Anthem Ohio Network Alert: Christ Hospital Health

Sourced from Anthem’s Producer Newsletter on 2/9/2023:

February 9, 2023

We’ve worked closely with The Christ Hospital Health Network for several months, but we haven’t reached an agreement to keep them in your clients’ plans.

This means that starting April 1, 2023, your clients may pay more for care they receive from Christ Hospital’s facilities, and May 1, 2023 for care they receive from Christ Hospital’s doctors. This includes care your clients received at the following Christ Hospital facilities:

  • The Christ Hospital
  • The Christ Hospital Medical Center – Liberty Township
  • The Christ Hospital Outpatient Centers
  • The Christ Hospital Urgent Cares
  • The Christ Hospital Surgery Centers
  • The Christ Hospital Outpatient Imaging Centers
  • The Christ Hospital Lab Draw and Pre-Surgical Testing Centers
  • The Christ Hospital Cardiovascular Testing Centers
  • The Christ Hospital Health Network Physical and Occupational Therapy Centers
  • The Christ Hospital Sleep Centers
  • The Christ Hospital Outpatient Clinics
  • The Christ Hospital Wound & Ostomy Care Centers
  • The Christ Hospital Medical Associates (physician practices)

We will be sending a notice to your clients letting them know. Unless we reach an agreement, Christ Hospital won’t be in your plan’s network starting April 1, 2023 for Christ Hospital facilities, and May 1, 2023 for Christ Hospital doctors.

Clients may pay more if they decide to keep seeing a Christ Hospital doctor or receiving care at these facilities
If the client decides to keep seeing this doctor or receiving care at these facilities after April 1, 2023 or seeing this doctor after May 1, 2023, they may pay more or all of the costs for the care. Some plans only cover care from doctors and care facilities in the plan’s network, except in emergencies. Employees can check their plan documents to learn more.

There may be exceptions
A client may be able to stay with Christ Hospital’s doctors and facilities for a limited time if they are in treatment for a serious and complex condition, in the hospital, scheduled for nonelective surgery, pregnant, or terminally ill. Their plan documents include more information about continuity of care.

We will continue to negotiate with Christ Hospital and hope to reach an agreement that keeps them in our plan’s networks.

 

UHC Ohio Medicaid Updates: Verification & Emergency Assistance Changes

Ohio Medicaid Verification Update via PHD, Jarvis, Mira
UnitedHealthcare has recently learned that the state of Ohio Medicaid verification system is undergoing a transitional stage that will prevent agents from verifying Medicaid in our state. Jarvis, Mira and the Producer Help Desk (PHD) are impacted by this change and currently do not have a workaround to verify eligibility.

What you need to know:

The state system will likely go down at 5 pm tomorrow, Tuesday, Jan. 31. This outage could potentially last for several days.
• You are able to continue writing new business during the outage, but you may need to ask additional questions of your prospects to verify their status & eligibility (ask if or who’s paying their Part B premium, are they part of MyCareOhio, do they have a local JFS office case worker they work with re their benefits, etc.)
• Please submit enrollment applications as soon as possible before the blackout window to avoid any potential delays.
• There may be a delay for applications being approved for Feb. 1 and March 1 effective dates.

At this time, UHC is unable to determine how long this outage will be. UHC will keep brokers updated as they receive additional information. UHC is working with the state of Ohio to get this resolved as quickly as possible.

 

Ohio Medicaid – Emergency Assistance Changes

Beginning in April, Medicaid expansion is set to begin unwinding across each state that took part in the COVID pandemic related Medicaid coverage increases. This will result in a county by county effort by local JFS offices to contact over 1 million Ohio Medicaid recipients letting each person know they need to reenroll.

 

This is very likely to cause confusion & frustration among clients & prospects at the low income venues and organizations you partner with. At the same time, this becomes an OPPORTUNITY for each of you to provide additional service and assistance and value to the locations you visit each week.

 

For additional information, please see this recent local TV video report from the local Columbus NBC station: Changes approaching for Medicaid recipients | NBC4 WCMH-TV (nbc4i.com)

 

The Health Plan: New OTC Vendor – InComm

Sourced from THP Broker Communication from 1/19/23:

The Health Plan has a new OTC vendor, InComm.  Enclosed is an instructional video “How to Access and Navigate My Benefits Center” that may help you communicate this benefit to your THP Medicare Advantage members.

Please advise your members that this benefit / Visa Card is already activated upon receipt and ready-to-use for their OTC purchase needs.  DSNP plan members can also use it for healthy foods and utility bill assistance, as instructed in the video. Every member who earns rewards & incentives for getting their annual physical, mammogram and / or colonoscopy will access their rewards through this card as well.

Click here to view the instructional video.

Please direct your members to contact The Health Plan’s Customer Service department with any questions at: 1-877-847-7907, M-F 8:00 am – 8:00 pm

If you have any questions, please reach out to your CSM Service Rep

Mutual of Omaha 2022 1099’s Coming to SPA

Great news, 2022 1099s will be available through Sales Professional Access (SPA) for all producers.

Please note: if the producer has a Compensation PIN assigned for SPA already, they will not be able to view their 1099 without their compensation pin. We wanted to give all of you the heads up before we send a general announcement in February.

 

READ MORE… 

SureBridge Cancelation Requests System Issue

System Issue: Cancelation requests through the SureBridge branded Self-Service Tool not processed
1/10/23
We recently identified a system issue with the SureBridge Self-Service tool (myportal.surebridgeinsurance.com) that prevented policy cancelation requests made through the portal from being processed between Nov. 23, 2022 and Jan. 7, 2023. This issue is isolated to cancelation requests only and updates have been made to correct the issue. The tool should be working as expected again.

The policies affected are being identified and will be processed accordingly.  Any refunds that may be due could take up to 10 days to be processed.  This email is for information purposes only and requires no action by the agent.

If you have list of customer cancelation requests that were made during this timeframe and would like to check status, please email producersupport@surebridgeinsurance.com instead of calling Customer Service.

We apologize for the inconvenience this may have caused you and your customers.

 

 

Georgia Market – OEP 2023 D-SNP Sales Incentive Program  – Learn More! 

Aetna is excited to announce to all brokers in Georgia that we have a NEW SALES INCENTIVE to help support you during Lock-In.

The top three D-SNP producers will be able to access marketing dollars in the form of traditional co-op or funds through our Medicare Marketing Studio, marketing collateral to support community events, and local Aetna support to host community events throughout the year.

Producer Rewards & Qualifications

Top 3 Producer Rewards:

#1 Top Producer
• $5,000 in marketing co-op dollars in Q1 Only
• Aetna Swag
• Event collateral (banners, table runner, flags)

#2 Top Producer
• $3,000 in marketing co-op dollars in Q1 Only
• Aetna Swag
• Event collateral (banners, table runner, flags)

#3 Top Producer
• $1,500 in marketing co-op dollars in Q1 Only
• Aetna Swag

Sales Incentive Details & Qualifying Criteria:

• New to Aetna D-SNP sales for February 1- April 1 effective dates (CMS issued sales only).
• Final sales numbers will run in early May. Winners will be announced at that time.
• Cancelled applications and rapid disenrollments will be removed from final counts.
• To qualify for the contest, the broker must have a minimum of 10 New Sales
• Top three winners will be announced in each of the following markets:
Atlanta Metro/North Georgia
Macon/Columbus/South Georgia
Augusta/Savannah

***NOTE: Plan replacement is excluded***

 

The Qualifying Plans Include the Following:
• Aetna Medicare Dual Choice Plus Plan (PPO Full D-SNP)
• Aetna Medicare Dual Preferred Plan (HMO Full D-SNP)
• Aetna Dual Choice Plan (PPO Partial D-SNP)
• Aetna Medicare Dual Select Plan (HMO Partial D-SNP)

The Aetna Medicare FULL D-SNP plans are available in 78 counties in Georgia. Our plans offer competitive benefits and includes many extras:

• Extra Benefits Card: $600 combined quarterly allowance on a prepaid debit card for OTC and healthy foods. No pre-qualifying conditions required.
• $0 Rx copays on all tiers at standard and preferred pharmacies.
• Dental: up to $4,500 allowance that covers preventive comprehensive care, including dentures and implants (excluding cosmetic services).
• Eyewear: up to $500 allowance.
• Transportation: up to 60 one-way trips (100 Mile radius) to medical appointments, pharmacies and SilverSneakers locations through SafeRide.
• LifeStation Personal Emergency Response: $0
• Hearing aids: up to $1,250 allowance per ear.
• Fall Prevention: $150 for home/bath safety devices.
• Plus … earn an extra $110 service fee when you complete the HRA via electronic submission.

Cigna’s VBE Program – Pays more for digital applications

It’s easy to make additional money with Cigna Medicare! Follow the steps below to earn up to $50 on every enrollment!

  1. Submit your new-to-Cigna application digitally and earn $20 per eligible approved application.
  2. Include a valid in-network PCP on the digital application and earn an additional $20.
  3. Include a valid customer email address on the digital application and earn an additional $10.

Eligible plans:

  • All Cigna MAPD plans are eligible for the additional VBE payments. 

Agent training qualifications:

  • Agents must complete all required training in order to be certified and ready to sell 2023 Cigna MAPD plans.
  • No additional VBE training modules are required.

Qualified digital applications:

  • Connecture (DRx)
  • Sunfire
  • eEnrollment
  • OEC files

Valid customer email addresses:

  • Agents must provide a unique and valid email address for the customer.
  • Generic email addresses or an agent’s personal/business email address will not be accepted.
  • Valid PCPs:
    • The provider must be in-network to qualify for the additional VBE payment. Out-of-network providers will not qualify for the additional VBE payment.
    • PCP information must be valid and correct. Incorrect information will not qualify for the additional VBE payment.

Application status:

  • Agents can view their application status in com.
  • Please note: The application status will not inform if the application qualifies for the VBE program payments.

Commissions statement:

  • “VBE – Digital Admin Fee” will be included in the Adjustment Notes column of the commissions statement.
  • The line item will indicate the name of the customer, so agents can verify that they have been paid for each successfully completed and eligible digital application.
Don’t forget about our health risk assessment (HRA) incentive!

 

·    Earn $125 when you enroll your Cigna Medicare Advantage customers in an eligible Medicare D-SNP or C-SNP plan and facilitate an HRA. (For 2023 effectives)

·    Earn $75 for each HRA that you facilitate with your other Cigna Medicare Advantage customers.

 

This means even more money in your pocket! Click here to learn more about Cigna’s HRA incentive.

Exciting update: Lumico.com has a fresh, new look!

Sourced from Distribution Partner News on 11/10/22:

We’ve been working hard to take Lumico.com to the next level, and are thrilled to announce the launch of our new website. Here are a few new features that your agents can expect from Lumico.com:

Access important information with ease

  • Under the “My Account” menu option, there’s a new “Are you an agent?” hyperlink. (You can see it here).
    • All portal links have been consolidated to one page; agents can use this to navigate to the e-App and their Life and Health Agent Portals.
  • Individual product pages offer Lumico product highlights and specifications at a quick glance.
    • Agents can download product fact sheets on each page for easy reference.

Be a valuable resource for customers

  • Support > Help Center – Easily search an expanded repository of FAQs; find answers to commonly asked questions in a central location; check back regularly for new content!
  • Support > Claims – Agents can share this dedicated page with clients and their beneficiaries; here they can download claim forms and submit life and health claims.

About Us > Blog – An educational resource center for all things insurance; agents can connect with their customers by sharing critical insurance topics, including trends, tips, and how-to’s.

 

VISIT LUMICO’S NEW WEBSITE NOW!

 

UCT Application Updates

The improvements don’t end there.

UCT also upgraded the EFT process. Now only one bank customer signature is needed along with one for the PandaDoc verification process.

THP: Express Scripts and Kroger Pharmacy Changes

THP AgentNewsflash communication from 10/27/22:

Express Scripts and Kroger Pharmacy Changes

 

As you may now know, Kroger Pharmacies will NOT be participating with Express Scripts (ESI) on 1/1/2023. As a health plan who contracts with ESI, this will impact our members. We will begin notifications next week to affected members.

Click here to find the latest updates to the 2023 Pharmacy Directory. You will see that our pharmacy network (and the preferred pharmacies within) remains robust.

NOTE: (Preferred pharmacies are marked with this symbol- ‡.)