Client Referral Program Open Enrollment Individual Referral Acceptance Deadline

The Cornerstone Agency Services Client Referral team accepts client referrals from brokers participating in the program. Our licensed Client Care team can assist referred prospects offering guidance and support with plan enrollment in the Individual market.

To ensure we continually provide referred clients with exceptional service during the busy enrollment season, please familiarize yourself with our readiness checklist, which details our submission process, acceptance deadlines, and turn-around times.

INDIVIDUAL

OPEN ENROLLMENT PERIOD

November 1 to December 15, 2018

  • Referrals are managed first in/first out*
  • A minimum of three client outreach attempts will be made
  • Whenever possible, provide two forms of client contact information; cell phone, spouse cell phone, email address, work phone number, or other.
  • Submit referrals via the broker online form (preferred method) or prospective clients may call us at 877-432-8803. The online form can also be downloaded and emailed to referrals@crnstone.com.
  • The following information is required for all referrals**: prospect name, address, county, two client contact information options, and date(s) of birth.

*Priority is given to Individual referrals received on or before December 3, 2018. Client outreach within 48 hours is not guaranteed during peak periods Oct 1 through Dec 15.

**Incomplete submissions will be returned requesting missing information.

 

Due to extremely high volumes of referrals during the open/annual enrollment period, we encourage clients to plan ahead and make decisions early.

If you have questions about referral submission, the referral acceptance deadlines, or other processes, please do not hesitate to contact us.

National General’s Short-Term Has Returned to Kentucky

National General’s short-term medical is now available in Kentucky, effective December 7.  These plans have coverage options for up to 12 months.

Reminder: National General short-term sales in Ohio are also available for quoting and enrollment.

Please contact Geoff Beglen with any questions or additional information about short-term sales carrier options in Ohio and Kentucky.

Geoff Beglen | 513-629-9358 | gbeglen@crnstone.com

Be Sure That Your Individual Market Clients Re-Enroll Before December 15

Consumers will be automatically re-enrolled into the ACA Marketplace after December 15

Your clients will be automatically re-enrolled in a 2019 Marketplace plan if they do not update their Marketplace application and enroll in a plan before December 15.

Your clients may be automatically re-enrolled if they…

  1. Received coverage in 2018 through participating issuers but have not selected 2019 coverage by December 15. Note: Re-enrollment in their issuer’s plan for 2019 may be different from their plan enrollment for 2018, depending on plan availability.
  2. Are currently enrolled in plans through issuers that will not be participating in the Marketplace for 2019. These clients will be matched with an alternate plan offered by a different issuer.

Be sure that your clients log in to Healthcare.gov, update their information, and review the plan options available to them for 2019.

Questions? Contact Geoff Beglen for additional information.

IMPORTANT UPDATE: National General Short-Term Products in OH to Activate TOMORROW

National General will open their Ohio plans for quoting and enrollment effective tomorrow, November 28, after temporarily suspending all sales of short-term medical plans.

Reminder: Short-term sales in Kentucky are still temporarily suspended as National General is required to refile their short-term plans and rates with the Kentucky Department of Insurance. This change does not impact current customers or sales submitted prior to November 13, 2018.

You are still able to quote and enroll all other National General products in Ohio, Kentucky, Indiana, and other states.

Please contact Geoff Beglen with any questions or additional information about short-term sales carrier options in Ohio and Kentucky.

Geoff Beglen | 513-629-9358 | gbeglen@crnstone.com

Another Important Update Regarding National General Short-Term Products

Effective immediately, National General is temporarily suspending all sales of short-term medical plans in Kentucky. No quoting or enrollment for short-term plans in KY will be permitted until they get approval from KY Department of Insurance. This change does not impact current customers or sales submitted prior to November 13, 2018.

Reminder: Short-term sales in Ohio have also been temporarily suspended as National General is required to refile their short-term plans and rates with the Ohio Department of Insurance.

You are still able to quote and enroll all other National General products in Ohio, Kentucky, Indiana, and other states.

Please contact Geoff Beglen with any questions or additional information about short-term sales carrier options in Ohio and Kentucky.

Geoff Beglen | 513-629-9358 | gbeglen@crnstone.com

What are Association Health Plans?

Gregg Amato

Gregg Amato | Director of Employee Benefits (Cleveland)

The Trump Administration and the United States Department of Labor (DOL) announced new rules for Association Health Plans (AHP). The new rules allow insurance carriers to expand access to the market for fully insured plans beginning September 1, 2018, and on January 1, 2019, for self-funded plans.

What are AHPs?

AHPs are group health plans that employer groups and associations offer to provide health coverage for employees. These plans exist today, and existing plans may continue after the new rule takes effect. The new AHP rule brings additional plans into the market, allowing more small businesses and sole proprietors to join together to create an AHP by either purchasing large group or self-insuring coverage. Business owners with no employees and small businesses that have employees will have access to these plans, and AHPs will now be able to cross state lines. Many AHPs will most likely choose to self-insure, which further reduces regulatory burden since self-insured plans are not subject to state insurance regulations.

A small group is defined in Ohio as having less than 50 employees. Local business groups and industry groups nationally will be able to band together, which will allow the insurance risk to be spread out over a larger group. Spreading out the risk over larger pools gives small businesses access to health coverage at a lower premium, which was only afforded to large groups in the past.

Large group plan underwriting guidelines are much less restrictive than the small group and individual plan rules. Less restrictive coverage would likely attract healthier people and the combination of reduced benefits, healthier enrollment, and administrative costs being spread across a larger group would generally result in lower premiums for an AHP. AHPs as a large group will have better leverage to negotiate premiums as compared to small group and individuals that are set by the insurance industry.

AHP rules available to small groups:

  • For the sole purpose of obtaining health insurance
  • Same geographically located industry and businesses
  • Members of chambers of commerce and nationally affiliated trade industry groups
  • Sole proprietors and non-employer firms

The new rule would give small businesses access to coverage as an alternative to the ACA market.

Number of Businesses and Associations

According to the 2016 U.S. Census Bureau’s Annual Survey of Entrepreneurs, there were 5.6 million employer firms. Employer firms with less than 20 employees made up five million firms and there were 24.8 million non-employer firms. The number of non-employer firms added to the firms with less than 20 employees equals nearly 30 million firms.

In January of 2015 The Power of Associations states, “In 2013, there were 66,985,501 organizations on file with the IRS. This subsection includes chambers of commerce and the majority of the trade associations and professional societies operating in the United States today. Associations are found in every state and territory in the country.”

Considering the number of small firms along with the number of associations that exist in the U.S., the expansion of AHPs has the potential to impact a large number of people.

New Rules/Pre-Existing Conditions

The Affordable Care Act (ACA) requires AHPs that sell health insurance plans to small employers and individuals and small employers must meet the same standards that the ACA applied to these respective markets. The ACA outlined certain essential benefits that have to be included in health insurance plans, including preventive care, ambulatory services, emergency services, hospitalization, mental health services, maternity care, prescription drugs, rehabilitation, laboratory services, and pediatric care. AHPs are exempt from these regulations and may not cover some of these services.

AHP new rules:

  • Do not have to include the ACA’s 10 essential health benefits for plans in the individual and small group market, businesses with fewer than 50 employees
  • Allows different premium rates based on age, gender, and location; charges can vary by industry
  • Does not allow discrimination based on health status
  • Cannot deny coverage or charge more because of pre-existing
  • Cannot cancel coverage due to an employee’s illness
  • Can vary charges, higher rates for high-risk industries compared to low-risk industries
  • Allows dependents on the plan until they reach age 26
  • Cannot charge older applicants more than three times as much as younger applicants
  • Must cover at least 60 percent of average medical costs
  • Subject to the ACA’s risk adjustment program for small group and individual plans
  • Sole proprietors and non-employee firms can get coverage for their family
  • Does not change or affect any existing association health plans
  • Requires AHP to elect a governing body
  • Effective dates for the new rule are September 1, 2018, for fully insured association plans and January 1, 2019, for self-funded association plans

Summary

Providing health insurance as a small business owner can be costly when balancing between growing their business and attracting new talent. The new rules and expansion of AHPs provide small businesses with the opportunity to offer health insurance at lower premiums, giving them the same kind of flexibility that large companies have when selecting a health insurance plan. AHPs can lower health insurance premiums because they are exempt from covering the 10 essential health benefits required by the ACA and the law allows for more flexibility in the way AHP premiums are set. Even though AHPs will most likely have lower premiums, it is important to remember the benefits plan options may not be the same as those in other more expensive health plans. With many small businesses facing rising premiums, having access to a more affordable coverage alternative in AHPs is a viable solution

It is important to research and understand the options before purchasing any health insurance plan, including an AHP. Even though the selection process can be time consuming, the investment is worthwhile to ensure the right health insurance plan is placed. Working with an experienced health insurance broker or consultant can be beneficial, saving both time and money when navigating the selection process.

If you need additional information about AHPs, the experts at Cornerstone can help. We have extensive experience working with AHPs and with understanding the positive impact of the new rules. Please ask your local Cornerstone representative about the available AHP plans offered through our contracted health insurance carriers.

Earn Cash with Molina’s New Agent Bonus

Molina Healthcare is excited to announce an agent bonus for NEW 2019 members!

Payment Details:

  • Bonus payment will pay out in May 2019 to your agency.
  • Bonus amounts are paid only when the enrollment tier threshold is met (no prorating).
    • Example: Enroll 50 members = $1,000, enroll 49 members = $500
  • Bonus amounts must be earned by each agent individually. New enrollments by an agent will not be added to enrollments by a different agent for purposes of meeting the enrollment tier.
  • One-time payment (not per member per month, PMPM).
  • The above table outlines the enrollment tiers for new 2019 members and the bonus amount that you will earn.
  • One-time payment will be made determined by the total amount of qualifying policies and the single tier that corresponds.

Program Terms and Conditions:

  • NEW MEMBERSHIP ONLY.
  • Members must effectuate January 1, 2019.
  • Members MUST remain enrolled with Molina through March 31, 2019.
  • Members must not have any data discrepancies in the 834 report.
  • Members cannot be in the Grace Period on March 31, 2019.
  • Bonus applies to the following Molina service states: Utah, Texas, New Mexico, Washington, Ohio, Michigan, Wisconsin, and Florida.

As a reminder, in order to write and be compensated for any Molina policy:

  • You must have a current Errors and Omissions on file with us at the time you write the policy. Your name must be noted on the policy.
  • You must have a current license in the state(s) you are contracted with us at the time you write the policy.
  • If you are contracted with Molina to sell in the following Molina Federally Facilitated Marketplace (FFM) states: MI/OH/FL/TX/NM/UT/WI, you must have completed the Federally Facilitated Markeplace Registration and you must show up on the FFM Registration List at the time you write the policy. if you are contracted with Molina to sell in WA you must have completed the Washington Health Plan Certification at the time you write the policy.

Important Updates Regarding National General Short Term Products

We have just received word from National General that they are being required to refile their short term plans and rates with the Ohio Department of Insurance. Until further notice from National General, no quoting or enrollment for any short-term sales in the state of Ohio will be allowed.

You are able to still quote and enroll their other products in Ohio, or all of their products in Kentucky, Indiana, and other states.

They will be sending out further notice sometime today, but wanted to get this out to you as quickly as possible.

If you have clients needing short term in Ohio, we would recommend going with UHOne for the time being.

Geoff Beglen | 513-629-9358 | gbeglen@crnstone.com

Medical Mutual Redefines SuperMed Service Area

Starting Jan. 1, 2019, Medical Mutual is redefining their SuperMed service area. The new service area will consist of all 88 counties in Ohio, three counties in Kentucky (Boone, Kenton and Campbell), and the 12 national/ancillary providers, which include labs, medical suppliers and other providers, listed below:

 Accredo Health  LabCorp
 Apria Healthcare  Lincare
 Coram Healthcare  The Little Clinic
 Davita  Quest
 Fresenius Medical Care  St. Elizabeth Healthcare (Kentucky only)
 Hanger  Tri-Health (all locations)

 

For more information, contact your Cornerstone representative.

Trump Administration Unveils Proposed Rule on HRA Flexibility

The Trump Administration recently unveiled a proposal that “expands the usability” of tax-free health reimbursement arrangements (HRAs) in direct response to President Trump’s executive order “Promoting Healthcare Choice and Competition Across the United States.” Under the proposed rule, small business would be allowed to use HRA funds to provide offsets for premiums purchased by their employees in the individual market.

Critics of the proposal, however, contend that this could allow employers to push higher-risk employees away from company-sponsored coverage and into individual coverage offered through the Affordable Care Act’s Marketplaces. The Administration says the proposed rule “includes certain safeguards to mitigate the risk that health-based discrimination could increase adverse selection in the individual market.”

Resources

7 Points for Employers to Know About Proposed HRA Regulations

Proposed Rule on HRA Flexibility Improves an Important Health Coverage Tool for Small Businesses

Trump Administration Proposal Expands Access to HRAs