WEBINAR: Humana MarketPoint’s D-SNP & LIS Enrollment Training

Join Humana for a Dual-Eligible Special Needs Plan (D-SNP) and LIS training webinar!

Take advantage of this training to learn how to market D-SNP plans, introduce Humana’s D-SNP products to offer to your clients in Ohio, and highlight how to enroll clients with LIS.


Wednesday, February 7

10:00 am–11:00 am

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Meeting Number (access code): 599-134

Contact your Cornerstone representative with any questions.

Medical Mutual Releasing Survey to Members

To meet requirements for the National Committee for Quality Assurance (NCQA), Medical Mutual is sending out a survey via email to 3,000 members beginning January 29. The survey is designed to assess members’ understanding of their benefits.

The survey will be sent only to policyholders age 18 and older. Recipients will be randomly chosen from two groups of active members – 1,500 who became members between July 1, 2017, and September 1, 2017, and 1,500 who became members before July 1, 2016. Medicare Advantage members and Medicare Supplement members will not receive the survey.

Click here for more information.

FDA Approves Gene Therapy to Treat Rare Form of Blindness

In December of 2017, the U.S. Food and Drug Administration (FDA) approved the new gene therapy, Luxturna (voretigene neparvovec) (see December 5, 2017 Broker Update). Luxturna, expected to launch in the first quarter of 2018, is meant to treat a rare form of blindness called biallelic RPE65 mutation-associated retinal dystrophy, which is estimated to affect 1,000 to 3,000 total patients in the U.S.

Cincinnati Eye Institute is currently the only facility in Ohio that has been certified to administer Luxturna. Medical Mutual is in the process of contracting with this facility.

Click here for more information.

FDA Approves Shingles Vaccine

Medical MutualThe U.S. Food and Drug Administration (FDA) approved the Shingrix vaccine for the prevention of shingles in October of 2017. This vaccine is given in two doses, two to six months apart.

Medical Mutual will cover the Shingrix vaccine as follows:

Business Segment Coverage
Non-grandfathered and ACA/metal plans Covered up to 100 percent of the cost for all members ages 50 and older, under both the medical and prescription drug benefits (for members with prescription drug benefits through our relationship with Express Scripts)
Grandfathered plans Covered under the medical benefits for members ages 50 and older, subject to deductible and/or coinsurance
Medicare Advantage Covered under members’ Part D coverage; members must pay their applicable cost share (Shingrix is currently Tier 3 on our Medicare formulary, subject to the member’s Tier 3 copay and any deductible requirements)
Medicare Supplement None (shingles vaccines are not covered by Medicare Supplement plans)

 

Click here for more information.

2018 $50 Aetna Funding Advantage Broker Bonus

Aetna Funding Advantage (AFA) broker bonus for small groups sold from February 1, 2018 through January 1, 2019 effective dates. Earn $50 per employee! Click here for more information.

2018 Anthem Specialty Bonus Program

Anthem Specialty announced its 2018 bonus program for new and renewing cases with effective dates between February 1, 2018, and January 31, 2019. Click here to learn more.

More Than 3 Million More Uninsured At The End of 2017 Than 2016

According to the Gallup-Sharecare Well-Being Index, 3.2 million more people are uninsured in 2017 relative to the end of 2016. The percentage of uninsured U.S. adults ended in 2017 at 12.2 percent, a 1.3 percent increase from the record low of 10.9 percent in fourth quarter 2016. Data from the index suggests that this percentage reached its peak in December of 2017 when the GOP tax bill passed with a repeal of certain parts of the individual mandate effective 2019.

There are several factors that may have contributed to this increase:

  • Lack of competition drove up costs. Some insurance companies stopped offering insurance through the exchanges, which caused costs to rise due to lack of competition.
  • Repeal of the penalty in the individual mandate. Section 5000A of the individual mandate provides the legal requirement for individuals to purchase minimum essential coverage even though the penalty for not doing so has been repealed.

The Gallup-Sharecare Well-Being Index suggests that the uninsured rate will likely increase in the years ahead because of the penalty repeal.

 

RESOURCES

U.S. Uninsured Rate Steady at 12.2% in Fourth Quarter of 2017

3.2 million more people were uninsured at the end of 2017 than at the end of 2016

Approval by Congress for Delays to Cadillac Tax and Health Insurance Tax

Congress approved delaying the 40 percent “Cadillac Tax” until 2022 and the implementation of a moratorium of the Health Insurance Tax (HIT) effective for 2019. The provisions were part of the stopgap funding bill (H.R. 195) that Congress passed and President Donald Trump signed into law on January 22. A two-year delay on the medical device tax was also implemented.

The package also includes renewing funding over six years for the Children’s Health Insurance Program (CHIP), which lapsed at the end of September.

As a supporter of NAHU, Cornerstone recognizes its efforts in advocating for Congress to include further delays or permanent repeals of the Cadillac Tax and the Health Insurance Tax both today and as a leading advocate for earlier delays in 2015.

Questions? Contact your Cornerstone representative today.

Aetna Releases New Deadlines for Case Submissions

New deadlines for case submissions effective February 1

Sales notification/CIR for electronic case submissions are due by the 22nd of the month with complete electronic case submission by the 27th of the month prior to the requested effective date. This applies to Small Group AFA new business and current customers moving to AFA at renewal.

Attention Brokers With AFA Customers

ATTENTION BROKERS WITH AFA CUSTOMERS: See notice from Aetna regarding new Service Agreements being sent to customers. Note that Aetna is sending notices of contract termination—this may alarm some customers. Aetna has also sent out an updated customer billing and banking handbook.

Click here to view the full release.

 

UPCOMING BROKER TRAINING DATES:

Training Date and time RSVP
AFA & Apple Watch® Fridays: 11:30 a.m. – 12:15 p.m. EST Click here to register
Springboard Marketplace:
AFA Renewal and Offer Acceptance Mini Sessions for Brokers
30 minute mini sessions
Tuesdays: 12:30 p.m. – 1 p.m. EST
Click here to register
Springboard Marketplace: Detailed AFA Renewal and Offer Acceptance Training for Brokers Wednesdays: 1 p.m. – 2 p.m. EST Click here to register
Springboard Marketplace:
general information
broker trainings
Thursdays: 1 p.m. – 2 p.m. EST Click here to register
Springboard Marketplace:
general information
plan sponsor trainings 
Tuesdays: 2 p.m. – 3 p.m. EST Click here to register

Click here to view the AFA Billing and Banking Handbook.