Merck Sues Over Drug Price Negotiation Law

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The pharmaceutical company Merck on Tuesday sued the federal government over legislation that empowers Medicare for the first time to negotiate prices directly with drugmakers.

Merck’s lawsuit, filed in federal court in Washington, is the drug industry’s most significant move so far to fight back against a substantial change to health policy, which will go into effect starting in 2026. Democrats pushed through the Medicare-negotiation program last summer as a provision of the Inflation Reduction Act, framing it as a way of lowering drug prices.

https://www.nytimes.com/2023/06/06/business/merck-medicare-drug-prices.html

Important Updates to LeadCENTER – Please Read!

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We are excited to announce some significant updates to the LeadCENTER platform that will enhance your lead management experience and empower you to grow your insurance business even further. Below are some of the updates that we are thrilled to share with you:

Design Changes for Enhanced User Experience: We have revamped the design of LeadCENTER to provide you with a more intuitive and streamlined interface. The improved design aims to make lead purchasing and order management a seamless and efficient process. We understand the importance of time in your profession, and these updates will allow you to navigate the platform with ease and speed. To give you a visual demonstration of the design changes, we have created a comprehensive video that showcases the new features and functionalities. Please take a moment to watch the video by clicking on the following link:

WATCH VIDEO

Introducing T-65 Leads: Additionally, in response to numerous requests from our valued users, we are pleased to inform you that we have expanded our lead types to include Turning 65 (T65) Medicare leads. This addition will provide you with a valuable opportunity to target the growing market of individuals transitioning to Medicare. With LeadCENTER, you’ll be able to purchase T65 Medicare leads now conveniently alongside your existing lead types, enabling you to diversify your portfolio and cater to a wider range of clients.

SHOP FOR LEADS

 

Should you have any questions or require further assistance, please don’t hesitate to reach out to our dedicated support team at support@IntegrityLeadCENTER.com. We are here to ensure a smooth transition and provide ongoing support.

Union Security Insurance Co: Important Med Supp Update

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Sourced from USIC email communication on 5/17/23:

Effective June 1, 2023 Union Security will be discounting the USIC Medicare Supplement offering in all states.

The Union Security Insurance Company (USIC) Medicare Supplement product, administered by Aetna, will be discontinued as of June 1, 2023.

 

  • We will not accept applications with a signature date after May 31, 2023
  • We will not offer effective dates later than June 1, 2023
  • Agent appointments under USIC will be terminated as of June 1, 2023
  • Paper sales materials for USIC Medicare Supplement plans in all states will be available through today, May 17th, 2023
  • Existing customers will continue to be serviced and offered renewal options
  • Existing policyholders will continue to have access to their account here
  • Agents will continue to be able to access reports and other information from their agent portal here

 

If you have any questions concerning USIC products or contracting please contact your CSM rep.

Cigna’s Value Based Enrollment Program Changes

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Sourced from Cigna broker email communication from 5/16/23:

Changes to VBE payments for digital applications starting with June 1 effectives.

At Cigna Healthcare, we believe that the Primary Care Provider (PCP) and patient relationship is of vital importance to drive better health outcomes and increase customer satisfaction and retention.

 

For this reason, we are making changes in how payments are earned through our Value Based Enrollment (VBE) digital application program to further promote the PCP and patient relationship and continue to encourage the collection of a customer email address. This change applies to June 1 effectives and beyond.

 

New VBE payment amounts

Here’s how you can continue to earn up to $50 per approved digital application for new Cigna Healthcare Medicare Advantage (MA) customers:

• Earn $30 for including a valid in-network PCP on the digital application.
• Earn $20 for including a valid customer email address on the digital application.

 

For more information on this change to our VBE program, please feel free to review our VBE Program Broker FAQ after logging in to Producers’ University.

Benefits of this program change

Capturing a customer’s valid PCP and email address at the time of enrollment gives Cigna Healthcare Medicare important information to provide better care for your customers.

Better care results in higher customer satisfaction and retention rates, as well as higher net promoter scores (NPS). This means you can spend more time selling and growing your business and less time addressing customer concerns.

Effective Immediately: UCT Suspends New Product Sales

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Important Message

Effective Immediately, UCT is voluntarily suspending the acceptance of new applications for all products due to last quarters filings that showed UCT has dropped below the minimum statutory surplus limit.

Customer service will continue to service existing policies/policy holders/providers. In addition, the processing of claims will not be affected and will continue as usual. 

 

Questions?

Contact your Cornerstone Senior Marketing Team

614-763-2255

service@cornerstoneseniormarketing.com

CSM Newest Carrier Partner: Introducing Clear Spring Health!

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Are you looking for a carrier that offers commissionable Part D (PDP) plans?

You are in the right place. Cornerstone Senior Marketing welcomes Clear Spring Health to its family of carriers. See what makes Clear Spring Health a must-have for your Medicare sales portfolio.

Clear Spring PDP

• Medicare Part D plans include an extensive list of generic and brand-name prescription drugs at affordable prices.
• Offers a 5 Tier Formulary that covers over 3,300 medications
• Nearly 30K pharmacies in the preferred network and over 70K retail pharmacies nationwide.
• Drug Pricing Tool – look up any drug to find the current cost at participating pharmacies wthin a 10-mile radius
• Sponsors Prescription Drug Plans in all states except NY.

About Clear Spring Health

• Clear Spring Health is an entrepreneurial, second-generation Medicare insurance company offering consumer focused products and innovative healthcare tools.
• The Company built a platform in a high barrier to entry space, demonstrated explosive growth and presents unique capabilities relative to their Prescription Drug competitors.
• Clear Spring is one of the fastest growing plans in the country and have tripled membership during the most recent Medicare Annual Enrollment Period.
• Clear Spring Health is part of the Group 1001 family of insurance companies with ~60 billion in assets under management.

 

REQUEST CONTRACTING HERE!

CLICK TO VIEW RATES! 

Important CMS Update to Definition of Marketing Eff July 10, 2023

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CMS has made an update to the Definition of Marketing as it relates to Medicare Advantage/PDP.  Any content included in a MA/PDP piece (mailer, flyer, television, social media, website, etc.) that a beneficiary can receive/view that includes mention of benefits such as Dental, Vision, Hearing, and cost-savings, will meet the standard definition of marketing.  Previously, unless a specific dollar amount was listed, these mentions in a piece would not meet the content standard for marketing and the piece would be considered ‘generic communication’. 

Beginning July 10, 2023, any material or activity that is distributed via any means (e.g., mailing, tv., social media, etc.) that mentions any benefit will be considered marketing and must be submitted for review/approval by CMS. 

What do I need to do?

Review any client-facing assets in-use/planned to use on/after July 10, 2023, either created in-house, through a third-party vendor, or from the Marketing team at Cornerstone Senior Marketing (mailers, flyers, brochures, ads, web pages, social media, etc.).  If any contain benefit information, (ie: mention of dental, vision, hearing, travel, cost-savings, etc. in relation to MA/PDP) and have not already been filed with CMS for review/approval, discontinue use or modify, removing benefit information, on or before July 10, 2023. 

 Alternately, you may send any such materials to Cornerstone Senior Marketing to submit to CMS for review/approval.  Please note the review and approval process may take upwards of 75 days to complete and use of the material on/after July 10, 2023, must be suspended until approval is granted.

 

Compliance Services from Cornerstone Senior Marketing

Client-facing materials for the Medicare market, specifically those that include information about MA/PDP, can be submitted for a compliance review prior to use, by sending via email to: compliance@cornerstoneseniormarketing.com.

 

We highly recommend submitting scripts with storyboards for television/video prior to recording or development of these projects to ensure compliance and avoid potential, costly re-work if the content requires changes in order to be compliant.

 

 CLICK TO READ FULL NEWS RELEASE: MAY 10, 2023| CMS NEWSROOM 

CMS Updates on Coverage for COVID-19 Tests

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CMS Official Communication from 5/1/23:

What you need to know: 

The COVID-19 Public Health Emergency is to end on May 11, 2023. The ending of the Public Health Emergency may impact an individual’s coverage of COVID-19 tests. We encourage you to know these changes and share the New Consumer Fact Sheet on COVID-19 tests.

 

Consumer Fact Sheets:

 

What to tell consumers:

 

Before May 11, 2023

If you have any type of health insurance, you can get up to eight over-the-counter tests per month with no out-of-pocket costs. Over-the-counter tests are available in most pharmacies and may also be available online for delivery.

 

After May 11, 2023 

Laboratory tests for COVID-19 that are ordered by your provider will still be covered with no out-of-pocket costs for people with Medicare. Over-the-counter tests will still be available, but there may be out-of-pocket costs. Coverage of over-the-counter tests may vary by your insurance type, as described below.

 

What does this mean for Medicare Beneficiaries?

Generally, Medicare doesn’t cover or pay for over-the counter products. The demonstration that has allowed us to offer coverage for COVID-19 over-the-counter tests at no cost ends on May 11, 2023.

 

However, if you are enrolled in Medicare Part B, you will continue to have coverage with no out-of-pocket costs for appropriate laboratory-based COVID-19 PCR and antigen tests, when a provider orders them (such as drive-through PCR and antigen testing or testing in a provider’s office).

 

If you are enrolled in a Medicare Advantage plan, you may have more access to tests depending on your benefits. Check with your plan.

 

What does this mean for people with Medicaid or Children’s Health Insurance Program? 

If you have coverage through Medicaid or the Children’s Health Insurance Program, you will have access to COVID-19 over-the-counter and laboratory testing through September 30, 2024. After that date, coverage of testing may vary by state.

 

What does this mean for people with Private Insurance?

If you have private insurance, coverage will vary depending on your health plan. However, private plans won’t be required by federal law to cover over-the counter and laboratory-based COVID-19 tests after May 11, 2023.

 

If your insurance chooses to cover COVID-19 testing, they may require cost sharing, prior authorization, or other forms of medical management.

SilverScript Application Email Error Notification

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Silverscript Agent Email Notification from 5/8/23: 

On Friday May 5, 2023 there was a trend identified of brokers receiving emails in error with the subject “Subject: Your client’s SilverScript application was cancelled.” After researching, the members were still enrolled. 11,704 emails were sent in error. 

 

The email shares the following information:

 

Please note that the SilverScript enrollment application you submitted on behalf of your client XXXXX XXXXXX has been cancelled. Most likely this occurred because of one of the following reasons:

  • Your client enrolled in another Medicare plan.
  • Your client requested to cancel the enrollment or change the effective date.
  • Your client is already a member of SilverScript, or a duplicate application was submitted.

We suggest that you contact your client to make sure he or she is aware of this cancellation and that they have arranged alternate Part D drug coverage. If your client still wants to enroll in a SilverScript PDP, then please complete a new enrollment application, validate that the client is entitled to Medicare Part D, and that all fields on the application are correct.

Thank you for your efforts.

SilverScript Insurance Company

Unfortunately, this email is an automated notification, which is unable to receive replies. If you have questions, please contact your agency or upline administrator.

 

The verbiage below was added into the portal and to our Broker Support reply backs regarding the erroneous emails. We wanted to share in case you receive any questions. If a broker has questions regarding their member’s enrollment status, please direct them to broker support. We will verify if they were sent the emails in error and advise on their member’s enrollment status. 

 

Cigna OH Network Updates

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Cigna Medicare Advantage Network is Growing in Ohio!

We are constantly working to expand our network to meet the needs of our customers. Some exciting network expansions are happening in your area! Please see below to learn more.

We have recently added the following providers to our network in the Ohio market:

Clinical Social Work
• St Elizabeth Physicians
• Christ Hospital Medical Associates LLC

 

Orthopedic Surgery

  • Crystal Clinic Orthopaedic Center LLC

 

Plastic Surgery

  • Crystal Clinic Orthopaedic Center LLC

 

Family, General, and Internal Medicine

  • Van Wert Medical Services LTD

 

As a reminder, you can search Cigna’s online provider directory to view the most up-to-date provider listing in your market. Click here to access the directory.

 

Questions? Reach out to your Cornerstone Senior Marketing Rep!