Medical Mutual recently announced an increase to the health commission rates on new COSE MEWA accounts with an effective date of January 1, 2022.

The new sale commissions are as follows:

Please note:

• This new sale commission amount is payable for the first 12 months and will revert to standard Schedule A renewal commission after these 12 months are complete
• Sole Proprietors are not eligible for the increased commission and remains at $25.00 PEPM.
• Existing Medical Mutual groups that transfer to a COSE MEWA plan from grandmothered/grandfathered plans, another MEWA or an ACA plan are not

These new sale commission rates will be included in the Ohio Standard Commission Schedule for Health and Life Accounts (Schedule A) which will be released prior to December 1, 2021.

Contact your Cornerstone representative with any questions.

The COVID-19 State of Emergency in Ohio has ended. As a result, Medical Mutual is ending the extended grace period for premium payments. Customers who are currently taking advantage of the extended grace period must bring their account up to date by October 1, 2021, to avoid an interruption in coverage.

Contact your Cornerstone representative for more information.

As a reminder, Senate Bill 9 requires health plan issuers to release certain claims data to fully insured groups and non-federal government plans with 50 or more full-time covered/enrolled employees.

Below is the required Group Data Reporting Form that must be completed and submitted by the group to initiate the request for the report. Also below are the instructions for how to complete the form correctly.

When reporting requests are received, Medical Mutual Account Executives will be required to meet with the appropriate group official to deliver the report. At the group’s request, these meetings will be coordinated with the appointed broker.

How to Complete Your Request for Group Data Reporting

Request for Group Data Reporting Form

Please reach out to your Cornerstone Broker Advisor for additional details and questions.

Medical Mutual Pharmacy Updates Effective July 1, 2021

Applies to all segments with the exception of Medicare Advantage and Medicare Supplement.

• National Preferred Formulary Updates: MMO is updating their National Preferred/National Preferred Plus formulary. About 30 medications will be added to the exclusion list (attached).
  • Will effect less than .25 percent of members.
  • Any members who are currently taking these medications will receive a letter notifying them of these changes at least 60 days before they take effect.
  • These changes will immediately apply to new groups that enroll on or after July 1, 2021, and any members who begin taking these medications after July 1, 2021.
• No changes to the Basic/Basic Plus or High Performance Plus formularies at this time.
• Step Therapy Updates (apply to Basic Plus, National Preferred Plus, High Performance Plus formularies)
  • Effective July 1, 2021, the MMO step therapy programs will be updated. Any members impacted by new step therapy rules will receive a letter notifying them of the change at least 60 days before the rules take effect. As with any step therapy program, if there is a medical reason a plan-preferred first-line drug cannot be used, the provider can request a coverage review.

Click here to review the National Preferred Formulary Full Exclusion List

Click here to review the National Preferred Formulary Exclusion List Changes

Medical Mutual Life Renewals

• MedMutualLife completed a comprehensive review of the Council of Smaller Enterprises (COSE), Toledo Regional Chamber of Commerce (TRCC) and Richland Area Chamber of Commerce (RACC) benefit plans for the upcoming renewal effective July 1, 2021. As a result, current rates will be guaranteed for three additional years. This included an analysis of the incurred loss ratio, demographic information, and the overall benefit package.
• New sales or renewals with effective dates between July 1, 2021, and June 30, 2022
  • Effective July 1, 2021, participating employers with renewal dates prior to July 1, 2022, will receive a renewal letter within 60 days of their renewal date advising them their rates have been guaranteed for an additional three years.
  • Proposal exhibits prepared for participating employers with effective dates from July 1, 2021, through June 30, 2022, will include a three-year rate guarantee.
• New sales or renewals with effective dates between July 1, 2022, and June 30, 2024
  • Participating employers with renewal dates between July 1, 2022, and June 30, 2024,will receive a renewal letter within 60 days of their renewal date advising them their rates have been guaranteed for an additional two years.
  • Proposal exhibits prepared for participating employers with effective dates between July 1, 2022, and June 30, 2024,will include a two-year rate guarantee.

 Contact your Cornerstone representative with any questions.

Medical Mutual of Ohio recently announced that they are simplifying their substantiation administration process for flexible spending accounts (FSA) and health reimbursement arrangements (HRA). This applies to small group (2–50), 51+, 100+ groups.

There will be no impact to the group’s FSA and/or HRA administration pricing. Please see below for important information regarding these changes.

What is Changing

• Member transactions less than $100 will be auto substantiated and not require substantiation documentation.
• Any transaction, regardless of dollar amount, at known low-risk merchants (e.g. hospitals, doctors), will no longer require substantiation. Eligible merchants will be determined by Medical Mutual.

These changes are implemented with the intention of reducing the number of member substantiation receipt requests and ultimately reduce employer disruption.

Existing Groups with a Medical Mutual CDHP

In late April, Medical Mutual will mail groups an updated consumer-driven health product (CDHP) agreement, along with a postage-paid return envelope and instructions. The updated agreement will allow them to apply their new substantiation process. For existing groups with a signed agreement on file, the new substantiation rules will only be applied once the signed agreement is returned to Medical Mutual. Groups with no signed agreement on file will automatically be transitioned to the new substantiation process. It is important that all groups sign and return the updated agreement.

Important Notes

• The revised CDHP Agreements will be posted to MyBrokerLink with the revision date of 4/21 in the title.
• Always download the latest version of the agreements from MyBrokerLink.
• Members should still keep transaction receipts for tax/record-keeping purposes.

Contact your Cornerstone representative with any questions.