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

 

Oscar Releases New Plan Grids and Renewal Information

Oscar recently released their 2019 plan grids, which are identical for Columbus and Cleveland.

Oscar also released information about the renewal letters that will be sent to members later in October. Brokers will not receive a copy of the member’s renewal letter. Renewals will be a part of the individual book of business, which is set to launch within Broker Accounts next week.

Cleveland Clinic/Oscar Ohio Individual and Family Plans 2019

Oscar Ohio Individual and Family Plans 2019

For more information, contact your Cornerstone representative today.

Oscar’s Doctor on Call Feature is Free with Oscar and Cleveland Clinic + Oscar Plans

With Oscar’s Doctor on Call feature in the Oscar app, members can send a request 24/7, and a board-certified doctor will call them back. The doctor will review your client’s symptoms, give a diagnosis, and send necessary prescriptions directly to the pharmacy.

The feature is simple, always unlimited, and available any time day or night. This feature is free with most Oscar and Cleveland Clinic + Oscar plans.

Click here to get started.

Anthem Has News About Your September Commission Checks

Anthem recently announced that the Individual, Small Group, and Large Group commission payments would move to a new system. These changes are effective with premium paid dates of 9/1/2018. With this change, the timing of when you get paid has changed from a bi-weekly to a monthly schedule.

Click here for additional information.

New Broker Marketing Tools Available from Medical Mutual

Check out new broker marketing tools now available from Medical Mutual on MyBrokerLink. The tools vary per line of business. The new materials include:

  • MyBrokerLink Flier (Individual, 1–50, 51–99, 100+)
  • MyBrokerLink Video (Individual, 1–50, 51–99, 100+)
  • Transitional Coverage Whitepaper (1–50)
  • Small Business Custom Prospecting Letters (1–50)

Click here to learn more about the available materials.

CMS’s New Registration Tracker is Now Available

Last month, the Centers for Medicare & Medicaid Services (CMS) launched a new tool that enables you to look up your Marketplace registration status using your National Producer Number (NPN) and ZIP Code.

The tool shows you a summary of your Marketplace registration status.

In addition, the tool displays details of the Marketplace training and registration steps you have completed.

It also shows the status of CMS’ validation of the NPN you provided in your Marketplace Learning Management System (MLMS) profile.

Short-Term Health Insurance: A New, More Affordable Option

Jennifer Agnello, President

Updated October 5, 2018.

Purchasing individual health insurance comes with many pressures. Those seeking coverage are often strapped with additional stressors such as loss of a job, loss of employer coverage, divorce, or other strains that negatively affect financial well being, leading to increased physical and emotional health risks. Many confusing questions go through a buyer’s mind: “Can I afford it?” “Does it cover my needs?” “I just don’t understand my buying options.”

Consumer studies have indicated that as a population, we are becoming better about making health care decisions. This may be because we have a greater stake in the game, higher premiums, higher deductibles, smaller networks, and fewer options. Though most of us receive health insurance benefits from our employers, there are still many who fall outside that category:

  • Individuals who cannot afford COBRA
  • Self-employed individuals that do not qualify for subsidies on Affordable Care Act (ACA) plans
  • Employees of smaller companies not providing coverage and part-time or seasonal workers
  • Students and/or children turning 26 and aging out of parents’ plans
  • Those between jobs or in their employer’s waiting period
  • Early retirees or spouses
  • Moving to a new state
  • Those whose providers are not “in-network”
  • Those going through a divorce
  • Those earning too much for Medicaid or too little/too much for government subsidies

A more affordable option for these circumstances may be short-term health insurance. In 2017, the average short-term premium was just $79 per month for a 30 year old. Also in 2017, individual medical plan rates rose at a national average of 21 percent. Short-term plans may fill a temporary gap in coverage and provide a more cost-effective option for those in these situations.

In October of 2017, President Trump signed an executive order directing federal agencies to draft regulations aimed at rolling back the former short-term medical restrictions. On February 20, 2018, Health and Human Services proposed the new rules and the final rule was issued on August 1, 2018. These new laws take place on October 2, 2018, but may be limited by final State rulings.

New federal regulations now allow up to 364-day short-term health insurance plans with the option to renew for up to 36 months. Many states have proposed their own limits to these federal regulations. Ohio and Kentucky, for example, allow up to 360 days, while Indiana allows up to 184 days and Kansas and Montana only up to 123 days. Each state has adopted varying levels on what they will allow and many states have yet to propose their own limits. This will be a state-by-state approach and it is important to understand the guidance and regulations based upon the state in which you reside. Individual plan buyers who are unable or unwilling to buy ACA compliant plans may soon be able to purchase longer-term plans with greater duration of coverage. Considering tax penalties will no longer be enforced for 2019, short-term plans are a viable option.

Short-term plans also offer financial advantages for brokers. These plans are not just an open enrollment period sale like the distant relatives in ACA. You can sell and receive commissions year round.

Be aware: These plans are not required to comply with the ACA, include the use of underwriting (pre-existing conditions are not covered and applicants may be declined), may not cover certain medical expenses, and may impose annual/lifetime maximums/limits. Additionally, termination of a short-term plan will not trigger a special enrollment period in the individual market and today short-term plans are not considered minimum essential coverage under ACA.

Many short-term plans come with additional perks and benefits such as wellness, telemedicine, etc.

Helping people during difficult times or transitions in their lives is a win-win situation. Providing options for those who formerly have had very limited choices is much appreciated by those in need. If you are looking for solutions and your clients fall into these categories, call Cornerstone today. We have several options to assist you in finding affordable solutions for your clients.

Aetna Works to Keep Your Data Safe with Self-Validation

Aetna recently announced the launch of a new broker full-disk encryption validation service, which would have required brokers to download a software agent to their devices. After growing concerns, Aetna has decided to use a self-validation solution instead.

Beginning on September 17, 2018, the first time you visit a broker website, you will see a pop-up message that asks you to verify if your device is encrypted. Your response (either “Yes” or “No/I don’t know”) generates a web browser file called a cookie, which can be read by any Aetna broker website you visit from the same device and browser.

Each cookie has an expiration date. When it expires, you will be asked to re-verify your encryption status. If you answer “yes” to the encryption pop-up, your cookie will expire in 12 months. This means you’ll be set for a year when you use the same device. If your device is not encrypted or you don’t know if your device is encrypted, the cookie will expire in 90 days. This will give you an opportunity to verify or install encryption.

Find out more about this system and why it is in place here.

Join Us for the Cincinnati-Anthem Ohio’s 2019 Broker Roadshow

Cornerstone invites you to attend the Anthem Ohio 2019 Broker Roadshow.

Please join us for Anthem Ohio’s 2019 Individual, ACA, SOCA MEWA, Specialty and Key Account updates.

DATE: Wednesday, September 19, 2018

TIME: 9:00 am–11:00 am

LOCATION: Cornerstone’s Cincinnati Office | 2101 Florence Ave | Cincinnati, OH 45206

PRESENTERS: Robyn Caupp & Matt Lapp, Anthem Blue Cross Blue Shield

Click here to register.

 

Anthem is coming back to the Individual market in Ohio for 2019 ACA plans! More details to come on service area counties, plans and benefits they are offering, how to get re-contracted to sell, etc.