Anthem SOCA BP New Sold Case Requirements

Effective May 15, Anthem SOCA BP will require the Annual Rate and Census Reconciliation (ARC) form for new sold submissions to ensure that plans comply with reporting requirements. The Quarterly Wage and Tax Statement will no longer be required.

The revised Sold Case Checklist will include the following documents:

  • Participation Agreement
  • Benefit Rate Proposal
  • Association Membership/Proof
  • Electronic Funds Transfer (EFT) Banking Form
  • Voided Check
  • Business Acknowledgement Agreement
  • Annual Rate & Census Reconciliation Form

Click here to view the 2019 Anthem SOCA Benefit Plan Sold Case Checklist.

Contact your Cornerstone representative with any questions.

Which Social Security Programs Pay Disability Benefits?

Social Security Solutions, LLCThe Social Security Administration (SSA) administers two programs that pay disability benefits:

  1. Social Security Disability (SSD) and
  2. Supplemental Security Income Disability (SSI)

SSD is based on your earnings from a job or self-employment. SSI is a needs-based program with income and resource limits. Both programs use the same disability definition: You must have a physical or mental condition that is expected to last at least 12 months or end in death. Both programs have complicated rules and limits if you return to work.

Disability medical decisions are made by an agency of the state where you live, not Social Security. An adjudicator from this agency reviews your medical records and decides if you meet the SSA “disability” definition. Several factors are considered to decide if you are disabled: age, education, work experience, and the severity of the medical condition(s). Some conditions are automatic approvals, like ALS, some advanced cancers, or other terminal diseases. Other conditions, like heart conditions and stroke, require more time and information. If you are denied Social Security, you have appeal rights.

There is a five-month waiting period after your disability onset month before SSD benefits are paid. The benefit amount is based on your work record. It takes an average of four to five months to process a disability claim.

There is no waiting period for SSI and the maximum SSI benefit for 2019 is $771/month and depends on other income available to you. SSI is not payable if you have over $2000 in liquid resources (individual) or $3000 (couple). Many children with physical or mental impairments can receive SSI. A parent’s income is no longer considered for children over age 18 living with them.

For more information please contact me.

About Dennis Heywood

Denny’s career with Social Security provides an in-depth, working knowledge of the Social Security Administration’s internal organization and processes. An expert in all phases of SSA programs: retirement, survivor, disability, and Medicare, Denny has expertise with the complex Social Security regulations based on more than 40 years of experience.

ss-help.com

SAVE THE DATE: Cornerstone’s CE Program in NW Ohio

Cornerstone in NW Ohio is hosting a CE program for Cornerstone group agents on Wednesday, June 19, 2019, with 2 credit hours available at a location in Toledo and a location in Lima:

 

PLACE

Swan Creek Metro Park

Yager Center

4301 Airport Highway

Toledo, OH  43615

Cornerstone Office

1662 Breese Road, Suite G

Lima, OH  45806

TIME

9:00–11:00 am 1:30–3:30 pm

SUBJECT

9:00–10:00 am

Long-term Disability Products & Contracts

10:00–11:00 am

Voluntary Insurance Benefit Programs

1:30–2:30 pm

Long-term Disability Products & Contracts

2:30–3:30 pm

Voluntary Insurance Benefit Programs

RSVP

SHogan@crnstone.com SHogan@crnstone.com

IMPORTANT: FormFire Annual Rate and Census Reconciliation Form Due March 31

Today, many of you received the important notice of the census reconciliation process required for all SOCA BP clients. This reconciliation must be completed by March 31, 2019. It has come to our attention that there was a programming error with regard to the census reconciliation process where you are unable to submit the month and year properly.

Please take note of the following information, which contains the fix to the programming issue in line 8 of the census:

  • To fix the error, right-click on the blue cells in line 8.
  • Right-click and select “Format Cells”.
  • Select “General”.
  • Click “OK”.

You must do this for both the “Month” cell and “Year” cell.

Click here to view the release from FormFire regarding the census reconciliation.

CMS Extends Transitional Relief Until January 1, 2021

The Centers for Medicare & Medicaid Services (CMS) recently released a bulletin extending non-enforcement policies against certain non-ACA-compliant non-grandfathered health insurance coverage in the small group and individual markets.

The extended transitional policy in this bulletin applies for policy years beginning on or before October 1, 2020, provided that all such coverage comes into compliance with the specified requirements by January 1, 2021.

Click here to read the full release from CMS.

Questions? Contact your Cornerstone representative for additional information.

Updated Analysis Shows More Competitive ACA Marketplaces in 2019

A 2017 analysis done by the Urban Institute and the Robert Wood Johnson Foundation found “strong inverse associations between the number of marketplace health insurers and premium levels and premium growth; rating regions with few insurers had higher premiums and higher premium growth.” The analysis has since been updated with 2018 and 2019 data, which concluded that more than 20 percent of the U.S. population now lives in an area with five or more marketplace insurers, though there are many regional variations.

For example, more than 40 percent of the population in the Northeast lives in areas with five or more marketplace insurers, while in the South, only 4 percent of residents live in areas with five or more insurers though a majority (nearly 53 percent) live in areas with between one and two insurers. In addition, the analysis found that marketplace premiums in the rating regions with fewer insurers tend to be substantially higher.

Click here to read the full analysis.

Click here to view a summary from the Robert Wood Johnson Foundation.

RSVP Today: 3 Large Group CEs in Northwest Ohio

If you work with employer groups of 50 or more, self-funded solutions are a great way to keep benefit costs down and add value to your groups. Join Cornerstone for lunch and 3 self-funded CEs the afternoon of April 2. Each presenter will also provide a brief product update.

Location: Oak Openings Lodge | 5440 Wilkins Road | Whitehouse (Toledo), OH 43571

Please RSVP to Sharon Hogan by March 22, 2019

Are You Using Anthem’s New Producer Toolbox?

If you are using the old version of Anthem’s Producer Toolbox, now is the time to switch to the re-imagined new design of the site because the old version will be going away at the end of March.

Click here to get started with the new design. Log into the Producer Toolbox like you normally do and choose the new broker website experience.

Producer Toolbox Quick Tour Video

Contact your Cornerstone representative with any questions.

Ameritas Now Offering PrimeStar Advantage Plus in Ohio

Ameritas DentalAmeritas recently announced that PrimeStar Advantage Plus plans will now be offered in Ohio. This plan does not have a deductible for preventive services and offers two-year graded benefits. With the PrimeStar Advantage Plus plan, there are no waiting periods or enrollment fees, and your clients can save more with the Ameritas dental network.

Click here to learn more about the PrimeStar Advantage Plus plan.

Click here to learn more about the PrimeStar Advantage Plus plan.

Contact Geoff Beglen for more information or to be appointed.

SAVE THE DATE: CEs Available in Toledo (April 2)

Working with groups of 50 or more? This is a CE day you won’t want to miss on April 2 at the Oak Openings Lodge. We’re putting together a program of three to four CEs for Cornerstone agents to learn more about self-funding and large-group requirements. The program will begin in the late morning and end at 4:30 pm.

Look for more details soon!