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/

INDIANA: Earn Points With Anthem’s ChamberCare Health Alliance MEWA Program

Earn 15 rewards points for your new ChamberCare Health Alliance MEWA medical sale. New sales with effective dates from October 1, 2019, through January 1, 2020, qualify.

Points can be redeemed for thousands of rewards options, including event tickets, name-brand merchandise, movies and media, and more.

Additional Rules

  • Only new Anthem contracts count towards Small Group ChamberCare Health Alliance bonus.
  • Points will be awarded 6 – 8 weeks after they are earned.
  • Agents must register on the program website to receive Anthem Points earned based on program rules.

Click here for more information.

Contact your Cornerstone representative with any questions.

Principal’s Fourth Quarter Promotion Rewards You For Your Sales

Leverage these tools to boost your sales—whether you’re working with a new or existing client. Clients with effective and renewal dates of September 1, 2019 – January 1, 2020 are eligible.

New business

Start-up dental discount
Your cases under 200 lives are eligible for:

  • 5% discount for cases without orthodontia
  • 3% discount for cases with orthodontia

Extended rate guarantee program
Your cases under 200 lives that meet all eligibility for the multiple product discount receive:

  • Free 2-year rate guarantee for dental and short-term disability
  • Free 3-year rate guarantee for group term life and long-term disability

Existing business

Extended rate guarantee program
Cross-purchase renewals receive:

  • Free 2-year rate guarantee when adding a coverage line to existing cases under 200 lives*

Principal – Great Lakes Region – 513-733-9400

Limitations: Doesn’t apply to Washington dental and vision small group cases. Doesn’t apply to Florida cases with fewer than 51 lives.

*Applies to all existing lines excluding accident and critical illness.

Anthem Kentucky Releases Chamber Advantage MEWA

Anthem Kentucky has released the Chamber Advantage MEWA solution. This MEWA was created through the partnership of Anthem and the Kentucky Chamber of Commerce. This is an underwritten solution for employers with 2 eligible to 50 total employees on payroll.

The product’s initial effective date will be October 1, 2019. All groups will have a common renewal date of June 1.

Below, you will find the Chamber Advantage Product Guide, Chamber Advantage/Employer FAQ, Chamber Advantage Broker Guide, and Employee Medical Questionnaire (required for groups with fewer than 6 enrolled employees).

Quoting

Quoting is now available for the Chamber Advantage product. You may request preliminary quotes by submitting a dependent level census. For an underwritten quote, medical questionnaires will be required for groups with fewer than 6 enrolled employees. Please send your quote requests to your Cornerstone quoting team at the corresponding office below:

To quote Chamber Advantage, the group does not need to be a member of a chamber.

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

ChamberAdvantage Product Guide

ChamberAdvantage FAQ

Employee Medical Questionnaire

ChamberAdvantage Broker Guide

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)

Aetna Announces 15-Month Contract and Updates to Underwriting Guidelines

Aetna recently announced that Aetna Funding Advantage (AFA) is offering a 15-month contract for December 2019/January 2020 new Aetna customers, along with their current AFA clients who renew in December 2019/January 2020. The contract will be offered in 25 markets*.

Details regarding the new AFA extended contract:
  • Offers a 15-month AFA contract
  • Applies to new and renewal AFA small group (5–50**) clients with December 1, 2019, and January 2020, effective dates
  • Moves your client to a March 1, 2021, or April 1, 2021, anniversary date
  • Is available in AZ, CO, FL, GA, IA, ID, IL, KS, KY, LA, ME, MI, MN, MO, MS, NE, NJ, NV, OH, OK, TN, TX, UT, WI and WY

Aetna has also updated their underwriting guidelines on AFA down to two lives. Click here to review the fact sheet regarding these updates.

Click here to access the AFA Quote Cover Sheet.


*Only available in AZ, CO, FL, GA, IA, ID, IL, KS, KY, LA, ME, MI, MN, MO, MS, NE, NJ, NV, OH, OK, TN, TX, UT, WI and WY.  Not available on our 1500 HSA plan. 
**2 to 50 in GA/KS/MO/S.IL/TX; 2 to 100 in N. IL/OH; 5 to 100 in CO/KY/LA/NJ/TN; 10 to 50 in NV

UnitedHealthcare MLR Premium Rebate Checks Will Mail in September for Impacted Groups

UnitedHealthcare recently announced that those who qualified for premium rebates for the 2019 MLR Payout Year will receive their checks by the September 30, 2019, deadline.

For a summary of which states, legal entities and size of business (aggregation set) will be receiving a rebate, refer to the Final 2018 MLR Rebate Report.

Click here for more information.

Contact your Cornerstone representative with any questions.

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

August 2019 Medical Mutual Updates

Medical Mutual released the following updates…

Group Sales Broker Advertising Program

Medical Mutual announced the Broker Advertising Program, which is for brokers who want to exclusively promote their products to group prospects through their media placements. MMO provides customizable marketing templates for brokers in the program to use.

Groups with COBRA Options Able to Add Ancillary Lines

Medical Mutual now allows groups of all sizes with their COBRA Options product to add external ancillary carriers.

Mutual Appreciation Reporting Capabilities

The Mutual Appreciation program encourages Medical Mutual’s employees to patronize their clients’ businesses. Medical Mutual now offers reporting capabilities for this program.

  • PDF Report for Prospective Customers: This piece, meant for prospective groups, showcases the potential employee support a group might experience if they become Medical Mutual’s customer and part of the program.
  • PDF Report for Active Customers: This piece showcases how much Medical Mutual employees have spent with a group and how many transactions have been made since they became their customer.
  • PowerPoint Renewal Report: For groups with upcoming renewals, Medical Mutual can create comprehensive reports for customers that showcase promotion spend (if applicable), year-over-year spend, rankings to similar customers within their industry and more.

Contact your Cornerstone representative for more information.

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