Anthem Medicare Certification Training Center Site Maintenance | 4.13.21 – 4.19.21

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Anthem Broker Update:

 

The Anthem Medicare Certification Training Center (including AHIP) is undergoing exciting changes to accommodate the 2022 AEP selling season.  The new interactive platform will provide a streamlined, one-stop resource that makes it even easier to start, manage, and benefit from your required annual training.

 

In order to make this transition happen smoothly, the current site will be unavailable starting at 9 PM ET on April 13, 2021 until April 19, 2021 at 9 AM ET.  Please note that the system will be down for maintenance but that does not include the refresh to our annual training (2022 AEP).  The date for our year-over-year transition is TBD and will occur towards the end of June.  Stay tuned for additional information.

 

If you have any questions please contact your Cornerstone Senior Marketing Service Rep. 

Anthem MS Replacement Commission Payment Reminder

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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.

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

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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.

Anthem Commission Statement Update

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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

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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 copay.  Freestyle 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. 

Anthem Ohio Network News: Oak Street Health

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Medicare Advantage Network now includes Oak Street Health in Akron, Ohio

 

Anthem has expanded their network, providing more choices for your clients, by adding quality providers. Oak Street Health in Akron, OH, is now part of the Anthem Medicare Advantage (HMO/DSNP/PPO) network.

This expanded network demonstrates Anthem’s ongoing commitment to improving people’s health –and ensuring your success by giving them what they want in a health plan.

 

If you have any questions regarding this network expansion or if you need contracting with Anthem, please reach out to your Cornerstone Senior Marketing representative

Anthem Revisions to 2021 Medicare Supplement Commission Schedules

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Revisions have been made to Anthem’s 2021 Medicare Supplement base schedules adding the language:

“Replacement policies will be paid at the renewal rate in alignment with state DOI guidelines”.

See below for specific state schedules

OHIO

KENTUCKY

INDIANA 

 

If yo have any questions please reach out to your Cornerstone rep.

Anthem Alert: Medicare Advantage AOR Policy Change

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Anthem Announcement from 2/1/21:

 

Plan changes trigger an automatic update to the Medicare Advantage Agent of Record

Changing Agent of Record (AOR) status is now easier for YOU and your clients. Previously, your client making a

plan change had to submit a signed, hand-written letter requesting you as their Agent of Record.

 

What’s changing?

If your client makes a PLAN CHANGE with an effective date on or after March 1, 2021, you will automatically be

designated as their Agent of Record for Medicare Advantage and Part D business.

 

The effective date for the Agent of Record change will match the effective date of the plan change. An Agent of

Record change request submitted apart from a plan change will not be accepted for Medicare Advantage and Part D

business.

 

Important Note: AOR rules are not changing for Medicare Supplement Plans or Anthem Extras. These plans

will continue to require a signed, hand-written letter from the member to request AOR changes. We reserve the right

to contact the member in order to validate all Agent of Record changes. If the AOR change request cannot be

confirmed with the client, the change request can be denied.

 

*This is a corporate policy. Not all plans/plan types mentioned are offered in all states. If you have questions, please

contact your Sales Team.

Anthem OH Network Update: Cincinnati Eye Institute

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Cincinnati Eye Institute Remains In-Network

Anthem and Cincinnati Eye Institute have resolved their contract negotiations and CEI has agreed to rescind their notice of termination.

CEI will remain IN-NETWORK for all Medicare business- HMO, PPO, and DSNP.

Cincinnati Eye Institute has also committed to notify Anthem members of their continued participation in Anthem networks on or before Thursday, November 26, 2020.

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

Anthem Ohio November 2020 AEP Updates & Reminders

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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:

https://event.on24.com/eventRegistration/EventLobbyServlet?target=reg20.jsp&referrer=&eventid=2699779&sessionid=1&key=66E707029C24E8066B1A61E7365EC4DA&regTag=&sourcepage=register

 

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.