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

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- ‡.)

The HealthPlan Network Update: Cleveland Clinic Foundation Facilities In Network

Sourced from THP Agent Newsflash Email from 10/6/22: 

 

The Health Plan is pleased to announce a change regarding Cleveland Clinic Foundation.

Effective 1/1/2023, all contracted CCF facilities are in network for both SecureCare HMO and SecureChoice PPO.
(Previously listed as Tertiary-only for HMO).

We are in the process of updating our online provider search and directories to reflect this change.

 

If you have any questions – reach out to your CSM representative!

Revisions to THP 2023 Agent Training: Medicare Product Certification

Sourced from THP broker communication from 9/1/22:

 

Dear THP Agent Partner:

As you know, CMS’ annual bid process continues after the release of our Agent Training. The following benefit changes have occurred after our training was released. These changes have been updated in our online training site materials. However, if you have already taken our training, please review the changes below:

  • SecureCare SNP, H3672-019 for OH/WV: 
    • Over-the-Counter item amount changed from $125 to $130
    • Healthy Food Benefit amount changed from $60 to $65
    • Premium changed from $0-$37.90 to $0-$40.80
    • Emergency Room Maximum copay changed from $90 to $95
  • Changes to OHIO Benefit Chart: 
    • Plan H3672-013 Over-the-Counter changed from $60 to $80
    • Plan H8604-010 Premium changed from $60 to $58
      • Hearing Services added Medicare-covered Hearing Exam; $45/In, $60/Out
    • Plan H3672-020 Premium changed from $35 to $33
    • Plan 8604-011 Premium changed from $115 to $113
      • Hearing Services added Medicare-covered Hearing Exam; $45/In, $60/Out 
  • Changes to WV Benefit Chart:
    • Plan H3672-020 Premium changed from $35 to $33
    • Plan H8604-011 Premium changed from $115 to $113
      • Hearing Services added Medicare-covered Hearing Exam; $45/In, $60/Out
    • Plan H3672-023 Over-the-Counter amount changed from $60 to $80
    • Plan 8604-013 Premium changed from $80 to $78
      • Hearing Services added Medicare-covered Hearing Exam; $45/In, $60/Out

 

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

New Updates for The Health Plan Agents

THP Broker communication from 5/27/22:

The Health Plan has three important updates for our agents!

  1. Those of you taking advantage of our Health Risk Assessment (HRA) surveys for new MA enrollments are reminded to send them to THP in a secure fashion.
  2. After June 1st all HRA surveys must be submitted within 3 days of THP receiving the member’s enrollment form.
  3. Anyone moving a THP Medigap member from a higher to a lower benefit plan, (ex: Plan F to G); please use the updated form available here. These changes are no longer limited to once per year at renewal.

 

If you have any questions please reach out to your CSM Sales or Service Rep.

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

The Health Plan: 2022 Medicare Sales Kits Now Available

THP Agent Broker Announcement form 9/21/21:

Great News!  You can now order your THP 2022 Medicare Products sales materials  at thehealthplan.mp-b.com/

Some items may indicate availability as “Out of Stock”.  Please place your desired quantities in the shopping cart and proceed through the check-out process.  We will ship those items as soon as they are available.  Check the site often as some materials are not available at this time but will be available soon.

As a reminder, kits include the following materials:

  • Enroll Guide
  • Summary of Benefits
  • Enrollment Forms
  • Scope of Appointment Form

*Some materials are also available to order as stand alone items.

 

 

If you have any questions, please contact your CSM representative 

THP: Annual Medicare Product Recertification for 2022 Info

THP email communication from 7/2/21:

It’s that time again!

The Health Plan’s (THP) 2022 Medicare Product Training will be available soon. Please watch for an email containing the training link, user ID and password.

What’s new this year?
You will see a new “step” in this year’s training – an annual HIPAA and Privacy attestation. Just like the Code of Conduct, you will review the document and click on the link as attestation.

We have removed the product benefit information from the main training slides. This information is now contained in separate benefit chart documents, displayed by state.

Once you have completed THP training and have submitted proof of successful Medicare Rules and Regulations training completion, we will send you a certification status email. This email will let you know when you are officially “Ready to Sell for 2022.”

If you take AHIP and have not already registered through The Health Plan AHIP URL, please visit ahipmedicaretraining.com/clients/thehealthplan.

Registering through this link will ensure that your AHIP certificate is automatically sent to The Health Plan, eliminating the need for you to forward the information.

 

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

The HealthPlan Updated Med Sup Compensation for West Virginia

The HealthPlan notice from 11/16/2020: 

There is an update to THP Medicare Supplement commission/admin rates in WV.  This update is required so that we can comply with the State of West Virginia Regulatory Rule 114-24-14, which went into effect 4/1/2020.  The rule requires that carriers pay the same amounts paid in year 2 for all compensated renewal years.   Unfortunately, the legislative change was missed by THP until now.

Summary Change

Current WV Medicare Supplement

20% YEARS 1-5

4% YEARS 6-10

ADMIN :  1% YEARS 1-5, .5% YEARS 6-10

 

Updated Schedule WV Medicare Supplement

 

New/Open Enrollment: 20% YEARS 1-8

Guaranteed Issue: 10% YEARS 1-8

ADMIN:   New Open Enrollment: 1% / Guaranteed Issue: .5% YEARS 1-8.

 

There are no other changes to either Ohio or West Virginia rates.

 

This change was effective 4-1-2020.  This means that you may see back-dated commission or admin. that is owed to you on future commission statements.  This will be paid by end of year in most cases.

We apologize for this late notice.  Procedures have been put into place to ensure that we deliver any compensation changes by 9/1 each year, moving forward. We are asking that your office reach out to Tracie Soptelean, Manager Broker Relations on how you would like this information communicated to your agents.   She has the updated exhibits that you can personally send to your agents or she can send an email notification. Please let her know as soon as possible how you would like to procced.

The Health Plan Receives 4-Star Rating for 2021

The Health Plan SecureCare (HMO) Medicare Advantage plan in Ohio and West Virginia has been recognized with a 4-Star overall rating for 2021 by the Centers for Medicare and Medicaid Services (CMS)!

Every year, Medicare evaluates plans based on a 5-star rating system to measure how effective they are in the following areas:
• Member Satisfaction
• Provider Satisfaction
• Healthy Outcomes
• Customer Service
The Health Plan’s SecureChoice (PPO) Medicare Advantage Plan was also awarded a half-star increase to a 3.5-Star rating.

2021 Star Ratings Marketing documents:
H3672
H8604