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.

Indiana’s Anthem Enhanced Choice plan is a 36-month Limited Duration plan (not 12 months as is required in Ohio).  The implementation date will be on the second of the month instead of the first.  The law requires that such plans have a 364 initial plan year so the second day of the month was chosen to account for that.

This is a comprehensive underwritten plan, not a short-term plan. The difference is that the contract will last for three years. After the third year, the member will need to begin a new policy that will be underwritten again.

Click here for additional details.

Contact your Cornerstone representative with any questions.

Cornerstone recently hosted Anthem for a Group Corner webinar covering their SmartShopper Rewards Program, which pays the participant for using better priced providers as well as online tools to shop for the best price on prescriptions and medical services.

Below are a few items referenced during the training on Anthem’s SmartShopper program. SmartShopper is included on all fully insured product lines and all market sizes from Anthem including the Anthem SOCA MEWA. The program is available separately for ASO groups. SmartShopper provides members with an incentive to seek out high value, lower cost care from providers on a select group of services.

Below are information pieces you can use:

• SmartShopper Member Flyer
• SmartShopper Information
• SmartShopper Condition List

If you missed this valuable training or you’d like to see it again, please follow this link.

Contact your Cornerstone representative for more information.

Anthem Kentucky ChamberAdvantage Product Dues

Groups that renew their Anthem ChamberAdvantage plan on June 1, 2021, can expect to receive an invoice, from the Kentucky Chamber, for their product dues during the month of July. The product dues charged will be calculated at $4.00 per enrolled employee per month and the dues are based upon the number of employees participating in the plan as of the renewal date each year. The product dues are invoiced annually and must be paid in full within thirty (30) days of receiving the invoice. Should you have any questions, do not hesitate to contact your Cornerstone Broker Advisor.

ChamberAdvantage Bundling Discount Program

Anthem Kentucky ChamberAdvantage invites groups to discover savings on savings when adding dental, vision, life, and/or disability coverage alongside and Anthem ChamberAdvantage medical plan.  See the flyer below for the bundling discount available.  Should you have any questions, please do not hesitate to contact your Cornerstone Broker Advisor.

Click here to access the flyer.