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

Aetna Mail Delays – IMPORTANT UPDATE

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Mail delays due to winter storms

Due to winter storm conditions across the country, policy and ID card delivery may be delayed by the USPS. Both policy pages and ID cards can be viewed at any time by signing into the member side of aetnaseniorproducts.com.

The Aetna office is currently closed due to the weather, and not able to receive, process or send any mail from their office at this time. Many Aetna vendors have also been dealing with mail delays, power outages, and diminished staff due to local weather conditions.

Aetna anticipates they will begin processing mail again on Monday, February 22.

Here’s how Aetna is supporting you and your clients:

  • No policies will lapse due to winter storms delaying mail delivery.
  • Teams are working remotely and continuing to process new business and claims as normal.
  • Customer service teams are available through both Live Chat on the website and by phone.

If you have any questions, just contact the Agent Services team by using the Live Chat feature at aetnaseniorproducts.com or by calling 866-272-6630, or reach out to your Cornerstone Senior Marketing Service Representative:  614-763-2255 or by email:  service@cornerstoneseniormarketing.com

DCP: Important Portal Registration Delay

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Dental Care Plus Group Broker Update from 2/8/21:

WellCare Introduces Summa Health to Ohio Market

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WellCare Broker Announcement from 2/9/21:

As the market continues to expand, we want to ensure we are providing you with the necessary resources to continue to be successful in the field – and best serve our members.

WellCare is excited to announce the addition of Summa Health to the Ohio market. As of Jan. 1, 2021, this partnership came with the addition of more than 600 providers – ranging in 12 different license types.

With Summa Health now in network, we are able to provide more resources and options when it comes to accessing affordable healthcare. We hope you keep WellCare and Allwell plans on the top of your list when presenting to potential members.

 

If you have any questions please reach out to your CSM rep.

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.

Medical Mutual Feb. Updates- PLUS Summa Health Added to Network!

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MMO Broker Update: 2.2.21:

Summa Health Added to Medicare Advantage Network Effective April 1, 2021
Category: Network
Applies to: Medicare Advantage
Effective April 1, 2021, Summa Health and their employed physicians will be part of the Medical Mutual Medicare Advantage network. Summa Health offers a wide range of high-quality primary care providers, specialists, hospitals and other facilities throughout Summit, Medina, Portage, Stark and Wayne counties.

We are in the process of updating our directory for the effective date. In the interim, please direct provider inquiries to your Medical Mutual representative.
 
 
Aultman, Aultman Orrville and Alliance Community Hospitals Added to NE Ohio HMO Network Effective Feb. 15, 2021
Category: Network
Applies to: Individual
Effective Feb. 15, 2021, Aultman Hospital, Aultman Orrville Hospital and Alliance Community Hospital will be part of the Medical Mutual NE Ohio HMO network. Aultman offers a wide range of high-quality hospitals and other facilities throughout Stark, Tuscarawas, Carroll, Holmes and Wayne counties.

We are in the process of updating our directory for the effective date. In the interim, please direct provider inquiries to your Medical Mutual representative.
 
2021 COSE MEWA Benefit Changes and SuperMed Share® Launch
Category: Network
Applies to: MEWA
The COSE MEWA product portfolio is updated with new plan additions and plan modifications for 2021. Among these updates, is the expansion of SuperMed Share® to the COSE MEWA market. All 2021 COSE MEWA plan designs are available for quoting in early February, with an effective date of May 1, 2021…
Read More »
 
 
Formulary Updates Effective April 1, 2021 for National Preferred Formulary
Category: Pharmacy
Applies to: Individual, Small Group (1-50), 51-99, 100+, MEWA
Effective April 1, 2021, minor changes are being made to the exclusion list for our National Preferred/National Preferred Plus formulary. A list of drugs added to the list can be viewed here. In addition, a full updated exclusion list is available here. There are no changes to the Basic/Basic Plus or High Performance Plus formularies at this time.

As a reminder, the National Preferred/National Preferred Plus formulary applies only to specific self-funded groups that elected it, including most MedFlex plans. Any members currently taking affected medications will receive a letter notifying them of these changes at least 60 days before they take effect. These changes will immediately apply to new groups that enroll on or after April 1, 2021 and any members who begin taking these medications after April 1, 2021.
 
 

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.

WellCare OTC Benefits: Help Clients Find CVS Pharmacies

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WellCare communication from 1/28/21:

We wanted to share a quick reminder about how members can access a key benefit that can make a big difference, our OTC benefit. This benefit gives members $15-$720 per quarter of OTC items from a plan-approved list of products (benefit coverage varies by plan).

CVS is the OTC benefit vendor for several plans in 27 of our Medicare markets. Members in plans with the OTC benefit can order covered products by mail order (phone or online) or in-store at a participating CVS location. When shopping from the catalog, items are shipped to members’ homes at no additional cost. (Reminder: Members are limited to three (3) in- store purchases per quarter).

Find Participating CVS Locations

Here’s how members can quickly find a local participating location:

  1. Go to http://www.CVS.com/
  2. Select STORE LOCATOR, enter a zip code, and choose OTC HEALTH SOLUTIONS
  3. Participating locations in the area of the chosen store will appear

For more information on OTC, check out the following available agent resources: