Allwell’s AEP Helpful Tips & Trends Update

Allwell hopes that you are off to a great start this AEP! This week Allwell is going to focus on making sure your marketing efforts are compliant, geo-coded directories, the broker portal and some fantastic partnerships Allwell has that you can share with your clients.

Tip # 1: Be Compliant

We realize that marketing is incredibly important when it comes to outreach so let us help you be compliant. Our compliance team is here to review any material, marketing or communication that will be seen or heard by your Medicare clients that represent Allwell.

CMS defines marketing as the use of materials or activities that are conducted with the intent to draw a beneficiary’s attention and to influence a beneficiary’s decision-making process when selecting a MA plan. Additionally, marketing contains information about the plan’s benefit structure, cost sharing, measuring, or ranking standards.

Check your materials, make sure that you are compliant. Simply reach out to your local Account Executive and they can help. Any and all client facing materials such as websites, social media posts, print, radio or local sponsorships that meet the definition of marketing must be reviewed and approved by our compliance team in advance.

NOTE: Compliant marketing also extends to social media posts with or without a sales intention. Any use of a company name without approval, whether the intent is positive or negative, can potentially be considered a non-compliant action.

Tip # 2: Geo-Coded Directories

Having a list at your fingertips of primary care physicians, specialists, hospitals and outpatient facilities that are within your client’s service area so that you can submit an accurate and compliant application is helpful. It is important to make sure that you are confirming availability and assigning your client’s (Primary Care Physician) PCP and (National Provider Identifier) NPI when submitting your client’s enrollment application.

Prior to your appointment printing out or having the link to a geo-coded directory for the area in which you are meeting your client may be a good idea. Log on to your local Allwell plan website and go to the “Find a Doctor or Pharmacy” tab. Click on the link labelled “Geocoded Provider Directory Search.” From there you are able to create a directory by Zip code or Address for the Product Type, State, and Specialty.

Tip # 3: Resources at your Fingertips in the Allwell Broker Portal

Once you are actively contracted with Allwell you have the ability to register for our broker portal where you can access a myriad of useful tools and resources to assist you in your sales. You can track your book of business, commission payments, VBE and Blue Button Administrative Payments, eligibility, view sales quoting tools, and access support documents such as forms, brochures and helpful how-to videos on our Ascend online application platform. To register for the broker portal simply visit broker.brokersecureportal.com and create an account. Once you log in you will find a complete user guide in the footer of the portal. If you have any questions or need assistance please contact our Medicare Broker Services Department at 1-844-202-6811 or email medicarebrokerservices@centene.com

NOTE: You must be contracted and have an NPN number in order to gain access to the portal.

Tip # 4: Use the Allwell Partnerships to your Advantage

Help your clients find FREE programs in their area that best suit their needs. BenefitsCheckUp® is the most comprehensive, free web based service of its kind in the nation that screens for benefits programs for seniors with limited income and resources. BenefitsCheckUp ® users can select categories of programs that interest them to screen for more than 2500 public and private benefit programs in all 50 states.

Inform your clients of how they can earn money by receiving specific preventative screenings or care visits. Your client is automatically enrolled in the My Health Pays ® program once they are an Allwell member. After they complete an eligible preventive screening or care visit and the claim is processed, a Visa ® Prepaid Card is sent to them with their reward amount pre-loaded onto the card. Your client can then redeem those reward dollars at any Walmart, or Sam’s club as well as for certain transportation, utilities, and telecom services. It pays to stay healthy!

Broker Services team at 1-844-202-6811

October 15th – December 7th, Monday thru Friday 9:00am to 7:00pm, and Saturdays, 9:00am – 1:00pm, each time zone.

2019 THANKSGIVING HOLIDAY HOURS:

Broker Services with be closed November 28 – December 1

Ascend Help Desk & VBE Wellness Advocate will be closed November 28

Bright Health’s Electronic Enrollment Admin Allowance Program!!

Bright Health is excited to formally release their new initiative that rewards contracted Brokers for using Bright Health’s electronic member enrollment application (Medicare Enrollment Dashboard – MED).

Brokers who assist their clients with enrollment application for a Bright Health MAPD plan using their Medicare Enrollment Dashboard (MED) will receive a one-time $50 administrative allowance per enrollment application.

VIEW INFO FLYER HERE

  • Bright Health has implemented a new electronic enrollment application for 2020, which provides Brokers the ability to create customized quotes, compare Bright Health plans, and simplifies the enrollment process.  Bright Health believe this system supports the Broker with providing the best information possible for your clients to decide which plan is best for them, while saving administrative costs for the carrier. This is why Bright Health will be paying Brokers a $50 allowance for applications submitted through their new system.
  • Click here to watch a video tutorial of the enrollment system.
  • First time accessing Bright Health’s Medicare Enrollment Dashboard? Click here for instructions.
  • Please review the FLYER which provides all the details for how to be eligible for and receive the allowance.

 

 

WellCare Update: EFT Set-Up Causing RFIs and Possible Disenrollment

WellCare has provided important tips to ensure the beneficiary’s EFT is set up properly, plus additional Request for Information (RFI) status definition and resolution information.

WellCare Newsletter

Dental Care Plus Broker Bonus through AEP!

Sell Individual Dental with DCPG!

Effective dates November 1, 2019 – February 1, 2020

 

    10 – 14 Subscribers              15 – 19 Subscribers

                         $50 Visa® gift card                                                                             $100 Visa® gift card

 

       20+ Subscribers

                          $250 Visa® gift card

 

As an extra expression of our gratitude for your partnership, we’re giving you the opportunity to receive a bonus for newly enrolled dental subscribers.

 

Terms and Conditions

  1. Broker bonus will be determined for all new subscribers enrolled between September 16, 2019 and January 15, 2020 with effective dates between November 1, 2019 and February 1,
  2. Broker bonus distribution is one-time only and will be delivered after the broker bonus eligibility enrollment deadline of January
  3. Subscribers must still be enrolled at the time of broker bonus distribution.
  4. Applies to new DCPG sales AORs and renewals not included.
  5. IRS regulations regarding market value of prizes will
  6. May not be combined with any other
  7. 10 percent commission applies to new

SureBridge’s Platinum Service Team

SureBridge has dedicated a special Platinum Service team exclusively for Cornerstone Senior Marketing and Integrity agents!

By using the phone number and email below instead of SureBridge’s standard producer support line and email, you will be routed directly to one of their most experienced and talented support reps to assist you with your needs.

 

Platinum Service Phone Number: 866-928-7613

Platinum Service Email: platinumsupport@surebridgeinsurance.com

 

If you have any questions or would like to get contracted with SureBridge, please reach out to Michelle Kapp.

 

November 13, 2019 WellCare Training Assignment Notification is not Mandatory

WellCare appointed brokers received an email notification today requesting they take a 45-minute updated Agent Connect training called SM 2019 Agent Connect.  The recommended training is available to ensure you understand the changes made to your Agent Connect Portal.  However, WellCare recognizes it is a busy time of year and have stressed in the message, the following:

  • The training is NOT required
  • It has no impact on your selling status with WellCare
  • There will be NO repercussions if it is not completed   

Check your email for the WellCare notification to read additional details regarding the SM2019 Agent Connect training.

Not appointed with WellCare? Contact your Cornerstone Senior Marketing Sales Representative today to get started!

Aetna Offers NEW HMO & DSNP Plans in NE Ohio for 2020

For 2020, Aetna has a new $0 premium MAPD plan, the Aetna Medicare Premier (HMO) H0628-005.  Aetna  also has a new 2020 Dual Eligible Special Needs Plan, the Aetna Medicare Assure (HMO D-SNP) H5337-001. Both plans offers your Northeast Ohio clients a strong provider network and impressive supplemental benefits!

Learn more about our new Aetna Medicare Premier (HMO)

The 2020 Aetna Medicare Premier (HMO) H0628-005 is available in Ashland, Belmont, Columbiana, Cuyahoga, Geauga, Harrison, Jefferson, Knox, Lake, Lorain, Mahoning, Medina, Morrow, Portage, Richland, Stark, Trumbull, Tuscarawas and Wayne counties. Benefits include:

  • Comprehensive provider network  
  • No referrals required
  • $0 annual medical deductible
  • $10 PCP/$30 Specialist (in-network)
  • Plan allowances on dental, vision & hearing benefits—No dental network
  • Over-the-counter (OTC) benefit—$45 allowance per quarter
  • 24 one-way non-emergency trips per year
  • SilverSneakers® fitness benefit—Free membership at participating
    fitness facilities

Discover the new Aetna Medicare Assure (HMO D-SNP)

The 2020 Aetna Medicare Assure (HMO D-SNP) H5337-001 is available in Belmont, Carroll, Columbiana, Coshocton, Cuyahoga, Franklin, Fulton, Guernsey, Lake, Lorain, Lucas, Mahoning, Medina, Montgomery, Morgan, Muskingum, Ottawa, Portage, Stark, Summit, Trumbull, Tuscarawas, Wayne and Wood counties. Benefits include:

  • $0 or low-cost monthly premium
  • Access to the Aetna HMO statewide provider network
  • $3,000 dental allowance, including dentures and crowns
  • Robust hearing and vision benefits
  • 40 one-way non-emergency trips per year
  • 28 home-delivered, post-discharge meals, at no cost
  • 40 one-way non-emergency trips per year
  • SilverSneakers® fitness benefit
  • OTC benefit—$210 per quarter
  • $150 fall prevention package

 

For more information contact Cornerstone’s Jaime Lebron, Sales Director of NE Ohio.

WellCare Agent Resources

WellCare Agent Services:

866-822-1339

WellCare Agent Services can assist your with resetting your system passwords, agent onboarding, 2020 application status, enrollment questions, HRA set up and sales compensation question.

*Note: They do not assist with benefit or provider/formulary lookup.

WellCare Eligibility (SPOP):

866-822-1339 option 2; or

866-211-0544

State Prompts: 1- IL & IN,

3 – OH, 4 – MI

SPOP can assist with Medicaid & Medicare eligibility and is open 7 days a week from 8am to 2am EST. They also have ability to validate MBI’s. At the end of the call, they will provide a confirmation number. Please include this on your application to assist with enrollment processing.
WellCare Request for Information (RFI):

866-822-1339 option 3

Request for Information (RFI) process is designed to assist with correcting inaccurate and/or missing information submitted on enrollment applications; and agents are permitted to resolve on behalf of the beneficiary. Please have the beneficiary information ready prior to calling in by checking your Agent History – Application Search Tool in Agent Connect
MeridianCare Agent Hotline:

866-821-2650 MI/OH

866-821-2540 IL/IN

Agent Hotline can still assist you with CCP benefit questions, 2019 application status and provider/formulary search.

*Note: If you are unable assign a PCP on an application due to WellCare’s provider search, please contact Agent Hotline to assist with locating the provider and documenting PCP/member information to ensure the PCP is assigned to the members account.Also, please include the PCP NPI on the application if the WellCare Provider ID is not available but the PCP is in network.

Aetna Medicare Supplement November Updates

NEW AND EXCITING:

New underwriting process and application tracker

Starting October 1, our underwriting process will give you faster decisions for underwritten Aetna Medicare Supplement applications. We have not altered our underwriting philosophy in any way. Most applications will have a decision within a few minutes. This exciting change also comes with an updated online application tracker, to give you clearer visibility to those decisions.

Changes: Point-of-sale telephone interview and voice signature option

To help make the underwriting process even easier for you, we’ll no longer require or offer a point-of-sale telephone interview as of October 1, 2019. We’ll also be discontinuing the voice signature option.

  • If any point-of-sale interviews are still pending after October 1, the phone line will still be available to use until those interviews are complete.
  • Instead of a voice signature, you’ll continue to have 3 easy signature options for your electronic applications: security question signature, in person signature, email signature.

Our new underwriting process

Once we receive your Medicare Supplement electronic application, we will provide one of the following underwriting decisions within a few minutes:

  • Approved
  • Needs further review
  • Declined

We will also provide decisions on your paper applications once we have verified all required information has been included with the submission. This review may delay how soon the decision is displayed on the website.

  • Approved applications will be processed as normal.
  • If an application needs further review, the application will be reviewed by our underwriting staff.  And if necessary, our associates will call your client with targeted questions for clarification. This new telephone interview process will be easier for your client, as we will not need to review all health questions.
  • If an application is declined, we’ll send the applicant (and you) a letter with details about how to get a copy of the information used to help with the underwriting decision. The application tracker on the agent website will show if an application is declined. A copy of the letter will be accessible within 24 hours.

MACRA 2020

Are you wondering how MACRA works and how it will affect you and your clients?  I have attached a cheat sheet that will help you have a better understanding of MACRA.

Aetna has launched their MACRA 2.0 strategy in 15 states with more coming either later this year or early next year.  Watch for your e-bulletins for more information.

August launches for MACRA 2020 – SC, IL, LA, AZ and TN

July launches – AL, GA, IA, MI and MS

September launch – FL

October launches – OH, NC, KS and PA

 What does all this mean?

Aetna plan F rates will be on average within $15-$20 a month of our plan G rates and our plan F rates have been lowered. You will be able to offer a high deductible G with effective dates after 1/1/20

 Why is Aetna putting out rates that are so competitive on plan F?

There are tens of millions reasons why.  After 1/1/20 anyone on a Medicare Supplement currently or Medicare eligible by 12/31/19 will still be able to purchase plan C, F and HIF after 1/1/2020. These clients that would like to receive a very competitive plan F rate with us will need to go through underwriting so this with be a very healthy group of insureds which can mean lower rate increases.

 

Aetna has a new agent services phone number: 866-272-6630

New Quoting App!

Aetna has launched their new app for quoting all products.  You no longer have to save the link to you home page. All you need to do is download our “quote on the go” app from the app store.  You can quote every product Aetna offers in one easy format!

UnitedHealthcare Plan Faces Medicare Sanction

UPDATE FROM UHC REGARDING THE SANCTIONS IN OHIO:

In Ohio, this effects only Dual Plan H5322-028 (Light Blue banded kit), which is now Closed to New Enrollment for 2020.  Members on this plan can remain for as long as they like.  Agents will continue their AOR status and be paid their renewal commissions.

The reason for this sanction is: the aggregate medical loss ratios of  the 9 states included in this plan number,  were less than the CMS required 85%.   So in essence UHC didn’t lose enough money on that plan.

To note: Ohio was not a contributor to the low losses ratio, UHC had plenty. 

UHC has replaced H5322 with H8125-002 for those 75 counties, so they can continue to serve Dual beneficiaries in the State of Ohio.

This does not affect the other Dual Plan H5253-059 (Purple banded kit) which serves Metropolitan 13 counties in Ohio.

All UHC Ohio Plans starting with: H5253 are all 4.5 stars plans and not effected!

 

By

UnitedHealthcare is facing enrollment restrictions next year in one of its Medicare Advantage health plan contracts, regulators say, because the insurer hasn’t been spending a large enough share of revenue on the health care needs of enrollees.

The sanction from the Centers for Medicare and Medicaid Services (CMS) applies to just one of United’s many contracts with the federal government to sell Medicare Advantage health plans and doesn’t apply to coverage sold in Minnesota.

Minnetonka-based UnitedHealthcare, the nation’s largest health insurer, says it fell out of compliance due to federal legislation that reduced the insurer’s tax liability last year. The sanction applies to a health plan contract for coverage sold in nine states to less than 1% of the company’s roughly 6 million Medicare Advantage members. The states include Florida, Georgia, Kansas, New Hampshire, New Jersey, Ohio, Oklahoma, Texas and Virginia.

“CMS imposed enrollment sanctions on a subsidiary of UnitedHealthcare … because the organization did not meet a Medical Loss Ratio (MLR) of at least 85% for a third consecutive year,” CMS said in a response to Star Tribune questions.

“This enrollment suspension will be in effect for contract year 2020,” the federal agency said. The federal MLR rule “requires that a percentage of revenue should be used for patient care, rather than for other items [such] as administrative costs or profit.”

UnitedHealthcare is one of the nation’s largest sellers of Medicare Advantage plans, a newer form of Medicare coverage in which enrollees opt to receive federal health insurance benefits through a private managed care company. In 2019, roughly one-third of Medicare beneficiaries are opting for Medicare Advantage coverage, according to the Kaiser Family Foundation, as opposed to receiving benefits through the original Medicare program.

The federal government monitors the share of revenue that Medicare Advantage plans spend on patient care needs, vs. the amount spent on administration and kept as profit. This measure is called the “medical loss ratio,” and it’s a standard way for regulators and consumers to assess the profitability of health plans.

When a Medicare Advantage plan’s MLR drops below 85% for three consecutive years, the government can suspend new enrollment in the plan while letting current enrollees maintain the coverage. In a Sept. 11 letter to UnitedHealthcare, CMS said the medical loss ratio (MLR) was 71.3% in 2016, 83.9% in 2017 and 84.1% in 2018 for health plans within the contract that’s being sanctioned.

In a response to Star Tribune questions, UnitedHealthcare said the MLR last year fell below the mark — despite added benefits — because the company saw a financial benefit from the federal Tax Cut and Jobs Act, which became law in late 2017. The company says it subsequently factored the change into its calculations and anticipates achieving an MLR above 85% in 2019.

“While we won’t be enrolling new members in [this contract] for 2020, existing members will continue to receive the same level of care and support, including an increase in their coverage and benefits,” the insurer said in a statement. “UnitedHealthcare also has additional Medicare Advantage plans available in many of these markets.”

“We anticipate that we will achieve the MLR threshold in 2019 for [this contract], which will allow us to resume enrollment in these plans in 2021,” UnitedHealthcare said.

The health plan contract that’s being sanctioned primarily provides coverage for people who quality for benefits from both Medicare and the state-federal Medicaid program. UnitedHealthcare officials have said these products for “dually eligible” enrollees are an important growth area for the company.

If the MLR for a Medicare Advantage plan falls below the 85% mark for five years, the government can terminate its contract with the health plan. CMS says the regulatory action against UnitedHealthcare is the first time the agency has suspended enrollment in a Medicare Advantage plan due to noncompliance with the MLR rule.