. PDP members who fall out of the automation process and who have not submitted a voided check are receiving letters requesting a voided check. Unfortunately, IT is unable to retrieve the electronic banking info from the system due to how the info is encrypted.  The voided checks need to be submitted until a fix is identified.

February bills are being dropped between 1/3 and 1/9 so please make members aware that they could receive another bill.

HOW to submit voided check info?

  1. If the draft info is in-house, but they just need to confirm if it is a checking or savings account,  work through Agent Services.
  2. Submit the correct EFT form with data via fax: 800 833 8554

Open Enrollment Period (OEP): 

The Centers for Medicare & Medicaid Services (CMS) has re-established an Open Enrollment Period (OEP).  OEP will begin January 1 and end March 31, 2020.

This enrollment opportunity is available to beneficiaries who are currently enrolled in a Medicare Advantage Plan (with or without drug coverage) and allows the following:

  • Switch to another Medicare Advantage Plan (with or without drug coverage).
  • Disenrollment from the Medicare Advantage Plan and return to Original Medicare and enrollment into a standalone Prescription Drug Plan.

During this period, beneficiaries may not:

  • Switch from Original Medicare to a Medicare Advantage Plan.
  • Join a Medicare Prescription Drug Plan (if currently enrolled in Original Medicare).
  • Switch from one standalone Medicare Prescription Drug Plan to another.

One change is permissible during this period, and any changes made will be effective the first of the month after receipt of the enrollment application.

Marketing Guidance

Plans, including agents/brokers, may NOT knowingly conduct any OEP marketing to Medicare Advantage members during the OEP timeframe. This prohibition includes knowingly targeting or sending any unsolicited marketing materials, by telephone, direct mail and/or e-mail.

Examples of ‘knowingly’ targeting for OEP:

  • Sending unsolicited materials advertising the ability/opportunity to make an additional enrollment change or referencing the OEP.
  • Messaging specifically calling out the OEP; including dates/timeframe – even in an ‘educational’ context for existing members/clients.
  • Marketing to beneficiaries who are in the OEP because they made a choice during the Annual Enrollment Period (AEP) by purchase of mailing lists or other means of identification.
  • Engage in or promote agent/broker activities that intend to leverage the OEP as an opportunity to make further sales.
  • Call/Contact former enrollees who elected a new plan during the AEP.

Marketing activities focused on other enrollment opportunities may continue to be conducted, such as (but not limited to):

  • Age-Ins
  • 5-star Plans (if available)
  • Dual-eligible and LIS beneficiaries

Agents/Brokers may also, upon beneficiary request, send marketing materials, schedule one-on-one meetings and provide information regarding OEP via telephone.

Note: The unintentional receipt of other marketing materials by beneficiaries who have already made an enrollment decision is not be considered knowingly targeting.

Additionally, if a beneficiary contacts an agent/broker and asks about their eligibility to enroll into the plan — but makes no explicit reference to OEP — the agent/broker can and should review their information and utilize an eligible enrollment period, including OEP, to assist the beneficiary with the desired plan change.

For example, if an agent/broker sends mailers to a list of age-ins discussing the Initial Coverage Election Period (ICEP), it is possible that some recipients may have already made an enrollment decision; however, the content of the message to the intended audience of age-ins is not prohibited OEP marketing.

OEP activity must be initiated by the member.

Any proactive marketing or unsolicited contact by an agent/broker during the OEP will be subject to a Sales Allegations and subsequent corrective action.

The Centers for Medicare & Medicaid Services (CMS) has re-established an Open Enrollment Period (OEP).  OEP will begin January 1 and end March 31, 2020.

This enrollment opportunity is available to beneficiaries who are currently enrolled in a Medicare Advantage Plan (with or without drug coverage) and allows the following:

  • Switch to another Medicare Advantage Plan (with or without drug coverage).
  • Disenrollment from the Medicare Advantage Plan and return to Original Medicare and enrollment into a standalone Prescription Drug Plan.

During this period, beneficiaries may not:

  • Switch from Original Medicare to a Medicare Advantage Plan.
  • Join a Medicare Prescription Drug Plan (if currently enrolled in Original Medicare).
  • Switch from one standalone Medicare Prescription Drug Plan to another.

One change is permissible during this period, and any changes made will be effective the first of the month after receipt of the enrollment application.

Marketing Guidance

Plans, including agents/brokers, may NOT knowingly conduct any OEP marketing to Medicare Advantage members during the OEP timeframe. This prohibition includes knowingly targeting or sending any unsolicited marketing materials, by telephone, direct mail and/or e-mail.

Examples of ‘knowingly’ targeting for OEP:

  • Sending unsolicited materials advertising the ability/opportunity to make an additional enrollment change or referencing the OEP.
  • Messaging specifically calling out the OEP; including dates/timeframe – even in an ‘educational’ context for existing members/clients.
  • Marketing to beneficiaries who are in the OEP because they made a choice during the Annual Enrollment Period (AEP) by purchase of mailing lists or other means of identification.
  • Engage in or promote agent/broker activities that intend to leverage the OEP as an opportunity to make further sales.
  • Call/Contact former enrollees who elected a new plan during the AEP.

Marketing activities focused on other enrollment opportunities may continue to be conducted, such as (but not limited to):

  • Age-Ins
  • 5-star Plans (if available)
  • Dual-eligible and LIS beneficiaries

Agents/Brokers may also, upon beneficiary request, send marketing materials, schedule one-on-one meetings and provide information regarding OEP via telephone.

Note The unintentional receipt of other marketing materials by beneficiaries who have already made an enrollment decision is not be considered knowingly targeting.

Additionally, if a beneficiary contacts an agent/broker and asks about their eligibility to enroll into the plan — but makes no explicit reference to OEP — the agent/broker can and should review their information and utilize an eligible enrollment period, including OEP, to assist the beneficiary with the desired plan change.

 

For example, if an agent/broker sends mailers to a list of age-ins discussing the Initial Coverage Election Period (ICEP), it is possible that some recipients may have already made an enrollment decision; however, the content of the message to the intended audience of age-ins is not prohibited OEP marketing.

OEP activity must be initiated by the member.

Any proactive marketing or unsolicited contact by an agent/broker during the OEP will be subject to a Sales Allegations and subsequent corrective action.

Medicare Supplement Plan F:

Due to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), we made changes to our portfolio of plan offerings. For members effective 1/1/2020 or later, Plan F that we offered through our Anthem Insurance Companies, Inc. (AICI) legal entity, will not be available. This change is reflected on the current Outline of Coverage, included with the sales kits in the market to support 2020 products and rates as of September 2019, and will be available through the Online Store and mProducer on January 24, 2020.

Importantly, Plan F and Select Plan F are still available for eligible enrollees through Community Insurance Companies, Inc. (CIC) dba Anthem Blue Cross and Blue Shield.  This change does not impact those currently enrolled in either plan.  Any applications for Plan F/Select F and 1/1/2020 effective dates using the OLD 2019 application will need to be resubmitted using the new application that supports the 2020 portfolio through Community Insurance Companies, Inc., or select a coverage effective date of 12/31/2019 if allowed under the applicants enrollment period.

Med Supp Kits are available with new 2020 Medicare Amounts. Rates have been updated to reflect the changes as noted above. See attached for current rates.

Medicare Supplement Bonus:

Our Medicare Supplement Broker Bonus is extended and increased for January, February & March 2020 Effective Dates!

  • If you sell 3-4 approved Medicare Supplement plan enrollments, you’ll receive an additional $150 bonus per sale!
  • If you sell 5-9 approved Medicare Supplement plan enrollments, you’ll receive an additional $200 bonus per sale!
  • But if you sell 10 or more approved Medicare Supplement plan enrollments, you’ll receive an additional $250 bonus per sale!
  • Anthem Medicare plans currently marketed include SilverSneakers and are designed with your clients in mind!
  • Our commission schedule pays lifetime renewals! You can earn 21% commission years 1-6 and 4% commission years 7+! (applies to new business only)

PDP AOR:

The AOR procedure applies to PDP plans along with Medicare Advantage, Medicare Supplement, and Anthem Extras policies.

The letter must include:

  1. The member’s name and policy number,
  2. The name and encrypted tax ID or agent ID of the new Agent of Record, and
  3. Must include a signature date indicated in the letter.

Ingenio RX replacing Express Scripts for 2020:

Attached are the IngenioRx mail order form and a claim form.

  • Improves affordability for our members.
  • Provides a more seamless member experience.  Anthem will leverage our provider relationships to ensure confident, informed decision making which will lead to better health of your members.
  • Simplified, consistent, and coordinated experience for the member.
  • Will help in keeping MAPD benefits consistent by driving total costs down.
  • 24/7 access pharmacy via toll free number on the back of their membership card.
  • Electronic Prior Authorizations.
  • Active mail-order and specialty scripts will automatically transfer 1/1/2020. Member will need to update payment information before a mail order prescription can be shipped.

MBI Only:

Effective 01/01, only the MBI format will be accepted in the online tools. You can help your prospects locate their MBI on www.SSA.gov if they do not have their card handy.  Incorrect MBIs will result in RFIs (Request for Information) whether paper or electronic apps. You can track the progress of the application in mProducer. RFI status will display what information is needed.

Transportation:

The transportation vendor in Ohio has changed effective 1.1.20. The new vendor is Access2Care.

  • Access2Care  Reservations: 877-478-5120 TTY: 866-874-3972

Optional Supplemental Benefits:

  • Optional Supplemental Benefits can only be added during certain times of the year. During AEP from October 15 – December 7, during OSB Open Enrollment Period from December 8 – March 31 or if you are a new member, you can add OSB within the first 90 days of your initial enrollment.
  • Fax the completed form to: 1-800-833-8554 or, mail to: Anthem Blue Cross and Blue Shield, P.O. Box 659403, San Antonio, TX 78265-9714

Medical Mutual’s January 2020 Updates

Medicare Updates from Medical Mutual of Ohio:

  • Medicare Advantage members can expect their ID cards to arrive by Jan. 1, 2020. The Welcome Kit will be delivered in the middle of January 2020.
  • As a reminder, MMO’s Medicare Advantage plans now offer a transportation benefit. If your clients have inpatient hospital stays, they automatically qualify for this service. To review the details of this benefit, click here.
  • To expedite the processing of Medicare Supplement applications, please submit them online. The online application is the only system that will give you access to tracking. To submit a Medicare Supplement application, follow the steps below:
    • Go to MyBrokerLink and log in.
    • Click on the Sales and Quoting tab and select Quote/Enroll Medicare.
    • Click on the Start New Medicare Application button.

If you have any questions, reach out to your Cornerstone Senior Marketing representative.

Humana’s Achieve Med Supp is now in Ohio!

ACHIEVE IS READY TO SELL IN OHIO!

Humana’s Achieve Medicare Supplement plan is now accepting new business in OHIO with an effective date of January 1, 2020 or later! 

Sales activities for Plans A, F, G and N can begin with 1/1/2020 as the first available effective date of coverage. Plan High Deductible G & N sales activities will begin with signature dates starting with 1/1/2020, as the first available effective date of coverage.

CLICK HERE TO VIEW OUTLINE OF COVERAGE

CLICK HERE TO VIEW FAQ DOCUMENT

 

ACHIEVE BONUS PROGRAM!

Producers can earn uncapped bonuses with a minimum of 3 underwritten cases in a month with Achieve plans! 

View more info here on bonus program

 

Not appointed with Humana? Contact your Cornerstone Senior Marketing Sales Representative today to get started!

Anthem’s Change to Med Supp Plan F Offering

Due to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Anthem made changes to their portfolio of plan offerings. For members effective 1/1/2020 or later, Plan F that was offered through Anthem Insurance Companies, Inc. (AICI) legal entity, will not be available. This change is reflected on the current Outline of Coverage, included with the sales kits in the market to support 2020 products and rates as of September 2019, and will be available through the Online Store and mProducer on January 24, 2020.

Importantly, Plan F and Select Plan F are still available for eligible enrollees through Community Insurance Companies, Inc. (CIC) dba Anthem Blue Cross and Blue Shield.  This change does not impact those currently enrolled in either plan.  Any applications for Plan F/Select F and 1/1/2020 effective dates using the OLD 2019 application will need to be re-submitted using the new application that supports the 2020 portfolio through Community Insurance Companies, Inc., or select a coverage effective date of 12/31/2019 if allowed under the applicants enrollment period.

 

If you have any questions please reach out to your Cornerstone Senior Marketing contact.

Anthem’s New Medicare Validation

Medicare Validation is Now Available on mProducer with Anthem

Starting Saturday, 12/14/2019, Brokers can perform Medicare validation using mProducer.  mProducer will return the following information: 

  • Medicare Part A Effective Date
  • Medicare Part B Effective Date
  • Current Contract Code
  • Drug Gap in Months
  • LIS Validation
  • LIS Level
  • Date LIS Last Used as an SEP

 

It’s simple!  Just click on the landing page tile Eligibility Check: Medicare and Medicaid, enter the client’s name, date of birth, proposed effective date, and Medicare Beneficiary Identifier (MBI).  Then click Check Eligibility.

 

If you have been requesting D-SNP validation using mProducer, take note!

  • The DSNP Eligibility Check tile has been renamed Eligibility Check: Medicare and Medicaid to reflect the enhancement for Medicare only validation.
  • When performing DSNP validation, you will now click on the Eligibility Check: Medicare and Medicaid tile and then click on the DSNP Eligibility Check tab.

Medicare Only Validation and D-SNP Validation Updates

  • The field titled Do they have LIS? has been renamed Do they have LIS for the Proposed Effective Date? to make that clear.
  • You can no longer perform validations with HICN due to CMS replacing HICN with MBI.  You MUST use the MBI.

 

D-SNP Validation Updates

  • When your client is ineligible for a D-SNP plan, it is because he does not have an eligible Medicaid level, or does not have Medicaid.  The values for MEDICAID LEVEL have been updated to differentiate between these two scenarios.
    • If a client does not have an active Medicaid policy, the MEDICAID LEVEL will indicate No Medicaid.
    • If the client does have an active Medicaid policy, the response will display the Medicaid level, or Unqualified if the Medicaid level cannot be interpreted from the state data.
  • Submitting DSNP applications is quicker than ever!  When you submit the application directly after performing the D-SNP validation, mProducer will automatically populate the application with Medicare Part A and Part B effective dates, MBI, and Medicaid Number or SS, reducing data entry!