Carrier Updates – Page 29

Aetna COVID-19 SEP

May 8, 2020/in Aetna, Recent News /by Marilyn Schultz

Special Enrollment Period (SEP) for individuals affected by a FEMA-Declared Weather Related Emergency or Major Disaster — Applicable for COVID-19

The Centers for Medicare & Medicaid Services (CMS) clarified yesterday that the Special Enrollment Period (SEP) for Individuals Affected by a FEMA-Declared Weather Related Emergency or Major Disaster is applicable and is available for beneficiaries who were eligible for — but unable to make — an election due to the COVID-19 pandemic and meet the terms of the SEP listed below.

Read the full release here

WellCare Confirmed Special Enrollment Period: COVID-19

May 7, 2020/in CMS Updates, Recent News, WellCare /by Marilyn Schultz

WellCare Agent Advisory 5/6/20

Confirmed Special Enrollment Period: COVID-19

As promised, we continue to closely monitor the COVID-19 pandemic and are working hard to keep you informed. At this time, CMS has reversed previous guidance and made the decision to allow for a one-time Special Enrollment Period (SEP) for those affected by COVID-19, in the event they 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 50 states, tribes, territories, and the District of Columbia.

Read Full Release

Humana – 2020 Compliance Communication: SEP Notice for Individual Affected by COVID-19

May 7, 2020/in CMS Updates, Humana, MarketPoint, Recent News /by Marilyn Schultz

2020 Compliance Communication

SEP Notice for Individuals Affected by Covid-19

CMS has officially announced an SEP is available for individuals affected by Covid-19. This SEP is available nationwide to residents of all states, tribes, territories, and the District of Columbia. The SEP can be used until June 30, 2020 under the following circumstances.

Who qualifies for this special enrollment period?

A SEP exists for individuals affected by a 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 eligible to apply for individual or public level assistance; and
Had another valid election period at the time of the 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.

Nationwide Covid-19 SEP – SEP Start Date March 1, 2020

SEP End Date – June 30, 2020

What Does This Mean to Agents

If an individual wants to enroll and believes they may qualify for this SEP, agents should:

Confirm that they had another election period available during the time of the incident period.
Once eligibility has been verified, use election code SEP DST on the application.

Enrollments made pursuant to this SEP are effective the first of the month following the receipt of the enrollment request. For enrollment requests where more than one enrollment effective date is possible, agents will need to determine the applicant’s desired effective date.

The Disaster SEP should never be used as a marketing tool to promote MA or PDP sales. Agents should not be actively marketing this SEP, but rather, should be aware that it is available in case they are approached by someone who believes they have missed an election period due to the incident.

Medical Mutual May Updates

May 6, 2020/in Medical Mutual, Recent News /by Danielle Flesch

• As a reminder, Medicare Advantage clients have access to the 24-hour nurse line which can assist with any questions about COVID-19 symptoms or other health-related issues. The nurse line is available toll free for members at 1-888-912-0636.

• Medical Mutual is taking further steps to be accommodating during the COVID-19 pandemic and is implementing a temporary solution for brokers writing Medicare Advantage plans. Effective Mar. 20, 2020, agents will be permitted to send and receive scope of appointment (SOA) consent via email. This will allow you to assist your clients in a compliant way without meeting them face to face or requiring an SOA form to be printed and mailed. Please contact your account manager for email submission template and further information.

• MedMutual Advantage members who are experiencing difficulty paying premiums or out-of-pocket healthcare costs due to COVID-19 may be referred to Centauri’s PremiumAssist program. Centauri will screen members to determine if they are eligible for financial assistance with their Medicare Advantage premiums and other medical expenses through the Medicare Savings Programs (MSP), as well as any additional assistance with prescription drug costs through the Extra Help program. Centauri’s PremiumAssist program can be reached at 1-877-236-4471 (TTY 711 for hearing impaired) Monday through Friday from 9 a.m. to 7:30 p.m. EST

• Effective Mar. 9, 2020, Mom’s Meals is implementing contactless delivery measures for all meals provided to MedMutual Advantage members who are being discharged from the hospital. These measures were implemented to help prevent the spread of the COVID-19. Details on the Mom’s Meals COVID-19 response can be found on MomsMeals.com.

• How are you communicating with your clients during this time? If you need something to talk about, remind the Medicare members of the SilverSneakers program through Medical Mutual. During this time, Medicare members can take advantage of online tools to help them stay fit, including SilverSneakers On Demand, SilverSneakers Go, as well as live Facebook events. Members can login to access these resources through SilverSneakers.com.

Humana Delays Background Checks

April 29, 2020/in Humana, MarketPoint, Recent News /by Danielle Flesch

Humana announcement as of 4/29/2020 :

You may be experiencing some delays with contracting agents. You may see “Background Check Pending” or “Application Under Review.” Many courts are still closed due COVID-19 which is causing major delays in the background industry. Depending on the county and vendor who is processing the background check, we are seeing some extremely long waits.

Humana is pending Legal and Risk guidance about whether we they will be able to make exceptions to move forward without full background checks when contracting agents. As of now, Humana is required to follow normal protocol.

If you have any questions or concerns please contact your CSM representative.

GTL Now Available on CSG Actuarial to Enroll Electronically

April 29, 2020/in GTL, Recent News /by Danielle Flesch

Guarantee Trust Life Insurance Company (GTL) is the newest carrier added to the CSG E-Application Platform!

Agents can now submit Medicare Supplement applications directly to GTL through the CSG quoting tool in all states where plans are offered.
Benefits of using the E-Application include:

• Verifies the application is accurate and complete before submission
• Real-time underwriting logic detects declinable conditions and prescriptions
• Signature methods include applicant verification or email signature link
• Same process for every carrier
• All carrier applications are stored in the same platform

From the quotes results page, click Apply Now to start application

Anthem Med Supp Rates July 1, 2020 – Approved

April 29, 2020/in Anthem, Recent News /by Danielle Flesch

Medicare Supplement rates for July 1, 2020 – June 30, 2021 have been approved. Click below to view the Outline of Coverage and rates. Sales kits have been updated on CustomPoint and are available to order. For effective dates prior to July 1, you can continue to use the current kits.

OUTLINE OF COVERAGE & RATES

Also, Anthem has refreshed some of the underwriting guidelines in thier medicare supplement field underwriting guide. This tool is designed to assist during the application process and help determine what medical conditions would result in automatic denial of an application and when other plan options should be considered that may be better suited for the prospect — all 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 an application denial. These guidelines are broker tools ONLY and are not to be shared with members or prospects. Brokers should remember that the company is the underwriter, and Anthem is not asking the broker to make underwriting decisions. If there are questions about whether or not a Med Supp application would be approved or denied due to medical underwriting, brokers/agents should submit applications as normal and allow the underwriters to manage the underwriting review process.

Finally, keep in mind Anthem’s Med Supp bonus is a great opportunity to increase your earnings. CLICK HERE TO VIEW!

UHC AARP med supp updates: COVID-19 cost sharing and telehealth info

April 27, 2020/in Recent News, UnitedHealthcare /by Danielle Flesch

What’s New?

AARP Medicare Supplement Plans will cover all cost-sharing, including Medicare Part B excess charges, for Medicare-eligible expenses for services related to COVID-19 treatment based on a confirmed positive diagnosis from February 4, 2020, until May 31, 2020.

This builds on the previously announced efforts by Medicare to waive cost sharing for COVID-19 testing and testing-related visits and Medicare’s temporarily expanded definition of telehealth.

In addition, from March 31, 2020, until June 18, 2020, AARP Medicare Supplement Plans will cover all cost-sharing, including Medicare Part B excess charges, for Medicare-eligible COVID-19 and non-COVID-19 telehealth visits.

Premium Payments

UnitedHealthcare understands that certain enrolled members may be adversely impacted by the COVID-19 situation and may be unable to make premium payments by the due date. There is currently a two-month period that allows insured members to make a payment. For those enrolled members who were in danger of cancellation due to non-payment of premium in March and/or April, coverage was not terminated. At this time, UnitedHealthcare is allowing an additional month for payments to be made. Although there is additional time to make premium payments, there is only a 31-day period during which claims will continue to be paid while the member’s account is past due.

UnitedHealthcare will continue to assess the situation. We will also abide by any state-specific guidelines regarding premium due.

Remote Enrollment Options

As a part of online enrollments through LEAN™, agents can easily and remotely enroll consumers in an AARP Medicare Supplement Plan by using Remote Signature via DocuSign® and Voice Signature.*

What if the consumer does not have access to the internet?
Now extended through the end of May, when consumers are unable to use LEAN to complete a Medicare Advantage, Prescription Drug or some Medicare Supplement plan enrollment applications, and it is not feasible to use a paper application, you can direct the consumer to call UnitedHealthcare telesales at 855-572-3837 to complete the application by phone. For consumers who do not have internet access that:
• Are in their Medicare Supplement Open Enrollment Period, or
• Qualify for Guaranteed Issue

Please use the process below:

1. Following your needs analysis conversation, direct the consumer to call 855-572-3837. Please note you cannot be on the phone with the consumer.
2. Inform your consumer to tell the representative the AARP Medicare Supplement Plan you discussed and that the representative will repeat some of the questions in order to meet all compliance requirements.
3. Email agentoversightadmin@uhc.com to indicate your consumer was unable to electronically sign documents and completed the application telephonically instead. Include name of prospect, state, plan chosen, date of presentation/referral to telesales, agent name, and writing ID. This will help ensure your commission payment and Agent of Record status.
Please mail enrollment materials via the normal paper process if the consumer:
• Is under age 65, or
• A current member looking to plan change, or
• Requires Underwriting

Thank you for your continued support. Please continue to check here for additional information related to COVID-19.

UHC PDP’s Advance Renewal Payments

April 27, 2020/in Recent News, UnitedHealthcare /by Danielle Flesch

The health of UHC members and all those who serve them – our agents, employees and health care partners – remains UHC’s top priority. UnitedHealthcare wants to continue to support you.

UnitedHealthcare will be advancing May and June renewal payments. Today, (4/27/20) please watch for your Prescription Drug Plan combined payments for April, May and June. You can find an updated commission calendar on Jarvis.

If you have any questions please reach out to our CSM rep