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.

Attention MMO Agents: Important Notice Regarding Payment of Commissions

Historically Cornerstone has paid Medical Mutual of Ohio commissions to all agents partnering with our General Agency. Beginning with January commissions payments (which are paid mid-February), Medical Mutual of Ohio will now be paying commissions directly to you or to your agency on a monthly basis.

This DOES NOT impact the relationship you hold with Cornerstone in any way, other than the transition to direct payment of commissions from MMO.

A notice from Medical Mutal of Ohio was sent to all MMO agents providing complete instructions for direct deposit/EFT* and included an EFT Agreement along with guidance for accessing commission statements using MyBrokerLink.com.  A copy of the MMO notification is attached for your reference. If MMO does not have an EFT Agreement on file, commissions will be paid by check and sent via US mail.

Cornerstone is here to assist you with this transition. If you have questions or need assistance, please email BrokerContracting@medmutual.com or reach out to your Cornerstone commission team for help.

Click here to see the official notice from MMO.


*MMO asks that you please include a voided check or bank letter with your EFT form.

Medical Mutual Update: PNC HSA Account Transfers

Through an agreement with PNC Bank, Medical Mutual has paid $2.50 per member/per month administrative fee associated for all MMO groups and individuals with a PNC Bank health savings account (HSA). This fee will no longer be paid effective March 1, 2018. There will be no charge to transfer funds from the PNC HSA to MMO’s HSA.

Communications will be sent to market segments currently with a PNC HSA informing them of this change:

View Group letter.

View Individual Policyholder letter.

View Group member letter.

Reminders About MMO Products Before AEP Ends

See below for a few last minute reminders from MMO as AEP comes to an end.

Competitive Advantage Medicare Advantage:

  • Broad service offering representing 80 of the 88 counties.
  • Many of the common medications are in the MMO MA formulary.
  • Drugs that typically fall in Tiers 3, 4, or 5 with other carriers are Tier 1 and 2 with MMO.
  • Very low maximum out-of-pocket
  • Comprehensive network of facilities and doctors spanning across the state of Ohio. Ability to go to any in-network doctor or hospital regardless of where a member is domiciled.
  • $0 HMO Classic available in Region 1 counties.
  • No referrals or Gatekeepers required.
  • Earn an additional $50 per member.

 

Competitive Advantage Medicare Supplements:

  • Low renewals trending over the last 5 to 7 years with some decreases that have occurred.
  • Competitive rates across all age bands across the entire state of Ohio.
  • One preferred rate for a potential applicant, no male/female, smoker/non-smoker, regional, or other factors when determining a rate.

Contact your Cornerstone representative for more information about MMO products.

Medical Mutual Releases New Commission Schedule

MMO has released their new commission schedule for their 2018 Medicare Supplement Market. Their new Medicare Supplement commission schedule will stack up very competitively in the marketplace. This schedule will reward you by paying a premium commission based on your volume of sales throughout the year. Once you hit the next tier level, MMO will pay you at the higher rate retroactively within the calendar year. Renewal commission will be based on the first year tier level.

Commission rates for brokers/agencies having at least 10,000 Medicare Supplement contracts in their book of business on January 1, 2018, are as follows for new Medicare Supplement accounts having an effective date of January 1, 2018, and thereafter.

  • First Year: 16%
  • Years 2 through 10: 8%
Number of First Year Sales Commission Tier Level Commission Rate: First Year Commission Rate: Years 2 through 6
1-24 contracts 1 18% 12%
25-49 contracts 2 22% 15%
50 or more contracts 3 26% 18%

 

Contact your Cornerstone sales representative with any questions you may have about the above schedule.

Important Notice From Cornerstone

ATTENTION: Cornerstone Brokers Appointed to Sell/Service Medical Mutual of Ohio Individual Health Plans

Due to the overall volatility in the individual market and the insecurity of future funding of individual cost sharing subsidies, effective January 1, 2018 Medical Mutual of Ohio has determined that all sales and service support for individual policies (including on and off exchange, non-ACA and ancillary) written through MMO will be managed directly through Medical Mutual of Ohio. To clarify, this includes all individual policies with January 1, 2018 effective dates and all in-force individual policies. This transition includes broker and member services, claims resolution, network issues, plan changes, etc.

Cornerstone will continue to service policies in effect through December 31, 2017.

Please note: this DOES NOT AFFECT the Group or Senior market. This change affects individual (under age 65) markets ONLY. We sincerely apologize for any inconvenience.

Referenced below is contact information for personnel at MMO who can assist with all of your individual sales and service needs.

Beverly Danner

Account Manager

513-313-3719

beverly.danner@medmutual.com

Abby O’Brien

Director of Broker Sales

440-572-6353

abigail.obrien@medmutual.com  

Cornerstone continues to represent a portfolio of individual carriers across the State of Ohio. If you should have any questions or if we can be of assistance with those options, we are here to assist. We appreciate your business and your patience during this unstable period.

Cornerstone’s Agency Service Program is also here to assist you. We can create a tailored plan designed to bring a continued source of revenue to you and your clients will receive superior day to day service and guidance from our tenured experts. We offer several servicing partnership and referral programs in order to allow you to concentrate on your core business model. You can contact your Cornerstone representative for more information on how you can always say “Yes” to your clients.

 

As always, thank you for your partnership,

 

Jennifer Agnello, President

Tim Shook, VP Individual and Senior Markets

2018 Medical Mutual of Ohio Med Supp Plan Rates

Good news!  The 2018 Medical Mutual of Ohio Medicare Supplement plan rates are now available on MyBrokerLink.

The current version of paper applications are still good for writing 2018 policies. The online enrollment is expected to be available next week.

CORRECTION: Medical Mutual In-Network Hospitals

Medical Mutual of Ohio has reported that on October 15, 2017, a Medicare Advantage ad in the Toledo Blade inaccurately listed ProMedica as an in-network hospital for plans. ProMedica is NOT part of the MMO Medicare Advantage HMO or PPO networks. The only exception being Lima Memorial Hospital, a ProMedica affiliate hospital which is in their network.

They apologize for any inconveniences and confusions. If you have any questions contact your Medicare Service Rep.

To verify providers for the MMO network go to www.medmutual.com and click on find a doctor, then select Medicare Advantage HMO or PPO directory.