Trump Administration Releases 5-Part Plan for Medicare Part D

With concern over the rising costs of prescription drug costs, the Trump Administration’s FY2019 budget proposal includes a proposed 5-part plan that would change several features of the Part D drug benefit.

The following proposals are part of the Administration’s 5-part plan for Part D:

  1. Share rebates with Part D enrollees
  2. Change the calculation of “TrOOP”
  3. Add an out-of-pocket limit to Part D and change reinsurance
  4. Relax Part D formulary standards
  5. Eliminate cost sharing for generics for low-income enrollees

Click the link below for more information, or contact your Cornerstone representative today.

RESOURCES

What’s in the Administration’s 5-Part Plan for Medicare Part D and What Would it Mean for Beneficiaries and Program Savings?

PCORI Fees Due to IRS No Later Than July 31

This Notice applies to all Employers who purchased a Level-Funded, Integrated HRA or a self-funded plan in 2017.

Fees to fund the Patient-Centered Outcomes Research Institute (PCORI) are due to the IRS no later than July 31, 2018 from employers who sponsor certain self-insured health plans, including health reimbursement arrangements (HRAs) that are not treated as excepted benefits.

How to Pay PCORI Fees
Employers that sponsor certain self-insured health plans must report and pay the required PCORI fees via IRS Form 720, Quarterly Federal Excise Tax Return. Complete Part II, line 133. For plan years ending between January 1, 2017 and September 30, 2017, the fee for an employer sponsoring an applicable self-insured plan is $2.26 multiplied by the average number of lives covered under the plan. For plan years ending between October 1, 2017 and December 31, 2017, the fee is $2.39 multiplied by the average number of lives covered under the plan.

There are three available methods that can be used to determine the average number of lives covered under a plan for the policy year. The most commonly used method is the Snapshot Method.

  1. Actual Count Method: A plan sponsor may determine the average number of lives covered under a plan for a plan year by adding the totals of lives covered for each day of the play year and dividing that total by the total number of days in the plan year.
  2. Snapshot Method: A plan sponsor may determine the average number of lives covered under an applicable self-insured health plan for a plan year based on the total number of lives covered on one date (or more dates if an equal number of dates is used in each quarter) during the first, second or third month of each quarter, and dividing that total by the number of dates on which a count was made.
  3. Form 5500 Method: An eligible plan sponsor may determine the average number of lives covered under a plan for a plan year based on the number of participants reported on the Form 5500, Annual Return/Report of Employee Benefit Plan, or the Form 5500-SF, Short Form Annual Return/Report of Small Employee Benefit Plan.

Payments should be made payable to the U.S. Treasury and submitted to the following address by July 31, 2018:

 

Department of the Treasury Internal Revenue Service

Cincinnati, OH 45999-0009

Upcoming Marketplace Learning Management System Closure

The Marketplace Learning Management System (MLMS) will be closed starting July 18 at 6:00 PM ET until training for plan year 2019 goes live.

Before this “go-dark” period begins on July 18 at 6:00 PM ET, you should:

  • Check that your MLMS profile is up-to-date.
  • Print your Registration Completion Certificate(s) to document your plan year 2018 registration for the Individual and/or Small Business Health Options Program (SHOP) Marketplace.

Certificates showing you have completed plan year 2018 registration and training will not be available after the MLMS closes.

To print your plan year 2018 Registration Completion Certificate(s), follow these three steps:

  1. Log in to the CMS Enterprise Portal.
  2. On the “My Status” page, the “Complete Agent Broker Training” entry will show “Complete” in the “Status” column if you have completed training.

Select the “Print Certificate(s)” link and follow the prompts.

During the go-dark period, the Centers for Medicare & Medicaid Services (CMS) will be preparing for plan year 2019 registration and training. Stay tuned for updates, or visit the Resources for Agents and Brokers webpage.

 

Contact your Cornerstone representative with any questions.

 

RESOURCES

Take Note: Upcoming MLMS Closure

Anthem BCBS 2019 Medicare Certification is NOW OPEN!

Anthem’s start of the 2019 AEP is finally here!

There are SIGNIFICANT CHANGES to the 2019 AHIP.  Please make sure to read this in its entirety.

Here’s what you need to know…

Certification opens TODAY, June 27, 2018!

  • Completed certification taken after June 27, 2018, allows you to sell for the remainder for 2018 AND 2019.
  • AHIP has UPDATED the information in various sections to include new legislation. So please add more time. See below for more details.
  • If you are looking to submit applications online, register for one of Anthem’s webinars on mProducer by clicking https://brokertraining.anthem.com.

 

Getting Started

  • Visit http://www.medicaremegastar.com/  for details on this year’s Medicare Megastar Contest with the link to “Get Certified”
  • Anthem highly recommends that you take a section or two at a time over a couple of days, rather than completing this all at once.
  • The test is OPEN BOOK. Please use your slides as ALL MODULES have updates in them.
  • If you were certified last year, please use the “Sign In” section.
    • Your user ID is your email address OR your National Producer Number (NPN)
    • If you forgot your user ID or password, there are links below to regain access
    • It will ask you for an access code. Please use External-SelfReg and it must be typed EXACTLY as is it appears here.
    • It will take approximately 8-12 hours to complete re-certification. There are significant changes which is why it takes so much time.
  • If you are new to getting certified this year, please use the box on the right that says “First Time Visitor”
    • It will ask you for an access code. Please use External-SelfReg and it must be typed EXACTLY as is it appears here.
    • It will take approximately 15-18 hours to complete the entire training.
  • Please complete your certification by August 30th so you can pre-order your 2019 Enrollment Sales Kits!
  • IN ORDER TO SELL MEDICARE ADVANTAGE AND/OR PRESCRIPTION DRUG PLANS for 2019, YOU MUST COMPLETE CERTIFICATION for 2019.
  • YOU MUST BE THE ONE WHO COMPLETES THIS CERTIFICATION, NOT AN ADMIN OR ANY OTHER PERSON.

 

AHIP – if you go through Anthem’s website, there is a discount on the standard cost of $175; it will cost the same as last year, $125.

  • AHIP requires section 4 & 5 this year to be taken and then the exam.
    • To download the slides, click into the module, then on left side click download slides. Click the save button and save to a file folder for this year’s AHIP.
  • Section 1 and 3 have been updated with new legislation and regulation information. Please make sure to spend some time reviewing Section 3 as it pertains to Part D.
  • Section 5 talks about the Open Enrollment Period in detail.
    • Please make sure to download the slides in each section
    • The exam is open book and these slides will help you.
    • These slides and information are great reference tools throughout the year.
      • To download, click the link on the left side of the page
      • A new browser will come up with the document. Move your mouse and you will see a save button that looks like a floppy disk.
      • Click that save button and save the file to your desktop or a folder.
    • You have 3 attempts to pass the exam.
  • If you are re-certifying, you only have to complete sections 4 & 5, but the exam includes all 5 sections.
  • There are Continuing Education credits that you can purchase for an additional cost PRIOR to taking the exam.
    • Cost is $26.00
    • 6 CE credits are available with a passing grade
    • You can only have one course apply within your renewal period.
  • Fraud, Waste, and Abuse training – Nondiscrimination Training
    • New module has quiz questions. Quizzes are not pass/fail.
    • Final exam requires 70% to pass module
  • FWA module now has 5 quizzes, plus a final that you need to score 70% to pass.
  • General Compliance has quizzes and a final that you need to score 70% to pass.

 

Anthem Modules – Please complete all until you have green checkmarks for everything listed for 2019.

  • These Modules include HMO, PPO, Part D, AND SNP plans. Please complete all Modules.
    • All modules now have downloadable slides
    • Product Basics (appeals, enrollment, etc.) 10 question exam must score 90%
    • Risk Prevention – 20 question exam must score 100%
    • Sales Event Reporting –  10 questions must score 90%
    • Tools for Compliant Selling –  15 questions must score 100%
    • HMO – 10 questions must score 90%
    • PDP – 10 questions must score 90%
    • PPO 10 questions must score 90%
    • SNP – 10 questions must score 90%
  • YOUR 2018 CERTIFICATION IS COMPLETE WHEN IT SHOWS SOLID GREEN BARS AT 100% FOR THE FOLLOWING:
    • 2019 Compliance Training
    • 2019 HMO
    • 2019 PDP – Anthem offers stand-alone Prescription Drug Plans in all 88 OH counties. ALL agents should take this module.
    • 2019 PPO –Anthem offers  Regional PPO plans in ALL 88 OH counties. ALL agents should take this module.
    • 2019 DSNP (Anthem highly recommends taking this module in the event you run across an opportunity mid-year. If you do not take this training BEFORE SELLING a DSNP HMO plan, the policy is NON-Commissionable, it is a CMS violation and you are out of compliance.)

 

Product Training MeetingThis meeting is the ONE meeting each year that Anthem wants you to please attend. There will be some great news to share this year so you will WANT AND NEED to be at this meeting! You can have your administrative team attend, but they do need to RSVP!

You can register for the Product Training Meeting  NOW at https://brokertraining.anthem.com

  • 8-28 Hilton Garden Inn – Mayfield (AM and PM)
  • 8-29 Hilton Garden Inn – Miamisburg
  • 8-30 Hilton Garden Inn – Perrysburg
  • 9-6   Dave & Buster’s –  Springdale (Cincinnati)
  • 9-11 Dave & Buster’s Hillyard – Columbus
  • 9-18 Holiday Inn – Boardman
  • 9-19 Holiday Inn – Lima
  • 9-20 Courtyard Marriott – Akron/Canton
  • 9-25 Dave & Busters – Westlake
  • 9-27 Dave & Buster’s –Springdale (Cincinnati)

 

Information You Need to Know

  • Once your certification is complete, within 48 hours, you will receive an email informing you that you are Ready-To-Sell. This email will also include the link to Custom Point and your login information.
    • If you do NOT receive this email, AND you show green status bars on all modules for 2018, please contact Broker Support at 800-633-4368 or email them at medicareagentsupport@anthem.com
  • You will be able to pre-order Sales Kits ONLY if your certification is completed by August 31st.
    • Pre-ordering will start August 7th.
    • Anthem will NOT have Enrollment Sales Kits at the Product Training meetings.
  • If you do not make the August 31st deadline, you will NOT be able to order kits and have the GUARANTEED to be at your home/office by October 3rd.

 

Marketing

  • Did you know that Anthem BCBS has FREE approved marketing materials for you to use to support your sales efforts?
    • These materials can be customized with your personal contact information including: name, phone and email!
    • The materials can be found on Custom Point in the Sales Toolkit. ALL MATERIALS WILL BE UPDATED OCTOBER 1ST AND ALL MATERIALS DOWNLOADED OR PRINTED BEFORE THAT DATE MUST BE THROWN OUT AND DISCONTINUED.
    • Please take 5 minutes RIGHT NOW to set up your profile in the Sales Toolkit! Doing so will allow you to download materials quickly once they become available.
      • Visit Custom Point (You must use a PC based Internet browser)
      • Click on the button across the top that says Sales ToolKit
        • Make sure your pop-ups are enabled.
      • On the left side, click on My Profile
      • Start completing the fields in each section exactly how you would like the information to appear on your materials.

 

Medicare Supplements

  • There is a NEW plan F available in Ohio. YOU MUST GET APPOINTED WITH THE NEW COMPANY, AICI, IN ORDER TO SELL IT.
    • To get appointed, please reach out to your Cornerstone Senior Marketing sales representative.
  • All Medicare Supplements in OH refresh on July 1st.
  • You can run quotes, download new PDF materials at http://shop.anthem.com/medicare
  • To check rates, look up doctors, check medications, please use http://shop.anthem.com/medicare

 

Not contracted with Anthem or have questions about the 2019 certification? Contact your Cornerstone Senior Marketing representative today!

UHC Medicare Solutions: 2019 Certification Opens June 25!

Mark your calendars! Starting Monday, June 25, you can certify to sell 2019 UnitedHealthcare products.

Certify early! The sales materials portal will open mid-August for Enrollment Guide orders! By certifying early, you can ensure you’ll have materials ready to go by October 1. The longer you wait to certify, the less likely you are to receive materials by October 1.

UHC Medicare Solutions

Passing the prerequisite Tests (Medicare Basics Test, Ethics and Compliance Test, and AARP Course) certifies you to sell Medicare Advantage (MA) AND Part D plans! Don’t forget to certify for Medicare Supplement Insurance Plans and Special Needs Plans to help grow your business.

NEW! A built-in Fraud, Waste and Abuse course
No need to visit the Centers for Medicaid Services (CMS) site to take the Fraud, Waste and Abuse course. The content is now built into UHC’s Ethics and Compliance module and streamlined to ensure you get the exact information you need while reducing content by 70 percent. A huge time saver for you!

NEW! Improved Conflict of Interest Disclosure
To make this annual process easier, UHC has simplified the Conflict of Interest Status Disclosure language (find it in the 2019 Ethics and Compliance Test).

NEW! Events Basics refresh
UHC has also streamlined the Events Basics course content – a 21% reduction from last year – and designed an easier navigation. The course can be found in the electives section, be sure to take it so you can be ready to conduct marketing events.

How to take certifications:

  • Certification modules and tests are open 24 hours a day, seven days a week on Jarvis>Knowledge Center>Training>Certifications.
  • You will have six attempts to complete an assessment with a minimum passing score of 85 percent.
  • Each time you launch the assessment an attempt is counted, whether you complete the assessment or not. Important: Be sure to schedule uninterrupted time in order to complete the entire assessment without losing an attempt.
  • Upon answering a question, immediate feedback lets you know if you answered the question correctly or incorrectly.
  • For more information, refer to the 2019 Certification User Guide on Jarvis>Knowledge Center>Training>Certifications.

UnitedHealthcare will once again accept America’s Health Insurance Plans (AHIP) certification in place of the UnitedHealthcare 2019 Medicare Basics Test (including Medicare Advantage and Prescription Drug Plans). More information here.

 

Questions? Reach out to your Cornerstone Senior Marketing representative today!

Anthem’s CareMore@Work Onsite/Nearsite Clinics Coming in January

Anthem’s CareMore@Work integrated employee health solution for self-funded large group employers will be available as an onsite or nearsite clinic option by January 1, 2019. This means a client can purchase a clinic now to be built over the next few months so that it could open as early as January 1 to see the first patients, but it also can be launched at any point in the calendar year.  New clinics take approximately 6 months to launch. If CareMore is taking over existing clinic space on an employer campus, the implementation timeline may be as short as 90 days.

If you have any questions, please feel free to contact your Cornerstone representative.

AHIP 2019 & Allwell Certification Update: 2019 AHIP Certification Training is Available as of, June 18, 2018

Completing your 2019 AHIP training through Allwell’s Training Site will provide you with a couple of unique opportunities:

RECEIVE AN IMMEDIATE DISCOUNT OF $50 ON YOUR 2019 AHIP FEES

QUALIFY FOR A FULL REIMBURSEMENT OF YOUR 2019 AHIP FEES after meeting a few key requirements*…

  • Must complete 2019 AHIP training through our Training Site (site link below)
  • Must be certified and contracted to sell 2019 Allwell/Health Net MA plans
  • Must have a minimum of 5 new sales with a 1/1/2019 effective date
  • Qualifying sales must remain active with the plan through 3/31/2019

This is the first step in completing your 2019 Medicare Training & Certification.

Follow the Simple Process Below:

STEP 1: Take your 2019 AHIP Certification Training

  • If you have already completed 2019 AHIP Certification training elsewhere, you can skip Step 1. Otherwise…
  • Go to our Training Site on or after June 18, 2018, at https://allwell.cmpsystem.com to access the 2019 AHIP training.
  • New User: Navigate to the “Create a New Account” link under the “First Time Visitor?” section
  • Returning User: Log in with the credentials you’ve used in prior years. Your username should be your NPN and the password you created previously.
  • Complete the 2019 AHIP, Fraud Waste & Abuse and Compliance Exam. Producers must receive a passing score of 90% or better on the test.

Once you complete and pass the 2019 AHIP Exam, print the PDF of your AHIP Certificate of Completion and retain for your records.

AHIP’s Medicare training also includes the CMS Fraud, Waste & Abuse and CMS   General Compliance training.  Successful completion of these courses will meet Centene’s CMS Fraud Waste & Abuse and CMS General Compliance training requirements. 

Please Note: Health Net will only accept AHIP training for certification.

STEP 2: Complete 2019 Allwell/Health Net Medicare Product Training

The launch date for this training will be provided at a later date.

Additional instructions for completing this training will be provided once the 2019 Medicare Product Training is launched.

 

Important Reminders:

Producers are encouraged to certify by 10/1/18 so they are able to discuss 2019 benefits the first day of marketing and be ready to sell when 2019 AEP (Annual Election Period) begins!

Producers are required to certify/recertify annually to sell 2019 MA-MAPD plans, and be eligible to receive commissions. Annual certification requirements must be met prior to marketing and/or selling Allwell/Health Net MA-MAPD plans for a 2019 effective date.\

  • Producers who do not intend to sell Allwell/Health Net MA-MAPD plans for 2019 must still meet the certification requirements listed below prior to 12/31/2018 in order to be eligible to receive renewal commissions.
  • Centene will accept your certification if you have taken the AHIP certification course through another plan sponsor.

Please reach out to your Cornerstone Senior Marketing representative with any questions.

Oscar Health Pharmacy Update

As of May 1, CA and OH Oscar Health members who currently get 90-day prescription refills at non-CVS pharmacies will no longer be able to refill their 90-day prescriptions there. If they want to continue getting 90-day prescriptions, they will need to refill at a CVS pharmacy. Members can continue to refill their prescription at their current pharmacy, but only for 30-day refills.

CE AVAILABLE: Join Cornerstone for Carrier Product Training Sessions in Toledo!

Join Cornerstone Senior Marketing in July for carrier product training sessions in our Toledo office with Allwell and Dental Care Plus.

We can’t wait to see you there!

 

Allwell Product Training

DATE: Thursday, July 5

TIME: 10:00 am–12:00 pm

LOCATION: Cornerstone Toledo Office

5555 Airport Highway, Suite 142 | Toledo, OH 43614

Click here to RSVP

 

Dental Care Plus “Dental 201” Training*

*Earn 1 hour of CE credit at the DCP training!

DATE: Tuesday, July 10

TIME: 10:00 am–11:30 am

LOCATION: Cornerstone Toledo Office

5555 Airport Highway, Suite 142 | Toledo, OH 43614

Click here to RSVP

 

Not appointed with Allwell or Dental Care Plus? Contact your Cornerstone representative to get started.

2019 Aetna Individual Medicare Producer Certification Begins July 11

Starting July 11, you can complete the 2019 annual certification process for Aetna and Coventry Individual Medicare products (MA/MAPD, PDP). It’s one of the annual requirements you must complete to sell Aetna 2019 plans this Annual Election Period. Watch for more details about certification later this month.

AHIP training will begin July 11. Completing the 2019 Aetna Individual Medicare producer certification includes AHIP and costs $125.

Aetna also has an app that you can use to enroll your clients. With the Ascend Virtual Sales Office app, the electronic enrollment tool, you can:

  • Shorten the sales cycle and hold more appointments
  • Submit enrollments electronically
  • Eliminate paperwork
  • Reduce application errors
  • Quickly access resources all in one place

To start using the Ascend app, login to Producer World, go to the Ascend Virtual Sales Office app section and then click on “request access” to get started.

Questions? Contact your Cornerstone representative for answers!