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Marketplace Learning Management System Closes on July 15

June 24, 2022/in Individual, Marketplace/by Cornerstone

This post was originally published by Healthcare.gov.

Starting July 15 at 6:00 p.m. ET, the Centers for Medicare & Medicaid Services (CMS) Marketplace Learning Management System (MLMS) will close or “Go Dark” in preparation for the launch of the Marketplace Plan Year 2023 registration and training.

Be sure you complete the following tasks before “Go Dark”:

Certificates showing you’ve completed Plan Year 2022 registration and training will not be available after the MLMS closes or when the system goes live for Plan Year 2023 registration and training. To print your 2022 Registration Completion Certificate(s):

  1. Log in to the CMS Enterprise Portal. After logging in, you’ll be automatically taken to the Agent/Broker Registration Status page, from which you can access your certificate(s).
  2. Click the Print Certificate(s) link and follow the prompts to download and/or print your certificate(s).

To update your information in your Marketplace agent/broker profile:

  1. Log in to the CMS Enterprise Portal.
  2. Click the My Apps icon in the middle of the blue toolbar at the top of the webpage.
  3. Click the Training link under the MLMS header. You will be taken to your agent/broker profile.
  4. Update any outdated information in your Business Profile to ensure the Marketplace has your most up to date information.
  5. Click the Save button to save your information.

More information on registration and training for Plan Year 2023 will be coming soon.

Contact your Cornerstone representative with any questions.

https://www.crnstone.com/wp-content/uploads/2022/06/Marketplace-Learning-Management-System-Closes-on-July-15.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2022-06-24 15:30:142022-06-27 18:21:34Marketplace Learning Management System Closes on July 15

Earn More with Anthem Ohio’s Individual SEP Bonus Program!

May 20, 2022/in Anthem, Bonus Programs, Carrier, Individual, Marketplace/by Cornerstone

Anthem Ohio recently announced a new Individual special enrollment period (SEP) broker bonus program beginning with June 1, 2022, effective dates and running through December 1, 2022, effective dates.

Anthem will pay $30 for each member (four-member maximum) enrolled in an on- or off-exchange product within these effective dates. There must be at least 10 members sold and they must remain enrolled with Anthem for at least 90 days for the enrollment to qualify for bonus payout.

Click here to learn more about the bonus program.

Contact your Cornerstone representative with any questions.

https://www.crnstone.com/wp-content/uploads/2022/05/Earn-More-with-Anthem-Ohios-Individual-SEP-Bonus-Program.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2022-05-20 14:44:362022-06-01 18:32:31Earn More with Anthem Ohio’s Individual SEP Bonus Program!

Help Your Clients Resolve Their Marketplace Data Matching Issues

May 20, 2022/in Individual, Marketplace/by Cornerstone

This post was originally published by Healthcare.gov.

Agents and brokers play a vital role in helping consumers understand data matching issues (DMIs) and submit documents or update their application to resolve their issues. DMIs are caused when information on a consumer’s application does not match the Centers for Medicare & Medicaid Services (CMS) trusted data sources or CMS does not have available data for a consumer.

Large numbers of consumers are running out of time to submit documents to resolve their DMIs and consumers who do not resolve their issues will lose advance payments of the premium tax credit (APTC) or coverage. Agents and brokers should check consumer accounts NOW and have consumers submit any needed documents.

Common causes of DMI expirations (when a DMI is not resolved) include:

  • The consumer did not submit any supporting documentation.
  • The type of documentation submitted is not on the list of approved documents for the consumer’s specific DMI. Frequent issues include:
    • Income documentation that is more than two years old.
    • Submitting a Social Security card to resolve a citizenship DMI. You should submit a passport or other acceptable document from the list, since a Social Security card will not resolve a citizenship issue on its own.
  • The documentation submitted does not have enough information to resolve the data inconsistency, such as only submitting income information for the applicant’s job but no information for their spouse’s job.
  • The documentation submitted has errors, such as the name on the application is different than on the submitted document.
  • The documents submitted are not in the proper format (they must be .pdf, .jpeg, .jpg, .gif, .xml, .png, .tiff, or .bmp, and no larger than 10 megabytes).
  • The information provided on the consumer’s application was incorrect.

To learn more about helping consumers resolve DMIs, you can review a recent CMS webinar deck on this topic, Submit Acceptable Documents to Resolve DMIs. Additionally, check out these resources:

Agent/Broker-Specific

  • Agent/Broker Video Learning Center: How to Resolve a Marketplace DMI
  • Agent/Broker Frequently Asked Questions

General Audience

  • Webinar Slides: How to Resolve Income DMIs
  • HealthCare.gov: How to Upload Documents
  • HealthCare.gov: How do I resolve a DMI?
  • HealthCare.gov: Guide to Confirming Your Income Information
  • HealthCare.gov: DMI Blog Post
https://www.crnstone.com/wp-content/uploads/2022/05/Help-Your-Clients-Resolve-Their-Marketplace-Data-Matching-Issues.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2022-05-20 14:11:372022-05-20 14:11:37Help Your Clients Resolve Their Marketplace Data Matching Issues

Consumers in Some States May Qualify for a Special Enrollment Period

May 20, 2022/in Individual, Marketplace/by Cornerstone

The following post was originally published by Healthcare.gov.

Several issuers that sell plans through the Marketplaces that use the federal platform were identified as having information in their publicly displayed plan data that was potentially misleading to consumers. In coordination with state Departments of Insurance, the Centers for Medicare & Medicaid Services (CMS) has worked with those issuers to correct their information on the Marketplace platform, and these issuers will clarify their plan information in notices to enrollees. Consumers who were negatively impacted by these plan data issues qualify for a Special Enrollment Period and can call the Marketplace Call Center at 800-318-2596 (TTY: 1-855-889-4325) for support in making a new plan selection, to be effective either prospectively or retroactively.

 

Please see the list below of issuer parent companies and states where consumers may be eligible for this Special Enrollment Period for specific plans.

Issuer Parent Company

States

Blue Cross Blue Shield of Arizona Arizona
Bright Health Management Alabama, Arizona, Florida, Georgia, Illinois, North Carolina, Nebraska, Oklahoma, South Carolina, Tennessee, Texas, Utah, Virginia
Cigna Arizona
Oscar Health, Inc. Arizona, Georgia, Illinois, Kansas, Michigan, Missouri, North Carolina, Nebraska, Ohio, Tennessee, Texas, Virginia
Medica Health Plans Arizona, Nebraska, Oklahoma
UnitedHealth Group Arizona, Virginia
https://www.crnstone.com/wp-content/uploads/2022/05/Consumers-in-Some-States-May-Qualify-for-a-Special-Enrollment-Period.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2022-05-20 14:02:132022-05-20 14:02:13Consumers in Some States May Qualify for a Special Enrollment Period

Register: Join Cornerstone at the NWOAHU Products Fair in Toledo

April 29, 2022/in Continuing Education, Cornerstone Updates, Employee Benefits, Events, Individual, Marketplace/by Cornerstone

Visit Cornerstone’s booth at the upcoming NWOAHU Products Fair in the Toledo, Ohio, area. There are three CE courses pending with speakers from the Department of Labor, Cornerstone’s Geoff Beglen with an update on the 2022 individual market, and Chris Hartmann from NAHU’s Government Affairs team.

There will also be a special keynote speaker during a seated luncheon. OAHU/NWOAHU members are also eligible for CEs for attending in-person meetings.

Date: May 10, 2022

Time: 8:30 am to 2:00 pm

Location: Brandywine Country Club
6904 Salisbury Road
Maumee, OH 43537

Click here to register
https://www.crnstone.com/wp-content/uploads/2022/04/Register-Join-Cornerstone-at-the-NWOAHU-Products-Fair-in-Toledo.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2022-04-29 13:51:452022-04-29 13:51:45Register: Join Cornerstone at the NWOAHU Products Fair in Toledo

Urgent: Submit Documents Before Data Matching Issue Deadlines!

April 22, 2022/in Compliance, Individual, Marketplace/by Cornerstone

Agents and brokers play a vital role in helping consumers understand data matching issues (DMIs) and submit documents or update their application to resolve their issues. DMIs are caused when information on a consumer’s application does not match the Centers for Medicare & Medicaid Services (CMS) trusted data sources or CMS does not have available data for a consumer.

Now is a critical time in the DMI process for consumers with open issues on their Plan Year 2022 applications because:

  • Large numbers of consumers are running out of time to submit documents to resolve their data matching issues.
  • Consumers who do not resolve their issues will lose advance payments of the premium tax credit (APTC) or coverage.
  • Agents/Brokers will lose commissions for many of these consumers if documents are not submitted and issues are not resolved.
  • Check consumer accounts NOW and have consumers submit any needed documents

Common Causes of DMI Expirations (when a DMI is not resolved):

  • The consumer did not submit any supporting documentation.
  • The type of documentation submitted is not on the list of approved documents for the consumer’s specific DMI. Frequent issues include:
  • Income documentation that is more than two years old.
  • Submitting a Social Security number (SSN) card to resolve a citizenship DMI. You should submit a passport or other acceptable document from the list, since an SSN card will not resolve a citizenship issue on its own.
  • The documentation submitted does not have enough information to resolve the data inconsistency, such as only submitting income information for the applicant’s job but no information for their spouse’s job.
  • The documentation submitted has errors, such as the name on the application is different than on the submitted document.
  • The documents submitted are not in the proper format (they must be .pdf, .jpeg, .jpg, .gif, .xml, .png, .tiff, or .bmp, and no larger than 10 megabytes).
  • The information provided on the consumer’s application was incorrect.

To learn more about helping consumers resolve DMIs, please view the webinar deck “Helping Consumers Resolve DMIs” available on REGTAP. Additionally, check out the resources below.

Agent/Broker-Specific:

  • Agent/Broker Video Learning Center: How to Resolve a Marketplace DMI
  • Agent/Broker Frequently Asked Questions

General Audience:

  • Webinar Slides: How to Resolve Income DMIs
  • gov: How to Upload Documents
  • gov: How do I resolve a DMI?
  • gov: Guide to Confirming Your Income Information
  • gov: DMI Blog Post

Contact your Cornerstone representative with any questions.

https://www.crnstone.com/wp-content/uploads/2022/04/Urgent-Submit-Documents-Before-Data-Matching-Issue-Deadlines.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2022-04-22 13:44:062022-04-22 13:44:06Urgent: Submit Documents Before Data Matching Issue Deadlines!

Earn More with The Dental Care Plus Group’s Quarter 2 Broker Bonus!

April 1, 2022/in Bonus Programs, Carrier, Individual, Marketplace, The Dental Care Plus Group/by Cornerstone

Sell more to earn more with The Dental Care Plus Group’s second quarter broker bonus program. For each personal dental plan you sell with an enrollment date between April 1, 2022, and June 30, 2022, you will earn an extra bonus on top of your commission:

You Sell

You Earn

1 policy

$25

5 policies

$50

10 policies

$100

20 policies

$200

30 policies

$300

40 policies

$500

50 policies

$1,000

Click here to review the bonus flyer.

Click here to access the DCPG/Cornerstone appointment kit.

https://www.crnstone.com/wp-content/uploads/2022/04/Earn-More-with-The-Dental-Care-Plus-Groups-Quarter-2-Broker-Bonus.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2022-04-01 14:59:322022-04-01 14:59:32Earn More with The Dental Care Plus Group’s Quarter 2 Broker Bonus!

Understanding Marketplace Compensation for Agents and Brokers

March 11, 2022/in Individual, Marketplace/by Cornerstone

This post was originally published by the Centers for Medicare and Medicaid Services.

Agents and brokers who participate in the Federally-facilitated Marketplace (FFM) receive compensation directly from affiliated qualified health plan (QHP) issuers in accordance with their agreements with those issuers and any applicable state requirements. The Marketplace does not play a role in arranging appointments, setting compensation levels, or ensuring that compensation is paid to agents and brokers. Contact your state department of insurance for more information about state licensure and appointment standards.

To get compensated for actively assisting a consumer with enrollment in a Marketplace QHP, you must:

  • Be appointed with the QHP issuer in accordance with state law;
  • Have completed FFM registration (including required training) for the applicable plan year at the time of enrollment;
  • Read and sign all applicable Marketplace agreements; and
  • Be licensed with an active health-related line of authority in the state(s) where the QHP is offered through the Marketplace.

The Marketplace will transmit agents’ and brokers’ identifying information included on the application with the enrollment to QHP issuers on the Marketplace enrollment transactions (called an “834”). In cases where an FFM-registered agent or broker receives compensation through a third-party entity, such as an agency or brokerage that is registered with the FFM, the agent or broker may work with the QHP issuer to appropriately direct compensation based on the National Producer Number (NPN) included on the 834.

Regardless of the pathway used to assist with Marketplace enrollments, you should work with each consumer to make sure that your correct identifying information (name and NPN) is included on Marketplace enrollment transactions you assisted with. This information must be correct for the Marketplace to associate the transaction with you.

If you believe your NPN was accidentally or intentionally removed from a consumer’s application, you can submit the Application ID with a description of the problem (without consumer personally identifiable information) to the Agent/Broker Email Help Desk at FFMProducer-AssisterHelpDesk@cms.hhs.gov for CMS to investigate the issue. In some cases, CMS may not be able to resolve your issue. You can always contact the QHP issuer directly to discuss the situation. When contacting the issuer, you will need to provide evidence that you are the Broker of Record (BOR) for a specific FFM enrollment.

Contact your Cornerstone representative with any questions.

https://www.crnstone.com/wp-content/uploads/2022/03/Understanding-Marketplace-Compensation-for-Agents-and-Brokers.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2022-03-11 14:04:122022-03-11 14:04:12Understanding Marketplace Compensation for Agents and Brokers

Insurance Companies and Group Health Plans Now Required to Cover Costs of At-Home COVID-19 Tests

January 11, 2022/in Compliance, Cornerstone Updates, COVID Tests (January 2022), Employee Benefits, Individual, Legislation, Marketplace/by Cornerstone

The following information was originally posted by CMS.gov.

As part of its ongoing efforts across many channels to expand Americans’ access to free testing, the Biden-Harris Administration is requiring insurance companies and group health plans to cover the cost of over-the-counter, at-home COVID-19 tests, so people with private health coverage can get them for free starting January 15th. The new coverage requirement means that most consumers with private health coverage can go online or to a pharmacy or store, buy a test, and either get it paid for up front by their health plan, or get reimbursed for the cost by submitting a claim to their plan. This requirement incentivizes insurers to cover these costs up front and ensures individuals do not need an order from their health care provider to access these tests for free.

Beginning January 15, 2022, individuals with private health insurance coverage or covered by a group health plan who purchase an over-the-counter COVID-19 diagnostic test authorized, cleared, or approved by the U.S. Food and Drug Administration (FDA) will be able to have those test costs covered by their plan or insurance. Insurance companies and health plans are required to cover 8 free over-the-counter at-home tests per covered individual per month. That means a family of four, all on the same plan, would be able to get up to 32 of these tests covered by their health plan per month. There is no limit on the number of tests, including at-home tests, that are covered if ordered or administered by a health care provider following an individualized clinical assessment, including for those who may need them due to underlying medical conditions.

“Under President Biden’s leadership, we are requiring insurers and group health plans to make tests free for millions of Americans. This is all part of our overall strategy to ramp-up access to easy-to-use, at-home tests at no cost,” said HHS Secretary Xavier Becerra. “Since we took office, we have more than tripled the number of sites where people can get COVID-19 tests for free, and we’re also purchasing half a billion at-home, rapid tests to send for free to Americans who need them. By requiring private health plans to cover people’s at-home tests, we are further expanding Americans’ ability to get tests for free when they need them.”

Over-the-counter test purchases will be covered in the commercial market without the need for a health care provider’s order or individualized clinical assessment, and without any cost-sharing requirements such as deductibles, co-payments or coinsurance, prior authorization, or other medical management requirements.

As part of the requirement, the Administration is incentivizing insurers and group health plans to set up programs that allow people to get the over-the-counter tests directly through preferred pharmacies, retailers or other entities with no out-of-pocket costs. Insurers and plans would cover the costs upfront, eliminating the need for consumers to submit a claim for reimbursement. When plans and insurers make tests available for upfront coverage through preferred pharmacies or retailers, they are still required to reimburse tests purchased by consumers outside of that network, at a rate of up to $12 per individual test (or the cost of the test, if less than $12). For example, if an individual has a plan that offers direct coverage through their preferred pharmacy but that individual instead purchases tests through an online retailer, the plan is still required to reimburse them up to $12 per individual test. Consumers can find out more information from their plan about how their plan or insurer will cover over-the-counter tests.

“Testing is critically important to help reduce the spread of COVID-19, as well as to quickly diagnose COVID-19 so that it can be effectively treated. Today’s action further removes financial barriers and expands access to COVID-19 tests for millions of people,” said CMS Administrator Chiquita Brooks-LaSure.

State Medicaid and Children’s Health Insurance Program (CHIP) programs are currently required to cover FDA-authorized at-home COVID-19 tests without cost-sharing. In 2021, the Biden-Harris Administration issued guidance explaining that State Medicaid and Children’s Health Insurance Program (CHIP) programs must cover all types of FDA-authorized COVID-19 tests without cost sharing under CMS’s interpretation of the American Rescue Plan Act of 2019 (ARP). Medicare pays for COVID-19 diagnostic tests performed by a laboratory, such as PCR and antigen tests, with no beneficiary cost sharing when the test is ordered by a physician, non-physician practitioner, pharmacist, or other authorized health care professional. People enrolled in a Medicare Advantage plan should check with their plan to see if their plan offers coverage and payment for at-home over-the-counter COVID-19 tests.

This effort is in addition to a number of actions the Biden Administration is taking to expand access to testing for all Americans. The U.S. Department of Health and Human Services (HHS) is providing up to 50 million free, at-home tests to community health centers and Medicare-certified health clinics for distribution at no cost to patients and community members. The program is intended to ensure COVID-19 tests are made available to populations and settings in need of testing. HHS also has established more than 10,000 free community-based pharmacy testing sites around the country. To respond to the Omicron surge, HHS and FEMA are creating surge testing sites in states across the nation.

Contact your Cornerstone representative with any questions.

https://www.crnstone.com/wp-content/uploads/2022/01/Insurance-Companies-and-Group-Health-Plans-Now-Required-to-Cover-Costs-of-At-Home-COVID-19-Tests.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2022-01-11 16:17:382022-01-21 14:38:29Insurance Companies and Group Health Plans Now Required to Cover Costs of At-Home COVID-19 Tests

Earn as You Enroll New Members in Ambetter

January 7, 2022/in Ambetter, Bonus Programs, Carrier, Individual, Marketplace/by Cornerstone

Contracted agents can earn a one-time, per member bonus for eligible new members they enroll!

https://www.crnstone.com/wp-content/uploads/2022/01/Earn-as-You-Enroll-New-Members-in-Ambetter.jpg 480 640 Cornerstone /wp-content/uploads/2019/11/Cornerstone_Logo.png Cornerstone2022-01-07 15:39:182022-01-07 15:47:59Earn as You Enroll New Members in Ambetter
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