Effective January 1, 2019, or upon renewal, all benefit limits for Autism Spectrum Disorder will be removed from Individual, Small Group and Large Group benefit plans. This is a result of House Bill 218 which was recently passed in the Kentucky legislative session.
Anthem has released their Medicare plans for 2019. Don’t miss your chance for a sneak peak at their plan benefits!
*If you would like to request a different state other than Ohio or in addition, please state in the email button above
Not contracted with Anthem? Reach out to your Cornerstone Senior Marketing Sales representative to get appointed!
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.
- 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 Meeting – This 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 firstname.lastname@example.org
- 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.
- 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.
- 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!
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.
New Explanation of Benefits Design
Anthem’s EOB will be getting a new design in July to become more of a “Health Care Summary” with a comprehensive view of all claims activity over approximately a 20-day period
Join Anthem for Their Wellness on the Run Webinar
Anthem will discuss how to create low budget wellness ideas, why workplace competitions can be the key to better employee engagement, and why a wellness committee might just be what your clients need for success.
Date: June 20
Time: 2:00 pm to 2:45 pm EST
Multiple Sclerosis and the Workplace
Check out Anthem’s new e-book, A Guide to Multiple Sclerosis for Well-Informed Employers, and share it with your clients. It’s full of useful information about MS, suggestions for accommodating various challenges, and resources to help meet the needs of employers and employees.
Questions about these Anthem updates? Contact your Cornerstone representative for answers!
Medical Loss Ratio Information
As part of the Medical Loss Ratio (MLR) provision of the Affordable Care Act (ACA), health insurers must categorize clients as either individual, small group, or large group. For employer groups, this is determined based on the average number of employees they had in 2017. This includes full-time, part-time and seasonal employees. This MLR provision applies to the amount of premium spent on medical care and quality improvement programs for members covered under fully insured group health care plans.
Anthem is required to send your clients the MLR request for group size. When your clients complete the brief one-question request and return it, they can accurately categorize their business. They will begin collecting this information from fully insured clients this summer and may follow up with an email.
New Member ID Cards Coming Soon
Anthem will introduce a streamlined membership ID card beginning in July. They will send employers an email to let them what’s coming for their employees.
Cornerstone employees and broker partners are required to report suspected Fraud, Waste and Abuse. You can report Fraud, Waste and Abuse to Cornerstone’s Tim Shook at 513-629-9505 or email email@example.com. Additionally, you can report suspected Fraud, Waste or Abuse anonymously via the following Plan Sponsor hotlines:
When selling a plan that uses network providers, make sure you explain to your clients that providers may join or leave the network at ANY time – without notice to the members. Before they seek care, it’s a good idea to contact the provider’s office directly to make sure they accept the specific plan your client chooses. And make sure they are in-network for that plan at that location. Some providers with multiple offices may only accept certain networks at some of their locations.
To help your clients locate in-network providers:
- Agents must use the Find a Doctor tool located on the Shop Medicare plans website listed below. The website is updated weekly: ABCBS Medicare Shop
- When searching for in-network providers, it would be helpful to select a specific plan first, and then select the other search criteria to narrow your results list down.
- Ensure to use the ‘Advance Search’ option, or use as many filters as possible when searching for specific in-network providers, hospitals and specialists. Some doctors and facilities are in-network for some locations and out-of-network at other locations.
- Enter the PCP ID # in the Find a Doctor tool to confirm the specific provider at that specific office participates in the selected plan.
- Once you select a PCP in the Find a Doctor tool, click on the ‘Details Link’ to find a list of all hospitals for which the physician is associated.
Remember that HMO plan members should coordinate their care with their primary doctor before seeing other providers. HMO members who use non-network providers in non-emergency situations will pay for the full cost of their care. Encourage your clients to contact Customer Service at the number on their ID cards if they have any questions you can’t answer for them.
Contact your Cornerstone senior service representative for more information
Certify with Anthem beginning June 27 on their one-stop certification site. By accessing the Medicare Certification Training Center through the Producer Toolbox (PTB) beginning June 27, you can complete all modules under 2019 AHIP Compliance Training and 2019 Anthem Product Training in one convenient location. In addition, by using the Anthem PTB to complete your certification, your access code will automatically populate AND you will benefit from a $50 discount off your certification fee.
Contact your Cornerstone representative with any questions.
Large group clients can save up to 4 percent on their medical premium for adding new dental, vision, life, or disability coverage with Anthem. Learn more about Anthem’s Whole Health Savings, a bundling savings program.