Important Reminders Regarding the New FormFire ACA Quoting Spreadsheets

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We hope that you have found the new and improved FormFire quoting spreadsheets useful in presenting the ACA rates to your clients. There are a few important items to keep in mind when presenting the rate information to your group.

The spreadsheet produces both, “Composite” and “Age Banded Rates” (on the second tab), however based on the specific carrier and group size the composite rates may not be available for a final sale. To ensure you are discussing the correct rates with your client please see the chart below:

ACA

Level Funded

MEWA

Aetna

 N/A Always Composite N/A

MMO

Age Banded Only

N/A

 Age Banded under 10 enrolled

Anthem OH

2-50 Group can choose age banded or composite rates

N/A

Always Composite

Anthem KY

2-50 Group can choose age banded or composite rates

N/A

Always Composite

Anthem IN

2-50 Group can choose age banded or composite rates

N/A

Always Composite

UHC

Age Banded under 15 enrolled

Always Composite

Always Composite

Humana

2-50 Group can choose age banded or composite rates

Always Composite

Always Composite (NKY Chamber)

In addition, MMO requires that you add Pediatric Dental to all ACA groups when the group does not have a standalone dental policy in place or when the specific subscriber has not enrolled his/her dependent children in the group dental coverage. In these instances, you must add an additional amount per applicable enrolled subscriber which covers all dependent children in the family. The 2020 Pediatric Dental rates for the state of Ohio are $23.66 per applicable subscriber. This fee must be added to the ACA age banded premium that you find on Tab 2 of the quote spreadsheet.

In cases where composite rates are not available to sold groups, based upon the carrier, we feel composite rates can still be quite helpful in determining an equitable and compliant Employer Contribution.

If you have any further questions, please contact your Broker Advisor.

FormFire: Essential Technology in the Small Group Market

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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.

EFFECTIVE IMMEDIATELY: Humana Small Group Quoting Requirements

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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.

Anthem SOCA BP 2019 Summary Annual Reports are Available

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The 2019 Summary Annual Reports (SARs) for participating employers in the Anthem SOCA BP are available for download in the group’s Manage Documents folder.

The Summary Annual Report is a summary of the group’s plan information for the plan year for employers enrolled in the Anthem SOCA BP between May 1, 2018, and April 30, 2019. If a group was not enrolled in the plan during this time, they will not receive a report. Additionally, churches and government entities enrolled in the Anthem SOCA BP will also not receive a report, as they are not subject to ERISA and exempt from SARs reporting.

To access the SARs report, the group’s 8-digit Anthem group number is required. For example, the 8-digit group number should be entered as: 00123456 when prompted.

The SARs reports are for informational purposes only, there is no action required by the broker or group.

Contact your Cornerstone representative with any questions.

Saving You Time on ACA Quotes: ACA Quoting Changes Effective June 1, 2020

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Cornerstone agents will receive ACA quotes in an Excel template format with plan design details starting June 1, 2020. There are several reasons for this that we believe our agents will really appreciate:

  • Faster turnaround times for ACA quotes and requotes.
  • Uses the top 30 most common plans. If the broker wants to establish their own “profile” or designate plans they would prefer, please include them in your request to the proposal mailbox. Remember, new plans are introduced in the fall of each year.
  • Automated spreadsheets are pre-filled with 30 of the most common plans with rates in order from least costly to most costly. There is space for the current and renewal plan and rates to be added.
  • Links to most Summary of Benefits and Coverage documents through links in the spreadsheet.

Why this change?

  • During high-volume times, the carrier systems used to generate official proposals slow down considerably. It can take as long as an hour to generate a single proposal in peak season.
  • FormFire invested in a rate validation partner to ensure factors were always correctly calculated.

What if I want to sell an ACA proposal?

  • Simply send an email to your normal quote mailbox with “REQUOTE ACA.” If you just want an updated spreadsheet with a new census, just send an email to the proposal mailbox with “Updated Census.”

How will this impact ancillary quotes?

  • We will provide rate sheets for groups with two to nine employees since they are readily available from many carriers for dental and vision.
  • Groups of 10 or more will be underwritten by the carrier with a potential for greater discounts from rate sheets.
  • Please be clear about plan design(s) and features you want quoted.

Cornerstone is proactively looking for ways to improve how you do business across our operations. We welcome your feedback and suggestions. We’re also working on a project to give our agents one-stop access to forms and tools.

Contact your Cornerstone broker advisor with any questions.

Update to FormFire Client Services Hours

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Effective Monday, March 30, 2020, FormFire’s Client Services hours will temporarily change to 9:00 am to 5:30 pm EST, Monday through Friday, until further notice. Their Client Services team will continue to be available via email, chat, and phone during these hours.

Contact your Cornerstone representative with any questions.

Anthem SOCA BP 1095 Tax Forms Available February 3

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The IRS recently extended the deadline for employers to submit 1095 Tax Forms from January 31 to February 28. According to FormFire, the Plan Administrator for the SOCA Benefit Plan is preparing the completed 1094-B and 1095-B Tax Forms on behalf of participating employers in the SOCA Benefit Plan. The forms will be available for active groups to download from FormFire’s Manage Documents folder on Friday, February 3.

Contact your Cornerstone representative with any questions.

FormFire Introduces Condition Selector

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In an ongoing effort to enhance the medical underwriting process while making our user experience as seamless and easy as possible, FormFire has made changes to the Employee Interview.

The Employee Interview now contains an easy-to-use categorized condition selection process, which allows employees to clearly state conditions they and their dependents have. This new enhancement allows tracking condition additions and removals on an individual basis.

Further, the employee certifies their family does not have any other conditions than those selected. Overall, this enhancement is a major step forward in FormFire’s Medical Health Questionnaire to allow easier tracking and reporting.

Contact your Cornerstone representative for more information.

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