EMPLOYER ACTION REQUIRED: Distribute Medicare Part D Notices by October 15

Group health plan sponsors must provide Medicare Part D “creditable coverage” notices prior to October 15, 2019, the start date of the Medicare annual enrollment period for Part D, Prescription Drug coverage (open enrollment runs from October 15 to December 7, 2019).

Most plan sponsors use the Model Medicare Part D Notices provided by the Centers for Medicare and Medicaid Services (CMS) to notify affected plan participants. Links to all the model letters (in English and Spanish) are available here in .pdf format. Cornerstone has provided versions of the notice in Word Document format for your convenience.

Creditable Coverage Notice

Non-Creditable Coverage Notice

The carriers plan listings and/or links to their creditable coverage site are available below:

Aetna: Please contact your Broker Advisor for more information.

Anthem: Click here.

Humana: Click here.

UnitedHealthcare: Click here.

Medical Mutual: COSE requested. All other plans, click here.

The October 15 deadline applies for all group health plan sponsors, regardless of plan year, plan size, employer size, grandfather status, or whether the plan is insured or self-funded.

Employers who send out Open Enrollment packets prior to October 15 often include the Medicare Part D notices in the Open Enrollment packets to avoid the extra cost and administrative burden of sending them separately.

Because these notices have not changed since 2018, employers who provided these notices earlier this year are not required to provide them again.

Employers are also required to notify CMS online annually that they have sent out these Part D notices. The notice to CMS is due within 60 days after the start of the plan year. See the last paragraph of this article for details.

When Is the Medicare Part D Notice Required?

Medicare Part D notices must be provided at least once annually, prior to October 15th, which is the beginning of the Part D annual enrollment period. Additional notices must be provided if the employer-provided coverage changes (from creditable to non-creditable, or vice-versa), if the individual requests a copy of the notice, and when an individual first enrolls in the employer plan.

Why is the Part D Notice Required?

The reason plan sponsors are required to provide Part D Notices is because a penalty will be imposed on an individual if he/she, after becoming eligible for Medicare Part D coverage, has a lapse of “creditable” prescription drug coverage for a period of at least 63 days. Additionally, such individuals may have to wait until the following October to join. An individual can elect either Medicare prescription drug coverage or other “creditable coverage” to avoid having a lapse in coverage. Thus, Medicare-eligible participants in employer group health plans must know whether or not the employer group coverage is “creditable” so they do not unwittingly incur a late enrollment penalty.

Additional Details on the Disclosure Requirements

  • Group health plan sponsors to whom this disclosure requirement applies include employers and Unions; multiple employer welfare arrangements (MEWAs); federal, state and local government employers; and churches.
  • The Part D Notice must be provided not only to Medicare-eligible active working employees and their dependents, but also to participants who are retired, on COBRA, or disabled and covered under the employer’s prescription drug plan.
  • Although the requirement is only that “Medicare-eligible” individuals be provided this notice, employers often provide it to all plan participants and dependents, because of the practical difficulty of knowing who is Medicare-eligible.

Annual Notice to CMS Also required, though not by October 15th

Additionally, plan sponsors are required to notify CMS annually, via the CMS website (Online Disclosure to CMS form). This notice must be made within 60 days after the beginning of the plan year (or contract renewal date, for small plans that do not file Form 5500s so do not specify a plan year), and it pertains to the creditable coverage status for the prior plan year. For calendar year plans, this notice must be provided to CMS no later than March 1.  Sponsors of non-calendar year plans should mark their calendars to make sure the disclosure to CMS is made within 60 days after the beginning of the plan year. (E.g., for an April 1 plan year, the CMS online disclosure should be made no later than May 30.)

Additionally, if applicable, plan sponsors must complete the Online Disclosure to CMS Form within 30 days after termination of a prescription drug plan or within 30 days after any change in creditable coverage status.

For additional information, click here for the main CMS webpage that provides guidance on “creditable coverage.” Or you can visit the web page at https://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/

ATTENTION: ACA FFM Certification Reminder

Agents with active on-exchange plans who want to receive renewal compensation must re-certify by the end of 2019. In addition, agents offering on-exchange coverage must certify prior to selling any plans during the 2020 open enrollment period.

Follow these steps to certify:

  1. Go to the CMS Enterprise Portal and log in
  2. Update your information on your Marketplace Learning Management System (MLMS) agent/broker profile
  3. Complete the Marketplace training requirement.
  4. Read and accept the applicable Marketplace Agreement(s)
  5. Print your 2020 Registration Completion Certificate
  6. Confirm your registration by using the Registration Completion List
  7. Please forward a copy of the registration completion certificate to Geoff Beglen at Cornerstone

Questions? Contact individual expert Geoff Beglen.

INDIANA: Earn Points With Anthem’s ChamberCare Health Alliance MEWA Program

Earn 15 rewards points for your new ChamberCare Health Alliance MEWA medical sale. New sales with effective dates from October 1, 2019, through January 1, 2020, qualify.

Points can be redeemed for thousands of rewards options, including event tickets, name-brand merchandise, movies and media, and more.

Additional Rules

  • Only new Anthem contracts count towards Small Group ChamberCare Health Alliance bonus.
  • Points will be awarded 6 – 8 weeks after they are earned.
  • Agents must register on the program website to receive Anthem Points earned based on program rules.

Click here for more information.

Contact your Cornerstone representative with any questions.

Principal’s Fourth Quarter Promotion Rewards You For Your Sales

Leverage these tools to boost your sales—whether you’re working with a new or existing client. Clients with effective and renewal dates of September 1, 2019 – January 1, 2020 are eligible.

New business

Start-up dental discount
Your cases under 200 lives are eligible for:

  • 5% discount for cases without orthodontia
  • 3% discount for cases with orthodontia

Extended rate guarantee program
Your cases under 200 lives that meet all eligibility for the multiple product discount receive:

  • Free 2-year rate guarantee for dental and short-term disability
  • Free 3-year rate guarantee for group term life and long-term disability

Existing business

Extended rate guarantee program
Cross-purchase renewals receive:

  • Free 2-year rate guarantee when adding a coverage line to existing cases under 200 lives*

Principal – Great Lakes Region – 513-733-9400

Limitations: Doesn’t apply to Washington dental and vision small group cases. Doesn’t apply to Florida cases with fewer than 51 lives.

*Applies to all existing lines excluding accident and critical illness.

Anthem Kentucky Releases Chamber Advantage MEWA

Anthem Kentucky has released the Chamber Advantage MEWA solution. This MEWA was created through the partnership of Anthem and the Kentucky Chamber of Commerce. This is an underwritten solution for employers with 2 eligible to 50 total employees on payroll.

The product’s initial effective date will be October 1, 2019. All groups will have a common renewal date of June 1.

Below, you will find the Chamber Advantage Product Guide, Chamber Advantage/Employer FAQ, Chamber Advantage Broker Guide, and Employee Medical Questionnaire (required for groups with fewer than 6 enrolled employees).

Quoting

Quoting is now available for the Chamber Advantage product. You may request preliminary quotes by submitting a dependent level census. For an underwritten quote, medical questionnaires will be required for groups with fewer than 6 enrolled employees. Please send your quote requests to your Cornerstone quoting team at the corresponding office below:

To quote Chamber Advantage, the group does not need to be a member of a chamber.

Please contact your Cornerstone Broker Advisor for more information on this product.

ChamberAdvantage Product Guide

ChamberAdvantage FAQ

Employee Medical Questionnaire

ChamberAdvantage Broker Guide

RSVP Today: Columbus Oscar Health Broker Seminar

Join Oscar and Mount Carmel leadership to learn more about Oscar, their 2020 products, and their network partnership with Mount Carmel in the Columbus market.

Space is limited, and you won’t want to miss out!

DATE: September 20, 2019

TIME: 10:30 am–12:30 pm

10:30 — Check-in + Networking

11:00 — Seminar begins + lunch

12:00 — Q&A

12:30 — Seminar ends

LOCATION: Mount Carmel East Hospital: Siegel Center | Columbus, OH

Click here to RSVP.

Signed Application Requirements for the Fourth Quarter

Effective Date and Application Requirements for December 1 and January 1 effective dates for Small Group.

Below is a list of carriers that will allow applications to be submitted for underwritten rates within 90 and 120 days of the effective date. Contact your Cornerstone Broker Advisor for additional information.

CARRIER

90 OR 120 DAYS

AETNA FUNDING ADVANTAGE 120 days (1/1/19 effective dates only)
ANTHEM SOCA 120 days from the date the applications are signed or 90 days from the date the employer’s paperwork is submitted.
ANTHEM CHAMBER ADVANTAGE 90 days
ANTHEM CHAMBERCARE HEALTH ALLIANCE 90 days
ALLSAVERS 120 days (12/1/19 & 1/1/19 effective dates)
UHC MEWA 120 days (12/1/19 & 1/1/19 effective dates)
HUMANA LF 90 days
MMO COSE MEWA 120 days (1/1/19 effective dates)

Aetna Announces 15-Month Contract and Updates to Underwriting Guidelines

Aetna recently announced that Aetna Funding Advantage (AFA) is offering a 15-month contract for December 2019/January 2020 new Aetna customers, along with their current AFA clients who renew in December 2019/January 2020. The contract will be offered in 25 markets*.

Details regarding the new AFA extended contract:
  • Offers a 15-month AFA contract
  • Applies to new and renewal AFA small group (5–50**) clients with December 1, 2019, and January 2020, effective dates
  • Moves your client to a March 1, 2021, or April 1, 2021, anniversary date
  • Is available in AZ, CO, FL, GA, IA, ID, IL, KS, KY, LA, ME, MI, MN, MO, MS, NE, NJ, NV, OH, OK, TN, TX, UT, WI and WY

Aetna has also updated their underwriting guidelines on AFA down to two lives. Click here to review the fact sheet regarding these updates.

Click here to access the AFA Quote Cover Sheet.


*Only available in AZ, CO, FL, GA, IA, ID, IL, KS, KY, LA, ME, MI, MN, MO, MS, NE, NJ, NV, OH, OK, TN, TX, UT, WI and WY.  Not available on our 1500 HSA plan. 
**2 to 50 in GA/KS/MO/S.IL/TX; 2 to 100 in N. IL/OH; 5 to 100 in CO/KY/LA/NJ/TN; 10 to 50 in NV

UnitedHealthcare MLR Premium Rebate Checks Will Mail in September for Impacted Groups

UnitedHealthcare recently announced that those who qualified for premium rebates for the 2019 MLR Payout Year will receive their checks by the September 30, 2019, deadline.

For a summary of which states, legal entities and size of business (aggregation set) will be receiving a rebate, refer to the Final 2018 MLR Rebate Report.

Click here for more information.

Contact your Cornerstone representative with any questions.

UnitedHealthcare Ohio Chamber MEWA Plans and Forms

We are excited to announce that the Ohio Chamber MEWA with UHC is ready to go. We will begin quoting immediately for a 9/1 effective date. That’s right! If you have a group that completed FormFire applications and didn’t get their decision made in time, we can still get you the 9/1 effective date.

The Ohio Chamber offers affordable membership for your clients and is required at the time of sale only. Click the link at the end of this message to access the available plan designs and all the necessary enrollment information.

The highlights below give you the details and value added benefits that your client will receive with the Ohio Chamber MEWA.

OHIO CHAMBER OF COMMERCE MEWA

  • Available for employer groups with an ATNE of 2–50
  • 15 Plan Portfolio (below)
  • Full National Choice Plus Network
  • Common 1/1 Renewal Date
  • Extended contracts available for 9/1 to 12/1 – RENEWAL 1/1/2021!
  • Applications accepted for 120 days from signature for 10/1 through 1/1 effective dates
  • Ohio Chamber Membership Required (or discounted Affiliate Membership)
  • $30 PEPM Commission Structure
  • Full UHC Value Added Benefits, including:
    • Real Appeal
    • Motion on all HSAs
    • Employer eServices
    • UnitedHeatlhcare Mobile
    • MyHealthcareCostEstimator
    • Virtual Visits

AHP_EE_Enrollment_Form_OH_final_fillable
AHP_EE_Health_Addendum_OH_final_fillable
AHP_ER_Application_OH_final_fillable
All Savers Plan Sponsor Certification Form
OCC MEWA Quote Install Checklist
OCC MEWA Quote & Install Checklist
OCHBP_Broker_Aug_2019
OH CHBP_Payment Authorization form
Ohio Chamber MEWA Coversheet & Census
Ohio Chamber Plan Grid