Earn Up To $200 With The 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.

Updates to Aetna/Coventry 2018 Pharmacy Network

Aetna pharmacy networks vary by plan so it’s important to understand the differences. For 2018 Aetna has 3 pharmacy networks, two of which are being used in Ohio. Some important points to note:

Walgreens is moving from a preferred pharmacy to a standard pharmacy…so it’s still in network, but will not have preferred pricing. On the new Select PDP, Walgreens is out of network (P3 network).

  • P1 – (All OH) MAPD – all plans
  • P1 – (All OH/KY MAPD plans, Aetna Rx Saver PDP, First Health Value Plus PDP)
  • P3 – (Aetna Select PDP)

The biggest difference between the two:

  • Walmart is NOT preferred in P3
  • No Aetna Rx Home Delivery in P3
  • Walgreens is out of network on P3 (Walgreens non-preferred/standard on P1)

S2 is used in states where there aren’t many preferred pharmacies so that pharmacy network does not use preferred pharmacies.

 

Read more here.

Premier Health Will be Out-of-Network for United Healthcare Members In January

Premier Health in Southwest Ohio will be out-of-network starting Jan. 1, 2018. The following United Healthcare Medicare Solutions plans in the southwestern Ohio and Kentucky regions will be impacted:

  • AARP MedicareComplete (HMO) Plan 6 H5253-052
  • AARP MedicareComplete (HMO)  Plan 2 H5253-053
  • AARP MedicareComplete (HMO) Plan 3 H5253-054
  • Dual Complete® (HMO) H5253-059
  • Dual Complete (HMO-POS) H5322-028

 

Member information

  • Letters to impacted members will start arriving Oct. 23 alerting them to the network change.

 

Members in AARP Medicare Supplement Insurance Plans, insured by UnitedHealth care Insurance Company, will not be impacted by this change and may continue to access care from any doctor or hospital that accepts Medicare patients.

Filing Lead Generator Websites with Humana

Effective immediately, Humana sales agents do not have to submit lead aggregator websites from which they purchase MA or PDP leads to Humana for review and approval. Though lead aggregator websites are no longer required to be submitted to Humana for review and approval, sales agents using these websites for the purpose of obtaining leads to sell Humana MA or PDP are still responsible for ensuring the websites are compliant with CMS regulations and other applicable state and federal laws. If Humana becomes aware of a noncompliant lead source via complaint or otherwise, Humana will take corrective action.

Humana: COPC Back in Network

Humana is happy to announce that Central Ohio Primary Care (COPC) in Columbus, OH will continue to be in network for all Humana products (HMO, PPO, and PFFS) heading into 2018.

 

Read More Here

URGENT NEWS: Humana MP MISPRINT on Walmart PDP flyers & PDP POP Brochures

Please discard ALL Humana Walmart PDP flyers and Walmart PDP POP brochures that you may have received and delete any Walmart PDP flyer and Walmart PDP POP brochure PDF’s that may have been saved. There is an incorrect $400 deductible listed on these pieces when in fact the Walmart PDP has a $405 deductible on T3, T4 and T5.

Humana will be reprinting and redistributing once they are corrected.  Please see a list of form numbers below that were impacted.

Walmart PDP GNHH30IHH_18 BROCHURE – 2018 PDP – POP Walmart, ENGLISH, Individual Medicare 1000 SPM_POPB_PDPW_MA_18
Walmart Bankers  GNHH30IHHBL_18 BROCHURE – 2018  PDP – POP Walmart, ENGLISH, BANKERS, Individual Medicare 1000 SPM_POPB_PDPW_MA_18BL
Walmart Spanish GNHH30ISP_18 BROCHURE – 2018 PDP – POP Walmart, SPANISH, Individual Medicare 500 SPM_POPB_PDPW_MA_SP_18
Chinese (electronic) GNHH30ICH_18 BROCHURE – 2018  PDP – POP Walmart, CHINESE, Individual Medicare N/A Y0040_SPM_POPB_PDPW_MA_CH_18
Vietnamese (electronic) GNHH30IVI_18 BROCHURE – 2018 PDP – POP Walmart, VIETNAMESE, Individual Medicare N/A Y0040_SPM_POPB_PDPW_MA_VI_18
Creole (electronic) GNHH30ICR_18 BROCHURE – 2018 PDP – POP Walmart, CREOLE, Individual Medicare N/A Y0040_SPM_POPB_PDPW_MA_CR_18
Korean (electronic) GNHH30IKO_18 BROCHURE – 2018  PDP – POP Walmart, KOREAN, Individual Medicare N/A Y0040_SPM_POPB_PDPW_MA_KO_18
Polish (electronic) GNHH30IPL_18 BROCHURE – 2018  PDP – POP Walmart, POLISH, Ind. Medicare N/A Y0040_SPM_POPB_PDPW_MA_PL_18
PDP Walmart “Outlier”  GNHJC36EN
Walmart Rx GNHHM52HH_18 FLYER – 2018 Humana Walmart Rx PDP Plan, ENGLISH, Individual Medicare 500 SPM_FLY_PDPW_18
Walmart Rx/Spanish GNHHM52SP_18 FLYER – 2018  Humana Walmart Rx PDP Plan, SPANISH, Individual Medicare 250 SPM_FLY_PDPW_SP_18

Why Cross Sell GTL’s Advantage Plus Hospital Indemnity Plans?

Who should you talk to about a Hospital Indemnity Policy (HIP)? What are the key selling points to mention? When and how can you bring it up?

 

Click here to view the full webinar.

 

A HIP Consumer Toolkit is coming Soon!

Remember to bring HIP up this Open Enrollment! Advantage Plus is specifically designed to help cover out-of-pocket expenses including:

  • Hospital Confinement
  • Dental/Vision
  • Outpatient Surgery
  • Ambulance Trips
  • Skilled Nursing Facilities
  • Cancer Treatments

Contact your Cornerstone representative today to get contracted!

Humana MP 2018 Group & BSN Map PLUS Enrollment Tips

Humana MP 2018 Group/BSN Map & Enrollment Error Tips

Help Reduce Paper Application Pends
One of the most important things to remember during Pre-AEP is that while agents can assist a beneficiary in completing a paper application, agents are prohibited from soliciting enrollment or taking possession of any 2018 applications prior to the start of AEP on October 15, 2017. Agents may assist clients in filling out applications, but may NOT take the application with them. Agents should tell their clients to wait to mail the application on October 15 or later. Important Reminder! Agents should NOT date the application during Pre-AEP as this is considered the date the application is “received” by the Plan Sponsor. Any application received by Humana prior to 10/15 or those with an agent date (10/1 – 10/14) will be investigated for potential agent solicitation and the enrollment will be rejected.

Common Application Errors

  • Wrong or missing GR/BN – Reference the link below!
  • PO Box listed as residential address – ALWAYS USE STREET ADDRESS!
  • Member signature missing

 

GR/BN Errors
Missing or incorrect GR/BN number continues to be an area of concern resulting in delays in enrollment and sometimes application denial. Each year we see Section A complaints that could have been avoided if the correct Plan Option Number and GR/BN were placed on the application. Always double check to make sure you have included and accurately captured this information on the app. You can get this information for each state in Vantage at this link:

CLICK HERE

Please Note: You must log into Vantage before selecting the link. GR/BN numbers are subject to change throughout AEP, so while this map gives agents access to a printable version, it is best practice to retain and refer to this tool for the most up to date information

 

Common Election Period Errors
Below are two of the most common errors made related to election type code.

IEP versus ICEP – The IEP should be used when beneficiary elects to enroll in a drug plan when they are newly eligible or aging-in, this includes enrollment in an MAPD. The only time you will use ICEP is:

  1. 1. When the beneficiary is newly eligible and elects to enroll in an MA Only plan
  2. 2. The beneficiary delayed enrollment for Part B and they want to enroll in an MA Only or MAPD plan (only available 3 months prior to Part B going into effect).

SEP Other (“SEP OTH”) – This should be used when none of the standard SEP reason codes are applicable, and the beneficiary has a special circumstance that would allow them an exception to enroll. When an agent selects this election period, it is very important to complete the “Notes” section to explain why the SEP OTH is being used. Failure to provide the explanation means the enrollment team must reach out to the beneficiary to determine what SEP they qualify for. If enrollment is unable to reach the beneficiary, we will reject the application.

 

Please see below for the much anticipated 2018 Group and BSN Map from Humana Marketpoint. 

Click here for the 2018 Group and BSN Map

Tips for a Successful AEP!

With AEP starting on Sunday, we would like to provide you with some helpful tips on how you can make this AEP your most successful!

 

SUBMITTING APPLICATIONS

  • Electronic submission is preferred
  • Submitting Direct to the Carrier
    • When you fax your applications to the carriers you must submit 1 application at a time and keep your fax confirmation for each app. If an application becomes lost or is not received, you may need your backup documentation to prove the initial submission date.

 

CARRIER FAX NUMBERS:

Aetna

Medicare Advantage & PDP

Medicare Supplement (AHLIC, ACI, CLI)

 

888-665-6296

877-380-2777

Allwell – Online submission strongly encouraged

Medicare Advantage

 

844-222-3180

Anthem

Medicare Advantage & PDP

Medicare Supplement

 

800-833-8554

844-236-7967

Cigna 877-704-8186
CSI 855-304-2855
Coventry

PDP

Medicare Advantage – OH

*Please contact senior service rep for out of state numbers

 

866-415-2232

877-819-9164

Gateway – SUBMISSION THROUGH CAVULUS REQUIRED
Humana MarketPoint 877-889-9936
Medical Mutual

Medicare Supplement

Medicare Advantage

 

513-629-9379

800-542-2583

Medico – OH ONLY

Medicare Supplement

All Other Products

*Please contact senior service rep for out of state numbers

 

844-850-2550

888-363-3420

Omaha 866-799-9076
Paramount 419-887-2039
Premier – SUBMISSION THROUGH CAVULUS REQUIRED
SilverScript – SUBMISSION THROUGH AGENT PORTAL REQUIRED
The Healthplan 740-699-6164
Transamerica (Medicare Supplements) 866-834-0437
UHC

PDP

Medicare Advantage

Medicare Supplements

 

866-994-9659

501-262-7070

888-836-3985

Wellcare 866-473-9124

 

TOP REASONS AN APPLICATION WILL PEND

  • INVALID MEDICARE CLAIM #
    • It’s always best that you request to see a copy of the beneficiaries Medicare card to ensure the claim number you are putting on the application is correct. You should never assume the Medicare number is their SSN with an A on the end.
  • INVALID ELECTION PERIOD
    • While most elections will be marked AEP this time of year, it’s still important to make sure you are using the correct election period for age-ins or other special circumstances. Not sure which election to use?  Find it here!
  • INVALID HUMANA GROUP ID, BENEFIT, CONTRACT & PBP NUMBERS
    • These numbers are extremely important! The plan numbers are how the carrier enrolls the beneficiary into the correct plan.  Here are the OH numbers.  Contact your senior service representative if you need additional states.
  • MISSING SIGNATURES / INVALID SIGNATURE DATES
    • Always make sure you and the applicant sign and date the application. Remember, you should not sign and date the application until it is in your possession.
    • Double check that all signatures are complete and the dates are correct (we see a date of birth or effective date listed as a signature date frequently).

 

OTHER HELPFUL TIPS!

  • 48 HOUR VIOLATION
    • Please remember, CMS states that you have 48 hours from the time YOU sign the application to get it submitted to the carrier. Some carriers now require receipt in 24 hours!  Electronic submission is safest.
  • CARRIERS THAT REQUIRE ONLINE ENTRY
    • Don’t forget that you have to enter Premier, Gateway and Silverscript enrollments online through their agent portals to receive commissions!
  • INVALID WRITING NUMBERS
    • This is very important as this is how you are paid! In cases when the incorrect writing number is listed on the application the carrier will drop the policy as a house account until a correction is processed.

NAHU’s Exclusive Membership Discount Available | Offer Ends Soon!

NAHU’s Exclusive Membership Offer!

Join NAHU today and save $50 off your annual dues as an investment in you and their commitment to the senior market.

BECOME A PART OF NAHU

Don’t wait! Hurry to join by October 15th to receive $50 off your annual dues!

 


 

 Who is the National Association of Health Underwriters (NAHU)?

NAHU is the only professional agent organization that represents agents and brokers who work with Medicare products and Medicare beneficiaries. Their strong relationships on Capitol Hill and growing influence with the Center for Medicare and Medicaid Services (CMS) should make NAHU your valued choice for professional development and advocacy.

 NAHU has a long history of working on Medicare issues. In 2002, NAHU joined in lobbying for a drug benefit and for a new program that would allow private insurance plans to include a separate drug plan to offer benefits to Medicare beneficiaries. After over a year of intense lobbying, the White House invited Janet Trautwein and John Greene to attend the bill signing of the Medicare Modernization Act. As Medicare Part D began the implementation process, NAHU was involved from the beginning, with prescription drug discount cards added to the current program today. NAHU was recognized during a special White House ceremony for extraordinary efforts in enrolling Medicare beneficiaries in Part D.

 

Why be a member of NAHU?

Today, Medicare remains a complex program touching private insurance and government programs alike. It is important that you stay up to date on the issues and regulations, and NAHU is a tremendous resource. 

 

Cornerstone Added Value

Cornerstone has recently accepted an invitation to be a part of NAHU’s Medicare Principals Council, which is specifically comprised of the most senior executives in this type of organization. Members of this group interact with peers at their practice level from around the country.