Anthem Monthly Broker Updates (Small Group 1–50)

Reminder: Attestation Forms due December and January renewals

Groups with more than 50 total employees (full time, part time, seasonal) averaged over the preceding calendar year should be renewed by large group. Anthem has proactively reached out to brokers on all groups that have at least 21 enrolled on the plan to verify the group size. Please be sure you are responding with this information. Once a small group renewal has been released, Anthem cannot move the group to large group until the following year. Please return attestations timely for groups that need to change market segments.

 

Reminder: July, August and September Grandmothered Renewals

These renewals are able to move to January 1, 2018 renewal date as long as the group is not on a plan year plan. Groups that do so will only see demographic rate changes at their January renewal (age band changes). Early renewals forms signed by the group are due no later than August 1, 2018. Otherwise they will renew next year to ACA plans (unless there is another extension granted by HHS).

 

Reminder: Dual Option down to 5 lives—New for ACA Groups

All NEW groups are now eligible for dual option down to 5 enrolled lives starting for May 1, 2017 effective dates for ACA.

  • You must have 5 enrolled in plan to eligible.
  • This is for dual option only.
  • You must have at least one member enrolled in each plan.
  • 10 percent difference in premium between plans

There is no change to the requirements to add a triple option. 10+ enrolled is still required. Please contact your Cornerstone representative with questions.

 

Updated New Business Checklist Available

Want a smoother implementation process—make sure you are using the updated new business checklist.

 

Promote Wellbeing in the Workplace with a new Healthy Workplace website

A new resource is available to help Small Group employers build a comprehensive well being strategy from start to finish—Healthy Workplace. This is an interactive website for employers who lack a dedicated wellness consultant and walks the user through a step-by-step process and provides documents and assessments to help along the way. Check it out and see how easy to use it is! Available to any group size, but please note it works best in newer browsers like Chrome or Firefox.

 

Date for move to new Employer Portal is July 28

The Employer Portal, also known as Employer Access is moving to a new and improved platform as part of a technical upgrade. The move was supposed to happen June 16 but has been delayed until July 28.
The new site has the same functions as before plus updated technology, it’s more secure, and has an improved look & feel – it’s easier to use. Here are the highlights:

  • New flow for self-registration
  • Enhanced Menu of Resources (MOR) including Client Information Insights* (CII) reports
  • Enhanced Online Group Billing (OGB) dashboard
  • Allows for more flexible improvements in the future
  • Employer Group Site Administrators can use their existing username/ password, but will be required to sign a new internet Group Usage Agreement and User Usage Agreement the first time they access the portal.
  • Brokers can use their existing username/password too. Similar to Employer Group Site Administrators, brokers will be required to sign a new internet User Usage Agreement the first time they access the portal after the upgrade. Note: If there isn’t an internet Group Usage Agreement on file for their Employer Group(s), Brokers will have a 30 day grace period in which to contact the group to request they complete the online Group Usage Agreement.

To experience the new look and feel, Employer Group Site Administrator/Users can log in to the portal after July 28 and bookmark the new login page. When users log in after July 28, they will be redirected to the new and improved site.

 

2017 MLR Survey Timing Clarification

The annual medical loss ratio survey’s began mailing May 25 and will be staggered over several weeks. This has resulted in increased call volumes from Anthem’s groups since a reminder communication was released prematurely.

Anthem has sent out a clarifying message to brokers and employers. In the meantime, if your groups have not yet received their mailing, please let them know that the mailing has been staggered over several weeks. When groups receive the survey notice, they will be prompted to visit a link and complete the survey. As a reminder, responses are not due until July 31.

NOTE: Although most fully-insured small and large group customers will receive the survey, a small subset of customers will not if it does not apply to them. If a customer has not received the survey by the end of June, it is most likely the survey does not apply to them.

 

Anthem reduces its individual health plan offerings in Ohio for 2018

Anthem will no longer offer Affordable Care Act (ACA) compliant Individual health plans through the Health Insurance Marketplace (also called the exchange) and will reduce our off-exchange plan offerings in Ohio for 2018. This means health benefits for these members will end on December 31, 2017. Soon, Anthem will send Individual members an email sharing this news. Then, in a couple of weeks, Anthem will begin sending impacted members a packet with more details. Members on a PPO plan will receive their packets in June. HMO members will receive theirs closer to the fall open enrollment period.

Anthem will continue to offer one off-exchange Catastrophic health plan in Pike County only. Details about this plan are coming soon. Members who receive their health insurance benefits through their employer and members on Grandfathered and Grandmothered Individual plans are not impacted by this decision. Likewise, Medicare Advantage and Medicare Supplemental plans are not impacted by this decision.

Plan offerings for dental, vision, and life benefits will not change, and will be available to current members and new customers in 2018. Members with dental and/or vision benefits will get renewal details in the fall.

 

Cuidado Médico on Life Health Online Now Available in 49 States

Cuidado Médico on Life Health Online is expanding access to 48 States to provide access to in network Spanish-speaking doctors from the comfort of home. Starting June 1st, members will be able to use the Live Health Online app to access in network Spanish speaking doctors via private and secure video visits using their smartphone or tablet. Spanish speaking doctors are available by appointment from 7 am to 11 pm, seven days a week. Same day appointments are available in most States.

Contact your Cornerstone representative for details.

 

New Dental Prime and/or Complete online member guides available

Anthem has developed a demo that guides Dental Prime and Complete members through the various online tools available to them including coverage details, how to perform a Dentist search, Dental Cost Estimator, Ask a Hygienist (email access) and Dental Health Assessment. Share this demo with your clients so they can engage their employees in their dental benefits.

 

Anthem to Pay $115M Settlement Over Data Breach

Anthem has agreed to a $115 million settlement to resolve a cyber attack in 2015 that affected nearly 79 million people. Attorneys are calling this the largest data-breach settlement in history. $15 million from the proposed settlement will be used to pay for out-of-pocket expenses incurred as a result of the data breach. The proposed plan also requires Anthem to spend an undisclosed amount to protect the information of its current and former customers for the next three years.

The data breach compromised the names, birthdates, Social Security numbers, medical IDs, street and email addresses, and employee data of current and former customers and employees of Anthem.

Cyber attacks can happen to anybody at any time. Have you talked to Cornerstone about offering your customers LifeLock? Reach out to your Cornerstone representative today for more information.

RESOURCES

Anthem agrees to $115M settlement over data breach

Anthem Revised 2017 Enrollment Applications Available

Anthem enrollment applications for Medicare Advantage/Prescription Drug (MAPD) with $0 premiums plans are missing language required by CMS. Necessary updates have been made to the enrollment applications and Anthem recommends ordering new kits through CustomPoint.

The company suggests going through the missing language with members that have been previously enrolled or those with whom you plan to meet if you believe they are subject to the income-related monthly adjustment.

Members do not have to sign a new enrollment form, but the newly revised forms should be used going forward.

Contact your Cornerstone representative with any questions.

RESOURCES

2017 Enrollment Applications Missing Mandated Language

Looking Ahead: Anthem Reducing Individual Health Plan Offerings in 2018

A press release by Anthem confirms that in 2018, the company will no longer offer ACA compliant Individual health plans through the exchange and will reduce off-exchange plan offerings in Ohio. Health benefits for those members will end December 31, 2017. The only off-exchange plan that will still be offered will be Catastrophic health plan in Pike County only. Members will receive more detailed communications soon.

Members who receive their health insurance benefits through an employer, members on Grandfathered and Grandmothered Individual plans, and Medicare Advantage and Medicare Supplemental plans will not be impacted by this decision. Likewise, Anthem’s plan offerings for dental, vision, and life benefits will not change.

Questions? Contact your Cornerstone representative today.

RESOURCES

Anthem is Reducing its Individual Health Plan Offerings for 2018

Anthem: Medicare Plans Will Not be Impacted by 2018 Changes to Individual Plan Offerings

Anthem recently announced that they will stop offering individual policies in the Ohio marketplace in 2018.  In response, Anthem emphasized that Medicare Advantage and Medicare Supplement plans will not be impacted by these changes.

Questions? Contact your Cornerstone representative for answers.

 

RESOURCES

Medicare Plans Are NOT Impacted by 2018 Changes to Ohio’s Individual ACA-Compliant Plan Offerings

 

Ohio Department of Insurance Anthem Fact Sheet

The following content has been published courtesy of the Ohio Department of Insurance. Source below.

Anthem Fact Sheet

Background

  • In 2016, 17 companies sold health insurance on the federal exchange in Ohio.
  • In 2017, only 11 companies are selling health insurance on the federal exchange in Ohio.
  • In 2016, all 88 counties had at least four insurers selling exchange products.
  • In 2017, 20 counties only had one insurer selling health insurance on the exchange and 27 counties had just two.
  • In 2017, Anthem is the only insurer selling health insurance exchange products in all 88 counties and it is the only insurer in the 20 counties with just one insurer.
  • Based on preliminary filing submissions made to the Ohio Department of Insurance (ODI), Anthem’s reductions across the state will leave at least 18 counties with no insurer in 2018.
    • Those 18 counties are; Coshocton, Crawford, Guernsey, Hancock, Harrison, Hocking, Holmes, Jackson, Knox, Lawrence, Morgan, Muskingum, Noble, Paulding, Perry, Van Wert, Vinton, Wyandot.
  • In Ohio, Anthem will continue to cover approximately 3.4 million people across many types of insurance including small group and large group plans.

Frequently Asked Questions

Who is impacted?

Ohioans who bought health insurance from Anthem on the exchange will need to find another insurer for 2018, but they have coverage until December 31, 2017. Approximately 10,500 Ohioans in at least 18 counties, however, will have no health insurance options from the exchange in 2018. The Department is looking at options to solve this problem.

When will I be impacted by these changes?

Those in the counties where no insurer is planning to sell exchange plans will be impacted starting January 1, 2018.

I’m not on the exchange so how does this announcement impact me and my health insurance?

Those with health insurance through employer provided insurance, Medicare or Medicaid will not be impacted.

What is causing these changes to Ohio’s health insurance market?

Before the Affordable Care Act (ACA) Ohio had a very competitive health insurance market—many companies offered plans so prices were relatively lower compared to other states. New regulations from ACA have driven some companies out of Ohio and made it harder for them to do business, both of which have driven up the cost of health insurance in Ohio.

What is ODI doing to improve the current situation?

The best, long-term fix is to repeal the ACA and replace it with better regulations that both ensure high quality and help drive down costs with more competition. Until then, the Department will work to identify potential options that could help the approximately 10,500 Ohioans living in the counties that may not have an insurer selling exchange plans in 2018.

Questions? Contact your Cornerstone representative today.

RESOURCES

Anthem Fact Sheet

Anthem to Exit the Individual Market in 2018

Anthem will stop offering individual policies in the Ohio marketplace in 2018. The company has not yet decided whether or not it will participate in other states’ exchanges.

Anthem’s decision is estimated to affect nearly 10,500 people, leaving about a fifth of the state’s counties without an ACA plan in 2018.

 

Questions or concerns? Contact your Cornerstone representative for answers and solutions!

 

RESOURCES

Anthem to Pull Out of Ohio Exchange, Leaving 18 Counties With No ACA Plan

Anthem Will Exit Health Insurance Exchange in Ohio

Anthem Network Addition: Aultman Hospital

Aultman Hospital and affiliated partners are now part of the Anthem Blue Cross and Blue Shield network, effective May 15, 2017. This network addition includes Aultman hospital, providers, and ancillary services (e.g., home care, infusion, dialysis, DME, skilled nursing, hospice, rehab, and LTAC), and applies to all Anthem networks (Blue Access, Blue Preferred, Medicare Advantage HMO and PPO, and the Exchange (Pathway) HMO and PPO).

For more information, contact your Cornerstone representative today.

Anthem Reviewing Participation in Obamacare for 2018

Joseph Swedish, CEO of Anthem, says the company is currently evaluating its participation in Obamacare next year because of the uncertainty surrounding the GOP’s repeal efforts, noting that the company may need to pull back in some markets. “We would prefer not to extract ourselves if we can get the math to work,” Swedish said during a health care conference.

Because of the uncertainty surrounding whether or not the Trump administration will continue Obamacare’s payments to insurers, known as cost-sharing reduction subsidies, insurers have threatened to raise premiums or pull out of markets if they don’t receive payments.

 

RESOURCES

Anthem reviewing whether it will participate in ObamaCare next year

Anthem to Release New Employer Portal June 16

Anthem’s new employer portal, also known as EmployerAccess, will release on June 16 featuring many of the same functions as the old portal with a new design and updated technology.

Some highlights of the updated portal:

  • New self-registration flow
  • Enhanced Menu of Resources, including Client Information Insights reports
  • Enhanced Online Group Billing dashboard

Clients’ existing usernames and passwords will give them access to the portal on June 16. Users will be required to sign a new internet Group Usage Agreement and User Usage Agreement upon logging in.

Questions? Contact your Cornerstone representative today.

 

RESOURCES

Coming Soon! Anthem is moving to a new and improved Employer Portal in June