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

 

 

The Health Plan OH Plan Terminated for 2021

THP Announcement as of 10/8/20:

 The Health Plan is terminating the following Medicare Advantage Plan for 2021: SecureCare Option IV HMO.

This is an Ohio only plan. Affected members are being notified this week.
Click here for information on the other plans that we are offering.

Please know that we did not arrive at this decision easily. We regret the inconvenience that this may cause you and your clients.

Please see your daily Enrollment Status report to identify any Option IV members.

 

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

The HealthPlan 2021 Sales Materials Now Available

 

GREAT NEWS: You can order your THP 2021 Medicare Products sales materials here!

Check the site often as some materials are not available at this time but will be available soon. If you have any questions about the materials, please contact your CSM representative with questions.

THP appreciates your business and look forward to a productive 2021 season!

The Health Plan – Member Costs Waived for COVID-19 Testing

The Health Plan Will Waive Member Costs for COVID-19 Testing

 

The Health Plan announced today it will cover the cost of copays, co-insurance, and deductibles for COVID-19 testing for all Commercial, Medicare and Medicaid lines of business when recommended by a medical professional. Our exclusive independent lab provider, LabCorp is making its NAA test available for ordering by physicians or authorized healthcare providers anywhere in the United States.

For The Health Plan’s self-funded (ASO) members, they will also waive cost-sharing for diagnostic testing related to COVID-19, unless they receive notice in writing of the group’s intent not to implement this temporary relief option.

The Health Plan wants to provide members with peace of mind. “Supporting the health and well-being of our members is important to us. We want to assure our members that we will do all we can to make health care treatment and services available to them at no additional cost, especially for seniors and people with chronic conditions,” said Jeff Knight, Interim President/COO of The Health Plan.

At this time, the Centers for Disease Control and Prevention (CDC) and state labs currently performing the testing are not billing for COVID-19 testing, so members should not incur costs when tested by these labs.

The Health Plan remains committed to ensuring access to medications is available during this time. Members have multiple options to obtain medication through The Health Plan, including the ability for Medicare and fully-insured members to fill 90-day supplies of long-term medications via mail order or local retail pharmacies. The Pharmacy Services Department will be available to assist with any extenuating circumstances such as ensuring formulary flexibility if medication shortages or access issues arise.

The Health Plan recommends contacting your doctor’s office first if you suspect you might have a flu or coronavirus infection. But to help reduce potential exposure, The Health Plan also encourages members to utilize telemedicine services if they are available as part of a member’s plan. The Health Plan will waive member cost share where applicable for telemedicine visits for the next 90 days. Telemedicine is a safe and effective way for members to see a doctor to receive health guidance related to COVID-19 from their homes via smart phone, tablet or computer-enabled web cam.

The Health Plan is providing the latest information on precautions members should take to help prevent the spread of COVID-19 and who should seek medical attention on their website. Visit healthplan.org for more information.

West Virginia University To Acquire The Health Plan

WVU Health System’s acquisition to make it an integrated financing/delivery network

West Virginia University Health System is taking the first steps toward becoming an integrated health care financing and delivery system with Tuesday’s announcement it would merge with a Wheeling, West Virginia-based insurer.

Financial terms of the deal between WVU Health System, also known as WVU Medicine, and managed-care provider The Health Plan, weren’t disclosed. The Health Plan would become a subsidiary of WVU Health System as a nonprofit corporation.

An integrated financing and delivery system puts under one system both the payor and provider of health care similar in structure to UPMC, which owns its own insurance division, as well as Highmark Health, which owns insurer Highmark and the Allegheny Health Network. It’s a model that is increasingly employed elsewhere in the country, including Geisinger in the central part of Pennsylvania.

“By aligning and integrating our two organizations and by leveraging our respective expertise in a more coordinated fashion, we can deliver better outcomes to the people of West Virginia,” said WVU Health System President and CEO Albert L. Wright Jr. in a statement Tuesday. “The Health Plan will also continue to build collaborative, value-based partnerships with other health systems and independent providers in West Virginia.”

WVU Medicine is a powerhouse in West Virginia, based in Morgantown and including hospitals throughout West Virginia. It’s also is in the midst of a growth spurt, including the building of a new children’s tower and other facilities in Morgantown, and it’s expanding in Pennsylvania, including a facility just over the border into Waynesburg as well as a potential affiliation with Uniontown Hospital.

The Health Plan began operations in 1979 and has licenses in West Virginia’s 55 counties as well as a 36-county area in Ohio. As of 2017, it had 400 employees and four offices in Ohio and West Virginia. It offers a wide range of insurance options, including HMOs, PPOs, point-of-service and self-funded health plans. The Health Plan’s market share in group health in West Virginia was 7 percent with coverage of 20,024 lives, according to a West Virginia state report in 2017.

The HealthPlan’s 2019 Marketing Materials are Available

The HealthPlan 2019 materials are now available to order through your direct THP Agent link!

Agent Certification for 2019 is required before the 2019 materials can be ordered. 2019 kits consist of Enrollment Guides that include all SecureCare HMO and SecureChoice PPO Summary of Benefits and Enrollment Forms for a particular region. Kits are designated by region and are labeled either OH, WVOH or CAP.

SecureCare DSNP kits contain a Summary of Benefits, Enrollment Form, and a Star Ratings Form. There are no Enrollment Guides included with DSNP kits. Additional quantities of enrollment forms for this product ARE available to order separately.

You will receive an email confirmation that your order has been submitted for approval, and will receive a follow-up email notification when the order has been processed and is ready for shipping.

Contact your Cornerstone representative for more information.

The HealthPlan 2019 Medicare Product Training and Certification is Now Available Online

You will soon receive an email with the training and testing link to complete your 2019 HealthPlan certification. In the meantime, please forward your 2019 AHIP/Gorman CMS compliant General Medicare Rules and Regulations certification to <a href=”mailto:brokerrelations@healthplan.org”>brokerrelations@healthplan.org</a>.

As a reminder, below is the contact information in case you experience any technical difficulties while completing this training:
Certification (training and testing) System Issues
The Health Plan Help Desk
740-695-7610 or 1-877-903-7501

The Health Plan Provides 2018 Quick Links

The Health Plan recently sent out a notice that all of their Medicare Services links have been combined into one easily accessible link. The links will continually update whenever THP updates their website.

To access the link, click here.