Anthem MS Replacement Commission Payment Reminder

Medicare Supplement Replacement Commission Payment Reminder:

This is a reminder of the Medicare Supplement replacement commission payment policy. Replacement policies are sold to applicants purchasing an Empire Medicare Supplement policy that replaces a Medicare Supplement policy held with either Empire or another carrier.

In accordance with state regulatory requirements, the commission for Medicare Supplement replacement policies is paid at the “year two” renewal commission rate. Per state regulatory requirements and our broker agreement, we cannot pay and brokers cannot receive compensation in an amount greater than the renewal compensation on replacement policies.

 

  • Applies to Medicare Supplement business for the Blue states listed below along with Amerigroup states Arizona and Texas.
    • Blue: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin.
  • Does not apply to HealthyBlue, Simply, Blue Louisiana nor North Carolina or Amerigroup states of New Jersey, New Mexico, Tennessee or Washington.

 

Need more information or have questions? Please contact your CSM Representative.

UnitedHealthcare Medicare Solutions – Data Security Reminder

UnitedHealthcare Release:

Reminder: Data Security, UnitedHealthcare and You

At UnitedHealthcare, we take data security and privacy seriously. As cyber and privacy risk change, we are committed to protecting customer and member information. One of your responsibilities in that commitment as a UnitedHealthcare® agent requires you to participate in the data security review and verification process.

What you need to know and required actions

  • UnitedHealthcare will continue to require online attestations and questionnaire responses through a portal, which generally takes less than five minutes.
    • Initial emails containing a brief introduction, program background, and portal registration/login instructions originate from: noreply.securebroker@uhc.com
    • Any follow up emails will be issued from a UnitedHealthcare IT Security Analysts’ personal mailbox
    • All agents will eventually receive an email. These are done in monthly waves between January and August
  • You may also be selected for an additional review and validation of your data security. More details will be provided should you be selected.
  • Make sure your email address is up to date – This request and directions to complete this process will be delivered via email. You can verify and if necessary update your email in Jarvis or contact the Producer Help Desk (PHD) for assistance (see contact options below).
  • Please respond in a timely manner once you receive your request to complete your review.
  • Don’t worry if you don’t see an email right away. This is an ongoing process, and agents will receive the email at different times throughout the year.
  • For more information, you can review the UnitedHealthcare Broker Risk Management Program FAQ on Jarvis

This process helps us confirm that your data security controls and encryption processes help minimize risk for our member data. Data security is important to all of us! Thank you for working with us to keep our member data safe and secure.

UHC 2021 Med Supp Rate Information

Annual rate change information for 2021 AARP® Medicare Supplement Insurance Plans from UnitedHealthcare® is now available for the states listed below.

The rates in the following states will be effective June 1, 2021.
Please click on a state name to view the state-specific communication.

Arizona California Colorado
Florida Illinois Indiana
Kentucky Louisiana Michigan
New Mexico North Carolina Ohio
West Virginia

 

Here to Help
For more information, send an email to the Producer Help Desk at phd@uhc.com (include agent writing number in the subject line) or contact your CORNERSTONE SENIOR MARKETING REP.

WellCare’s Digital Resource Center: New for 2021!

NEW for 2021! – Pre-Enrollment Materials Available in Seconds

WellCare is excited to share a great new tool that provides all the information you need to meet with beneficiaries at your fingertips. Plus, materials are available in multiple languages!

The new digital resource center gives you easy access to:

  • Sales Presentations
  • Pre-Enrollment Guides
  • Benefit Highlights
  • OTC Catalogues
  • Formularies

Click the link Centene First Look – Digital Resource Center to access the digital resource center.

 

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

UHC 2021 Med Supp Rates & New Kits Are Available

UHC’s Med Supp communication from 2/26/21:

 

2021 rates are here! Fortunately we were able to come well below the 5% typical threshold and rate are only going up about 3.5%! UHC Supps are already incredibly competitive in OH so this should make things even better!

 

And that’s not all…. Fortunately the Med Supp team were able to increase the Multi Insured Discount from 5% to 7%!  This will go into effect 6/1/2021 as well and will apply to all current members as well as new members who:

  • Have the same address
  • Share the same AARP Number
  • Both have an AARP Med Supp Plan with us

This discount is automatically applied so nothing is needed from the members or the agents.

Go to the sales material portal in Jarvis and order yours today!!!   Here’s what it looks like:

 

If you have any questions regarding UHC’s new Med Supp rates or kits, contact your CSM representative. 

Lumico Holiday Calendar 2021

Lumico communication from 2/25/21:

 

To help you prepare for the year, please review Lumico’s Holiday Calendar.

This contains the specific dates that our office and service centers will be closed, or hours of operation may be limited.

 

If you have any questions please contact your CSM representative.

Anthem: TX – FEMA Disaster Declaration Issued Due to Winter Storm & SEP

Anthem BCBS communication from 2/23/21:

In regards to the recent weather storm in TX, a disaster declaration was issued by the TX Governor on 2/12 in all 254 counties, and a FEMA disaster declaration was approved on 2/14. Therefore, the SEP for the Texas winter storm will be 2/12/2021 –  6/12/2021. Please see the MCMG guidance below and links to the aforementioned disaster declarations:

  1. SEP for Individuals Affected by a FEMA-Declared Weather Related Emergency or Major Disaster

42 CFR 422.62(b)(4)

(Rev. 1, Issued: July 31, 2018; Effective/Implementation: 07-30-2018)

A SEP exists for individuals affected by a weather-related emergency or major disaster who were unable to, and did not make an election during another valid election period. This includes both enrollment and disenrollment elections. Individuals will be considered “affected” and eligible for this SEP if they:

  • Reside, or resided at the start of the incident period, in an area for which FEMA has declared an emergency or a major disaster and has designated affected counties as being eligible to apply for individual or public level assistance;
  • Had another valid election period at the time of incident period; and
  • Did not make an election during that other valid election period.

In addition, the SEP is available to those individuals who don’t live in the affected areas but rely on help making healthcare decisions from friends or family members who live in the affected areas. The SEP is available from the start of the incident period and for four full calendar months thereafter.

TX Governor Disaster Declaration Statement 2/12

https://gov.texas.gov/news/post/governor-abbott-issues-disaster-declaration-in-response-to-severe-winter-weather-in-texas

 

FEMA Disaster Declaration Statement 2/14

https://www.fema.gov/node/613509

 

If you have any further questions regarding this SEP, please contact your CSM rep.

Aetna MA Q1 Insights Newsletter

Communication produced by Aetna on 2/23/21:

Aetna Insights for consultants and brokers:

News you can use:

• Breaking News: Leadership announcement
• Top Story: CVS Health® and Aetna®: Where you want us to be — Caring, Connected and Closer to Home
• Legislative Update
• COVID-19 Update: Supporting you and your clients through the next phase of the pandemic
• Local Focus:
o CVS® HealthHUB™ expansion continues in the Ohio and Kentucky market
o Learn about Aetna Whole Health – Cleveland Clinic plan

 

BREAKING NEWS:

Daniel Finke named President of Health Care Benefits Segment
Daniel Finke is now Executive Vice President, CVS Health® and President, Health Care Benefits Segment, Aetna. His appointment was effective February 1. He takes over from Karen S. Lynch, current President and CEO of CVS Health. She stepped into that position after Larry Merlo’s retirement in early February.

“It’s an honor to lead the Health Care Benefits segment and to support our customers, members, providers and colleagues,” said Finke. “I’m committed to simplifying the health experience for members using digital solutions and bringing to market CVS Health integrated products that demonstrate our unique ability to serve the needs of our customers.”

Finke brings more than 25 years of diverse health care experience to the company. He joined Aetna in 2014. Most recently he was leading the Commercial Business and Markets organization. He also held leadership roles in network and clinical services and was a key leader on the transformation team during the integration with CVS Health.

Before joining Aetna, Finke served as President and Chief Operating Officer of EmblemHealth. He previously spent more than a decade at Anthem in various national executive roles in healthcare operations, government programs and pharmacy benefit management.

 

CVS Health® and Aetna®: Where you want us to be — Caring, Connected and Closer to Home
Both CVS Health and Aetna separately have long-standing commitments to their customers and members. We put them at the center of everything they do. Together, we’re showing how CVS Health and Aetna can reimagine the health care experience.

Leveraging the assets of both CVS Health and Aetna has created unique benefits and advantages for customers and members that show the value of an integration of these two companies. These include:
• A more personalized, simplified member experience that meets people where they are
• More connected care that offers better end-to-end solutions, improved outcomes and lower costs
• Unmatched engagement that promotes behavior change
We are bringing solutions to the market that deliver a health experience that is more caring, connected and closer to home.
Caring: Reinventing the member experience
We’re transforming the way members manage their health like never before. We make it more seamless and relevant at every stage of their health journey. We do so by combining retail convenience, face-to-face engagement, expanded telehealth care and bundled products and services. Taken together, we deliver an improved health care experience that fits our members’ individual needs and lifestyles.
Connected: More connected care
We’re connecting care for both members and providers throughout the health journey. We use innovative technology that connects our data and expertise. This means we can offer end-to-end solutions that help members manage their care, and costs, in ways that no one else can. With deeper connectivity and richer data exchanges among Aetna, CVS Pharmacy and members’ own providers, we can create a more holistic awareness of member health, helping providers have access to the same electronic medical records. Driven by rich data and analytics, we can identify health opportunities. At the same time, members have an entirely seamless, connected interaction.
Closer to home: Unmatched engagement for our members
Combining CVS Health and Aetna means making care more accessible. When this happens, we can better engage members. This empowers behavior change, resulting in better health outcomes earlier for members. Over 4.5 million Americans engage with our enterprise daily. With nearly 10,000 CVS Pharmacy stores, Americans have access to thousands of community-based CVS pharmacists who can provide face-to-face clinical advice.

With unique channels that are both in-person and virtual, no one can engage members like we do.
Why it matters: For you and your clients
The integration of medical and pharmacy benefits continues to yield savings. Our 2020 study confirms savings of $6 to 11 per member per month each year. That’s an average of $95 per member per year. And that’s a savings of 1.5 to 3 percent annually.1

Our medical cost savings from integrated pharmacy benefits grew due to our unique approach to member engagement. This is especially true for members with chronic conditions such as behavioral health, diabetes and COPD.

Key capabilities and expertise from both Aetna and CVS fuel innovations and enhancements in how we support Specialty patients and manage Specialty spend. Full adoption of Specialty Rx programs, and PrudentRx for further copay optimization, can mean up to 27 percent in total savings across specialty medical and pharmacy.2

CVS Health and Aetna also has the power to go beyond just pharmacy and medical integration. Together, we can see a total cost-of-care savings for plan sponsors of as much $50 per member, per month.3

CVS Health and Aetna aren’t waiting for the future ¬. We’re defining it today. And we’re willing to prove it. Ask your Aetna Account team about our Integrated Value Guarantee.*

 

Legislative Update

New year, new president, new administration and congress. We expect a wave of health care related changes this year. Efforts to curtail the ongoing pandemic will likely take the spotlight.

The Biden administration has proposed, and Congress is actively considering the America’s Recovery Plan stimulus plan. This plan proposes an increase of the Affordable Care Act (ACA) Premium Tax Credit. It will cap enrollee payments at no more than 8.5 percent of income for coverage. Subsidies are currently capped at 400 percent of the federal poverty level. In addition, the administration proposes to extend subsidies for people to afford their COBRA insurance though the end of September 2021. In general, CVS Health® supports strengthening employer sponsored insurance and promoting affordable access to coverage.

Longer term, the new administration’s health care agenda also includes pushing for broader access to health care. The goal is to improve the ACA marketplace and strengthen Medicaid services. President Biden has signed Executive Orders expanding the enrollment period for ACA. He’s also urged agencies to review and rescind policies that make enrolling in ACA and Medicaid programs more difficult.

CVS Health has a long track record of supporting affordable health coverage for all Americans. We support strengthening the ACA. It has already brought affordable coverage to millions of Americans. This can be done by enhancing federal reinsurance, funding cost-sharing subsidies, providing states with incentives to expand Medicaid, and maintaining protections for those with preexisting conditions.

Also, we are committed to strengthening the employer-based insurance system, particularly during the public health emergency. CVS Health supports preserving coverage by providing subsidies for employer-sponsored coverage during the public health emergency and expanding pre-deductible coverage for primary and preventive care.

We also expect the Biden administration and congress to turn their attention to lowering drug costs. The price of prescriptions is still too high and out of reach for far too many. Lowering drug prices is a prerequisite to controlling health care costs. In turn, drug costs affect affordability, access to care and improving outcomes.

CVS Health believes that lower drug prices can be achieved by:
• More competition in the pharmaceutical marketplace by increasing the number of approved drugs available to patients and removing barriers to market entry for new ones
• Comprehensive reform to the Medicare Part D program that caps Medicare beneficiaries’ out-of-pocket costs and better aligns incentives between manufacturers, plans and the government
• Drug patent reform, including ending pharmaceutical manufacturer gaming of the drug patent system
• Improving access to generic drugs and biologically similar medicines by changing provider reimbursement to give physicians incentives to prescribe and administer lower-cost drugs
CVS Health is actively working with members of congress, their staff, and the new Biden administration to consider policies to help:
• Get the COVID-19 pandemic under control
• Improve access to quality health care
• Lower costs for consumers

 

COVID-19 UPDATE:

Supporting you and your clients through the next phase of the pandemic

Aetna, as part of CVS Health®, remains committed to supporting our consultants, clients and members during the pandemic.

CVS Health® is one of the distribution partners for the vaccine. CVS Pharmacy® will play a prominent role in administering vaccinations across the nation. Aetna®, as part of CVS Health, is staying close to the vaccine developments. And we’re committed to making it easier for your clients and their employees to get the latest information at the right time to help inform their decision making.

The following captures some of our actions that are already underway:

  • On February 11, 2021, CVS Health® began offering COVID-19 vaccinations to eligible populations at a limited number of CVS Pharmacy locations in 11 states. CVS Health will receive about 250,000 doses from the federal government. Click here for more details.
  • Aetna is preparing to support essential worker vaccinations using our national CVS Pharmacy footprint and immunizers. This will follow the vaccination of frontline health care workers and long-term care residents, and prior to the availability to the general population. For employers that meet requirements, an onsite or dedicated COVID-19 vaccine clinic for essential workers may be an option.
  • All Aetna insured and self-funded plans, including Aetna Funding AdvantageSM plans offer members a $0 cost share for the vaccine at both network and out-of-network providers. This approach follows the federal mandate.
  • Access our COVID-19 and vaccine resource page on Aetna.com for frequently asked questions and the latest tools and information. There’s also a state lookup tool that connects members to state resources on vaccine eligibility and rollout phases.

* For more details and client eligibility requirements, contact your Aetna account representative.

For the latest information, visit our COVID-19 support site. You can also check out the CVS Health COVID-19 resource center for information on managing health and well-being.

LOCAL FOCUS

At CVS Health and Aetna, we set out to reimagine what the health care experience could be – we are revolutionizing community-based health care by safely connecting people to care, when and where they need it, with CVS® HealthHUB™. Despite the challenges of COVID-19 last year, our commitment to continue the expansion of CVS HealthHUB locations exceeded our goal for the end of 2020, and since December 2020, an additional 159 locations were opened in 28 states across the country.  We are excited to continue the momentum and reach 1,300 locations nationally by the end of 2021.

Now more than ever, the need for convenient care is paramount.  When health care is coordinated and timely, and data and technology are utilized effectively, people can be better engaged in their care. This can help improve outcomes and reduce health care costs. CVS HealthHUB locations help connect people to care, when and where they need it, by:

  • Serving as a channel for member engagement and personalized care support with a professional care team and our consumer-centric model that ensure your supported every step of the way
  • Delivering on the continued need for convenient and affordable care that’s available 7 days a week, including evenings, virtual or in-person
  • Supplementing the in-store experience for consumers with integrated digital and telephonic resources

To learn more about our approach to community-based health care delivery, and see what’s behind the scenes at a CVS HealthHUB, watch this quick video watch this quick video  and experience how we’re revolutionizing community-based health care.

CVS HealthHUB locations in the Ohio and Kentucky market

The Ohio and Kentucky market has 58 open CVS HealthHUB locations and 6 additional planned openings through second quarter 2021.

Recently opened locations:
ADDRESS CITY STATE ZIP
1949 West Market Street
Akron
OH
44313
418 East Main Street
Ashland
OH
44805
1331 North Fairfield Road
Beavercreek
OH
45432
7230 Market St.
Boardman
OH
44512
601 East Main Street
Canfield
OH
44406
16801 Chillicothe Rd.
Chagrin Falls
OH
44023
1495 West 5th Ave.
Columbus
OH
43212
7470 Sawmill Rd.
Dublin
OH
43016
60 N. Stygler Rd.
Gahanna
OH
43230
3761 Massilon Rd.
Green
OH
44685
4961 Roberts Road
Hilliard
OH
43026
111 South Memorial Drive
Lancaster
OH
43130
1443 Richmond Rd.
Lyndhurst
OH
44124
900 Coshocton Ave
Mount Vernon
OH
43050
1339 N. Main St.
North Canton
OH
44720
620 S. Cleveland Ave.
Westerville
OH
43081
6005 Som Center Rd.
Willoughby
OH
44094

 

The power of two – Aetna and the Cleveland Clinic – offering care that’s simple, engaging and affordable for Northeast Ohio employers

The Aetna Whole Health – Cleveland Clinic plan is a multi-faceted collaboration with a co-branded insurance plan and the strength of the world-renowned Cleveland Clinic.

This unique plan offers Northeast Ohio employers and their employees:

  • Improved clinical outcomes
  • A more engaging experience, and a
  • Stronger bottom line
 

Anthem Commission Statement Update

Exciting news!

Anthem BCBS is now going to be moving from monthly to weekly commission statements. Whether you get your Commission Statement from Producer Toolbox or by mail, you’ll see a simpler, easier to understand format. Some of the highlights include easier navigation, improved member tracking and more clearly defined data.

For more information from Anthem, click here

 

If you have any follow up questions or concerns, reach out to CSM commissions department

Anthem’s Review on Insulin Coverage

Do you have questions about Insulin? Anthem BCBS is here to help!

Email communication from Anthem OH Medicare team from: 2/22/21

 

There are many questions regarding insulin coverage so we’d like to take a moment to highlight Insulin specific benefits on our MAPD Plans.  We have solutions to help your members manage their Insulin costs.  In many cases, these options can be even lower than the $35 Insulin Copay program.  Take a moment to review the tips below to help members make the most out of the opportunity to $ave!

Lispro, Humulin, Humalog and Levemir FlexTouch PEN are in our MAPD Tier 3 Category.  Using Mail Order, the member will receive a 90 Day Supply for 2 Months copay!  That equates to a total cost of $84; or, $28 per month!

Be certain, when doing a drug search in the OnLine Store (https://shop.anthem.com/medicare ), search “Humalog” or “Insulin Lispro”.  Make sure to indicate Mail Order for the 90 day supply pricing. Please note: you must enter “Insulin Lispro”.  Also, make sure you are running a full comparison of all drugs the individual is taking.  There can be a significant difference in pricing.

On our MAPD plans, Lancets are covered at a $0 copay.  Lifescan One Touch and Roche Accu-Check Diabetic Test Strips and Monitors are covered at a $0 copayFreestyle Libre Glucose Monitor is also covered at a $0 copay.

Our plans also provide Unlimited Routine Foot Care with a $0 copay.  Competitor plans often limit the number of visits per year and include a copay.

In addition to our Insulin benefits, there are many other benefits to consider when comparing plans:

  • MOOP
  • PERS
  • OTC benefit that carries over quarter to quarter
  • $3000 hear aid benefit
  • Essential Extras option that improve quality of life

We hope that this brief overview has helped answer some questions you have around Insulin and Diabetic Supplies.

 

 

If you have additional questions, don’t hesitate to reach out to your CSM Representative.