Medical Mutual Update: Six-Month COBRA Subsidy Period Effective April 1, 2021

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The American Rescue Plan Act (ARPA) of 2021 was signed into law by President Biden on March 11, 2021. ARPA introduces a COBRA subsidy period from April 1, 2021, to September 30, 2021, which provides full COBRA premium payments for eligible individuals.

For Medical Mutual groups, COBRA Options is allowing groups to flag members that will be eligible for the subsidy. Once groups have flagged their subsidy-eligible members and the Department of Labor model notice has been released, letters will be mailed to those members. For MHS groups, the MHS COBRA vendor TRAVISOFT is updating its system to allow the MHS COBRA team to run reports of individuals who are eligible for the subsidy to supply to groups for confirmation.

COBRA Options and the MHS COBRA team will continue to collect the standard 2 percent administrative fee from groups. Tax credits should be taken for the full premium amount (including the administrative fee). Members should keep paying their COBRA premium as scheduled and will receive a refund or premium credit.

Medical Mutual does not administer State Continuation.

Contact your Cornerstone representative with any questions.

Good News From Medical Mutual! Increase in New Sale Commission for COSE MEWA Groups

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Medical Mutual of Ohio has recently announced an increase to the health commission rates on COSE MEWA accounts with effective dates of April 1, 2021, through June 1, 2021.

The new sale commissions are as follows:

Account Size

New Sale Commission Rate

2 to 9

$35 per employee per month

10 to 50

$60 per employee per month

An Amendment to the Ohio Standard Commission Schedule for Health and Life Accounts (Schedule A) has been emailed or mailed to independent brokers and agency principals.

Note: These rates will revert to the normal broker fee schedule after 12 months.

Contact your Cornerstone representative with any questions.

Not appointed with MMO? Contact us today to get started!

Medical Mutual Invoice and Group Number Updates

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Medical Mutual recently released the following updates…

Clarification on Invoices for Small Group ACA Dental Coverage

Small Group ACA medical plans now include pediatric dental coverage for dependents and employees up to age 19. On their invoices, groups may see a member’s dental coverage marked twice under COVERAGE TYPE (see sample). This does not indicate any additional charges. Rather, the coverage is marked twice because the members have both traditional dental benefits and the pediatric dental benefit included in their medical section.

There is no additional charge for the pediatric dental.

New Group Numbers Will Soon Transition to Alpha-Numeric Format

Because Medical Mutual will soon run out of six-digit group numbers to assign to new groups, they will update their Corporate Membership System (CMS) to include alphabetic characters. They are now able to use any letter (except B, D, I, L, O, S, T and Z) as the first character of a new group number (e.g., A12345).

The Information Technology and Membership departments have worked to make sure internal systems and external vendors can work with their new alpha-numeric group number format. As there are still some numeric-only group number combinations available, the new methodology will be introduced gradually to ensure all aspects work as expected.

No existing group numbers are changing.

Medical Mutual Including Premium Credit Clarifications with December Invoices for Some Groups

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As a follow up to the premium credits issued to small groups over the past two weeks, two clarifications are being sent with December invoices.

The first clarification is for groups that are enrolled through the ACA and are tobacco rated. Because of invoicing system limitations, the original set of December invoices sent to 1,450 groups does not show the credit applied to the premium amounts listed. Medical Mutual is sending a revised December invoice with the 30 percent credit shown as being applied to the groups’ previous balances. This letter explaining the situation will be included with the new invoices.

The second clarification is for groups that added a line of business to their Medical Mutual coverage on or after June 1, 2020. The premium credits apply only to those Medical Mutual lines of business with which a group was active prior to June 1, 2020. Any line of business a group may have added June 1, 2020, or later is not eligible for the premium credit. This letter is being included with the December invoices to explain the situation. There are 84 groups that fall into this category. Invoices for a portion of these groups were generated with the clarification noted, so a letter will NOT need to be included.

Contact your Cornerstone representative with any questions.

Medical Mutual Issuing Premium Credits to Small Group Fully Insured Clients

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In an effort to provide direct financial relief, Medical Mutual is issuing a premium credit to Small Group fully insured (off exchange, Grandfathered, Grandmothered) customers. The credit reduces the groups’ applicable December medical, dental and/or vision premiums by 30 percent.

Contact your Cornerstone representative with any questions.

September Updates From Medical Mutual

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Changes to ReportLink Login: Users Must Change Their Password

ReportLink is a tool that provides groups and brokers with access to reports and group invoices to perform administrative functions and analysis. ReportLink is accessed through an internet URL address. Medical Mutual is making changes to the login authentication for ReportLink beginning in early September. Users will be required to change their passwords when they log in to the site.

Security Compliance Best Practices and Pilot Review Program

Medical Mutual is committed to making sure our clients’ information is secure. With an increasing number and sophistication of data breaches, cybersecurity awareness is more important today than it has ever been.

With that in mind, they have developed a Security Compliance Best Practices checklist to help you understand what they consider industry standard best practices. Please take some time to review this important information. The document will be posted on MyBrokerLink under the Knowledge Center.

Responding to Concerns About Potential Delays in Medication Deliveries Made by the U.S. Postal Service

With concerns about delays of U.S. Postal Service (USPS) deliveries in the news and on social media, Express Scripts (ESI) wants to assure groups and members that it is not experiencing significant disruptions in USPS performance at this time.

Pharmacies to be Removed from National Plus Network and Sam’s Club to be Removed from All Networks Effective Oct. 1, 2020

Medical Mutual’s pharmacy department regularly reviews network pharmacies to ensure their members are provided the best quality, price, and service when receiving their prescription medications. In order to continue offering the most competitive pricing, Express Scripts is narrowing their networks by eliminating chain pharmacies with little presence within particular regions. As result, effective October 1, 2020, the following pharmacies will be removed from MMO’s ESI National Plus pharmacy networks:

  • Ahold
  • Albertson’s
  • Safeway
  • Epic (outside Ohio)
  • Sam’s Club

New Requirements to Duplicate EOB Claims Feed Administration

Medical Mutual has new requirements for new groups requesting a duplicate EOB claims feed and existing groups receiving a duplicate EOB claims feed. The new requirements ensure groups are correctly priced and that Medical Mutual has the appropriate contracts in place.

Contact your Cornerstone representative with any questions about these updates.

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

Important ACA Updates From Medical Mutual

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Below is a selection of important product updates, coverage changes, and business tips from Medical Mutual:

  • Medical Mutual’s off-exchange application now includes Individual Coverage Health Reimbursement Arrangement (ICHRA) as a Special Enrollment Period (SEP). If you have a group offering an ICHRA or a new employee enrolling in an ICHRA, he or she can select this new SEP. Members can submit this ICHRA form for proof of SEP. They can also submit proof of hire and ICHRA eligibility as SEP documentation. Please refer to the SEP grid for additional SEPs and documentation requirements.
  • Medical Mutual has extended the timeframe during which cost sharing for all treatments related to COVID-19 will be waived through July 24, 2020. Treatments include hospitalizations and ground ambulance transfers for individuals with a positive COVID-19 diagnosis.
  • Members losing Medical Mutual group coverage due to COVID-19 can consider an individual ACA health plan or Medical Mutual short-term plan. Medical Mutual will allow a deductible credit toward a new Medical Mutual individual plan and may be able to help expedite the new plan’s effective date to help eliminate or minimize gaps in coverage for members.
  • As a reminder, the grace period for non-subsidized individual business has been temporarily extended to 60 days.

Contact your Cornerstone representative with any questions.

Network and Program Updates From Medical Mutual

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Medical Mutual recently announced that, effective July 1, 2020, Walmart and Sam’s Club will join VSP’s Choice network as retail providers. Also on July 1, groups and members who don’t currently have retail (i.e. COSE groups) and all new business will have access to retail providers as in-network options, including VisionWorks, Costco, Walmart, Sam’s Club, and Pearle Vision locations nationwide. This applies to individual, small group, 51 to 99, 100+, and MEWA clients.

In addition, Medical Mutual announced that, effective June 2020, and continuing through early fourth quarter of 2020, they are going to transition a majority of the approximately 9,750 members currently engaged in Optum’s telephonic Disease Management program to one of the following programs, depending n the member’s needs:

  • Digital health coaching through Lark Health
  • Automated self-monitoring and survey programs through Emmi Solutions
  • Medical Mutual CQHS telephonic chronic condition management
  • Medical Mutual CQHS complex case management
  • More advanced home monitoring through our regional health system partners

These changes apply to any group that is currently enrolled in our Chronic Condition Management program.

Contact your Cornerstone representative with any questions.

Information About the Medical Mutual Employee Care Card

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Medical Mutual recently announced their new Employee Care Card (ECC), which allows employers to provide tax-advantaged financial assistance to employees during the COVID-19 pandemic. Please note that this solution will only be available while there is an active federal disaster declaration which triggers IRS Section 139.

The ECC is a pre-paid debit Mastercard that employers can use to provide tax-advantaged funds to their employees for “reasonable and necessary” expenses incurred as a result of the negative economic impact caused by the pandemic.

Click here to learn more.

Contact your Cornerstone representative with any questions.

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