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Anthem Updates: New Producer Toolbox Dashboards, Live Chat, and More

August 7, 2020/in Anthem, Carrier, Employee Benefits /by Cornerstone

Live Chat and New Producer Toolbox Dashboards

Anthem’s new Producer Toolbox dashboards give you a window to your business and quick, easy access to the tools and information you use most often:

  • Frequent Tasks: Use a button to Start a New Quote, Start an Application, or View All Clients.
  • Recent Activity: Check the status of your recent quotes and applications, and upcoming renewals.
  • Commissions: View your last 3 months of commissions and access a full report.
  • Billing Summary: See the status of your clients’ invoices.
  • Last Viewed Clients: Return to clients you’ve recently viewed.
  • Popular Documents: Access all resources and forms quickly and generate reports here.
    Coming soon: Pin your favorite documents and reports.
New Producer Assistant live chat
Producer Assistant now connects you to a live representative from Broker Services or User Software Support to give you the answers you need right away, including assistance with billing inquiries.

Click here to learn more.

Anthem Joins XPRIZE to Foster COVID Testing Innovation

The Anthem Foundation and Anthem, Inc., are Founding Anchor Partners of the $5 million XPRIZE Rapid COVID Testing competition.

XPRIZE, OpenCovidScreen, and a coalition of partners are calling on the global community to develop frequent, affordable, and easy-to-use screening tests with fast results to catch COVID-19 occurrences before they become outbreaks. Affordable testing and rapid results are designed to enhance access to testing and support better, data-driven contact tracing and isolating strategies.

Click here to learn more.

New EmployerAccess Mobile App Now Available

Anthem’s new EmployerAccess mobile app has added features to make managing group plans easier. If you’re designated as the group administrator for your clients, you will be able to manage your groups from anywhere. You can make payments, find member benefit information, and view/share ID cards. The virtual Employer Assistant will help you navigate the app and find the information you need, including the latest Anthem news and notifications.

Click here to learn more.

https://www.crnstone.com/wp-content/uploads/2020/08/Anthem-Updates-August-2020.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2020-08-07 14:31:442020-08-07 14:31:45Anthem Updates: New Producer Toolbox Dashboards, Live Chat, and More

Anthem Will Issue MLR Rebates in August

August 5, 2020/in Anthem, Carrier, Employee Benefits, Individual, Legislation /by Cornerstone

In an effort to ease the financial burden of the COVID-19 pandemic, Anthem will fast-track the annual medical loss ratio (MLR) rebates that groups and individual members typically receive in late September to August.

The medical loss ratio provision of the Affordable Care Act (ACA) encourages health plans to spend most of the premium dollars they collect on health care costs rather than overhead. It’s a ratio of insurance claims costs to insurance premiums, and is expressed as a percentage.

In the fully insured small group and individual markets, the MLR provision requires plans to spend at least 80 percent of premium income on health care claims and quality improvement. In the fully insured large group market, it requires at least 85 percent. In markets where Anthem doesn’t meet the minimum ratio, they are required to issue rebates to employer groups and individual members. ASO plans and stop-loss insurance are excluded from the rebates.

Anthem groups and individuals in 8 states will receive rebates this year.

Anthem will send rebate checks to employer groups and individual members along with a federally mandated notice that explains MLR and how it is calculated. They are also mandated to notify employees of the groups that receive rebate checks.

ACA rules require that employers either distribute the rebate among their employees covered by the rebated plan or use it to lower premiums in the next plan year. Rebate distributions must be made within three months of the policyholder’s receipt of the rebate. Group plans that are subject to Employee Retirement Income Security Act (ERISA) laws may also use the rebate funds to pay current plan premiums.

View this FAQ for more details on the rebates.

Contact your Cornerstone representative with any questions.

https://www.crnstone.com/wp-content/uploads/2020/08/Anthem-MLR-Rebates.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2020-08-05 13:51:132020-08-05 13:51:14Anthem Will Issue MLR Rebates in August

Why Aetna International?

July 29, 2020/in Aetna, Carrier, Employee Benefits /by Cornerstone

Expatriates, inpatriates, local nationals, and business travelers need the peace-of-mind and confidence that comes from a strong and experienced global leader offering a comprehensive health care benefits strategy. If you have a group customer that has some sort of International exposure, Aetna International has the tools, resources, and plan offerings needed to ensure your valued customer is properly taken care of.

We are very grateful to Andy Koesterman, Aetna’s sales representative for this product, who was kind enough to provide a 1 hour CE for Cornerstone agents on international benefits.

Click here to view the PDF or contact your Cornerstone representative for more information.

https://www.crnstone.com/wp-content/uploads/2020/07/Why-Aetna-International.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2020-07-29 20:36:582020-07-29 20:36:59Why Aetna International?

Employee Benefit Extensions for the COVID-19 Pandemic: COBRA, FSA, HRA, and More

July 20, 2020/in Employee Benefits, Legislation, Whitepapers /by Sonya Poland

This post was submitted by Navia Benefit Solutions. In February 2020, FlexBank Administrators, a trusted and tenured provider of pre-tax benefits, COBRA administration, and compliance solutions, announced its partnership with Navia Benefit Solutions, a nationwide consumer-directed benefits provider of health, life, and compliance solutions.


On April 29, 2020, the Department of Labor, Revenue, and Treasury (the “Departments”) issued benefit extensions for certain group health plans, disability and other welfare plans, and pension plans during the COVID-19 National Emergency.

The goal of the benefit extensions is to minimize the possibility of individuals losing benefits because of a failure to comply with an applicable timeframe.

There are eight benefit timeframes that have been extended. We go into detail about each one below and provide examples to illustrate how the benefit extensions will work. You can also download our benefit extensions infographic for a snapshot of the extensions and new timeframes.

Navia COVID-19 Timeline Extensions

Outbreak Period

The term “Outbreak Period” is used to define the period of time affected by the extensions.

  • The Outbreak Period started on March 1, 2020 when President Trump declared a National Emergency in response to COVID-19.
  • The Outbreak Period will end 60 days AFTER the National Emergency is declared over.
  • For example, the National Emergency became effective March 1, 2020 and if President Trump announces on May 31, 2020 that the National Emergency is over, the Outbreak Period will be March 1 to July 31, 2020 (National Emergency timeline plus 60 days).

The Outbreak Period goes from the beginning of the national emergency through the end of the 60 days after the national emergency is declared over. During the Outbreak Period , standard election and filing time frames are essentially on “pause” and then resume after the Outbreak Period ends.

Timeframe Extensions Disregard the “Outbreak Period”

On March 13, 2020, President Trump issued the Proclamation on Declaring a National Emergency Concerning the Novel Coronavirus Disease (COVID-19) Outbreak and by separate letter declared a national emergency under the Stafford Act effective March 1, 2020.

As a result of the National Emergency, the Departments recognized that participants and beneficiaries covered by group health plans, disability or other employee welfare benefit plans, and employee pension plans may find it difficult to meet or comply with certain pre-established timeframes. Similarly, the Departments recognized that group health plans may have difficulty in complying with certain notice obligations.

Essentially, this guidance requires benefit plans to disregard the period from March 1, 2020 until sixty (60) days after the announced end of the National Emergency, or such other date announced by the Agencies in a future notice (the “Outbreak Period”).  To the extent there are different Outbreak Period end dates for different parts of the country, the Departments will issue additional guidance.

8 New Benefit Extensions and How they Work

Please note the date used in the examples for the “end of the national emergency” is just an example date to help illustrate how the extension timeframes work. We do not yet know when the end of the emergency will be declared.

(1) HIPAA special enrollment period

Generally, group health plans (GHPs) must allow individuals to enroll in the GHP if enrollment is requested within 30 days of the occurrence of the event (or within 60 days, in the case of the special enrollment rights added by the Children’s Health Insurance Program Re-authorization Act of 2009).

Example: Assume the end of the national emergency is April 30, 2020. During open enrollment, Randy declines coverage in his employer’s GHP.  On March 31, 2020, Randy’s wife gives birth.  Randy would like to enroll himself, his wife, and his child in his employer’s plan.  Open enrollment does not begin until November 15, 2020.  Since the timeframe beginning March 1, 2020, through the Outbreak period is disregarded, Randy now has until July 29, 2020, to enroll, provided that he pays the premiums for any period of coverage.  Practical Point: If Randy waits until July 29, 2020, to exercise his special enrollment rights, neither the employer or the carrier would know to provide coverage to Randy and his family until his election is made. 

(2) COBRA Election Period

COBRA generally provides a qualified beneficiary 60 days to elect COBRA continuation coverage under a group health plan.

Example: Assume the end of the Outbreak Period is June 30, 2020.  Sandy is terminated on February 25, 2020.  Sandy’s specific rights notice is mailed on March 1, 2020.  Sandy’s 60-day COBRA election period would end on April 29, 2020 but since the timeframe beginning March 1, 2020, through the Outbreak Period is disregarded, Sandy has until August 29, 2020 to elect COBRA.

<<Need help managing COBRA? Learn how Navia can help>>

(3) COBRA Premium Payments

COBRA continuation coverage may be terminated for failure to pay premiums timely. A premium is considered timely paid if it is made not later than 30 days after the first day of the coverage period.

Example: Assume the end of the Outbreak Period is July 31, 2020.  Jim is enrolled and making timely payments on COBRA as of March 31, 2020.  He does not make April’s premium payment within the 30-day payment grace period.  Because the 30-day grace period is disregarded through the Outbreak Period, Jim has until August 30, 2020 to make April, May, June, July, and August’s premium payments.

(4) COBRA Notices – Qualifying Event

Notice requirements prescribe time periods for individuals to notify the plan of certain qualifying events or a determination of disability.  Notice requirements also prescribe the time period for employers to notify the plan of certain qualifying events.

Example: Assume the end of the Outbreak Period is September 30, 2020. Bob is enrolled in COBRA with his spouse Tricia.  Bob and Tricia divorce on April 1, 2020.  Bob has the obligation to notify the plan sponsor/administrator of the divorce within 60 days which will trigger a dependent level COBRA offer for Tricia.  Because the 60-day notice requirement is disregarded through the Outbreak Period, Bob has until November 29, 2020 to notify the plan sponsor/administrator of the divorce.

(5) Benefit Plan Claims Filing Procedure Timeframe (FSA/HRA)

The date within which individuals must file a claim under the plan’s claims procedures.

Example: Employer, Teresa Co., provides her employees an FSA benefit.  Teresa Co.’s plan runs January through December with a ninety-day claims run-out period ending March 31, 2020.  The national emergency is effective March 1, 2020.  In this example assume the national emergency ends May 31, 2020.  As of March 1, 2020, Teresa Co’s participants had 30 days until the claims run-out deadline—due to the guidance, that timeframe is disregarded until the end of the national emergency plus 60 days.  Therefore, plan participants new claims run-out deadline is August 29, 2020.  August 29, 2020, is reached by assuming May 31, 2020, is end of the national emergency, plus 60 days, plus the 30 days disregarded from March to March 31st.

(6) ERISA Adverse Benefit Determination Appeals Deadlines

The date within which claimants may file an appeal of an adverse benefit determination under the plan’s claims procedure.

FSA Example 1: Assume the end of the national emergency is May 31, 2020.  Tim, an FSA participant, receives a denial of his FSA claim on March 15, 2020.  Tim normally has 180 days from March 15, 2020, to file an appeal.  Since the timeframe beginning March 1, 2020, through the Outbreak period is disregarded, Tim now has until January 26, 2021 to file his appeal.  In this example the January 26, 2021, is determined by assuming the end of the national emergency is May 31, 2020.  Add sixty more days to get to July 30, 2020 (the outbreak period) plus the 180 days to appeal.

HRA Example: Assume the end of the national emergency is April 30, 2020. Bob, an HRA participant, receives a denial of his HRA claim on January 28, 2020.  Bob normally has 180 days from January 28, 2020, to appeal his denial.  Since the timeframe beginning March 1, 2020, through the Outbreak period is disregarded, Bob now has until November 24, 2020, to file his appeal.  In this example November 24, 2020, is determined by assuming the end of the national emergency is April 30, 2020, plus sixty days, plus 148 days (180 – 32 days following January 28 to March 1st). 

(7)  ERISA External Review

The date within which claimants may file a request for an external review after receipt of an adverse benefit determination or final internal adverse benefit determination.

Example: Assume the national emergency ends April 30, 2020. Megan receives a denial on March 15, 2020.  Normally, Megan has four months from March 15, 2020, to file a request for external review.  Since the timeframe beginning March 1, 2020, through the Outbreak period is disregarded, Megan now has until October 29, 2020, to file her request.  In this example October 29, 2020, is determined by assuming the end of the national emergency is April 30, 2020, plus sixty days, plus four months.

(8) Deadline to Submit Additional Information for External Review

The date within which a claimant may file information to perfect a request for external review upon a finding that the request was not complete.

Example: Assume the national emergency ends April 30, 2020. Natalie receives notice of an incomplete external review request on March 15, 2020.  Normally, Natalie has four months from March 15, 2020 to perfect her request.  Since the timeframe beginning March 1, 2020, through the Outbreak period is disregarded, Natalie has until October 29, 2020, to perfect her request.  In this example October 29, 2020, is determined by assuming the end of the national emergency is April 30, 2020, plus sixty days, plus four months.

Navia’s commitment to providing high-quality service has never been more important and we will continue to find ways to help during these difficult times. Please check back regularly for updates. Stay safe and healthy.

https://www.crnstone.com/wp-content/uploads/2020/07/Employee-Benefit-Extensions.jpg 480 640 Sonya Poland /wp-content/uploads/2019/11/Cornerstone_Logo.png Sonya Poland2020-07-20 20:16:482020-07-20 20:16:49Employee Benefit Extensions for the COVID-19 Pandemic: COBRA, FSA, HRA, and More

All Savers Now Available for Companies with 100 to 300 Employees

July 17, 2020/in All Savers, Carrier, Employee Benefits /by Cornerstone

UnitedHealthcare All Savers Alternate Funding now can provide an effective solution for businesses with 100 to 300 employees looking for alternatives to traditional fully insured plans without the same risk as self-funding.

All Savers availability will be expanded to include groups sized 100 to 300, as well as groups with more than 100 eligible and at least 75 enrolled employees that fall into the following market and effective-date categories:

Aug. 1, 2020 Effective Dates

  • Arkansas
  • Arizona
  • Georgia
  • Idaho
  • Iowa
  • Illinois
  • Indiana
  • Kansas
  • Kentucky
  • Missouri
  • New Mexico
  • Nevada
  • Pennsylvania
  • South Carolina
  • Texas
  • Wisconsin
  • Wyoming

Sept. 1, 2020 Effective Dates

  • Colorado
  • Florida
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Minnesota
  • Michigan
  • Mississippi
  • North Carolina
  • Nebraska
  • Ohio
  • Oregon
  • Rhode Island
  • Tennessee
  • Utah
  • Virginia
  • U.S. Virgin Islands
  • Washington
  • West Virginia

Additional markets will be added in the coming months.

Contact your Cornerstone representative with any questions.

https://www.crnstone.com/wp-content/uploads/2020/07/All-Savers-Now-Available-for-Companies-with-100-to-300-EEs.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2020-07-17 13:01:282020-07-17 13:01:29All Savers Now Available for Companies with 100 to 300 Employees

Sell More and Earn More with the Anthem New Business Bonus

July 7, 2020/in Anthem, Carrier, Employee Benefits /by Cornerstone

Sell more, earn more!

New Southern Ohio Chamber Alliance Benefit Plan and ACA groups sold with effective dates between August 1, 2020, and December 31, 2020, are eligible. Earn even more if you sell a line of specialty along with the medical.

SOCA Benefit Plan/ACA New Business Bonus

Tier

Contracts Sold

Payout Rate Per Contract

1

Under 50

$25

2

50–124

$100

3

125–199

$125

4

200–399

$150

5

400+

$175

Sell a line of Specialty along with the medical and earn even more!

10 percent multiplier if 25 percent of new groups include a line of specialty

20 percent multiplier if 40 percent of new groups include a line of specialty

Here are the program details:

  • Group needs to still be active with Anthem as of February 1, 2021
  • Agent of record changes do not qualify for the bonus payout Existing Anthem clients that transfer to the SOCA Benefit Plan or an ACA plan are not eligible for the bonus program
  • New contracts on existing groups are not eligible for the bonus program
  • Payout will be a one-time payment targeted for March/April 2021
  • Bonuses will be paid based on current Anthem commission and licensing contracts
  • Incentive payments will be disclosed and reported where required by applicable law
  • Anthem reserves the right to adjust future bonus amounts if groups are termed retroactively after the period’s bonus program calculations and payments have been made
  • Bonus payments are based on enrolled contracts as of the original effective month.
https://www.crnstone.com/wp-content/uploads/2020/07/Anthem-New-Business-Bonus.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2020-07-07 19:57:412020-07-09 14:08:19Sell More and Earn More with the Anthem New Business Bonus

WEBINAR WITH CE AVAILABLE: Get the Latest Updates on Aetna’s New Plans for Groups

July 1, 2020/in Aetna, Carrier, Employee Benefits /by Cornerstone

Cornerstone is hosting a two-hour web-based training and CE session. Get the latest updates on Aetna’s new plans available September 1 along with 1 hour Ohio CE on Wednesday, July 15 from 10:00 am to 12:00 pm.

The Aetna team will review updates to their employer plan portfolio available September 1, go over their current plans and  value adds.

The CE is “Understanding an Employer’s Risk to Global Assignments,” a one hour CE course covering several topics for groups with International exposure, such as risk diversity by population, compliance, health and well-being, employee safety, global security, and mitigating strategies. Presented by Andy Koesterman.

YOU MUST REGISTER AND COMPLETE A FORM BY JULY 10, 2020:

1. Click here when the webinar starts.

(The session password is Cornerstone2020! If you don’t have WebEx loaded on your computer, there is an option to join by web browser.)

2. To receive CE credit for this course, please fill out this attestation and licensing information document and return it to koestermana@aetna.com by Friday, July 10, 2020.

Contact your Cornerstone representative with any questions.

https://www.crnstone.com/wp-content/uploads/2020/06/CE-Available-Aetna-New-Plans.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2020-07-01 19:08:562020-07-15 13:05:54WEBINAR WITH CE AVAILABLE: Get the Latest Updates on Aetna’s New Plans for Groups

Earn Money with Humana’s Ancillary Bonus Programs!

June 26, 2020/in Bonus Programs, Carrier, Employee Benefits, Humana /by Cornerstone

It’s as easy as 1,2,3 to earn additional money with Humana ancillary products (dental, vision, and life). See the flyers below for three easy programs to earn you bonus dollars August 2020 through December 2020.

Humana 2020 First-Case Bonus

Humana 2020 Bundling Bonus

Humana 2020 Dental Growth Bonus

https://www.crnstone.com/wp-content/uploads/2020/06/Humana-Ancillary-Bonus.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2020-06-26 20:12:282020-06-26 20:12:29Earn Money with Humana’s Ancillary Bonus Programs!

FormFire: Essential Technology in the Small Group Market

June 26, 2020/in Employee Benefits, FormFire, Whitepapers /by Jeff Lewis

Cleveland-based FormFire, has been a fixture in the Ohio health insurance marketplace since its introduction more than ten years ago. Today, the company offers their services in 24 states. Brokers take advantage of FormFire technology to price, place, and enroll small group medical products with Aetna, Anthem, Medical Mutual, UnitedHealthcare, Humana, and other medical carriers in Ohio.

FormFire’s most valuable application is their process for supporting medically underwritten small group health insurance products. The company was, arguably, originally created for that purpose. The Affordable Care Act (ACA) became law in 2010 and its rules around small group medical plans certainly threatened to end the entire concept of underwriting with Individual Medical Questionnaires (IMQs). In Ohio, the adoption of transitional plans (also known as Grandmothered plans) essentially saved the small group marketplace by allowing most small employer groups to keep their current plan and not subject themselves to the community-rated ACA products.

Fast forward to 2020 and you will find that the Ohio small group market offers a large number of medically underwritten products. Aetna’s Aetna Funding Advantage, Humana Level Funding, and UnitedHealthcare’s All Savers products are offered using a “level funding” approach. More recently, Medical Mutual, Anthem, and UnitedHealthcare are offering Multiple Employer Welfare Arrangement (MEWA) products that require IMQs. While FormFire’s IMQs are accepted by all of these carriers, the Anthem SOCA MEWA and Medical Mutual COSE MEWA require that groups are priced and enrolled through FormFire. For brokers who want to compete in today’s small group market in Ohio, access to FormFire is essential.

The expense of maintaining a FormFire account can be prohibitive to brokers who have a small block of group medical business or who are building their group practice. Some small group carriers have offered limited access to their own products through FormFire. Cornerstone can help by offering better pricing for full access to FormFire. Insurance markets are rapidly moving into the digital age and producers need to embrace the technology available to them.

Contact your Cornerstone broker advisor to get started.

https://www.crnstone.com/wp-content/uploads/2020/06/FormFire-Current-State-of-Play.jpg 480 640 Jeff Lewis /wp-content/uploads/2019/11/Cornerstone_Logo.png Jeff Lewis2020-06-26 13:19:372020-06-26 14:41:43FormFire: Essential Technology in the Small Group Market

EFFECTIVE IMMEDIATELY: Humana Small Group Quoting Requirements

June 24, 2020/in Carrier, Employee Benefits, FormFire, Humana /by Cornerstone

Humana has released new requirements for quoting Level Funded and NKY Chamber products. Click here for the new Humana coversheet. We have highlighted a few of the new changes below that are now in effect.

Important Changes:

Ohio and Kentucky Alert!

  • In order to quote Humana Level Funded, they will now require the Level Funded application. This application has been updated in FormFire. Effective immediately, Humana Level Funded will not accept the Kentucky or Ohio 51+ application.
  • In order to quote Humana NKY Chamber quotes, they will still require the Kentucky 51+ employee application. The NKY Chamber will not accept the Level Funded application.
  • If you are quoting your group with Humana Level Funded and NKY Chamber, the group must complete the Kentucky 51+ application and the Humana Level Funded application.

Ohio Alert!

  • Health questionnaires will be required for all Ohio groups with 5 to 25 enrolled. Health questionnaires will be waived for Ohio groups with 26+ enrolled and a renewal of less than 25 percent.

Kentucky Alert!

  • Health questionnaires will be required for all Kentucky groups that are 5 to 9 enrolled. For 51+ on payroll, they will also require a Risk Assessment Form.

We have updated our Sending Forms via FormFire cheat sheet with the new form requirements.

Please contact your Cornerstone Broker Advisor with questions.

https://www.crnstone.com/wp-content/uploads/2020/06/Humana-Small-Group-Quoting-Requirements.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2020-06-24 17:45:562020-06-24 17:45:56EFFECTIVE IMMEDIATELY: Humana Small Group Quoting Requirements
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