Aetna Medicare Network Update: Mount Carmel Health System & Negotiations with Trinity

Sourced from Aetna broker communication from 11/10/21:

Network Update | November 10, 2021

Update on negotiations with Trinity – Mount Carmel Health System – OH

 

Highlights

As promised, we are keeping you informed on the progress made during Aetna’s negotiations with Trinity – Mount Carmel Health System – OH. This update, and the ones that follow, will supplement the original network communication you received on 10/26/2021. We will keep you informed of updates until negotiations are complete and/or concluded.

Update # Date of Update Update Description
1 11/09/2021 Trinity Health has provided Aetna with a contract extension to 1/31/22 – for the Commercial and Medicare products.

The parties agree to continue to work through the local market negotiations and memorialize the terms and conditions of a new National LOA over the next several weeks.   This National LOA will memorialize the new national template contract language, the respective rate increases for the respective markets and a commitment to utilize a Trinity-specific national contract template for all of their Trinity Ministries by January 1, 2023 or sooner.

Aetna and Trinity Health have signed a contract extension, assuring continued in-network access for its members in NY, OH, MI, and IL.  We’re pleased that our members will be able to continue receiving in-network care from their hospitals and doctors with the intent to limit further disruption during open enrollment.

Trinity Health extended the termination date of the following NY, Ohio, Illinois and Michigan hospitals to 1/31/22:

  • Samaritan (Troy)
  • Samaritan / Albany Memorial (Albany)
  • St. Josephs (Syracuse)
  • Mt. Carmel East Hospital (Columbus)
  • Mt. Carmel New Albany Surgical Hospital (New Albany)
  • Mt. Carmel St. Ann’s Hospital (Westerville)
  • Mt. Carmel Health System Grove City (Grove City)
  • Diley Ridge Medical Center (Canal Winchester)
  • Loyola University Medical Center (Chicago)
  • MacNeal Hospital (Chicago)
  • Gottlieb Hospital (Chicago)
  • Mercy St. Mary (Grand Rapid)
  • MHP Mercy Campus (Muskegon)
  • MHP Hackley
  • Lakeshore (Shelby)
  • St. Joseph Mercy (Chelsea)
  • St. Joseph Mercy (Ann Arbor)
  • St. Joseph Mercy (Oakland)
  • St. Mary Mercy (Livonia)
  • St. Joseph Mercy (Livingston)

 

 

We appreciate your support in this matter, as we continue to try to address the rising cost of health care services for Central Ohio area employers and residents.  We will continue to keep you informed of any changes in our local network.

Anthem’s OTC Network to Now Include Kroger Stores

Sourced from Anthem broker communication on 11/10/21: 

Kroger Company Stores will soon be included in Anthem’s OTC network of retailers

Convenience and value are important factors when your clients shop using their OTC network — and they deserve nothing but the best. That’s why we are proud to include all Kroger Company stores as participating retailers.

You and your clients will both be pleased to know that as of January 1, 2022, Kroger Company retail stores and affiliates* will be part of the Anthem OTC retail network.

 

As a MEDICARE AGENT, If you have any questions or concerns regarding Anthem’s OTC network or issues  please reach out  to  ANTHEM’S BROKER SERVICES AT   (800) 467-1199

Mutual of Omaha Senior Health Social Media Group- New Launch

Mutual of Omaha has created an exclusive marketer LinkedIn group. This group will focus on promoting Senior Health products, lifestyle events, and business tools. You can interact with other marketers and the Senior Health Sales Team directly.

To stay connected with Mutual of Omaha, please join the SHS Marketer Connect group on LinkedIn.

 

If you have any questions please reach out to your CRM representative.

WellCare 2022 Enrollment Tips & Reminders

Selecting the Correct Plan Year Application (2021 or 2022)

Plan year determines which application to use. Make sure to select the correct application based on the plan year of enrollment.

  • 2021 Application – 11/1/2021 or 12/1/2021 effective date
  • 2022 Application – 1/1/2022 – 12/1/2022 effective date

Note: Current members remaining in the same plan do not require a new application submission. Enrollment will continue into the new year.

 

Documenting the Correct Plan of Enrollment

  • Select only one (1) plan on Pg. 1 of the application.
  • The plan selected on Pg. 1 of the application MUST match the plan written on the last page.

If there is a conflict, the plan code/name documented on the last page of the application will take precedence.

 

Capturing Provider Information on Applications (Medicare Advantage plans)

Be sure to document accurate and complete Primary Care Provider information on applications to avoid auto-assignment of providers.

  • PCP ID (WC) or NPI ID (CNC) must be on applications.

Note: If submission of IPA or PPG IDs is necessary for the enrollment, be sure to also submit the PCP/NPI ID and ensure they are valid providers for the plan.

 

Election Periods: Using AEP vs. SEP

For 2022 applications, you may notice that there is no longer a ‘check box’ to select AEP on the application. This is okay! As long as the Application Received Date is between 10/15/2021 – 12/7/2021 and the Requested Effective Date is 1/1/2022, the application will automatically process as the AEP option. If any SEP option is selected, the application process will use that SEP.

 

Additional Enrollment Reminders

Member Addresses – Accurate and Complete

Verify the members address and zip code to prevent enrollment rejections or denials if the member is determined to be out of the service area. Additional points to keep in mind regarding addresses:

  • Street Name: Must be accurate, spelled correctly and in the right order
  • Zip Code: Must be provided on all applications and accurate
  • Rural Addresses: Must include the unit or space numbers

Member Changes Only – Provider, Premium Withhold Option, Address, etc.

  • An application submission is not required for changes to a members address, provider or premium withhold option. Customer Service is available to assist with these type of changes.

Note: Pay special attention to the member’s provider and premium withhold option selected, and document accordingly.

SureBridge’s Newest Features to their Point of Sales Tool

See What’s New in the Point of Sale Tool Beginning October 22

Sourced from SureBridge’s broker announcement from 10/21/21:

 

Point of Sale (POS) Tool Impacts

Updates to the SureBridge Point of Sale tool will begin around 7 PM CST Thursday, October 21 which could cause the system to be temporarily unavailable. For Email Proposals – If the application is not started by the customer before Thursday (10/21), a new Proposal must be created.

In addition to the new SureBridge products and revised Applications, the following updates will be made to the POS Tool:

• Primary Beneficiary Designation – Now allows up to two Primary Beneficiary designations. Providing as much information as possible (Date of Birth, Address, etc.) to properly identify the Beneficiaries is important and will help expedite and ensure accurate payments to the designated Beneficiaries.

• Revised Product and Summary Information Form – Updated to include the new Product(s) and the premium amount. This form is part of the Voice Review screen and is required to be read aloud during the call recording process. Note: Applications that include SecureWise Term Life will NOT have Voice Signature as an option.

 

 

New SureBridge Products – Underwritten by The Chesapeake Life Insurance Company

  • SecureWise™ Term Life (10 Year & 20 Year) – Alaska, Delaware, District of Columbia, Idaho, Maine, Minnesota, Mississippi, North Dakota, Oregon, Virginia, West Virginia, and Wyoming

Click here for more information regarding SecureWise.

For Idaho* – The following SureBridge products are back!

  • Accident Direct
  • Accident Disability Direct
  • CancerWise® Plus (Individual & Senior) 
    • Optional Rider: Invasive Cancer Recurrence Rider
  • Critical Accident Direct
  • HospitalWise™ (Individual & Senior)
    • No Riders available

*Product information can be found in the Supplemental Product & UW Guide and brochures located on the Broker Portal for product details. Additional product information can be found in the Training guides available in SBU Continu LMS: https://surebridge.continu.co/#/view/tracks/61095a8cf1f45e0012afa4b5

See our chart for SureBridge state product availability.

Medical Mutual of Ohio: Important Information on Secure HMO Plan LIS Levels

Taken from MMO’s Special Broker Update from 10/21/21:

Important Information on Secure HMO Plan LIS Levels

 

As you know, the Secure HMO plan has been a great option for those members who are full LIS. It has also provided agents the opportunity to offer a competitive plan at $0 premium. We feel it is important to share in advance that, as we move into 2022, the premium will be changing. Members who are full LIS will now receive a bill for $2 per month beginning in January 2022. 

 

We understand expenses are a priority for these members, which is why we wanted to ensure you were made aware of this change. We also want to provide you with the information in advance so you can reach out to your clients and determine which product best fits their needs moving forward. 

 

Click Here to view the Secure plan LIS premium levels for 2022. You can download a copy of this flier on MyBrokerLink.

 

 

If you have any questions, please reach out to your Cornerstone Senior Marketing rep.

WellCare OH Medicare Broker Sales Team Info & Important Ohio Plan Info

WellCare Broker Announcement from 10/19/21:

 

Welcome to the first of our Wellcare “Help For You” series. These emails are designed to hub all updates and resources in one place to help you access any product, administrative updates along with resources you may need during the 2022 AEP selling season. If you read nothing else during this time, read these emails.

Meet your Ohio Wellcare broker sales team for AEP!

Ohio Medicare Broker Sales Team:

Kimberly Scott
Director, Sales
859-512-7857
Kimberly.Scott2@wellcare.com

Nick Poirier
OH South Sales Executive
313-212-2635
Nicholas.Poirier@mhplan.com

Kim Cordell-Fife
OH North Sales Executive
614-202-5549
Kim.Cordell-Fife@wellcare.com

Materials:
Per our previous communication, we are aware that sales materials have been delayed for some agents. We apologize for the inconvenience. We have arranged for several pick up locations and are able to ship you certain supplies upon request. We thank you for your patience during this busy time.

Provider Look up
Please see the buttons below for the provider look up tool website according to plan. Below you will find hospital, physicians, dental and vision providers for your selected plans.

Select the plan button below for more information

H0908 and H0724 (Allwell Legacy)
H5475 (Wellcare Legacy)

 

2022 Plan Name Changes

As a reminder, all legacy Allwell plans will be rebranded to Wellcare for 2022. Please refer to the table below as resource when referring to the mapping of 2021 and 2022 plans.

 

Don’t Forget:

• · Complete member HRA/VBE at time of enrollment for maximum bonus earnings
• · Verify DSNP Medicaid before enrollment
• · Update your email and contact information in Agent Connect

Wellcare Important Numbers:
Enrollment Verification and RFI (Request For Information): 877-677-5609

WellCare Agent Support: 866-822-1339

Pharmacy Help Desk: 866-592-5825

Ascend Technical Help Desk: 866-338-7772 or help@ascendproject.com

AVL/SOA – Scope of Appt. Line: 877-780-3894

Agent Hotline: 866-439-1189 ( RX and Provider look up)

Medicaid Verifications Line (SPOP): 866-211-0544

 

2022 AEP Readiness Resources
Medicare Health Plan Reference
2022 LIS Grid Levels Ohio
PDP Consolidation Highlight

 

Ohio At A Glance:

OH_Greater-Cleveland
OH_Greater-Cleveland-D-SNP
OH_Outstate-Ohio

 

Critical WellCare PDP Update- RESOLVED AS OF 10/25/2021

Updated plan information from WellCare has been uploaded and accurate data is reflected in the plan quoting effective October 25, 2021.  

Please reach out to your Cornerstone Senior Marketing Rep if you have any questions. 

____________________________________________________________________________________________________________________

WellCare Quoting and Enrollment Rate Info Discrepancies

We have been informed that updated plan information from WellCare has NOT been provided to vendor partners and is causing issues with agents quoting and enrolling for these plans so far, this AEP.

The WellCare information discrepancies are reportedly found on all platforms, including:

• WellCare website
• Medicare.gov
• MedicareAPP (MedicareCENTER)
• MedicareLINK (MedicareCENTER)

Also, we have learned that accurate data should be loaded by October 25th, or sooner, if possible.

We apologize for the inconvenience this may cause at the onset of AEP and know that the our teams are working diligently with WellCare to resolve and upload updated plan information to ALL platforms including MedicareCENTER as quickly as possible.

We will confirm to you as soon as we know the issue has been corrected and accurate WellCare information is available.

Helpful Hint For Your Prescription Drug Plan Clients:
With these plan discrepancies, it may be wise to re-evaluate any of your PDP client’s prescription calculations, who have enrolled or are planning on enrolling in a WellCare 2022 plan, to make sure they are on the best fitting stand-alone PDP plan.

Please reach out to your Cornerstone Senior Marketing Rep is you have any questions.

614-763-2255 or email:

service@cornerstoneseniormarketing.com

Anthem: Here’s How to Earn FREE 2023 Certification Training

Sell & Retain 22 During AEP 2022 to Earn FREE 2023 Certification Training!

Sell and retain 22 or more NEW Medicare Advantage plans with 1/1/22 effective dates to earn FREE 2023 Certification Training from Anthem!*

Eligible NEW sales include all types of Medicare Advantage plans including D-SNP and C-SNP plans. PDP sales are not included.

Make sure rapid disenrollment doesn’t reduce your chance of earning Free Certification Training!
• Follow up with clients two weeks after their enrollment is approved.
• Make sure they have their Welcome Kit, ID card and the PCP of their choice.

*Only approved new enrollments with 1/1/22 effective dates that are still enrolled as of 2/15/22 count toward the goal to earn FREE 2023 Certification training.

 

CLICK HERE TO READ MORE

 

Questions? Contact your CSM representative for more information.

 

 

 

 

The HealthPlan – 2022 Sales Kit Delivery Delays

The Health Plan apologizes for the delay in getting the 2022 Sales Kits out to you.

Supply shortages have moved an expected arrival date to later next week. For those agents who do not use an online platform to enroll members, open the document link below to access the materials you will need to manually enroll a prospect including: Ohio, WV and DSNP SOB’s; SOA’s; applications and star ratings. The SOA’s are located on pages 83-85 and applications are on pages 87-97 in the Ohio and WV SOB attachments. The DSNP application is separately attached.  If you have any questions or concerns, please reach out to your Cornerstone Senior Marketing sales and/or service team.

Sales Materials with Corrected Links