Update from Anthem Ohio Regarding Welcome Kits & ID Cards

Anthem updates on the welcome kits and cards that are being sent out to Ohio clients.

Member Welcome Kit Includes (See link below for more details):

  • Member ID card
  • New member checklist
  • Instructions on how to set up their introduction call

OTC Welcome Kit Includes (See link below for more details):

  • OTC card
  • Important tips on using the OTC card
  • How to use the OTC card guide
  • List of retail stores where members can use their OTC cards

Flex Card:

  • Pre-activated Mastercard that is ready to use when delivered
  • To check the balance of their account members can visit https://mymedicareflexaccount.com or call member services at 1-833-299-5088 and choose the option to hear their current balance.

 

DOWNLOAD ANTHEM GUIDE HERE

 

Lastly, Please be sure to visit Anthem Broker Connection website (using Google Chrome) to register for upcoming trainings https://www.anthembrokerconnection.com/#/home.

 

 

 

IMPORTANT AETNA OHIO NETWORK UPDATE: TRINITY – MOUNT CARMEL HEALTH SYSTEM

Negotiations Completed with Trinity – Mount Carmel Health System – OH in the Central Ohio network

Aetna announced they have reached a new multi-year agreement with Trinity – Mount Carmel Health System – OH effective 01/01/2022. Trinity will be sending out a patient letter. As a result of this successful negotiation process, Trinity – Mount Carmel Health System – OH will continue to participate in Aetna’s Central Ohio network for the following products:

• Open Choice® PPO
• Aetna Open Access® Managed Choice® POS
• Aetna Select℠
• Aetna Open Access® Elect Choice® EPO
• Quality Point-of-Service® (QPOS®)
• Aetna Health Network Only℠ (HNO)
• Aetna Medicare℠ Plan (HMO)
• National Advantage Program (NAP)
• Mount Carmel Neighborhood Network
• Central Ohio Primary Care Managed Choice • Aetna Choice® POS II
• Managed Choice® POS
• Open Access Aetna Select℠
• HMO
• Aetna Choice® POS
• Aetna Health Network Option℠ (HNO)
• Aetna Medicare℠ Plan (PPO)
• Aetna Premier Care Network℠
• Aetna Whole Health℠ – (NAME OF ACO
• National Advantage™ Program

There has been no interruption to member access because an agreement was reached before the contract’s termination date. Member letters were never released; therefore, retraction member letters are not necessary.

 

Provider Search/directory information
Trinity – Mount Carmel Health System – OH is included in Aetna’s online provider search tool and in their current printed provider directories.

Click HERE to read Trinity- Mount Carmel Health’s announcement regarding the completed negotiations.

 

 

Questions? Reach out to your Sales or Service Rep at any time!

614-763-2255

or by email:  service@ornerstoneseniormarketing.com

WellCare: Declared Special Enrollment Period for Kentucky

Special Enrollment Period: Kentucky Emergency Declaration – Inclement Weather, Flooding

Please be advised that a state of emergency was declared, impacting the individuals in all Kentucky counties. This declaration allows for a one-time Special Enrollment Period (SEP), in the event beneficiaries were unable to make an election during another qualifying election period. Please reference the following guidelines for the incident period. This SEP applies to all the impacted counties in Kentucky.

Important Compliance Information

Who is eligible:

This SEP opportunity is ONLY available to beneficiaries who:

• Reside, or resided at the start of the SEP eligibility period described in this guidance, in an area for which a federal, state or local government entity has declared a disaster or other emergency or they do not reside in an affected area but rely on help making healthcare decisions from one or more individuals who reside in an affected area; and
• Were eligible for another election period at the time of the SEP eligibility period, and;
• Did not make an election during that other valid election period due to the disaster or other emergency.

Details:
Impacted Counties: All Counties

Incident Period: The incident period occurred on December 31, 2021. The declaration was announced on January 1, 2022.

Timeframe: Effective immediately, individuals meeting the requirements listed above can enroll, dis-enroll, or switch MAPD plans until March 31, 2022.

*Note: Eligible enrollments will be effective the first of the month after the application has been processed.

Reminders:
Agents can accept/submit an application by the beneficiary’s request through the following steps:
1. Obtain a compliant Consent to Contact (C2C).
2. Capture a compliant Scope of Appointment (SOA).
3. Host a compliant 1:1 appointment.
4. If the beneficiary is prepared to enroll, complete an application noting this SEP, either by selecting the “Emergency or Major Disaster” option or writing “Severe Weather” in the “Other” option. WARNING! Only select one election type.

Centene will communicate any changes to this SEP, if necessary, when they become available.

 

Aetna OH Network Update: Negotiations with Trinity – Mount Carmel Health System

Sourced from Aetna Broker Communication on 12/22/21:

Network Update                

December 22, 2021

       

Update on negotiations with Trinity – Mount Carmel Health System – OH

Highlights

As promised, we are keeping you informed on the progress made during Aetna’s negotiations with Trinity – Mount Carmel Health System – OH. This update, and the ones that follow, will supplement the original network communication you received on 10/26/2021. We will keep you informed of updates until negotiations are complete and/or concluded.

Update #

Date of Update

Update Description

2

12/22/2021

Negotiations were to be concluded and continue with a positive tone for Trinity nationally as well as in the local markets.

Trinity has made a slight modification to one state fee schedule and due to the holidays, we have been given an extension until 2/15/2022 to finalize the contracts with Trinity.

1

11/09/2021

Trinity Health has provided Aetna with a contract extension to 1/31/22 – for the Commercial and Medicare products.

The parties agree to continue to work through the local market negotiations and memorialize the terms and conditions of a new National LOA over the next several weeks.   This National LOA will memorialize the new national template contract language, the respective rate increases for the respective markets and a commitment to utilize a Trinity-specific national contract template for all of their Trinity Ministries by January 1, 2023 or sooner.

Aetna and Trinity Health have signed a contract extension, assuring continued in-network access for its members in NY, OH, MI, and IL.  We’re pleased that our members will be able to continue receiving in-network care from their hospitals and doctors with the intent to limit further disruption during open enrollment.

Trinity Health extended the termination date of the following NY, Ohio, Illinois and Michigan hospitals to 1/31/22:

  • Samaritan (Troy)
  • Samaritan / Albany Memorial (Albany)
  • St. Josephs (Syracuse)
  • Mt. Carmel East Hospital (Columbus)
  • Mt. Carmel New Albany Surgical Hospital (New Albany)
  • Mt. Carmel St. Ann’s Hospital (Westerville)
  • Mt. Carmel Health System Grove City (Grove City)
  • Diley Ridge Medical Center (Canal Winchester)
  • Loyola University Medical Center (Chicago)
  • MacNeal Hospital (Chicago)
  • Gottlieb Hospital (Chicago)
  • Mercy St. Mary (Grand Rapid)
  • MHP Mercy Campus (Muskegon)
  • MHP Hackley
  • Lakeshore (Shelby)
  • St. Joseph Mercy (Chelsea)
  • St. Joseph Mercy (Ann Arbor)
  • St. Joseph Mercy (Oakland)
  • St. Mary Mercy (Livonia)
  • St. Joseph Mercy (Livingston)

We appreciate your support in this matter, as we continue to try to address the rising cost of health care services for Central Ohio area employers and residents.  We will continue to keep you informed of any changes in our local network.

 

If you have questions regarding Aetna’s Ohio network, please contact your CSM representative.

Mutual of Omaha: Important New EFT Direct Deposit Requirements Effective 2/1/2022

Sourced from Mutual of Omaha’s broker email communication from 12/15/21: 

Get Ready!

Effective February 1, 2022, Mutual of Omaha will require an electronic deposit for all commission payments. Enrolling in EFT will get you paid in a more timely, secure, and convenient manner with no checks needing to be deposited. Once compensation totals more than $25, we will send an electronic payment directly to the bank that is in your profile on Sales Professional Access.

Failure to enroll in EFT will result in your commissions being delayed and will be paid annually in January following the end of a calendar year.

 

CLICK HERE TO READ COMPLETE EFT INSRUCTIONS FROM MUTUAL OF OMAHA

 

 

Anthem Ohio News: 2022 Member ID Cards & Non-SNP Medicare Advantage HRA Bonus

Sourced from Anthem Broker Communication from 12/14/21:

We would first like to acknowledge that our friends and families in Western KY are in our thoughts and prayers during this difficult time. When things like this happen it makes us all stop and think about what is really important and to be grateful for the things that we have. We are doing outreach to all of our brokers in Western KY to see how we can help. If anyone on this email needs anything, please let us know.

 

Now that AEP is behind us, we want to thank all our broker partners for finishing strong and putting up some great numbers for Kentucky. We appreciate all your hard work and we can’t thank you enough.

Here is what is included in your Ohio News:

  • ID cards and when to expect them.
  • HRA for Non-DSNP members eff 1/1/2022

 

Member ID Cards 2022: What To Expect

For 2022 plan effective dates, based on product availability and selection, our members can receive up to four different member Identification (ID) cards as follows:

  1. Member ID card: to be used for all medical services
  2. OTC card: to be used to purchase over-the-counter products at specific retailers
  3. Healthy Groceries: A monthly grocery allowance that can be used to purchase healthy grocery items.
  4. Flex Account –An annual allowance that a member can use to extend their supplemental coverage for dental, vision, and hearing.

 

When will the member receive their cards? On certain plans, some of the benefits included in Essential Extras/Everyday Extras for 2022 are embedded supplemental benefits. Please review specific plan documentation for more details and lists of specific plans.

 

Member ID Card:

  • New members will receive their ID card and either a Welcome Guide or a Checklist in their Welcome Kit that is mailed to the member approximately 10 days after their enrollment is confirmed.
  • Existing members MAY receive a new ID card.  Existing members with plan benefit changes (copay amount, phone number, etc.) can expect to receive a new card late November or early December.

OTC Card:

  • New and Existing members – Members will receive their ID card in their 2022 OTC Welcome kit along with the catalog. No activation is required.
  • New members enrolling during AEP will receive their OTC card and product catalog by 1/1/2022. If enrolling after AEP, they will receive it approximately 4 weeks after their enrollment  date.
  • Example of Kroger OTC card below (for Kroger branded plans). Reminder, OTC can be used at both Kroger AND Walmart in store.

Grocery Card:

  • If pre-certification IS NOT required (DSNP Plans) – The Grocery Card should arrive prior to the member’s enrollment effective date. No activation is required
  • If pre-certification IS required – Essential Extras/Kroger HMO & PPO – The Grocery Card should arrive within 5 weeks from initial request. Member must call in to request this benefit.

Flex Card:

  • Essential Extras/Everyday Extras – The Flex Card should arrive in about 3 weeks from initial request.

 

Earn EXTRA CASH While Building Relationships with Your New Non-SNP Members

OEP is just around the corner. As promised, beginning January 1, 2022, you can earn an extra $50 for the completion and submission of a Health Risk Assessment (HRA) for members enrolled in a NEW Non-SNP Medicare Advantage (MA) plan for January 1, 2022 effective dates and beyond.

You read that right! During OEP, from January 1 through March 31, when following up with your NEW Non-SNP members who enrolled and are effective January 1, 2022 and beyond, simply help them complete the Non-SNP HRA and you’ll receive an additional $50.

 

Be on the lookout for a separate email communication that includes the following details:

  • Ways to submit the Non-SNP HRA
  • Talking Points for OEP check-in calls leading to the completion of an HRA
  • Payment process and timing of payment

 

 

We appreciate your support and commitment to us during this selling season and thank you for your dedication to our members.

 

 

WellCare Ohio Member ID Card Information

Sourced from WellCare broker communication from 12/2/21: 

Member ID Cards

ID Cards are mailed within 10 days once the application has been approved. Existing MA and MAPD members that did not change plans during AEP will begin to receive new cards this December.
MA Only plans still get RX codes printed on the card, because they may qualify for limited pharmacy benefits that are tied to medical procedures.
The signifier if a member has prescription drug coverage on their ID card is Medicare Prescription Drug logo.

MA ONLY SAMPLE

MAPD ONLY SAMPLE

RFI – Request for Information

Our RFI line is experiencing higher call volume – we appreciate your patience
You can also resolve your RFI by submitting a ticket in agent connect.

Common Application Mistakes

As you are filling out the application, make sure you include the entire plan name. Even though you have entered the correct plan code, an RFI can occur if the plan name is incorrect. Example: Leaving out HMO-POS or D-SNP.

HICN Missing: Double checked the MBI number and it is correct? Make sure you also have entered the correct birthday.

Aetna Medicare Network Update: Mount Carmel Health System & Negotiations with Trinity

Sourced from Aetna broker communication from 11/10/21:

Network Update | November 10, 2021

Update on negotiations with Trinity – Mount Carmel Health System – OH

 

Highlights

As promised, we are keeping you informed on the progress made during Aetna’s negotiations with Trinity – Mount Carmel Health System – OH. This update, and the ones that follow, will supplement the original network communication you received on 10/26/2021. We will keep you informed of updates until negotiations are complete and/or concluded.

Update # Date of Update Update Description
1 11/09/2021 Trinity Health has provided Aetna with a contract extension to 1/31/22 – for the Commercial and Medicare products.

The parties agree to continue to work through the local market negotiations and memorialize the terms and conditions of a new National LOA over the next several weeks.   This National LOA will memorialize the new national template contract language, the respective rate increases for the respective markets and a commitment to utilize a Trinity-specific national contract template for all of their Trinity Ministries by January 1, 2023 or sooner.

Aetna and Trinity Health have signed a contract extension, assuring continued in-network access for its members in NY, OH, MI, and IL.  We’re pleased that our members will be able to continue receiving in-network care from their hospitals and doctors with the intent to limit further disruption during open enrollment.

Trinity Health extended the termination date of the following NY, Ohio, Illinois and Michigan hospitals to 1/31/22:

  • Samaritan (Troy)
  • Samaritan / Albany Memorial (Albany)
  • St. Josephs (Syracuse)
  • Mt. Carmel East Hospital (Columbus)
  • Mt. Carmel New Albany Surgical Hospital (New Albany)
  • Mt. Carmel St. Ann’s Hospital (Westerville)
  • Mt. Carmel Health System Grove City (Grove City)
  • Diley Ridge Medical Center (Canal Winchester)
  • Loyola University Medical Center (Chicago)
  • MacNeal Hospital (Chicago)
  • Gottlieb Hospital (Chicago)
  • Mercy St. Mary (Grand Rapid)
  • MHP Mercy Campus (Muskegon)
  • MHP Hackley
  • Lakeshore (Shelby)
  • St. Joseph Mercy (Chelsea)
  • St. Joseph Mercy (Ann Arbor)
  • St. Joseph Mercy (Oakland)
  • St. Mary Mercy (Livonia)
  • St. Joseph Mercy (Livingston)

 

 

We appreciate your support in this matter, as we continue to try to address the rising cost of health care services for Central Ohio area employers and residents.  We will continue to keep you informed of any changes in our local network.

Anthem’s OTC Network to Now Include Kroger Stores

Sourced from Anthem broker communication on 11/10/21: 

Kroger Company Stores will soon be included in Anthem’s OTC network of retailers

Convenience and value are important factors when your clients shop using their OTC network — and they deserve nothing but the best. That’s why we are proud to include all Kroger Company stores as participating retailers.

You and your clients will both be pleased to know that as of January 1, 2022, Kroger Company retail stores and affiliates* will be part of the Anthem OTC retail network.

 

READ FULL ARTICLE HERE 

 

If you have any questions or concerns regarding the new OTC network news please reach out to your CSM Rep

Mutual of Omaha Senior Health Social Media Group- New Launch

Mutual of Omaha has created an exclusive marketer LinkedIn group. This group will focus on promoting Senior Health products, lifestyle events, and business tools. You can interact with other marketers and the Senior Health Sales Team directly.

To stay connected with Mutual of Omaha, please join the SHS Marketer Connect group on LinkedIn.

 

If you have any questions please reach out to your CRM representative.