WellCare’s Digital Resource Center: New for 2021!

NEW for 2021! – Pre-Enrollment Materials Available in Seconds

WellCare is excited to share a great new tool that provides all the information you need to meet with beneficiaries at your fingertips. Plus, materials are available in multiple languages!

The new digital resource center gives you easy access to:

  • Sales Presentations
  • Pre-Enrollment Guides
  • Benefit Highlights
  • OTC Catalogues
  • Formularies

Click the link Centene First Look – Digital Resource Center to access the digital resource center.

 

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

WellCare Introduces Summa Health to Ohio Market

WellCare Broker Announcement from 2/9/21:

As the market continues to expand, we want to ensure we are providing you with the necessary resources to continue to be successful in the field – and best serve our members.

WellCare is excited to announce the addition of Summa Health to the Ohio market. As of Jan. 1, 2021, this partnership came with the addition of more than 600 providers – ranging in 12 different license types.

With Summa Health now in network, we are able to provide more resources and options when it comes to accessing affordable healthcare. We hope you keep WellCare and Allwell plans on the top of your list when presenting to potential members.

 

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

WellCare OTC Benefits: Help Clients Find CVS Pharmacies

WellCare communication from 1/28/21:

We wanted to share a quick reminder about how members can access a key benefit that can make a big difference, our OTC benefit. This benefit gives members $15-$720 per quarter of OTC items from a plan-approved list of products (benefit coverage varies by plan).

CVS is the OTC benefit vendor for several plans in 27 of our Medicare markets. Members in plans with the OTC benefit can order covered products by mail order (phone or online) or in-store at a participating CVS location. When shopping from the catalog, items are shipped to members’ homes at no additional cost. (Reminder: Members are limited to three (3) in- store purchases per quarter).

Find Participating CVS Locations

Here’s how members can quickly find a local participating location:

  1. Go to http://www.CVS.com/
  2. Select STORE LOCATOR, enter a zip code, and choose OTC HEALTH SOLUTIONS
  3. Participating locations in the area of the chosen store will appear

For more information on OTC, check out the following available agent resources:

WellCare Commission Payments Delayed

Commission Payments Delayed

An error was identified that prevented commission payments from processing. We have resolved the issue and are processing the payments.

  • Impacted commission statement: 12/18/2020
  • Payments will process on 12/30/2020.
  • Payments will be deposited by EFT (Electronic Funds Transfer).

We apologize for any inconvenience this has caused.

WellCare is a wholly owned subsidiary of Centene Corporation

WellCare/Centene: Retroactive Enrollment Reminders

WellCare/Centene Announcement from 11/13/20:

Retroactive Enrollment Reminders

Did You Know – CMS monitors and scrutinizes retroactive enrollments that result from broker errors during the initial enrollment application process? As such, these largely preventable, broker-related errors present compliance issues for Centene that may have downstream effects on any related broker contractual arrangements. As a best practice, please review all applications prior to submitting to ensure accuracy of the submission.

For further insight, we have identified some of the most common mistakes to watch for:

  • Incorrect effective dates selected
  • Plan name and plan number mismatches
  • Missing required information, and no responses to our requests for information
  • Incorrect plan segment (PBP) selected by agent during agent assisted web application

If you have any further questions, please contact your Cornerstone rep.

Centene/WellCare 2021 Star Ratings

Centene is pleased to announce their 2021 Star Ratings!

Each year, the Centers for Medicare & Medicaid Services (CMS) issues objective ratings on all Medicare Advantage and Medicare Drug plans to determine if they provide high-quality care for their members.

These quality scores include several factors, such as the clinical care members receive, their service experience, and member feedback detailing how well plans did in various categories. Using a one through five-Star rating system, CMS evaluates nearly 50 measures, broken into multiple areas.

Centene oversees CMS Star measures and performance within five chapters:

  • Admin/Ops (service quality)
  • CAHPS (member satisfaction)
  • HEDIS (clinical services)
  • HOS (Health Outcomes Survey)
  • Pharmacy (taking prescribed medications)

Achieving positive quality ratings is vital. These ratings are crucial to Centene members, brokers and partners, and their overall growth. With CMS’ increased focus on patient experience and access to care, Centene must continue to put members first and empower them to partner with their providers to make good healthcare decisions.

Downloadable 2021 Star Ratings:

  • Click here to access 2021 Star Ratings for all Centene health plans.

 

NOTE: 2021 Star Ratings are state- and product-specific.

 

Action Required: Please ensure that you are distributing the most current 2021 Star Ratings. Be sure to dispose of any outdated Star Ratings.

 

WellCare: EFT/ACH Vendor Payment Postponed

WellCare communication from 10/26/20:

WellCare’s transition to a new broker payment vendor is delayed. Originally the transition was to take place on October 30, 2020; now, it will take place on November 13, 2020.

  • The first payout using the new vendor will take place on November 13, 2020.
  • You will continue to receive payment through our existing process and vendor until the transition is completed.

There will be no interruption in broker payments, as we transition to the new broker payment vendor.

 

If you have any questions, please contact your CSM service representative. 

WellCare: AEP is HERE

WellCare Message from 10/2/2020:

AEP is Here! AEP is finally here, and the combination of Centene and WellCare means greater opportunity for you!

Now, you can market and sell up to 5 health plans!

  • Allwell
  • Ascension Complete
  • Fidelis Care
  • Health Net
  • WellCare

Note: Not all health plans are available in all areas.

The easiest and fastest way to ensure that you are offering all plans available in your area and you are credited for each sale is to use the Ascend Enrollment Platform. (Currently, Ascend cannot be used for Fidelis Care enrollments.)

Application and Enrollment

Broker Identifier:

It is crucial that all applications include the correct agent identifier. Ascend will automatically attach your agent identifier to each application you submit: National Producer Number (NPN), Producer ID (PID), or Fidelis Care ID.

When submitting applications OUTSIDE of the Ascend Enrollment Platform, be sure to input the correct agent identifier:

*Fidelis Care Notes:

  • Beginning 10/1/2020, Fidelis Care will begin using a unique broker identifier consisting of the letters FB + NPN, for example: FB123456

Fidelis Care does not accept paper applications.

Ascend:

All health plan information has been loaded into Ascend. Please note, 2021 Enrollment Applications will not be accessible until 10/15.

As of 10/1 you should be able to access 2021 rates and benefits in the Ascend Mobile App. If you are not able to access 2021 plan information, please be sure to update the App. Click here for information on how to download and update the Ascend Mobile App.

Warning! Beginning 10/1/2020, the WellCare Mobile Enrollment Platform and Desktop Enrollment Platform (agent assisted) will be retired and no longer accessible. You will find our 2021 plans, benefits, rates and enrollment capabilities in Ascend.

Additional Resources:

Click here for Application & Enrollment Tools.

2021 CMS Enrollment Guidance Policy Revisions

The Centers for Medicare & Medicaid Services (CMS) has issued annual enrollment and disenrollment guidance revisions for contract year 2021.

All enrollments with an effective date on or after January 1, 2021, must be processed in accordance with the revised guidance requirements.

Significant Changes To Guidance:

  1. Effective for the plan year beginning January 1, 2021, CMS removed the prohibition on beneficiaries with ESRD enrolling in a Medicare Advantage (MA/MAPD) plan. Health plans can accept and process elections made by ESRD beneficiaries that choose to join a MA/MAPD plan during a valid election period.
  2. Special Election Periods (SEP) for Exceptional Conditions: CMS has codified a number of SEPs previously adopted and implemented through subregulatory guidance as exceptional circumstances SEP, additionally two new SEP’s have been added for exceptional circumstances: SEP for Individuals Enrolled in a Plan Placed in Receivership & SEP for Individuals Enrolled in a Plan that has been identified by CMS as a Consistent Poor Performer
  3. Medicare Advantage and Prescription Drug Plan Model Enrollment forms: CMS revised and improved the standard (“long�) model form used for MA/MAPD and PDP enrollments to a new streamlined form. All health plan enrollment applications have been revised in accordance with CMS guidance, including Allwell, Ascension Complete, Fidelis Care, Health Net, and WellCare.
  4. Electronic Signatures: As part of the Electronic Enrollment process, electronic signatures from a beneficiary that affirms his/her intent to complete the enrollment are acceptable. This change only applies to electronic enrollments. The affirmation requirements for the telephonic and paper enrollments remain the same.