ARP COBRA rules require SGs with less than 20 employees to take action
The American Rescue Plan (ARP) provides premium subsidies to qualifying individuals with federal COBRA coverage and state health continuation coverage. The legislation provides a 100 percent subsidy of premiums from April 1 through September 30, 2021. Small group employees who have lost coverage due to involuntary termination or reduced hours qualify if they have COBRA coverage or a qualifying enrollment event during the subsidy period, these individuals are referred to as Assistance Eligible Individuals (AEIs).
What action is required of Employers?
By May 31, 2021, and for each month during the eligible period, small group employers in all markets (except CA, IN, KY, NH, and NV) must notify eligible individuals that subsidies are available. IN and NV small group employers are excluded from this requirement and will not receive any communication and no action is necessary for those employers or sales teams. Please see FAQ and webinar deck to address questions you may have on this.
Important Cost Share Waiver Update
Anthem has made the decision to extend cost share waivers for audio-only, in-network provider telephone-only visits for fully-insured, individual, Medicare, and Medicaid plans through July 31, 2021.
Broker Service Team Anthem Account Inquiries update:
Effective immediately, when reaching out to your customer service representative, the below information is required with every inquiry. These items are required as part of the HIPAA Verification Process. Please provide the following:
- Group Name
- Group #
- Member Name
- Member ID # or SSN
- Member Date of Birth
If specific claims need to be reviewed, please also provide:
- Date of Service(s)
- Name of Provider
- Total Charge
If the above information is not provided, your email will be returned thus causing delays in service and resolution.
SOCA Employer Access
The EmployerAccess Administration Guide has been discontinued. In lieu of that, employers are directed to use the interactive chat bot and/or FAQs available in EmployerAccess. To alert MEWA employers to these resources, here is an updated EmployerAccess Registration flyer you can provide to your groups to show that these tools are available.
October 2021 Formulary Changes:
There are upcoming changes to the formulary effective October, 1 2021. Additionally as a reminder, Anthem’s drug list changes are available on their public site under “see our latest drug list changes”. For your convenience, here is a list of the changes.