Kettering Health Network & Kettering Physician Network’s Contract Expiring

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Kettering Health Network and Kettering Physician Network’s contract with Cigna is expiring in June.

One of the largest healthcare networks in the region is set to end its relationship with a health insurer in June, if new terms aren’t reached.

Kettering Health Network and Kettering Physician Network’s contract with Cigna (NYSE: CI) will be expiring June 14. If the parties cannot reach new terms by this date, Kettering Health Network hospitals and Kettering Physician Network providers will be considered “out of network” with all Cigna plans beginning June 15, according to a letter from the health network to patients.

“For an extended period of time, Kettering Health Network and Kettering Physician Network have been in discussions with Cigna regarding new contract terms for the care we provide to our patients who have Cigna insurance coverage,” the letter reads. “We believe you have a right to know about how your access to care may be affected so you can make informed decisions about your health care.”

If this agreement expires, patients covered by Cigna can still receive care from the network’s nine area hospitals, 12 area emergency centers and more than 700 physicians and practitioners. But, beginning June 15, these patients could experience reduced benefits from Cigna. In addition, patients set to receive ongoing care or have already scheduled future treatment from the health network may be able to receive care from their physician by requesting approval for continuation of care through Cigna.

Cigna is a global health service active in 30 countries and jurisdictions, with more than 95 million customer relationships across the world. The health insurer also staffs more than 40,000 employees, according to its website.

Kettering Health Network is one of the region’s top companies with a 2018 revenue of $1.75 billion. The network staffed 8,909 local employees and 9,647 employees total in 2018, according to DBJ research.

 

— Dayton Business Journal

Ohio Department of Insurance: Together We Celebrate Older Americans Month

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Together We Celebrate Older Americans Month

By: Ursel J. McElroy, Ohio Department of Aging Director &  Jillian Froment, Ohio Department of Insurance Director

Each year, older adults are making positive contributions in Ohio. As dedicated volunteers, employees, employers, educators, mentors, advocates, caregivers and more, they offer insight and experience that benefit the entire community. We must celebrate and recognize their impact each and every day – especially during the month of May which is “Older Americans Month”. The 2019 theme, Connect, Create, Contribute, encourages older adults and their communities to:

  • Connect with friends, family, and services that support participation.
  • Create by engaging in activities that promote learning, health, and personal enrichment.
  • Contribute time, talent, and life experience to benefit others.

Older Ohioans deserve the very best support and in his budget proposal, Governor Mike DeWine is ensuring the departments of Aging and Insurance protect and assist older Ohioans. From our offered services to the information we provide, we are always ready to lend a trustworthy hand to older Ohioans.

The Department of Aging offers a range of programs designed to help older Ohioans and family members, neighbors and friends who care for them. Health and wellness programs like HEALTHY U Ohio and the STEADY U Ohio falls prevention initiative help individuals make informed decisions about their health and safety. Home and community-based supports, like home-delivered meals, transportation programs, the PASSPORT Medicaid home care waiver and more, help older adults remain active and independent in their communities for longer. When care is needed, the State Long-Term Care Ombudsman advocates for consumers, and the National Family Caregiver Support Program and other programs provide resources and assistance. Visit www.aging.ohio.gov for more information and resources.

The Department of Insurance’s Ohio Senior Health Insurance Information Program (OSHIIP) is the lead Medicare educational and enrollment assistance program in the state. Medicare experts help older Ohioans become familiar with the different benefits, coverage options, financial assistance offerings, and key deadlines that they will encounter. Last year, OSHIIP helped Ohioans save nearly $36 million for Medicare consumers by aligning them with the coverage most suitable for their needs.

May is also the time when OSHIIP’s popular statewide Welcome to Medicare events are in full swing. Geared to those approaching the age of 65 and transitioning into Medicare, older Ohioans can learn about their Medicare and prescription drug coverage options during face-to-face sessions with OSHIIP’s Medicare experts through June. A listing of the events as well as Welcome to Medicare webinars are available at www.insurance.ohio.gov. OSHIIP staff also can be reached at 1-800-686-1578 for those who want unbiased answers to their Medicare questions.

Both agencies work with the state’s 12 area agencies on aging to make their services and resources available to you. Call 1-866-243-5678 to be connected to the agency serving your community.

The dedicated employees of our agencies are proud to serve older Ohioans and it is an honor to celebrate Older Americans Month. We urge all Ohioans to become familiar with the resources provided by the Departments of Aging and Insurance and to take advantage of them.

Surebridge’s DVH Product: Coming Soon to OH, KY & IN!

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Surebridge has your clients covered from the neck up for Dental, Vision, and Hearing.

Highlights about the company and product:

  • Backed by UnitedHealthcare & underwritten by The Chesapeake Life Insurance Company.
  • Industry-leading premiums, commissions, and lifetime renewals!
  • Insured can visit any provider they choose or take advantage of big discounts using a large network.
  • Day 1 preventive dental covered at 100% with NO deductible (Policy maximums apply).
  • Day 1 vision & hearing exams covered at 100% with NO deductible (Policy maximums apply).
  • Easy Online Application & Enrollment

 

Click here for more information or to get contracted! 

Important Message from Humana & Aetna: Members Who Requested to Have Premiums Withheld by SSA/RRB in 2019

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FROM HUMANA MARKETPOINT: 

  • Humana has taken action for our impacted members and worked quickly to re-trigger deductions with a 6/1/2019 effective date (next available date).
  • Members were sent a letter on 5/9 (verbiage below) that states we have requested a future date (6/1/19) due to a SSA delay and the amount they owe – letter contains a remit slip.
  • Customer Service has been ramped up for potential calls and no collection actions will take place due to them being on SSA/RRB.

Please see the letter verbiage below. Members should call our Customer Care Team at 1-800-457-4708 if they have questions.

Thank you for choosing Humana for your Medicare coverage.

You asked us to deduct your monthly premium from either your Social Security (SSA) or Railroad

Retirement Board (RRB) benefit check. Your request could not be processed in time for the next

premium payment. We requested your premium deduction to begin with the next available premium

payment for 06/01/2019. It can take SSA or RRB up to 90 days to process this request. At that time,

you may see up to three months of premiums deducted from your check.

You are responsible for paying the monthly premium(s) due prior to 06/01/2019. Please make a

payment for the amount due of $.

To PAY YOUR PREMIUM:

Go to Humana.com/pay or use the MyHumana mobile app

Detach and mail the payment slip below with your payment

Call our Customer Care Team at 1-800-457-4708. If you use a TTY, call 711.

FROM AETNA: 

We want to notify you about an issue affecting all Medicare members who elected to pay plan premiums from their Social Security Administration (SSA) or Railroad Retirement Board (RRB) check.

Background

Normally, when members select this premium payment option, the SSA/RRB withholds funds from members’ SSA/RRB checks to cover their plan premiums.

Unfortunately, due to a system issue, this did not occur for two or more months starting February 1, 2019. This issue affected all carriers, not just Aetna. Although the system issue is now fixed, the SSA/RRB cannot retroactively deduct premium payments from members’ checks.

What do members need to do?

Because these members now have past-due accounts, their premium payment method has changed to direct billing, effective February 1, 2019. This means they now need to pay any past-due premium amounts to Aetna directly.

Member communication

Members will receive a letter explaining what happened and what they need to do later this month. Letters are being mailed in waves, between May 10-24, so members will receive them over several weeks. View the member letter.

What happens next?

  • We’ve already submitted a new request to restart SSA premium deduction for the affected members, effective June 1, 2019. If the request is accepted by SSA, they will send members a letter of approval. Please be aware this can take up to 90 days.
  • Please explain to your clients that SSA will only deduct future premiums from their Social Security check as of the effective date noted in their approval letter, so any balances owed up until that effective date must be paid to Aetna directly. Members need to pay premiums directly to us for any months the SSA or RRB doesn’t cover.

While these members are not currently at-risk for termination due to nonpayment, they do need to begin making payments to ensure their plan does not face termination for nonpayment in the future.

 

 

 

Please contact your Cornerstone Senior Marketing representative if you have any questions.

Anthem’s MS Bonus Extended Through Dec. 2019!

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Anthem’s Medicare Supplement Bonus Program has been such a success, they are extending it through December 1, 2019 effective dates! We want to help you maximize your earning potential; along with 21% commission (years 1-6; 4% years 7+), you can earn up to $250 per Medicare supplement application per month. Below is an overview of each tier and earning potential. Full details can be found here.

Anthem’s July 1, 2019 rates were released last week and will be available to quote on https://shop.anthem.com/medicare/ on May 11th. Kits are available to order on Custom Point

How Does it Work?

  • If you sell 3-4 approved Medicare Supplement plan enrollments, you’ll receive an additional $100 bonus per sale!
  • If you sell 5-9 approved Medicare Supplement plan enrollments, you’ll receive an additional $150 bonus per sale!
  • But if you sell 10 or more approved Medicare Supplement plan enrollments, you’ll receive an additional $250 bonus per sale!

 

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

MeridianCare and WellCare Health Plans, Inc. Consolidation

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As previously communicated, MeridianCare became a subsidiary company of WellCare, and as of 1/1/2020, the companies will be fully integrated and operating under the same platforms. Going forward, email communications regarding the WellCare and MeridianCare transition will be on new co-branded template.

What’s Next?

During the transition, you can expect the following in preparation for 2020 open enrollment period:

  1. Invitation from WellCare Health Plans prompting you to complete the 1099 agent contract
  2. Enrollment into the 2020 WellCare Annual Certification Training (ACT)
    1. This will be replacing the MeridianCare’s Miramar (formally known as Sentinel Elite) annual certification program
  3. Communications regarding 2020 America’s Health Insurance Plans (AHIP) requirement
    1. WellCare does not accept PinPoint or Gorman Health Plan certificates for the Medicare Advantage annual certification requirement.
  4. Transition of the MeridianCarebrand to WellCare (plans and communications)

Please look for upcoming communications regarding all topics outlined above.

If you have any questions please reach out to your Cornerstone Senior Marketing Representative 

May Broker Trainings in Cleveland

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Join Cornerstone Senior Marketing for our broker training sessions in May at our Cleveland office! Please RSVP to Danielle Flesch @ Danielle.Flesch@cornerstoneseniormarketing.com. When RSVPing, please indicate which training and date you will be attending. 

THURSDAY MAY 16- MMO

TIME: 10:00 am – 12:00 pm

LOCATION: CSM’s Cleveland Office

4500 Rockside Rd., Suite 330

Independence, OH 44131

Join Medical Mutual of Ohio & CSM for a review of MMO’s 2019 Medicare products and updates! MMO will be highlighting the following:

  • Why choose MMO products?
  • New online tools and marketing resources
  • Marketing opportunities

TUESDAY MAY 21- AETNA WITH CE CREDIT!!

TIME: 12:00 pm – 3:00 pm

LOCATION: Double Tree by Hilton Hotel Akron- Fairlawn

3150 W. Market Street

Akron, OH 44333

Join CSM & Aetna to for a lunch and learn session about Aetna’s Extra Help  & Dual Eligibility products for your clients and earn (2) Continuing Education Credits!!

This training provides 2 Continuing Education credits with specific information about:  

  • Extra Help with Part D (Low Income Subsidy-LIS)
  • Medicare Savings Programs (MSPs)
  • QMB – SLMB – QI – QDWI
  • Medicaid
  • Special Needs Plans (SNPs)
  • How to sell Special Needs Plans (SNPs)

WEDNESDAY MAY 22- ALLWELL

TIME: 10:00 am – 12:00 pm

LOCATION: CSM’s Cleveland Office

4500 Rockside Rd., Suite 330

Independence, OH 44131

Join CSM and Allwell for an in-person training on how to increase your business in our Cleveland office!

Highlights that will be discussed during the training:

  • Allwell’s ancillary products
  • Marketing tools
  • How to increase your sales
  • Company wide updates

TUESDAY MAY 28- SOCIAL SECURITY TODAY: BASICS OF SOCIAL SECURITY

TIME: 10:00 am – 12:00 pm

LOCATION: CSM’s Cleveland Office

4500 Rockside Rd., Suite 330

Independence, OH 44131

Join Cornerstone Senior Marketing & Brandon P. Smith from the Social Security Administration for a very informative session to learn the basics of Social Security to better serve your clients!

Topics to be discussed:

  • The Social Security program- How does it work and 2019 updates
  • Retirement benefits
  • Spousal and dependent benefits
  • Disability benefits

 

If you have any questions regarding the sessions above, please reach out to Jaime Lebron.

TECH TIP: Company Size Doesn’t Matter

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Think hackers are only trying to target large corporations for their cyber attacks? Think again! If you are an employee of a small to medium size business, you may have an even bigger bulls-eye placed on you by hackers.

Smaller businesses have recently become a bigger target for cyber attacks because the hackers know that they likely have fewer defense resources in place. According to the National Cyber Security Alliance, one in five small businesses falls victim to cyber crime each year. And of those, some 60 percent go out of business within six months of an attack.

Remember these tips to stay safe:

  • Never provide your password to anyone. Use complex passwords, and use different ones for each of your online accounts or programs.
  • Check for red flags in emails to tip you off that the sender may not be legitimate. Check domain names carefully.
  • Don’t open any email attachments if you don’t know exactly why you received them or what they contain.
  • When in doubt, throw it out. Hit that delete button.

Remember, you are the last line of defense to prevent a cyber attack. You are the key to keeping the “human firewall” strong for your organization, no matter the size.

Let’s stay safe out there!   Stop, Look, and Think.

NAHU’s Annual Convention 2019

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NAHU’s 2019 Annual Convention in San Diego, from June 29-July 2, promises to be the most innovative, productive and fun meeting you’ve ever attended.

For example, on Saturday, June 29, Personal and Professional Development Day kicks off with a Health and Wellness Assembly, a morning devoted to improving your personal health and well-being. A lineup of innovative speakers will clarify what works and how it fits into daily life in a sustainable and integrative way. Be sure to arrive on Friday, June 28, as Saturday kicks off at 8:00 am and you won’t want to miss a thing!

Want to rise above your competitors? Saturday afternoon features an exciting new format that will deliver ideas you can implement in your business now. From retaining today’s new workforce and buying or selling your agency, to data transparency and alternative healthcare management, this cutting-edge program will provide fresh ideas that can be turned into practical solutions for your business.

An expanded Medicare Extreme! returns with proven practices and important trends on changes in Medicare, technology solutions, growing your business with group Medicare sales and more.

The day concludes with a Welcome Reception in The Marketplace, your opportunity to visit with a variety of vendors and network with colleagues.

 

For more information on the convention click here

MeridianCare Compliance Updates

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As Meridian continues their integration with WellCare they would like to inform everyone of a new process. Starting May 1st, 2019 any grievance or CTM that is filed against an agent will now be investigated by the WellCare Compliance Investigation Unit (CIU).

Below are a few important things to know about the change:

  • Lizeth Villa will now be conducting the investigation directly (contact information below)
  • During her investigation she will be reaching out to both the member and the agent
  • She will make three phone call attempts to reach the agent at different times to obtain a response
  • If she does not reach the agent after the third attempt then it will be a founded complaint against the agent

Any compliance concerns can still be directed to Agentoversight@mhplan.com

Lizeth Villa  |  313-324-3700 ext. 21461  |  Compliance Investigator

 

If you have any questions please reach out to your Cornerstone Senior Marketing Sales Representative.