MMO: Updated Medicare Advantage Compliance Addendum and First Amendment to Compliance Addendum

MEDICAL MUTUAL OF OHIO BROKER UPDATE:

Date: September 20, 2022

Subject: Updated Medicare Advantage Compliance Addendum and First Amendment to
Compliance Addendum
Topic: Medicare
Applies to: Medicare Advantage

The Centers for Medicare & Medicaid Services (CMS) released new marketing requirements for the 2023 calendar
year that go into effect Oct. 1, 2022. These requirements can be found in the Final Rule in 42 CFR 422.2274(g) of
the Medicare Compliance Addendum

READ FULL UPDATE FOR 2024 CERT SEASON HERE

Wellcare: Urgent: Attachment of IRA for Inclusion with 2023 AEP Sales Materials

Sourced from WellCare’s Broker Bulletin on 9/23/22:

Urgent: Attachment of IRA for Inclusion with 2023 AEP Sales Materials

Attention Valued Partner,

We would like to inform you that due to the passage of the Inflation Reduction Act (IRA) on August 16, 2022, your 2023 AEP Enrollment Guides, Comprehensive Formulary, and/or Benefit Highlights will now include the following separate standalone documents:

  • Important Message About What You Pay for Vaccines and Insulin
  • Notice of Changes to the Formulary (Drug List) or Cost Sharing that affect your drug coverage (Comprehensive Formulary – List of Covered Drugs 2023)

The above separate attachment(s) must be included with all of your 2023 Enrollment Guides, Comprehensive Formulary, and/or Benefit Highlights to prospects. If you did not receive a printed addendum in your order, please print the attachments and provide to your prospects per CMS guidance.

Please note: The above referenced documents will be available for digital download on 10/4/2022 via Custom Point and will be pre-merged into your Digital Download 2023 AEP Enrollment Guides, Comprehensive Formulary, and Benefit Highlights.

 

Important Message About What You Pay for Vaccines and Insulin – effective 01/01/2023

  • Plan covers most Part D vaccines at no cost.
  • Member will not pay more than $35 for a one-month supply of each insulin product covered by the plan, no matter what cost-sharing tier it’s on.

Please select the specific attachment for more detailed information.

Wellcare
Health Net of California
Ascension Complete

Comprehensive Formulary Update – effective 01/01/2023

  • Plan covers most Part D vaccines at no cost, even if member has not paid their deductible.
  • Member will not pay more than $35 for a one-month supply of each insulin product covered by the plan, no matter what cost-sharing tier it’s on, even if the member has not paid the deductible. Refer to Evidence of Coverage and other plan materials for any deductible that may apply.

Please select the below attachment for more detailed information.

Wellcare – Comprehensive Formulary Attachment

 

If you have any questions or concerns, please reach out to your CSM Service Rep

2023 Medicare Parts A & B Premiums and Deductibles 2023 Medicare Part D Income-Related Monthly Adjustment Amounts

On September 27, 2022, the Centers for Medicare & Medicaid Services (CMS) released the 2023 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, and the 2023 Medicare Part D income-related monthly adjustment amounts.

Medicare Part B Premium and Deductible Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A. Each year the Medicare Part B premium, deductible, and coinsurance rates are determined according to the Social Security Act. The standard monthly premium for Medicare Part B enrollees will be $164.90 for 2023, a decrease of $5.20 from $170.10 in 2022. The annual deductible for all Medicare Part B beneficiaries is $226 in 2023, a decrease of $7 from the annual deductible of $233 in 2022.

The 2022 premium included a contingency margin to cover projected Part B spending for a new drug, Aduhelm. Lower-than-projected spending on both Aduhelm and other Part B items and services resulted in much larger reserves in the Part B account of the Supplementary Medical Insurance (SMI) Trust Fund, which can be used to limit future Part B premium increases. The decrease in the 2023 Part B premium aligns with the CMS recommendation in a May 2022 report that excess SMI reserves be passed along to people with Medicare Part B coverage.

Beginning in 2023, certain Medicare enrollees who are 36 months post kidney transplant, and therefore are no longer eligible for full Medicare coverage, can elect to continue Part B coverage of immunosuppressive drugs by paying a premium. For 2023, the immunosuppressive drug premium is $97.10.

Medicare Open Enrollment and Medicare Savings Programs

Medicare Open Enrollment for 2023 will begin on October 15, 2022 and ends on December 7, 2022. During this time, people eligible for Medicare can compare 2023 coverage options between Original Medicare, and Medicare Advantage, and Part D prescription drug plans. In addition to the soon-to-be released premiums and cost sharing information for 2023 Medicare Advantage and Part D plans, the Fee-for-Service Medicare premiums and cost sharing information released today will enable people with Medicare to understand their Medicare coverage options for the year ahead. Medicare health and drug plan costs and covered benefits can change from year to year, so people with Medicare should look at their coverage choices annually and decide on the options that best meet their health needs.

To help with their Medicare costs, low-income seniors and adults with disabilities may qualify to receive financial assistance from the Medicare Savings Programs (MSPs). The MSPs help millions of Americans access high-quality health care at a reduced cost, yet only about half of eligible people are enrolled. The MSPs help pay Medicare premiums and may also pay Medicare deductibles, coinsurance, and copayments for those who meet the conditions of eligibility. Enrolling in an MSP offers relief from these Medicare costs, allowing people to spend that money on other vital needs, including food, housing, or transportation. People with Medicare interested in learning more can visit: https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/medicare-savings-programs.

Medicare Part B Income-Related Monthly Adjustment Amounts

Since 2007, a beneficiary’s Part B monthly premium is based on his or her income. These income-related monthly adjustment amounts affect roughly 7 percent of people with Medicare Part B. The 2023 Part B total premiums for high-income beneficiaries with full Part B coverage are shown in the following table:

Full Part B Coverage
Beneficiaries who file individual tax returns with modified adjusted gross income: Beneficiaries who file joint tax returns with modified adjusted gross income: Income-Related Monthly Adjustment Amount Total Monthly

 Premium Amount

Less than or equal to $97,000 Less than or equal to $194,000 $0.00 $164.90
Greater than $97,000 and less than or equal to $123,000 Greater than $194,000 and less than or equal to $246,000 $65.90 $230.80
Greater than $123,000 and less than or equal to $153,000 Greater than $246,000 and less than or equal to $306,000 $164.80 $329.70
Greater than $153,000 and less than or equal to $183,000 Greater than $306,000 and less than or equal to $366,000 $263.70 $428.60
Greater than $183,000 and less than $500,000 Greater than $366,000 and less than $750,000 $362.60 $527.50
Greater than or equal to $500,000 Greater than or equal to $750,000 $395.60 $560.50

The 2023 Part B total premiums for high-income beneficiaries with immunosuppressive drug only Part B coverage are shown in the following table:

Part B Immunosuppressive Drug Coverage Only
Beneficiaries who file individual tax returns with modified adjusted gross income: Beneficiaries who file joint tax returns with modified adjusted gross income: Income-Related Monthly Adjustment Amount Total Monthly

 Premium Amount

Less than or equal to $97,000 Less than or equal to $194,000 $0.00 $97.10
Greater than $97,000 and less than or equal to $123,000 Greater than $194,000 and less than or equal to $246,000 $64.70 $161.80
Greater than $123,000 and less than or equal to $153,000 Greater than $246,000 and less than or equal to $306,000 $161.80 $258.90
Greater than $153,000 and less than or equal to $183,000 Greater than $306,000 and less than or equal to $366,000 $258.90 $356.00
Greater than $183,000 and less than $500,000 Greater than $366,000 and less than $750,000 $356.00 $453.10
Greater than or equal to $500,000 Greater than or equal to $750,000 $388.40 $485.50

Premiums for high-income beneficiaries with full Part B coverage who are married and lived with their spouse at any time during the taxable year, but file a separate return, are as follows:

Full Part B Coverage
Beneficiaries who are married and lived with their spouses at any time during the year, but who file separate tax returns from their spouses, with modified adjusted gross income: Income-Related Monthly Adjustment Amount Total Monthly Premium Amount
Less than or equal to $97,000 $0.00 $164.90
Greater than $97,000 and less than $403,000 $362.60 $527.50
Greater than or equal to $403,000 $395.60 $560.50

Premiums for high-income beneficiaries with immunosuppressive drug only Part B coverage who are married and lived with their spouse at any time during the taxable year, but file a separate return, are as follows:

Part B Immunosuppressive Drug Coverage Only
Beneficiaries who are married and lived with their spouses at any time during the year, but who file separate tax returns from their spouses, with modified adjusted gross income: Income-Related Monthly Adjustment Amount Total Monthly Premium Amount
Less than or equal to $97,000 $0.00 $97.10
Greater than $97,000 and less than $403,000 $356.00 $453.10
Greater than or equal to $403,000 $388.40 $485.50

Medicare Part A Premium and Deductible

Medicare Part A covers inpatient hospital, skilled nursing facility, hospice, inpatient rehabilitation, and some home health care services. About 99 percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment.

The Medicare Part A inpatient hospital deductible that beneficiaries pay if admitted to the hospital will be $1,600 in 2023, an increase of $44 from $1,556 in 2022. The Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period. In 2023, beneficiaries must pay a coinsurance amount of $400 per day for the 61st through 90th day of a hospitalization ($389 in 2022) in a benefit period and $800 per day for lifetime reserve days ($778 in 2022). For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $200.00 in 2023 ($194.50 in 2022).

Part A Deductible and Coinsurance Amounts for Calendar Years 2022 and 2023
by Type of Cost Sharing
  2022 2023
Inpatient hospital deductible $1,556 $1,600
Daily coinsurance for 61st-90th Day $389 $400
Daily coinsurance for lifetime reserve days $778 $800
Skilled Nursing Facility coinsurance $194.50 $200.00

Enrollees age 65 and over who have fewer than 40 quarters of coverage and certain persons with disabilities pay a monthly premium in order to voluntarily enroll in Medicare Part A. Individuals who had at least 30 quarters of coverage or were married to someone with at least 30 quarters of coverage may buy into Part A at a reduced monthly premium rate, which will be $278 in 2023, a $4 increase from 2022. Certain uninsured aged individuals who have less than 30 quarters of coverage and certain individuals with disabilities who have exhausted other entitlement will pay the full premium, which will be $506 a month in 2023, a $7 increase from 2022.

For more information on the 2023 Medicare Parts A and B premiums and deductibles Notices (CMS-8080-N, CMS-8081-N, CMS-8082-N), please visit:

CMS-8080-N: https://www.federalregister.gov/public-inspection/2022-21180/medicare-program-calendar-year-2023-inpatient-hospital-deductible-and-hospital-and-extended-care

CMS-8081-N:https://www.federalregister.gov/public-inspection/2022-21176/medicare-program-cy-2023-part-a-premiums-for-the-uninsured-aged-and-for-certain-disabled-individuals

CMS-8082-N:https://www.federalregister.gov/public-inspection/2022-21090/medicare-program-medicare-part-b-monthly-actuarial-rates-premium-rates-and-annual-deductible

Medicare Part D Income-Related Monthly Adjustment Amounts

Since 2011, higher income beneficiaries’ Part D monthly premiums are based on income. These income-related monthly adjustment amounts affect roughly 8 percent of people with Medicare Part D. These individuals will pay the income-related monthly adjustment amount in addition to their Part D premium. Part D premiums vary from plan to plan and roughly two-thirds of beneficiaries pay premiums directly to the plan, while the remaining beneficiaries have their premiums deducted from their Social Security benefit checks. Regardless of how a beneficiary pays their Part D premium, the Part D income-related monthly adjustment amounts are deducted from Social Security benefit checks or paid directly to Medicare. The 2023 Part D income-related monthly adjustment amounts for high-income beneficiaries are shown in the following table:

Beneficiaries who file individual tax returns with modified adjusted gross income: Beneficiaries who file joint tax returns with modified adjusted gross income: Income-related monthly adjustment amount
Less than or equal to $97,000 Less than or equal to $194,000 $0.00
Greater than $97,000 and less than or equal to $123,000 Greater than $194,000 and less than or equal to $246,000 12.20
Greater than $123,000 and less than or equal to $153,000 Greater than $246,000 and less than or equal to $306,000 31.50
Greater than $153,000 and less than or equal to $183,000 Greater than $306,000 and less than or equal to $366,000 50.70
Greater than $183,000 and less than $500,000 Greater than $366,000 and less than $750,000 70.00
Greater than or equal to $500,000 Greater than or equal to $750,000 76.40

Premiums for high-income beneficiaries who are married and lived with their spouse at any time during the taxable year, but file a separate return, are as follows:

Beneficiaries who are married and lived with their spouses at any time during the year, but file separate tax returns from their spouses, with modified adjusted gross income: Income-related monthly adjustment amount
Less than or equal to $97,000 $0.00
Greater than $97,000 and less than $403,000 70.00
Greater than or equal to $403,000 76.40

Ohio Department of Insurance- Press Release: 2023 Medicare Changes. Are You Ready? Statewide Check-up events underway for Ohioans on Medicare

For Immediate Release
September 23, 2022

2023 Medicare Changes. Are You Ready?
Statewide Check-up events underway for Ohioans on Medicare

 

COLUMBUS – Medicare’s annual open enrollment period starts Oct. 15. This means if you’re one of the more than two million Ohioans on the federal health insurance program, it’s time to become familiar with changes for 2023 and review your healthcare needs, including preferred prescription drugs and doctors. So, when the plan options are announced, you’re ready to pick one that’s best for you and your budget.

Of course, all of this is easier said than done. That’s why the Ohio Senior Health Insurance Information Program, the state’s official Medicare educational, plan comparison, and enrollment assistance program is conducting free virtual and on-site Medicare Check-up events in communities across the state now and through open enrollment, which ends Dec. 7.

“This is an important time of the year for Ohioans on Medicare. Our OSHIIP Medicare experts are ready to be of assistance every step of the way,” Ohio Department of Insurance director Judith L. French said.

Let’s take a deeper dive into OSHIIP and its Medicare Check-up events, and Medicare.

OSHIIP’s impact 

OSHIIP, funded in part by Medicare, is celebrating its 30th anniversary this year of helping Ohioans navigate Medicare. Over the past year, OSHIIP helped thousands of Ohioans save more than $25 million through unbiased careful coverage evaluation and financial assistance identification.

Take advantage of the Medicare Check-up events

During the events, experts will go over Medicare fundamentals, what’s new, how to review current plan and compare plans for 2023, prescription drug coverage options, and ways to save money. The events are presentation-only until Oct. 15 when plan comparisons and counseling services become included in most events.

To find an event in or near your community, an on-site schedule, which can be sorted by date and county, is available at www.insurance.ohio.gov, where you can also find a listing of virtual events. The virtual events will be recorded for online viewing.

Medicare plan options for 2023

Medicare will release plan information on Oct. 1 at www.medicare.gov. Careful evaluation is imperative because Medicare plans can change year-over-year. Plans may have different benefits, out-of-pocket costs, covered prescription drugs, in-network physicians, and premiums than the year before.

Questions? OSHIIP can help

If you can’t attend a Medicare Check-up event, OSHIIP offers individual virtual counseling appointments that can be scheduled on the department’s website. Staff also provide assistance through 800-686-1578 and [email protected], Monday through Friday, 7:30 a.m. to 5 p.m. Ohioans on Medicare can also call 800-MEDICARE (1-800-633-4227) 24-hours-a-day, seven days a week for Medicare help.

# # #

Media Note: Please visit OSHIIP’s Medicare Check-up events on-site schedule, sortable by date and county, and include details of upcoming events that are in your coverage area.

Media Contact:

Robert Denhard
[email protected], 614-644-3366

CMS Won’t Delay New MA Marketing Regs, Despite Broker Requests

By  Amy Lotven / September 21, 2022 at 11:22 AM

Sourced from Inside Health Policy

 

CMS confirms it has no plans to delay implementation of the 2023 Medicare Advantage and Part D final rule that cracks down on aggressive MA marketing tactics, despite calls to do so from health insurance agents and brokers who object to being included in the definition of a third-party marketing organization (TPMO).

As TPMOs, the brokers and insurance agents would be required to record – and retain – their enrollment calls if the proposed rule is finalized as written.

The National Association of Heath Underwriters (NAHU) have repeatedly asked CMS to either delay the rule or to carve agents from the definition of a TPMO.

From a public policy perspective, it makes no sense to discourage legitimate agents from participating in Medicare Advantage by sweeping them into an effort to curb bad actors, says NAHU Executive Director Janet Trautwein.

NAHU has warned that if CMS doesn’t delay or revise the rule, fewer agents and brokers would participate in Medicare’s forthcoming Annual Enrollment Period (AEP), which the group says would only worsen marketing problems.

Still CMS recently told NAHU that it would not make the changes to the rule that the lobby requested, Trautwein says.  A CMS spokesperson also told IHP that “CMS does not plan to delay implementation of the CY 2023 Medicare Advantage and Part D Final Rule (CMS-4192-F).”

At issue are the allegedly aggressive marketing tactics used by TPMOs who make unsolicited sales calls to seniors to push Medicare Advantage plans. Trautwein explains that in contrast to agents and brokers who take time to discuss which plan is best for a Medicare beneficiary based on lifestyle, networks and formularies, TPMOs will often push products that might not be appropriate. The marketers also allegedly mislead consumers by telling them they’re calling from Medicare – or a well-known insurer – or use other tactics to lure seniors to enroll in coverage regardless of whether it’s a good fit.

The proliferation of those calls is a huge problem for licensed, certified agents and brokers, Trautwein recently told a panel of health insurance commissioners who have been looking into improper marketing of health plans.

NAHU members tell their clients to ask marketers for their license numbers, but the challenge has become almost insurmountable as many seniors fail to understand that the calls are not legitimate, she says.

CMS stepped up oversight of third-party marketing organizations in its proposed 2023 MA and Part D rule, noting that a significant amount of the 40,000 complaints received in 2021 were about TPMOs. As part of the rule, which was finalized in April, the agency tweaked the definition of a TPMO to include agents and brokers, meaning that NAHU members will also be required to adhere to the new requirements, including the proposed mandate to record all enrollment calls with clients.

NAHU says the requirements will be burdensome to some agents and brokers. Many NAHU members are small, one-person shops and cannot afford the HIPAA-compliant recording equipment needed to record and retain calls, she says. Some agents and brokers might choose not to participate in open enrollment due to the new requirements.

NAHU raised its concerns in comments on the proposed rule, in a separate letter to CMS in July and again in its response to CMS’ request for information on improving MA. 

AHIP also talked about the rule’s potential impact on brokers in its response to the RFI.

“While we appreciate CMS’ goals in protecting against confusing and potentially misleading activities, we have heard questions about the scope of the TPMO requirements and concerns that without further clarifications or modifications, those rules could expand costs and inhibit access to certain agents and brokers,” AHIP says. “We ask CMS to engage with stakeholders to discuss and address concerns related to the TPMO requirements and ensure beneficiaries are protected from inappropriate marketing activities.”

Other stakeholders asked CMS to strengthen oversight over aggressive marketers.

Trautwein says NAHU and CMS have had several discussions about the brokers’ worries, but the agency has refused to bend. 

In addition to declining the delay and the carve out, the agency said it would not offer enforcement relief to parties that attempt to follow the rule in good faith, Trautwein says.

NAHU had asked for guidance on several outstanding questions, including what a broker should do if a client does not want to be recorded. CMS says a broker or agent must terminate the call in those situations, according to Trautwein.

Another source tracking the issue also says some agents and brokers might not participate in MA due to the new rules, but suggests those who bow out might not sell many plans in the first place. The source also says there are reasonably priced options for the phone equipment needed to record and retain calls.

Trautwein also says that some marketing organizations are offering recording solutions to their member agents and brokers, but not all will have access. Brokers and agents also can ask clients to enroll in-person so the requirement would not apply.

She declined to speculate on how many agents and brokers might bow out of the AEP because of the rule, but she says NAHU will survey members once the enrollment period is over to get a better sense of how many agents/brokers opted out.

She says NAHU is still lobbying to get the rule delayed or agents carved out, and adds the group has sent thousands of messages to Capitol Hill about its concerns, but so far there’s been no legislative action.

NAIC

Trautwein also brought her concerns about the proliferation of aggressive MA marketing, as well as what she views as the problems with CMS’ rule, to the National Association of Insurance Commissioners’ summer meeting in August. During a session of the NAIC’s recently established Improper Marketing Working Group, which was created to address the growing amount of misleading marketing in the individual market, Trautwein explained how agents and brokers selling MA plans have been overwhelmed by the marketing calls. She also raised concerns that CMS’ solution could drive legitimate players out of MA.

State insurance commissioners do not regulate MA marketing, but they are well aware of the problems since they often hear about it from residents or other enrollment assisters.

Congress gave authority over MA marketing to CMS as part of the Medicare Modernization Act. But in May, NAIC asked key lawmakers to consider returning jurisdiction to the states, which it says are better equipped to handle the oversight.

Meanwhile, Senate Finance Chair Ron Wyden (D-OR) in mid-August asked commissioners from 15 states to send information on annual changes in MA marketing complaints from 2019 through 2022, and examples of allegedly false or misleading marketing materials. Wyden asked the states if the marketers are targeting any particular populations like dual-eligible, Black or lower-income beneficiaries.

Responses were due on Friday (Sept. 16), but it’s unclear if they have been received. – Amy Lotven ([email protected])

Important:  New CMS Review Time fo TV Commercials/Ads

NEW CMS REVIEW TIME FOR TV COMMERCIALS/ADS

IMPORTANT CHANGE: We have received notification via our carrier partner, Elevance Health/Anthem, that CMS has confirmed to them a change to the review process and timing for TV commercials/advertisments updated in HPMS on 9/16/22.

Verified by the Anthem Compliance Team (9/19/22), CMS stated: We have recently changed the review period for TV advertismenets to 20 days.  We are currently discussing communication strategies.

The new 20 Day Review will require an official review from CMS prior to use.  This differs from the previous submission type of 5 day File and Use, with no immediate review by CMS at time of filing.

As of Wednesday, 9/21, 10 days remain before AEP marketing can occur.  If you have TV commercials/advertisments you are planning to use and have not yet filed with CMS, please be aware of this change, as this can impact when your TV commercial / advertisement can be released.

 We will share additional details as they become available from CMS.

___________________________________________________________

Please take a moment to review the definitions of generic communication and marketing, a subset of communications, that requires material submission for review and approval by CMS. Access the most recent version of our Agent Medicare Compliance Guide here for additional information.

Generic Marketing and Communications

We generally refer to advertising pieces – print, radio, tv, website, etc., as marketing however, CMS uses the terms ‘marketing’ and ‘communication’ to make a distinction  between generic advertising.  

 

Communications are all activities and materials used to provide information that is targeted to current and prospective enrollees, including their caregivers and other decision makers.  

Generic mailers and advertising materials you create to promote your business and generate leads fall under the definition of “communication” materials (given they are free of carrier names and specific plan informaiton, and do not list benefits, premiums, copays, and cost sharing).

 

Marketing is a subset of communications and is determined based on both the content and intent of activity or materials.

Marketing includes activities and materials with the intent to draw a beneficiary’s attention to a specific plan or plans and to influence a beneficiary’s decision-making process when selecting a plan for enrollment or deciding to stay enrolled in a plan (retention-based marketing). Additionally, marketing has content with information about the plan’s benefits, cost sharing, measuring, or ranking standards.

Materials that meet the definition of marketing will require submission to CMS through HPMS filing.  The term ‘marketing’ takes on new meaning when we talk compliance. The CMS definition is used to distinguish materials that require review and approval vs. materials that fall under the ‘communication’ definition, which can be used without CMS review/approval.

___________________________________

 

We’re here to help.  Call if you have questions (614-763-2255).  If you have marketing materials that require filing with CMS for approval or have marketing or communication materials you want reviewed for compliance, please send them via email to: [email protected]

Exciting Updates to CignaforBrokers Portal

Exciting updates coming to CignaforBrokers on September 15! 

Cigna is so excited to share the new and exciting improvements to their Cigna Broker Portal, CignaforBrokers.com, coming soon! 

Cigna has heard your feedback and continue to improve tools to make your selling experience easier! Starting September 15, you’ll see a new landing page and streamlined design across all Cigna lines of business. Here’s what else you can expect when you log in to CignaforBrokers.com starting on September 15:

  • Alerts for incomplete applications which require your attention
  • New easy access via direct links to your membership book of business and application status reports
  • New message panel to share important information that you need to know
  • News alert features under My Messages informing you of your ready-to-sell states, expiring licenses, or missing state appointments

Be on the lookout for even more improvements coming soon to CignaforBrokers including direct access to your MA Commission statements and State Medicaid look-up capabilities.

 

If you have any questions regarding Cigna’s portal, please reach out to your CSM Service Rep.

IMPORTANT WELLCARE READY-TO-SELL REMINDER

When completing Wellcare’s 2023 Annual Certification Requirements, agents who are currently contracted with WellCare will receive a new 2023 Recertification Workflow within Centene Workbench to show Ready-To-Sell status. 

Completing 2023 Recertification case in Centene Workbench:

  • Access by logging into your portal via the Single Sign-On portal, and select the My Credentials section.
  • Select My Certification Cases.
  • You will be prompted to (1) verify Demographic, Payment Information, and Selling States and (2) sign the 2023 TPME Agreement and W9. Please Note: Licensed Only Agents and Dual Assignment Agents will not be prompted to update payment information.

Please view the 2023 Contract Recertification Step-Action document for detailed instructions on the contracting recertification process.

All annual certification requirements must be completed by September 30th, to be able to market and sell Wellcare products and avoid suspension on October 1st, 2022.

If the 2023 contracting recertification step is missed while completing training, agents will not be considered Ready-To-Sell nor will they be able to order supplies until this has been completed.

Questions or Issues?
Contact your CSM Service Team for additional help!

 

SureBridge: HospitalWise makes a great companion to Medicare Advantage and ACA plans!

SureBridge is offering a Guarantee Issue Hospital Indemnity plan for all ages 0-90 starting September 16, 2022.

There is no underwriting if the GI amounts are chosen, and the premium and commission rates will be staying the same. GI is only applicable when all benefit levels fall within the very competitive GI thresholds as indicated by SureBridge.  See the attached highlights flyer for details. Non GI plans will still be available for flexibility of benefit amount selection.

If you’ve never considered offering HospitalWise before, now is the perfect time.  Available in 31 states including OH, KY, IN & MI.

AEP and OEP…

are just around the corner!

As you gear up for the selling season, consider how SureBridge products underwritten by The Chesapeake Life Insurance Company can help you offer the ancillary health coverage that your clients may need!

 

HospitalWise State Approval

 

HospitalWise Highlight Sheet

 

Why Ancillary?

HospitalWise Indemnity

Ancillary products are a great way to help ease potential blows to the budget, especially for costly medical events like a hospital stay.  A HospitalWise Hospital Indemnity plan could help with your client’s out-of-pocket exposure, whether it’s a substantial deductible in an ACA plan or the hospital copays in a Medicare Advantage plan.

The HospitalWise plan provides a daily benefit for hospitalization. Designed for flexibility, optional riders can be purchased for additional benefits if other conditions are met, such as an ambulance ride, a visit to the ER, or even a prolonged stay in a skilled nursing facility.  Your clients will love the fact that the benefits are paid directly to them; the payments are theirs to use as they see fit.

 

Questions?  Contact Michelle Kapp to discuss the benefits of adding SureBridge to your product portfolio.  614-763-2257

Introducing the Anthem Benefits Prepaid Card

Easy Access to OTC Benefits, Account Balances & MORE from a Single Benefits Prepaid Card!

AEP 2023 is bringing big changes to how your current & prospective clients access popular benefits like OTC, Healthy Grocery, Flex Accounts and MORE! Now all their spending allowance-based benefits and funds will be accessible through ONE Benefits Mastercard® Prepaid Card! Your clients will enjoy using a proven and familiar benefits prepaid card they can use as debit or credit (no PIN required). *

This easy-to-use card is automatically loaded with the monthly, quarterly, or annual benefits included in their Medicare Advantage plan. That means they can begin shopping as soon as their plan is effective.

One, integrated call center supports your client’s questions about all of their plan’s spending allowance-based benefits.

*Note – Benefits vary by plan and member eligibility. Members will still have a separate member ID card for their Medicare Advantage plan medical benefits.

 

If you have any questions, please contact your CSM Sales or Service Rep