Members of Grandmothered Small Groups Receive Letter About Transitional Relief Extension

Medical Mutual mistakenly sent out a letter regarding a notification about the Ohio Department of Insurance (ODI) to some members in grandmothered small groups. The letter was intended for group officials, who will receive revised letters this week explaining their extended rates following ODI’s adoption of the transitional relief extension. If groups inquire about members receiving the letter, please let groups know the letter was sent by mistake and their members can discard the communication.

Questions? Concerns? Contact your Cornerstone representative today.

Enhance Your Clients’ Benefits with Disability Contract Differentiators

Disability contracts have a lot of moving parts.  Make the sale and boost your clients’ benefits by underlining distinct differences and flexible options that come with the disability contracts we offer such as:

  1. “Or” definition of disability, which means employees who aren’t “totally disabled” may still qualify from day 1
  2. Own job evaluation for short-term disability vs. the more common “own occupation”
  3. Extended earnings protection to help employees earning commissions or billing for services bridge the earnings gap after a long-term disability
  4. “Inability to earn 80%” of income vs. “20% income loss” language, which allows employees to qualify sooner

Contact us today to discuss how these benefits help provide the best fit for your disability clients.

Anthem Trainings for SOCA Benefit Plan

You have been invited to sell the Southern Ohio Chamber Alliance (SOCA) Benefit Plan.  Anthem, along with SOCA and NOACC, is pleased to announce an exciting new option for 2–50 life groups.

 You must attend this training seminar to sell these plans.

Join us for an information training session and learn how this alternative solution could benefit your small group clients:

  • Competitive rates
  • Medically underwritten
  • Predictable, fixed monthly payments
  • Protection of being part of a larger, self-funded pool backed by Anthem’s stop loss
  • Anthem’s broad Blue Access PPO network


Space is limited. RSVP today to secure your spot!

*This event is by invitation only for brokers currently using Cornerstone for their Anthem business.


DATE: June 6, 2017

TIME: 1:30–3:30 pm

LOCATION: Cornerstone Media Center
2101 Florence Avenue | Cincinnati, OH 45206



DATE: June 12, 2017

TIME: 12:00–2:00 pm

LOCATION: Yankee Trace
10000 Yankee Street | Centerville, OH 45458



DATE: June 16, 2017

TIME: 9:00–11:00 am

LOCATION: Anthem Columbus Office
6740 N. High St. | Columbus, OH 43085



DATE: June 28, 2017

TIME: 1:00–3:00 am

LOCATION: Cleveland

6000 Lombardo Center | Seven Hills, OH 44131



DATE: June 29, 2017

TIME: 9:00–11:00 am

LOCATION: ​Monclova Community Center

8115 Monclova Road | Monclova, OH 43542



DATE: June 29, 2017

TIME: 1:00–3:00 pm

LOCATION: Lima Public Library

650 West Market Street | Lima, OH 45801



CMS Issues Pre-Enrollment Verification Process for SEP Eligibility

On April 18, 2017, CMS released Patient Protection and Affordable Care Act; Market Stabilization, which finalizes changes designed to stabilize the individual and small group markets. This final rule amends standards regarding SEPs, guaranteed availability, and the timing of OEP for 2018.

Beginning in June 2017, HHS will implement a pre-enrollment electronic verification process for SEP in all states that use the  platform. The pre-enrollment verification process will fall into two phases:

  • Phase 1 (June 2017): CMS will verify SEPs, including Loss of MEC and Permanent Move
  • Phase 2 (August 2017): CMS will verify SEPs including Marriage, Medicaid/CHIP Denial, and Addition of a Dependent through Birth, Adoption, Foster Care, or Court Order

This pre-enrollment verification process is designed to promote continuous coverage, protect the risk pool, and stabilize rates.

Once the enrollee completes the application and makes a plan selection, they will have 30 days to provide documentation and prove eligibility.

Questions? Contact a Cornerstone expert today.

Read through Cornerstone’s write up of the final rule here.



Market Stabilization Final Rule

Medical Mutual Updating Step Therapy Programs Beginning July 15

Medical Mutual’s step therapy programs for prescription drugs, which promote clinically effective alternative drugs to improve cost savings and quality of care, will be updated effective July 15, 2017. In early May, Express Scripts will send out a letter to members who have filled a alternative drug prescription in the last month about the new requirements, which will be specific to the drug(s) that the member takes. Medical Mutual expects that the updates will effect up to 9,600 members.

These updates do not apply to Medicare Advantage and Medicare Supplement plans.


Not appointed with Medical Mutual? Contact your Cornerstone representative today to get started!


Updates to Step Therapy Programs Begin July 15, 2017; Express Scripts to Notify Members

IRS Announces 2018 Indexing Adjustments

The IRS recently announced the 2018 indexing adjustments for two percentages under the ACA, as well as a reminder that the required contribution percentage used to determine whether individuals are exempt from individual shared responsibility penalties also decreased to 8.05 percent for 2018. The first percentage under the ACA, which is the percentage required to determine whether employer-sponsored health coverage is “affordable” for purposes of employer-shared responsibility, has decreased from 9.69 percent in 2017 to 9.56 percent for 2018. The second percentage, which is the percentage required to determine the amount individuals eligible for premium tax credits must contribute toward the cost of Exchange coverage, will decreases slightly.

For more information, refer to the full text of the announcement below.

Questions? Contact your Cornerstone representative for answers!



Refundable credit for coverage under qualified health plan—indexing adjustments.

Anthem’s Online Billing System Delayed Indefinitely

ACA Small Groups in Kentucky will not receive notices electronically through EmployerAccess. Clients will continue to receive paper invoices, but can pay their premiums using any of the online payment options within EmployerAcess.

For  more information, contact your Cornerstone representative.


Online Billing Suspended for ACA Small Groups in Kentucky

SAVE THE DATE: 2017 NW Ohio CE Training Days

Businessman hand touching SAVE THE DATE tab on virtual screen , business concept , business ideaWHERE*: Toledo: 4444 Keystone Drive, Suite F | Maumee, OH | 43537
Lima: 3745 Shawnee Road, Suite 104 | Lima, OH | 45806

*Please RSVP to Jenni Henry no later than 2 weeks prior to the event to reserve your space.

WHAT: Four (4) hours of CE available each day with product updates and training from our carrier representatives. There is a 15-minute break between each speaker so you can check emails/phone calls.



Information for the July 18th (Lima) and July 19th (Toledo) training days will be provided closer to the date of the event.

Contact your Cornerstone representative today for more information.

Medical Mutual Making Claims Adjustments Involving University Hospital Providers

After discovering that two pediatricians at University Hospital Medina Health Center were incorrectly loaded into the SuperMed network, Medical Mutual is working to update the directory so that the 70 members whose in-network claims were rejected will receive revised Explanation of Benefits statements with the correct claim information. Members who already submitted payment for those claims may be entitled to a refund.

For more information, contact your Cornerstone representative today.


Medical Mutual Broker Update — May 3, 2017

Medical Mutual Requests Count for Total Number of Employees

Per the requirements laid out by CMS, Medical Mutual is requesting that all group health plan officials with 150 or fewer members report their total number of employees to help ensure Medicare accurately coordinates benefits and property pays claims. The total count should include full and part-time employees in each location, but does not include the total number of dependents under the plan.

Contact your Cornerstone representative today to submit your total number of employees.



Letter from Medical Mutual

Medical Mutual Broker Update — May 3, 2017