Medical Mutual Updating Step Therapy Programs Beginning July 15

Medical Mutual’s step therapy programs for prescription drugs, which promote clinically effective alternative drugs to improve cost savings and quality of care, will be updated effective July 15, 2017. In early May, Express Scripts will send out a letter to members who have filled a alternative drug prescription in the last month about the new requirements, which will be specific to the drug(s) that the member takes. Medical Mutual expects that the updates will effect up to 9,600 members.

These updates do not apply to Medicare Advantage and Medicare Supplement plans.

 

Not appointed with Medical Mutual? Contact your Cornerstone representative today to get started!

RESOURCES

Updates to Step Therapy Programs Begin July 15, 2017; Express Scripts to Notify Members

Anthem Releases Updated Medicare Supplement Rates

Anthem has released their updated Medicare Supplement rates effective July 1, which includes the introduction of Plan G to their portfolio. Like Plan F, Part G covers Medicare Part B Excess Charges, however, it does not cover the annual Part B deductible. And remember, all Modernized Anthem Medicare Supplement members are also now eligible for the Silver Sneakers Fitness program which offers members a basic membership at no extra cost*.

The new rates for Anthem’s Medicare Supplement plans are below.

Please be aware that with this release Anthem has also updated their Medicare Supplement application.  The new application as well as the updated kits will be available to order through custom point on May 16. Old applications will may be rejected.

Interested in getting appointed with Anthem? Contact your Cornerstone representative today.

 

RESOURCES:

Ohio Anthem BCBS July 2017 Supplemental Rates

 

*SilverSneakers is a value-added program. It is not insurance and not part of the Medicare Supplement insurance plans. It can be changed or withdrawn at any time.

 

Have you registered for Senior Expo 2017?

IRS Announces 2018 Indexing Adjustments

The IRS recently announced the 2018 indexing adjustments for two percentages under the ACA, as well as a reminder that the required contribution percentage used to determine whether individuals are exempt from individual shared responsibility penalties also decreased to 8.05 percent for 2018. The first percentage under the ACA, which is the percentage required to determine whether employer-sponsored health coverage is “affordable” for purposes of employer-shared responsibility, has decreased from 9.69 percent in 2017 to 9.56 percent for 2018. The second percentage, which is the percentage required to determine the amount individuals eligible for premium tax credits must contribute toward the cost of Exchange coverage, will decreases slightly.

For more information, refer to the full text of the announcement below.

Questions? Contact your Cornerstone representative for answers!

 

RESOURCES

Refundable credit for coverage under qualified health plan—indexing adjustments.

Dental Care Plus Group Offers Four Different Plan Options

The Dental Care Plus Group has four different plan options for your customers to choose from, and four rate tiers to cover spouses, children, or the whole family. DCPG pays a flat 10 percent commission on both new sales AND at renewal.

For more information about DCPG plans, click here.

 

Not appointed with DCPG? Contact Cornerstone today to get started!

 

RESOURCES:

www.dentalcareplus.com/individual-info

AETNA WEBINAR: Refresh Your Knowledge of Aetna & Coventry’s Fitness Benefit

Smiling senior woman swimmers in pool

WPA agents: Join Aetna and Coventry for a webinar discussing the ins and outs of their 2017 Medicare Advantage (MA/MAPD) plan’s fitness benefit.

Some topics that will be covered in the webinar include:

  • The free monthly fitness club membership at participating facilities
  • The at-home fitness kit options
  • Traveling with Silver&Fit
  • Online tools and resources

DATE: May 17, 2017

TIME: 10:00 am–11:00 am EST

REGISTRATION: To register, contact your Cornerstone representative today.

Webinar details will be sent after you register.

AETNA NETWORK ADDITION: Ohio Valley Surgical Hospital in Springfield, OH

Effective May 15, 2017 Ohio Valley Surgical Hospital will join Aetna networks in Cincinnati, Dayton, and Northern Kentucky. The hospital participates for a myriad of products, including Aetna Medicare Plan PPO, Aetna Medicare Plan HMO, and more.

Ohio Valley Surgical Hospital currently participates for the following products:

 

 

Please note: Currently these provider contracts do not support Network Access Businesses (NAB) products.

 

Improved Hospital and Physician Access

Ohio Valley Surgical Hospital is located at 100 West Main Street, Springfield, OH 45504. This addition will increase member choice and improve hospital and physician access in this service area.

 

DocFind/directory information

Ohio Valley Surgical Hospital has been added to Aetna’s DocFind online directory by the effective date. Current printed provider directories do not include Ohio Valley Surgical Hospital but will be included in the next directory edition.

 

Questions? Contact your Cornerstone representative for answers.

HSA Contribution and Coverage Limits for 2018 Announced

The IRS recently released Revenue Procedure 2017-37, which outlines the 2018 cost-of-living contribution and coverage adjustments for HSAs, as required under Code Section 223(g). The procedure also includes the minimum deductible and maximum out-of-pocket expenses for the high-deductible health plans (HDHPs).

According to the procedure, the amount that individuals may contribute to their HSAs for self-only coverage will increase by $50 (from $3,400 in 2017 to $3,450 in 2018) in 2018, while HSAs linked to family coverage will rise by $150 (from $6,750 in 2017 to $6,900 in 2018). Rate changes reflect cost-of-living adjustments.

 

Contribution and Out-of-Pocket Limits for Health Savings Accounts and High-Deductible Health Plans
2018 2017 Change
HSA contribution limit (employer + employee) Self-only: $3,450
Family: $6,900
Self-only: $3,400
Family: $6,750
Self-only: +$50
Family: +$150
HSA catch-up contributions (age 55 or older)* $1,000 $1,000 No change**
HDHP minimum deductibles Self-only: $1,350
Family: $2,700
Self-only: $1,300
Family: $2,600
Self-only: +$50
Family: +$100
HDHP maximum out-of-pocket amounts (deductibles, co-payments and other amounts, but not premiums) Self-only: $6,650
Family: $13,300
Self-only: $6,550
Family: $13,100
Self-only: +$100
Family: +$200
* Catch-up contributions can be made any time during the year in which the HSA participant turns 55.
** Unlike other limits, the HSA catch-up contribution amount is not indexed; any increase would require statutory change.


RESOURCES

Revenue Procedure 2017-37

IRS Sets 2018 HSA Contribution Limits

 

Questions? Contact your Cornerstone representative today for more information!

Anthem’s Online Billing System Delayed Indefinitely

ACA Small Groups in Kentucky will not receive notices electronically through EmployerAccess. Clients will continue to receive paper invoices, but can pay their premiums using any of the online payment options within EmployerAcess.

For  more information, contact your Cornerstone representative.

RESOURCES

Online Billing Suspended for ACA Small Groups in Kentucky

Aetna Will Exit Obamacare Individual Insurance Market (Virginia)

Aetna will exit the Obamacare individual insurance market in Virginia because of the “financial risk” and “growing uncertainty in the marketplace.”  The move only affects individual plans sold on and off the federal Obamacare exchange at HealthCare.gov.

T.J. Crawford, Aetna’s spokesman, said in an email, “Despite significantly reducing our exchange footprint, our individual commercial products could potentially lose more than $200 million in 2017.”

Source: CNBC (http://www.cnbc.com/2017/05/03/aetna-will-exit-obamacare-markets-in-virginia-in-2018.html)

Customers covered by Aetna through employers or Medicaid and Medicare Advantage plans will not be affected by this change.

 

Questions? Contact your Cornerstone representative today.

RESOURCES

Aetna Will Exit Obamacare Markets in Virginia in 2018

Aetna to Exit Virginia Obamacare Individual Insurance Market

GOP Health Care Bill Passed by the House

A Republican-drafted health care bill that would eliminate many provisions of the Affordable Care Act was passed by the House with a 217–213 vote on Thursday. The bill still awaits the Senate’s final approval.

The vote came only 6 weeks after House leaders failed to pass an earlier version of the bill. The bill includes last-minutes amendments that were written to appeal to the most conservative House Republicans and eliminates tax penalties for people that do not have health insurance. The bill will also offer tax credits between $2,000 and $4,000 per year, depending mainly on age, and provides $8 billion for states to set up high-risk pools to cover those with pre-existing conditions who are unable to find coverage on the open market. A number of Republicans in the Senate have expressed concern over how the bill would affect states that expanded Medicaid and how much it would drive up premiums for seniors.

The bill is expected to be significantly altered by the time it reaches the Senate chamber.

This is a developing story. We will continue to provide details as they come.

RESOURCES

House Passes GOP Health Care Bill

House Passes Measure to Repeal and Replace the Affordable Care Act