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.

Medical Mutual Extends Transitional ACA Policies Through 2021

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Following the Ohio Department of Insurance’s memo extending transitional policies through 2021, Medical Mutual will allow their transitional individual and small group business to renew their non-ACA-compliant coverage through the 2021 plan year.

Grandmothered individuals and groups will not be mapped to ACA-compliant plans effective January 1, 2021, as previously planned. Instead, all qualifying transitional plans will be able to keep their current plans at least through their next renewal. Depending on the renewal date, certain policies may be extended until later in the year.

Contact your Cornerstone representative with any questions.

Medical Mutual’s SuperDental Network Expands Provider Options

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Effective January 1, 2020, Medical Mutual will combine Superior Dental Care’s dental network with their DenteMax network to create the SuperDental Network, which will provide dental members with nearly 1,600 more dental providers than the current network. This network will give members access to more than 4,000 dentists, orthodontists, periodontists, and other dental professionals.

Members can view the expanded selection of participating SuperDental dentists and specialists in their area by visiting ProviderSearch.MedMutual.com.

October Medical Mutual Updates: Changing Payments, Deadlines, and Individual Market Updates

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Updating Medical Mutual Payments to Huntington Bank

Medical Mutual recently switched from PNC Bank to Huntington Bank for processing of premium and ASO-related payments. Group customers should now send payments to Huntington. Reminder letters will be sent to all affected groups ahead of shutting down the PNC Bank accounts prior to the end of the year.

COSE MEWA Columbus Territory Change

Effective November 1, 2019, the exclusive territory for the Columbus Chamber MEWA plan will expand beyond Franklin County and will include Union, Delaware and Licking counties. Any new group sold in those counties must be a member of the Columbus Chamber in order to enroll in the COSE MEWA health plan.

Two-Year Moratorium on Re-Entry to the COSE MEWA

Small groups choosing to leave the COSE MEWA and obtain other coverage will not be able to return to the COSE MEWA for two years. If a group wishes to return to the COSE MEWA before two years have elapsed, they will be charged a one-time fee of $1,000 per subscriber.

Pre-Submission Checklists

To help with submissions during the busy season, please complete your pre-submission checklist and send it in with your sold case documentation. Any submissions that are made after December 5, 2019, may not receive approval letters prior to the January 1, 2020, start date.

Health Insurance Tax

The federal government has not suspended the Health Insurance Tax for 2020, as they did in 2019. That means Medical Mutual will need to pass this tax along to their customers.

Medical Mutual Individual Market Updates

Medical Mutual will be offering ACA coverage in 12 new counties during plan year 2020. Click here to review the updated service area map. They have also added new $5,000 silver and $8,000 bronze deductible options that include office visit and Rx copays. Click here for the 2020 Plan Highlights flier for full details.

In addition, Medical Mutual has added statewide convenience walk-in clinics across Ohio and has expanded their Mercy HMO network with the addition of St. Luke’s hospital and more physicians.

Medical Mutual will discontinue the Promedica HMO network in Northwest Ohio. All members of that network will be moved to the Mercy HMO network.

Lastly, Knox Community hospital will no longer be a part of the OhioHealth HMO in Central Ohio.

Don’t forget to re-certify by the end of 2019 to receive renewal compensation for on-exchange plans!

Federally Mandated Fee Updated for 2020 Renewals

Since the Affordable Care Act went into effect in 2014, Medical Mutual has been subject to the Health Insurance Providers Fee, often referred to as the Health Insurance Tax or the Market Share fee. As a result, Medical Mutual has applied the Health Insurance Providers fee to all 2020 renewals.

Contact your Cornerstone representative with any questions about these updates.

Medical Mutual’s 2020 Small Group ACA Plan Grids are Now Available

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Medical Mutual’s updated plan grids, benefit highlight sheets, and Summary of Benefits and Coverage (SBC) documents are now available for the 2020 Small Group ACA rollout.

Updates to these plans include:

  • The elimination of the 1750 HSA plan. Current 1750 HSA members will be mapped into the 2800 HSA plan.

The addition of two HRA plans below:

  • Gold 5000 HRA with employer first contribution.
  • Silver 5000 HRA with employer second contribution.

Additionally, quoting for first quarter 2020 is now available in QRS. January 2020 renewals will be released soon.

MedFlex HMO Plan Options

2020 ACA Plan Options (Off Exchange)

Contact your Cornerstone representative for more information.

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