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.

Earn Up To $200 With Medical Mutual’s Medicare Supplement Bonus Program

MMO Med Supp bonus programs are an exciting way to be compensated for selling a very competitive and reputable Medicare Supplement plan.

Take advantage of the MMO Med Supp bonus program that will earn you up to $200 an application.


Click here for the full details.

Medical Mutual to Include Northeast Ohio in HMO Strategy

Beginning January 1, 2018, Medical Mutual will expand their HMO strategy to include Northeast Ohio. Members currently enrolled in the MMO Individual ACA Point of Service (POS) product will be mapped to the new network, Northeast Ohio HMO.

Medical Mutual will also be expanding their individual portfolio to the following counties…

Mercy HMO
  • Allen
  • Auglaize
  • Brown
  • Butler
  • Champaign
  • Clark
  • Clermont
  • Columbiana
  • Defiance
  • Fulton
  • Hamilton
  • Hancock
  • Henry
  • Huron
  • Lorain
  • Lucas
  • Mahoning
  • Mercer
  • Putnam
  • Seneca
  • Trumbull
  • Wood
OhioHealth HMO
  • Athens
  • Delaware
  • Fairfield
  • Franklin
  • Hardin
  • Hocking
  • Licking
  • Marion
  • Morrow
  • Richland
  • Union
  • Ashland
  • Ashtabula
  • Cuyahoga
  • Geauga
  • Lake
  • Medina
  • Portage
  • Summit
ProMedica HMO
  • Lucas
  • Wood

Medical Mutual of Ohio’s New MAPD PCP Visit Program | Broker Compensation Available!

MMO’s New PCP Visit Program

Medical Mutual is introducing a new Primary Care Physician (PCP) Visit Program for brokers working with Medicare Advantage members.

Medical Mutual will compensate $50 for each Medicare Advantage member you work with who completes a Welcome to Medicare Preventive Exam, Annual Wellness Visit, Annual Wellness Subsequent Visit, or Preventive Service Visit from his/her PCP within 90-days of the member’s 2018 policy effective date.

Click here for more information.


In order for you as a broker to be eligible for the $50 compensation, you must be 2018 certified and the Addendum must be completed and returned to Medical Mutual’s compliance department at: MASalesCompliance@medmutual.com.

MMO MA Network Update — COPC

Medicare Mutual of Ohio has announced that effective January 1, 2018, Central Ohio Primary Care Physicians (COPC) will no longer participate in Medical Mutual’s Medicare Advantage network. Medical Mutual is diligently working to notify affected members of the provider exit to ensure a smooth member experience. COPC will continue to remain as an in-network provider with all other lines of business for Medical Mutual.

New Medical Mutual Underwriting Guidelines Available

Medical Mutual recently released its Underwriting Guidelines for 2017, which outlines guidelines for new business, existing business, and personal health plan general policies.

Click here to access the Underwriting Guidelines.

Cornerstone & Medical Mutual’s 2018 Individual Roll Out Meeting

You are invited to attend Cornerstone & Medical Mutual of Ohio’s 2018 individual plan roll out meeting in Cincinnati!

MMO will be expanding their sales footprint to include additional counties in 2018, helping to cover even more Ohioans. They will also be making changes to their product portfolio.


DATE: Thursday September 21

TIME: 2:00 pm–4:00 pm

LOCATION: Cornerstone Cincinnati Media Center

2101 Florence Avenue | Cincinnati, OH 45206

Medical Mutual 2018 Individual ACA Plan Meetings

Medical Mutual will be hosting a number of meetings to provide a first look at the 2018 Medical Mutual ACA Individual plan updates.

The company will be expanding their sales footprint to include additional counties in 2018, helping to cover even more Ohioans. They will also be making changes to their product portfolio.

There are a number of meetings conveniently scheduled in Strongsville, Cincinnati, Powell, Toledo, Lima and Mansfield.

To RSVP for any of the 2018 Individual ACA Plan Meetings, click here.



Sign Up Now for our 2018 Individual ACA Plan Meetings

Medical Mutual Broker Update

Mailings to Collect Missing Dependent Social Security Numbers
(Applies to: All fully insured business except Medicare Advantage)

This week Medical Mutual will start sending letters to approximately 5,100 group and individual members for whom they do not have Social Security numbers on file for their covered spouses and/or dependents. The mailings will occur in multiple phases over the next two to three weeks.

Medical Mutual is obligated by law under Internal Revenue Code Section 6055 to do this outreach to affected members one more time before the end of the year. As a reminder, members who do not comply with the requirement may be subject to IRS fines on their tax returns.

To capture any members whose policies take effect after this mailing, additional mailings are planned for November 2017 and January 2018. Mailings are released every January, August and November. The company will send a brief reminder before each mailing.

Implementing Coverage of Statins at No Cost Share for Certain Members of Non-Grandfathered Plans, Effective for Plan Years on or after December 1, 2017
(Applies to: All except Medicare Advantage, Medicare Supplement)

On November 13, 2016, the United States Preventive Services Task Force (USPSTF) recommended the use of low- to moderate-dose statins as preventive medications for cardiovascular disease. Statins are prescription medicines used to decrease high cholesterol. Based on this recommendation, all non-grandfathered plans under the Affordable Care Act must cover these medications at no cost share to members who meet certain criteria related to risk for cardiovascular disease. Criteria include being between ages 40 and 75, having no symptoms or history of cardiovascular disease, having one or more cardiovascular disease risk factors (e.g., diabetes, smoking, high blood pressure or high cholesterol), and having a calculated 10-year cardiovascular disease event risk of greater than or equal to 10 percent. Please refer to the December 13, 2016, Broker Update for more details.

Benefit Additions

Zero cost share for statins will apply to all non-grandfathered groups and individuals beginning with their first plan year on or after December 1, 2017, as noted below. Medical Mutual’s Underwriting department will adjust renewals to reflect the additional cost of this benefit change beginning with first renewals on or after December 1, 2017.

  • Medical Mutual
    • Non-grandfathered individual and small group plans: The benefit will be effective January 1, 2018.
    • Non-grandfathered alternative group structure plans (e.g., Middle Marketplace, Balanced Solutions, MEWAs): The benefit will be effective January 1, 2018.
    • Non-grandfathered 51+ groups: The benefit will be implemented effective at first plan years beginning December 1, 2017, and continuing implementation through plan years beginning November 1, 2017
  • Mutual Health Services
    • The benefit will be effective at first plan years beginning December 1, 2017.
    • Members must meet the clinical criteria noted above to qualify for statins at no cost share. We will communicate those criteria and our interpretation of them to our in-network providers through the third quarter issue of Mutual News, our provider newsletter.

Please see the attached talking points you can use to explain this benefit update to affected non-grandfathered groups.

Process at the Pharmacy

Members must get a prescription from their doctors or health providers and present it at an in-network pharmacy (retail or mail order). Members who qualify based on the clinical criteria will see the $0 cost share reflected at the point of sale. Member qualification will be determined based on pharmacy and medical claims data we send to Express Scripts. Members who do not meet the clinical criteria for the $0 cost share will pay their standard prescription drug plan’s cost share for the prescriptions they are filling.

Note: Zero cost share for preventive statins is limited to low- and moderate-dose generic products. In the rare instance none of the generics is appropriate or a member has tried and failed an equivalent generic, his/her provider should contact Express Scripts for a copay review for an equivalent brand-name statin. Before initiating statin therapy, providers are still advised to discuss lifestyle modifications and improve other cardiovascular disease risk factors, if applicable.

Early Release Planned for January 2018 Small Group Renewals
(Applies to: Small group)

To give their brokers adequate time to renew their small group business, Medical Mutual will release January 2018 renewals for transitional and grandfathered groups in early September. Typically, they release renewals 60 to 75 days prior to the group’s renewal date. This schedule will provide 120 days to renew this business.

Renewals for all ACA groups and grandfathered groups with November and December renewal dates will be released according to the traditional schedule. As a reminder, all transitional groups were converted to January renewal dates due to the anticipated end of transitional relief.