Humana’s PDP Vendor Service Level Issues

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Humana is committed to supporting agents in helping members find the best plan for them. Humana previously communicated a toll free number for your PDP members to call if they wanted to change to another PDP. At this time Humana is experiencing long hold times that may not result in the best experience for members.

  • Due to these longer than expected hold times, we encourage agents to complete the plan change themselves using Enroll Hub, AOA, DMM, humana.com (agent will be protected) or the abbreviated paper enrollment form.
  • Humana will advise when service levels return to an acceptable level
  • Remember! Some PDP members experiencing increased premiums may find that a Humana Medicare Advantage plan provides them with benefits and convenience of a prescription drug plan and helps with healthcare costs not covered by Original Medicare and includes lots of other great benefits.

View The Agent of Record Protecion Pledge

Compliance Communication From Humana

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Humana has been notified of two issues with Medicare Plan Finder on Medicare.gov.  These are not limited to Humana plans and appears to impact other carriers as well.  Humana has notified CMS of the issue and are awaiting their response.  The issues are related to mail order pharmacies not displaying correctly on the Medicare Plan Finder’s newly redesigned website:

  1. Medicare.gov is not providing preferred mail order pricing or giving an option to view the preferred mail order pricing when beneficiaries click “Review Plan Details”.
  2. When a beneficiary selects that they use both retail and mail order pharmacies, mail order pharmacies do not appear in the results.

In the meantime, Humana is asking agents and prospective members to use Humana’s Rx Calculator tool for mail order pricing information found at the following URL’s:

Agent: https://drug-pricing.apps.cf.humana.com/

Prospective member: www.humana.com/medicaredrugcosts

Humana Benefits At A Glance Error

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Important AEP Notice!

Humana identified an issue associated with the Benefits-At-A-Glance (BAAG) document included within the enrollment packet.  This error does not impact Care Plus BAAGs.

Specifically, in an effort to eliminate possible member confusion, additional information was added to the benefits grid to provide clarity surrounding member cost-share.  However, due to an error in the coding logic used to populate plan specific information, member cost-share was erroneously listed as $0 in the column labeled “With Medicare and State Cost-Share Protection.”  In response, this information has been corrected and new BAAGs are being printed. See below for details:

Old Version

New Corrected Version

What Does this Mean for External Agents?

You will be receiving new Benefit at a Glance documents associated with the 228 plans linked below.  Please tear out the old version found in the sales kit, and if desired, print the new version to replace it.  We ask that you discontinue use of the old BAAG document immediately.  Note that the Benefits at a Glance document is not required as part of the sales kit or the sales presentation; you can continue to use the Summary of Benefits.  When you re-order sales kits, the new version will be included.

IMPORTANT:  When using one of the previously printed all-in-one books from a Contract/PBP/Segment listed in the link below, the existing BAAG (with the error) should be torn out of the book and the separate new BAAG, if desired, should be used during prospect appointments.

 

Click Here to Access the New BAAG’s

Humana’s NEW Medicare Supplement Product: ACHIEVE

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Introducing Humana Achieve: premium coverage that’s affordably-priced.

Humana’s Achieve is a plan that offers many of the same benefits as Humana’s premier line of products at a great value!

Approved States:

New business will be accepted for Georgia and South Carolina effective immediately with an effective date of October 1 or later. This will be available via the Humana Fast App for business submission and agents holding appointments in these states can begin ordering supplies. Below you will find the Outline of Coverage available for download for both Georgia and South Carolina.

As new states become available (OH & KY), Humana will notify agents in those states and update the Humana Achieve Medicare Supplement coverage maps.

Georgia Application

 

Georgia Outline of Coverage

 

South Carolina Application

 

South Carolina Outline of Coverage

If you have any questions please contact your Cornerstone Senior Marketing representative

Important Message from Humana & Aetna: Members Who Requested to Have Premiums Withheld by SSA/RRB in 2019

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FROM HUMANA MARKETPOINT: 

  • Humana has taken action for our impacted members and worked quickly to re-trigger deductions with a 6/1/2019 effective date (next available date).
  • Members were sent a letter on 5/9 (verbiage below) that states we have requested a future date (6/1/19) due to a SSA delay and the amount they owe – letter contains a remit slip.
  • Customer Service has been ramped up for potential calls and no collection actions will take place due to them being on SSA/RRB.

Please see the letter verbiage below. Members should call our Customer Care Team at 1-800-457-4708 if they have questions.

Thank you for choosing Humana for your Medicare coverage.

You asked us to deduct your monthly premium from either your Social Security (SSA) or Railroad

Retirement Board (RRB) benefit check. Your request could not be processed in time for the next

premium payment. We requested your premium deduction to begin with the next available premium

payment for 06/01/2019. It can take SSA or RRB up to 90 days to process this request. At that time,

you may see up to three months of premiums deducted from your check.

You are responsible for paying the monthly premium(s) due prior to 06/01/2019. Please make a

payment for the amount due of $.

To PAY YOUR PREMIUM:

Go to Humana.com/pay or use the MyHumana mobile app

Detach and mail the payment slip below with your payment

Call our Customer Care Team at 1-800-457-4708. If you use a TTY, call 711.

FROM AETNA: 

We want to notify you about an issue affecting all Medicare members who elected to pay plan premiums from their Social Security Administration (SSA) or Railroad Retirement Board (RRB) check.

Background

Normally, when members select this premium payment option, the SSA/RRB withholds funds from members’ SSA/RRB checks to cover their plan premiums.

Unfortunately, due to a system issue, this did not occur for two or more months starting February 1, 2019. This issue affected all carriers, not just Aetna. Although the system issue is now fixed, the SSA/RRB cannot retroactively deduct premium payments from members’ checks.

What do members need to do?

Because these members now have past-due accounts, their premium payment method has changed to direct billing, effective February 1, 2019. This means they now need to pay any past-due premium amounts to Aetna directly.

Member communication

Members will receive a letter explaining what happened and what they need to do later this month. Letters are being mailed in waves, between May 10-24, so members will receive them over several weeks. View the member letter.

What happens next?

  • We’ve already submitted a new request to restart SSA premium deduction for the affected members, effective June 1, 2019. If the request is accepted by SSA, they will send members a letter of approval. Please be aware this can take up to 90 days.
  • Please explain to your clients that SSA will only deduct future premiums from their Social Security check as of the effective date noted in their approval letter, so any balances owed up until that effective date must be paid to Aetna directly. Members need to pay premiums directly to us for any months the SSA or RRB doesn’t cover.

While these members are not currently at-risk for termination due to nonpayment, they do need to begin making payments to ensure their plan does not face termination for nonpayment in the future.

 

 

 

Please contact your Cornerstone Senior Marketing representative if you have any questions.

Upcoming Broker Trainings in Cleveland- IMPORTANT CHANGES

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IMPORTANT CHANGES: The MMO training on Tuesday April 23 has been rescheduled to THURS. MAY 16 from 10am – 12pm in the Cleveland Office. See below for details. 

*Also a LIVE Medicare Center training has been added. See below.

Join Cornerstone Senior Marketing for our broker training sessions in April at our Cleveland office with UnitedHealthcare, Humana, Medical Mutual of Ohio, Dental Care Plus, & a Medicare Center review training!

RSVP HERE

*When RSVPing, please indicate which training and date you will be attending

Friday, April 12- UHC

TIME: 10:00 am – 12:00 pm

LOCATION: CSM’s Cleveland Office

4500 Rockside Rd., Suite 330

Independence, OH 44131

Join UHC and CSM to learn what tools UHC offers to better your business! UHC will be highlighting the following:

  • UHC’s toolkit
  • Marketing tools offered
  • Share best practices

Wednesday, April 17- HUMANA MP

TIME: 10:00 am – 12:00 pm

LOCATION: CSM’s Cleveland Office

4500 Rockside Rd., Suite 330

Independence, OH 44131

Join Humana & CSM to review updates on Humana’s 2019 Medicare products. Humana will also be discussing the following:

  • Online enrollment tools
  • Marketing strategies
  • Hot products to offer your clients

*THURSDAY MAY 16* – MMO

TIME: 10:00 am – 12:00 pm

LOCATION: CSM’s Cleveland Office

4500 Rockside Rd., Suite 330

Independence, OH 44131

Join Medical Mutual of Ohio & CSM for a review of MMO’s 2019 Medicare products and updates! MMO will be highlighting the following:

  • Why choose MMO products?
  • New online tools and marketing resources
  • Marketing opportunities

Wednesday, April 24- DCP

*CE CREDIT OFFERED*

TIME: 11:00 am – 2:00 pm

LOCATION: CSM’s Cleveland Office

4500 Rockside Rd., Suite 330

Independence, OH 44131

Join Dental Care Plus & CSM for a Lunch & Learn event with CE CREDIT OFFERED! DCP will also be discussing the following:

  • Dental 201 Presentation (Why Dental Matters, Today’s Dental Exams, and Expanding Dental Services)
  • How to cross sell Dental plans
  • Product information and services

*Tuesday, April 30- LIVE MEDICARE CENTER TRAINING*

TIME: 10:00 am – 12:00 pm

LOCATION: CSM’s Cleveland Office

4500 Rockside Rd., Suite 330

Independence, OH 44131

Join CSM’S Jaime Lebron & Matt Fry to review and learn more on the new Medicare Center enrollment tool. This will be an interactive training- please bring laptops or iPads! We will be discussing the following:

  • How to submit business through Medicare Center
  • Features of the available tools inside Medicare Center including the prescription drug lookup

 

If you have any questions regarding the sessions above, please reach out to Jaime Lebron

REMINDER: Humana MP Changes Agent Release Policy

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Agents must follow the Humana Release Policy when ending or changing an affiliation. This policy is applicable to agents contracted to sell Individual Medicare, Ancillary and Supplemental benefit products.

Immediate Release Policy:
To receive an immediate release, external agents must secure a release letter from their current upline. It is at their discretion whether or not to release an agent prior to 90 days (see Delayed Release Policy below). The current upline is required to formally communicate the release of the agent in writing using company letterhead, signed by the principal, with a current or future effective date of the release. Release letters must be sent to Humana’s Agent Support at AgentSupport@humana.com.

If the immediate release is accepted it will be processed within 5 business days. Humana will notify the agent via email when the release has been processed.

Delayed Release Policy
In instances where an immediate release is not granted, the agent may request a delayed release. The delayed release will be effective 90 days after the agent’s request is received*. Such requests must be in writing and sent to Humana’s Agent Support at AgentSupport@humana.com.

Agent Release Timeline

Received 90 day Release Immediate Release
1/2 through 7/10 Effective 90 days post request Processed within 5 business days
7/11 through 9/30 Effective 1/2 Processed within 5 business days
10/1 through 1/1 Effective 4/1 Effective 1/2

 

 MGA Hierarchy Release Timeline
Received 90 day Release Immediate Release
1/2 through 7/10 Effective 90 days post request Processed per standard contracting turnaround time
7/11 through 9/30 Effective 1/2 Processed per standard contracting turnaround time
10/1 through 1/1 Effective 4/1 Effective 1/2

*The delayed release will be effective 90 days after the agent’s request is received
*agencies can realign one time per year

Agent’s Status upon Release
Once an agent is released they will be free to align themselves with another upline. (There are specific situations under which an agent cannot align themselves. Please contact your External partner for more information.) The agent must notify Humana in writing indicating what upline they wish to be aligned with. The name of the new upline can be included in the original release request.  It will be the agent’s sole responsibility to maintain all license, training, certification, and appointment requirements with Humana.

Impact on Agent’s Book of Business

  • New: Any business submitted to Humana while the agent was aligned with the previous upline will result in the appropriate overrides and commission being paid as indicated by the contracts and schedules in place.
  • Renewal: Any renewals earned while the agent was aligned with the previous upline will result in the appropriate overrides and renewals being paid as indicated by the contracts and schedules in place.

The release ONLY affects business that occurs after the date of the release.

If you have any questions please contact your CSM Sales Representative.

Important Humana AOR Changes!

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Effective December 14, 2018, Humana has an updated policy regarding Agent of Record changes. This aligns with Humana’s Agent of Record Protection Pledge and is in-line with industry norms. This change also represents the commitment to protect the integrity of the agent-member relationship and supports confident book-of-business growth.

Humana will no longer process the following change requests:

  • AOR change requests received from a member (e.g. handwritten letter or email).
  • AOR change request received from an agent (other than through the Agent Business Transferal Form).

Click here for the updated policy.

Any questions please contact your Cornerstone Senior Marketing representative.

Open Enrollment for Medicare Advantage is Near! Read Through Humana’s Guidelines

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Humana’s Resources to Understanding the Open Enrollment Period

Now that AEP is over with, you have a few weeks to gear up for Open Enrollment Period beginning January 1, 2019 through March 31, 2019! This is a one-time chance for your MA clients to change plans and it comes with some new regulations of which you should be aware.

Click here to view Humana’s OEP guide and guardrails that will help you navigate through OEP.

If you have any follow up questions in regards to OEP reach out to your Cornerstone Senior Marketing representative!

Important News From Humana Med Supp!

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Did you know?

Humana Marketpoint

Humana Marketpoint offers plans G & N on a GI basis along with the typical plans (A, B, C, F, K, & L) for clients who are coming off of a group health plan and if they have had Medicare Part B over a six month time frame, along with Silver Sneakers!

For more information, view the 2019 Humana Medicare Supplement Sales Guide.

Questions? Reach out to your Cornerstone Senior Marketing representative today!