September Anthem News Updates

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Helping Employees Protect Themselves and Their Loved Ones

Life insurance is a key part of an employee’s overall financial wellness. This September is Life Insurance Awareness Month—and a good time for your clients to remind their employees of the importance of protecting their family members if they, unfortunately, face a loss.

You can guide your clients by reminding them of the life insurance provisions that can help their employees receive the coverage they need, even if they were to lose their job or have their hours reduced:

  • Continuation of coverage: If an employee is not working due to a layoff, leave of absence, or disability, their employer can continue to pay their premiums for a period of time — usually 1 to 3 months.
  • Conversion: If an employee leaves or loses their job, they can convert their group life coverage to an individual life policy and pay the premiums directly to Anthem.
  • Portability: If an employee leaves or loses their job, they may be able to keep their voluntary or supplemental life plan by paying the premiums directly to Anthem.

Click here to learn more.

Cancer Care Navigator Program

Anthem’s new Cancer Care Navigator program helps fully insured and ASO members understand their cancer diagnosis and treatment plans, make sense of benefit options, and connect to helpful resources in their community.

Cancer Care Navigators serve as the central point of contact at Anthem for members and their cancer care teams across the care experience. They work to reduce the burdens facing many members with cancer by:

  • Supporting member and caregiver needs.
  • Connecting the member to critical Anthem and community resources.
  • Reinforcing treatment plans and medications, and providing education about possible side effects.

Click here to learn more.

Updates to ACA Preventive Care Drug List

Anthem is removing Annovera, Balcoltra, Falessa Kit, Lo Loestrin FE, Natazia, Slynd, Taytulla, and Twirla from the ACA Preventive Care Drug List January 1, 2021, for fully insured and ASO members with women’s contraceptive benefits. Members will pay their plan’s cost share for these branded drugs. Anthem will continue to cover generic contraceptives at no cost to members.

Anthem is sending letters to affected members and their prescribing doctors on October 1, 2020, to allow time to explore options and provide new prescriptions for their patients. Letters to health care professionals will include some generic contraceptive alternatives that our plans cover at no cost to members.

Click here to learn more.

Mental Health Trends Webinar

Anthem is offering another opportunity to learn about important topics for your business.

Please join Anthem leaders at 2 p.m. (ET) on Monday, September 21, 2020, as they share the latest information on COVID-19, including legislative and clinical updates. They’ll focus on regulatory and mental health trends and resources.

REGISTER NOW and save the event to your calendar.

Click here to learn more.

GM/Legacy Renewals for January 1, 2021

The average rate increase for the entire Renewal Block is 6 percent. Anthem also has about 80 percent of the block coming in at less than a 10 percent rate increase!  There will obviously be some outliers, but they believe this will give your groups’ some relief during these uncertain times.  Also, the GM/Legacy renewals will be released in mid-September.

Dental PPE Reimbursement Extension to October 31, 2020

Many dental providers are charging an additional $10 per visit to help them cover the cost of the Personal Protective Equipment (PPE) for their staff. Anthem will reimburse members for this additional charge up to $10 per patient per visit to in-network PPO providers through October 31, 2020.

Telehealth Cost Share Changes

As of September 30, 2020, Anthem member cost share waivers for video only telehealth visits will expire.

Starting October 1, 2020, Anthem members will pay their usual cost shares for visual telehealth visits with in-network providers. Anthem will continue to cover in-network telephone only visits at no cost share through December 31, 2020.  Starting October 1, 2020, LiveHealth Online visits will require member cost shares.

Eligibility Requirements Continue to Be Relaxed to the End of the Year

Anthem’s requirement for employees to be actively working in order to be eligible for coverage will be relaxed through December 31, 2020, as long as the monthly premium payment is received.

Anthem will allow employees that have a reduction in hours (work less than 30 hours per week) to continue coverage through December 31, 2020, as long as the monthly premium payment is received.

SBC Template Updated for 2021

CMS released an updated 2021 SBC Template, Instructions, Uniform Glossary and Guide, Narratives (Maternity, Diabetes and Foot Fracture) and Calculator for coverage examples. The AI/AN zero cost sharing template is now also available for use.

As a reminder, group health plans and health insurance issuers will be required to use the 2021 SBC template and associated materials beginning on the first day of the first open enrollment period for any plan years (or, in the individual market, policy years) that begin on or after January 1, 2021, with respect to coverage for plan or policy years beginning on or after that date.

Contact your Cornerstone representative to learn more.

Important September Anthem Updates

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Plasma Donations to Fight COVID-19

Members who have fully recovered from a positive COVID-19 diagnosis can support research that might save lives by donating their blood plasma. It may contain antibodies that can help researchers understand how the immune system fights the virus and how to more effectively treat patients. Help Anthem spread the word by sharing this information with your clients.
Plasma donation is safe, quick, and similar to donating blood. Visit the Anthem coronavirus website to learn more about the donation process and eligibility requirements.

Dental PPE Reimbursement Extension

To protect the health of their members and minimize unexpected fees, Anthem began paying dentists a personal protective equipment (PPE) reimbursement as of June 15, 2020. They pay $10 per dental patient, per visit, on dental PPO network claims for PPE. Anthem will be extending the reimbursement from August 31 through October 31, 2020.

Phishing Scams Target Brokers

Email-based malware has targeted health care professionals and brokers recently. Anthem has identified information-security practices that you should consider adopting to protect your business and clients.
  • Microsoft Office macros often deliver email-based malware. You can disable macros if you do not need them for day-to-day work.
  • Consider blocking access to websites that have no category or no reputation in the network security product you use.
  • Reject email messages that contain attachments with software scripts, executable files, or zip files containing scripts (such as .vbs or .js) or executables.
  • Call a trusted contact number for the payee to verify before authorizing a change to electronic payment details when the payee requests the change in an email message. Report suspicious email messages to the payee immediately.
  • Require two-factor authentication for remote access to work-related applications, including web based email. This is like having two locks with different keys.
  • Train your employees and users to recognize their login pages and to be suspicious when they’re asked to login to a system or page that they do not recognize.

RSVP Today! 2021 Small Group Carrier Update Webinars

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Join us for these brief, informative sessions focused on small group to get up-to-speed on 2021 plans, what to expect with renewals, and more!

Unable to make a session? No problem! We are recording sessions for our agents who aren’t able to attend. Please contact your Cornerstone representative for a link to the recording and materials.

*Sessions are for active Cornerstone Employee Benefit agents.

Webinar Schedule:

Day 1: Monday September 14, 2020

9:00 am–10:00 am — Aetna, hosted by Nelson Culp

  • Scott Bredmour from Aetna will cover their 2 to 100 eligible level-funded product (Aetna Funding Advantage). With Aetna now a CVS company, Scott will go through how all members can get a COVID-19 test through one of their CVS locations without a doctors note and no cost to the member, as well as how you can book an appointment online.

10:00 am–11:00 am — Humana, hosted by Shelly Brownell

  • Humana’s Leslie Isler will cover dental and vision, a level-funded premium overview, On Hand, a reminder about EAP, and Go365 updates.

Register for the September 14 webinars

Day 2: Monday September 21, 2020

9:00 am–10:00 am — Anthem and Anthem SOCA, hosted by Shelly Brownell

  • Please join the Anthem sales team as they cover new products and networks for 2021, technology enhancements for members, and more for small group 2 to 50 and key accounts 51 to 99.

Register for the September 21 webinar

Day 3: Monday September 28, 2020

9:00 am–10:00 am — MMO and MMO COSE, hosted by Kim Kinnaird

  • MMO will present updates on all their plans for January 2021 including ACA, Grandmothered/Grandfathered, the COSE MEWA, and ancillary. They’ll also cover what to expect with upcoming renewals and new options for wellness.

10:00 am–11:00 am — UnitedHealthcare, hosted by Jeff Lewis

  • Get up to speed for fourth quarter with UnitedHealthcare. UHC will discuss January 1, 2021, readiness for small businesses (2–50).

Register for the September 28 webinars

Anthem Updates: New Producer Toolbox Dashboards, Live Chat, and More

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Live Chat and New Producer Toolbox Dashboards

Anthem’s new Producer Toolbox dashboards give you a window to your business and quick, easy access to the tools and information you use most often:

  • Frequent Tasks: Use a button to Start a New Quote, Start an Application, or View All Clients.
  • Recent Activity: Check the status of your recent quotes and applications, and upcoming renewals.
  • Commissions: View your last 3 months of commissions and access a full report.
  • Billing Summary: See the status of your clients’ invoices.
  • Last Viewed Clients: Return to clients you’ve recently viewed.
  • Popular Documents: Access all resources and forms quickly and generate reports here.
    Coming soon: Pin your favorite documents and reports.
New Producer Assistant live chat
Producer Assistant now connects you to a live representative from Broker Services or User Software Support to give you the answers you need right away, including assistance with billing inquiries.

Click here to learn more.

Anthem Joins XPRIZE to Foster COVID Testing Innovation

The Anthem Foundation and Anthem, Inc., are Founding Anchor Partners of the $5 million XPRIZE Rapid COVID Testing competition.

XPRIZE, OpenCovidScreen, and a coalition of partners are calling on the global community to develop frequent, affordable, and easy-to-use screening tests with fast results to catch COVID-19 occurrences before they become outbreaks. Affordable testing and rapid results are designed to enhance access to testing and support better, data-driven contact tracing and isolating strategies.

Click here to learn more.

New EmployerAccess Mobile App Now Available

Anthem’s new EmployerAccess mobile app has added features to make managing group plans easier. If you’re designated as the group administrator for your clients, you will be able to manage your groups from anywhere. You can make payments, find member benefit information, and view/share ID cards. The virtual Employer Assistant will help you navigate the app and find the information you need, including the latest Anthem news and notifications.

Click here to learn more.

Anthem Will Issue MLR Rebates in August

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In an effort to ease the financial burden of the COVID-19 pandemic, Anthem will fast-track the annual medical loss ratio (MLR) rebates that groups and individual members typically receive in late September to August.

The medical loss ratio provision of the Affordable Care Act (ACA) encourages health plans to spend most of the premium dollars they collect on health care costs rather than overhead. It’s a ratio of insurance claims costs to insurance premiums, and is expressed as a percentage.

In the fully insured small group and individual markets, the MLR provision requires plans to spend at least 80 percent of premium income on health care claims and quality improvement. In the fully insured large group market, it requires at least 85 percent. In markets where Anthem doesn’t meet the minimum ratio, they are required to issue rebates to employer groups and individual members. ASO plans and stop-loss insurance are excluded from the rebates.

Anthem groups and individuals in 8 states will receive rebates this year.

Anthem will send rebate checks to employer groups and individual members along with a federally mandated notice that explains MLR and how it is calculated. They are also mandated to notify employees of the groups that receive rebate checks.

ACA rules require that employers either distribute the rebate among their employees covered by the rebated plan or use it to lower premiums in the next plan year. Rebate distributions must be made within three months of the policyholder’s receipt of the rebate. Group plans that are subject to Employee Retirement Income Security Act (ERISA) laws may also use the rebate funds to pay current plan premiums.

View this FAQ for more details on the rebates.

Contact your Cornerstone representative with any questions.

Sell More and Earn More with the Anthem New Business Bonus

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Sell more, earn more!

New Southern Ohio Chamber Alliance Benefit Plan and ACA groups sold with effective dates between August 1, 2020, and December 31, 2020, are eligible. Earn even more if you sell a line of specialty along with the medical.

SOCA Benefit Plan/ACA New Business Bonus

Tier

Contracts Sold

Payout Rate Per Contract

1

Under 50

$25

2

50–124

$100

3

125–199

$125

4

200–399

$150

5

400+

$175

Sell a line of Specialty along with the medical and earn even more!

10 percent multiplier if 25 percent of new groups include a line of specialty

20 percent multiplier if 40 percent of new groups include a line of specialty

Here are the program details:

  • Group needs to still be active with Anthem as of February 1, 2021
  • Agent of record changes do not qualify for the bonus payout Existing Anthem clients that transfer to the SOCA Benefit Plan or an ACA plan are not eligible for the bonus program
  • New contracts on existing groups are not eligible for the bonus program
  • Payout will be a one-time payment targeted for March/April 2021
  • Bonuses will be paid based on current Anthem commission and licensing contracts
  • Incentive payments will be disclosed and reported where required by applicable law
  • Anthem reserves the right to adjust future bonus amounts if groups are termed retroactively after the period’s bonus program calculations and payments have been made
  • Bonus payments are based on enrolled contracts as of the original effective month.

Anthem SOCA BP 2019 Summary Annual Reports are Available

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The 2019 Summary Annual Reports (SARs) for participating employers in the Anthem SOCA BP are available for download in the group’s Manage Documents folder.

The Summary Annual Report is a summary of the group’s plan information for the plan year for employers enrolled in the Anthem SOCA BP between May 1, 2018, and April 30, 2019. If a group was not enrolled in the plan during this time, they will not receive a report. Additionally, churches and government entities enrolled in the Anthem SOCA BP will also not receive a report, as they are not subject to ERISA and exempt from SARs reporting.

To access the SARs report, the group’s 8-digit Anthem group number is required. For example, the 8-digit group number should be entered as: 00123456 when prompted.

The SARs reports are for informational purposes only, there is no action required by the broker or group.

Contact your Cornerstone representative with any questions.

Anthem MEWA Groups Will Receive Premium-Equivalent Credits

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As a response to the challenges presented by COVID-19, Anthem will provide premium-equivalent credits the MEWA benefit plan sponsor groups based on April 2020 medical invoices. If groups also have dental Fully Insured coverage with Anthem, they will receive a premium credit on that as well.

The groups will either see the credit on their August 2020 invoice (issued in July 2020) or receive a check for:

  • 10% of the April premium-equivalent for medical plans
  • 50% of the April premium bill for dental plans (if applicable)

Anthem is working to avoid negative impact to broker commissions.

MEWA sponsors issuing the credits include:

  • Southern Ohio Chamber Alliance (SOCA) Benefit Plan
  • Missouri Chamber Benefit Plan
  • Georgia Chamber SMART Plans and Georgia FARM Plans
  • ChamberAdvantage (Kentucky)
  • ChamberCare Health Alliance (Indiana)

WEBINAR: Learn About Anthem’s SmartShopper Cost of Care Tool

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Anthem is expanding its offering of SmartShopper to all Ohio fully insured groups and will be offering to ASO clients starting July 1, 2020.

SmartShopper is a cost of care tool your clients can share with their employees to support their health and economic security. SmartShopper empowers members to save money and earn a reward by giving them full transparency into alternative, high-value, low-cost facilities for a number of established services.

You may have received an email related to SmartShopper webinars in May, which we unfortunately had to reschedule. The good news is that we have two upcoming webinars to review how SmartShopper works and how you can promote and sell the product. We will list the care services included, the member incentives and explain where and how members can self-serve.

Register for one of the two webinars below to learn more on how to leverage this great product.

Tuesday, June, 16th 10:00-11:00am ET

Thursday, June, 18th 12:00-1:00pm ET

Upon registering, you will receive an email with information about logging in to the webinar online or listening by phone.

Contact your Cornerstone representative with any questions.

SOCA Benefit Plan and MEWA.io Walkthrough Video

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You may have recently received a series of messages from MEWA.io, a digital MEWA management system, highlighting Anthem’s SOCA BP Medicare and Cobra administration. MEWA.io will help to simplify the administration processes and maintain compliance to ERISA.

This system will manage the Medicare Small Employer Exception process with CMS for groups under 20 with members turning 65 years old. It will also streamline confirming required information with the employer on a recently termed employee prior to sending a COBRA or state continuation notice. These were both functions that were previously happening behind the scenes.

With MEWA.io, groups are getting a new, more efficient experience! Below is a link to a quick video from Anthem, which gives you an inside look into the new system. Cornerstone has highlighted some of the new features below.

MEWA.io will be launching June 8, 2020, for Anthem SOCA BP groups.

MEWA.io is designed to simplify administration, maintain compliance with ERISA, and keep plan costs down—all at no cost to the group.

Coordination of Coverage

  • When a plan participant terms coverage, an email is generated to the employer to verify the information on file, which can be verified with single click.
  • If changes need to be made, they can click on a link and make the changes right there if needed. In the case of multiple term records for a month, they can do this all at once. Once complete, MEWA.io will send continuation information to plan participant.

Medicare Eligible Employees

  • By default, Medicare is secondary.
  • If your group is fewer than 20, your group can use the exception request.
  • io will notify employers via email when a member becomes eligible.
  • Employers complete the forms and sign digitally. Plan administrators will confirm, countersign, and submit to CMS.

Document Center

  • Anytime an employer signs a form using MEWA.io, and the document will be stored in document center.
  • Other documents to be stored will include the MEWA agreement, MEWA information, SPD, etc.

Click here to access the walk through: https://mewa.io/soca/employer-walkthrough-email/#video

Contact your Cornerstone representative with any questions.

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