EMPLOYER ACTION REQUIRED: Distribute Medicare Part D Notices by October 15

Group health plan sponsors must provide Medicare Part D “creditable coverage” notices prior to October 15, 2019, the start date of the Medicare annual enrollment period for Part D, Prescription Drug coverage (open enrollment runs from October 15 to December 7, 2019).

Most plan sponsors use the Model Medicare Part D Notices provided by the Centers for Medicare and Medicaid Services (CMS) to notify affected plan participants. Links to all the model letters (in English and Spanish) are available here in .pdf format. Cornerstone has provided versions of the notice in Word Document format for your convenience.

Creditable Coverage Notice

Non-Creditable Coverage Notice

The carriers plan listings and/or links to their creditable coverage site are available below:

Aetna: Please contact your Broker Advisor for more information.

Anthem: Click here.

Humana: Click here.

UnitedHealthcare: Click here.

Medical Mutual: COSE requested. All other plans, click here.

The October 15 deadline applies for all group health plan sponsors, regardless of plan year, plan size, employer size, grandfather status, or whether the plan is insured or self-funded.

Employers who send out Open Enrollment packets prior to October 15 often include the Medicare Part D notices in the Open Enrollment packets to avoid the extra cost and administrative burden of sending them separately.

Because these notices have not changed since 2018, employers who provided these notices earlier this year are not required to provide them again.

Employers are also required to notify CMS online annually that they have sent out these Part D notices. The notice to CMS is due within 60 days after the start of the plan year. See the last paragraph of this article for details.

When Is the Medicare Part D Notice Required?

Medicare Part D notices must be provided at least once annually, prior to October 15th, which is the beginning of the Part D annual enrollment period. Additional notices must be provided if the employer-provided coverage changes (from creditable to non-creditable, or vice-versa), if the individual requests a copy of the notice, and when an individual first enrolls in the employer plan.

Why is the Part D Notice Required?

The reason plan sponsors are required to provide Part D Notices is because a penalty will be imposed on an individual if he/she, after becoming eligible for Medicare Part D coverage, has a lapse of “creditable” prescription drug coverage for a period of at least 63 days. Additionally, such individuals may have to wait until the following October to join. An individual can elect either Medicare prescription drug coverage or other “creditable coverage” to avoid having a lapse in coverage. Thus, Medicare-eligible participants in employer group health plans must know whether or not the employer group coverage is “creditable” so they do not unwittingly incur a late enrollment penalty.

Additional Details on the Disclosure Requirements

  • Group health plan sponsors to whom this disclosure requirement applies include employers and Unions; multiple employer welfare arrangements (MEWAs); federal, state and local government employers; and churches.
  • The Part D Notice must be provided not only to Medicare-eligible active working employees and their dependents, but also to participants who are retired, on COBRA, or disabled and covered under the employer’s prescription drug plan.
  • Although the requirement is only that “Medicare-eligible” individuals be provided this notice, employers often provide it to all plan participants and dependents, because of the practical difficulty of knowing who is Medicare-eligible.

Annual Notice to CMS Also required, though not by October 15th

Additionally, plan sponsors are required to notify CMS annually, via the CMS website (Online Disclosure to CMS form). This notice must be made within 60 days after the beginning of the plan year (or contract renewal date, for small plans that do not file Form 5500s so do not specify a plan year), and it pertains to the creditable coverage status for the prior plan year. For calendar year plans, this notice must be provided to CMS no later than March 1.  Sponsors of non-calendar year plans should mark their calendars to make sure the disclosure to CMS is made within 60 days after the beginning of the plan year. (E.g., for an April 1 plan year, the CMS online disclosure should be made no later than May 30.)

Additionally, if applicable, plan sponsors must complete the Online Disclosure to CMS Form within 30 days after termination of a prescription drug plan or within 30 days after any change in creditable coverage status.

For additional information, click here for the main CMS webpage that provides guidance on “creditable coverage.” Or you can visit the web page at https://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/

ATTENTION: ACA FFM Certification Reminder

Agents with active on-exchange plans who want to receive renewal compensation must re-certify by the end of 2019. In addition, agents offering on-exchange coverage must certify prior to selling any plans during the 2020 open enrollment period.

Follow these steps to certify:

  1. Go to the CMS Enterprise Portal and log in
  2. Update your information on your Marketplace Learning Management System (MLMS) agent/broker profile
  3. Complete the Marketplace training requirement.
  4. Read and accept the applicable Marketplace Agreement(s)
  5. Print your 2020 Registration Completion Certificate
  6. Confirm your registration by using the Registration Completion List
  7. Please forward a copy of the registration completion certificate to Geoff Beglen at Cornerstone

Questions? Contact individual expert Geoff Beglen.

Signed Application Requirements for the Fourth Quarter

Effective Date and Application Requirements for December 1 and January 1 effective dates for Small Group.

Below is a list of carriers that will allow applications to be submitted for underwritten rates within 90 and 120 days of the effective date. Contact your Cornerstone Broker Advisor for additional information.

CARRIER

90 OR 120 DAYS

AETNA FUNDING ADVANTAGE 120 days (1/1/19 effective dates only)
ANTHEM SOCA 120 days from the date the applications are signed or 90 days from the date the employer’s paperwork is submitted.
ANTHEM CHAMBER ADVANTAGE 90 days
ANTHEM CHAMBERCARE HEALTH ALLIANCE 90 days
ALLSAVERS 120 days (12/1/19 & 1/1/19 effective dates)
UHC MEWA 120 days (12/1/19 & 1/1/19 effective dates)
HUMANA LF 90 days
MMO COSE MEWA 120 days (1/1/19 effective dates)

UnitedHealthcare Ohio Chamber MEWA Plans and Forms

We are excited to announce that the Ohio Chamber MEWA with UHC is ready to go. We will begin quoting immediately for a 9/1 effective date. That’s right! If you have a group that completed FormFire applications and didn’t get their decision made in time, we can still get you the 9/1 effective date.

The Ohio Chamber offers affordable membership for your clients and is required at the time of sale only. Click the link at the end of this message to access the available plan designs and all the necessary enrollment information.

The highlights below give you the details and value added benefits that your client will receive with the Ohio Chamber MEWA.

OHIO CHAMBER OF COMMERCE MEWA

  • Available for employer groups with an ATNE of 2–50
  • 15 Plan Portfolio (below)
  • Full National Choice Plus Network
  • Common 1/1 Renewal Date
  • Extended contracts available for 9/1 to 12/1 – RENEWAL 1/1/2021!
  • Applications accepted for 120 days from signature for 10/1 through 1/1 effective dates
  • Ohio Chamber Membership Required (or discounted Affiliate Membership)
  • $30 PEPM Commission Structure
  • Full UHC Value Added Benefits, including:
    • Real Appeal
    • Motion on all HSAs
    • Employer eServices
    • UnitedHeatlhcare Mobile
    • MyHealthcareCostEstimator
    • Virtual Visits

AHP_EE_Enrollment_Form_OH_final_fillable
AHP_EE_Health_Addendum_OH_final_fillable
AHP_ER_Application_OH_final_fillable
All Savers Plan Sponsor Certification Form
OCC MEWA Quote Install Checklist
OCC MEWA Quote & Install Checklist
OCHBP_Broker_Aug_2019
OH CHBP_Payment Authorization form
Ohio Chamber MEWA Coversheet & Census
Ohio Chamber Plan Grid

Anthem Indiana Releases ChamberCare Health Alliance MEWA

Anthem Indiana has released the ChamberCare Health Alliance (CHA) MEWA solution. This MEWA was created through the partnership of Anthem and the Indiana state and Indanapolis Chambers of Commerce. This is an underwritten solution for employers with 2 to 50 total employees, where your small group clients will gain access to coverage generally only available to large groups. The product’s initial effective date will be October 1, 2019. All groups will have a common renewal date of October 1.

Below, you will find the CHA Product Guide, CHA flyer, FAQ, employer medical questionnaire, employee medical questionnaire, and additional chamber information for review.

Quoting

Quoting for CHA begins on August 19, 2019! You may request preliminary quotes using one of three risk levels: low, medium, or high risk. For an underwritten quote, medical questionnaires may be required, as well as the Employer Medical questionnaire. Please send your quote requests to your Cornerstone quoting team at the corresponding office below:

Membership Information

To quote CHA, the broker and the group does not need to be a member of a chamber.

However, employers interested in the Anthem CHA must be a member of the Indiana Chamber of Commerce and/or the Indianapolis Chamber of Commerce. The employer will be required to join the respective chamber based upon the county in which the employer is domiciled prior to submitting for installation and enrollment.

In order for brokers and their agencies to sell CHA, you must have an active Indiana state and/or Indianapolis  Chamber of Commerce membership.

The Indianapolis Chamber of Commerce is offering a silver membership at NO Charge to brokers at this time that are selling CHA.

Please contact your Cornerstone Broker Advisor for more information on this product.

MEWA ChamberCare Health Alliance Map

CHA MEWA Employee Medical Questionnaire

CHA MEWA Employer Medical Questionnaire

ChamberCare Health Alliance (CHA) Product Guide

MEWA ChamberCare Health Alliance Flyer

MEWA ChamberCare Health Alliance FAQs

Cornerstone Invites You to Attend the Anthem Ohio Broker Roadshow Update Meeting

Please join us for the Anthem Ohio 2020 Small Group and Key Account product update meeting with Robyn Caupp and Taylor Grant of Anthem.

DATE: September 18, 2019

TIME: 9:00 am–11:00 am

LOCATION: Cornerstone Cincinnati Office

2101 Florence Avenue | Cincinnati, OH 45206

Click here to RSVP.

Reserve Your Place Today: 2020 Small Group Carrier Updates via Webinar

Join us for these brief, informative sessions focused on small group to get up to speed on 2020 plans, what to expect with renewals, and more!

Not able 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.


UnitedHealthcare Updates

September 16, 2019

9:00 am–10:30 am

UnitedHealthcare will review renewals and what to expect, changes to ACA plans, their enhancements to Ancillary products and package deals. The final hour will review All Savers (level-funding) and the NEW Ohio Chamber MEWA available for 10.1.2019 effective dates*.

*pending state approval of rates

Click here to register for UHC updates.

September 4 (In-person UHC Ohio Chamber MEWA meeting)

UHC is hosting a training on this date in Toledo. Click below for details and to register. You can choose to attend this in person session or join us via webinar on September 16.

Click here to register for UHC Chamber Plan training.


AFA and Humana Ancillary Updates

September 23, 2019

9:00 am–10:30 am

AFA, the Aetna Funding Advantage, is Aetna’s level-funded solution for groups of 2-99. Yes! AFA will now be available for groups of TWO or more. Join us for an overview of AFA, 2020 plan changes, what to expect with renewals, how their blocks are running, and a discussion on what the proposed merger between CVS and Aetna mean for the insurance business.

10:00 am–10:30 am

Humana will present updates on their ancillary products: Dental, Vision, and Life. Humana has taken the lead on their dental plans, unique in Ohio, with unlimited reimbursement of expenses beyond the annual limit as well as higher annual maxes.

Click here to register for AFA/Humana updates.


Anthem Updates

September 30

9:00 am–10:00 am

Anthem will present what to expect with renewals, updates on ACA, their grandmothered block and the Anthem SOCA MEWA. They will also have folks from their ancillary side discuss enhancements to those lines and package deals available.

Click here to register for Anthem updates.

IMPORTANT: FormFire Price Increase

Effective with September usage, the price per employee account is now $2.40. The monthly fee of $99.00 will remain the same for full agent access. The pricing for SOCA sub-agents, restricted to the Anthem SOCA Benefit Plan, will also increase to $2.40. This means that the new pricing will be reflected in your October billing statement for the September employee record counts.  Now is a great time to go in and clean up or delete employee accounts that are no longer active.  Below, you will find instructions on how to delete Groups and Individual Employees (DALs) from your account.

FormFire

FormFire has been a key platform as you know for the MEWA plans and for the collection of medical health questionnaires used by the majority of the small group and 51-99 medically underwritten products. With the continued MEWA development in OH, KY, and IN, FormFire will continue to be a primary player for Cornerstone brokers.

Cornerstone’s partnership with FormFire allows us to provide you with the technology you need to sell more and increase productivity at a substantial savings compared to the market and FormFire’s direct pricing.

Please contact your Broker Sales Representative with any questions.


To Clean up by Group:

If you have a group that you want to delete, and you want the employees deleted as well, all you have to do is delete the group and it will free up the DALs.

It’s actually better to do it that way because the employees stay assigned to the group, which makes it easier down the road if the group gets reinstated to FormFire.

You can delete the group by selecting the Orange ClipBoard next to the client to open the activity menu, then select Delete Client at the bottom of the category listing.

To Clean up by Employee (or individual DAL):
To remove an employee record (dormant, etc.) to avoid the $2.40 charge, follow the steps below:

Steps:

  1. Highlight group and select “View Employee List” from the left navigation pane
  2. Highlight employee that want to delete and select “Administer User” from the left navigation pane
  3. Of the two available options in the left navigation bar, choose Delete Employee”

NEW Medical Option Coming: UnitedHealthcare Introduces the Ohio Chamber MEWA Plan

UnitedHealthcare (UHC) has received approval for a new MEWA offering in Ohio this week in conjunction with the Ohio Chamber of Commerce. Rates have not been approved by the state so quotes are not yet available, but it is expected to be available starting with October 1 effective dates.

Cornerstone will be offering a webinar to learn more about the MEWA on September 16 along with other 2020 updates from UHC.

Click here to view the plan grid.

Don’t Miss Out on the Cornerstone/Anthem 2020 Broker Roadshow!

Don’t miss out on the Cornerstone/Anthem 2020 Broker Roadshow!

Join Cornerstone and Anthem to review updates in individual, small group, and key accounts in Dayton.

DATE: September 20, 2019

TIME: 9:00 am–11:00 am

LOCATION: Yankee Trace

10000 Yankee St. | Centerville, OH | 45458

Click here to RSVP.