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

SAVE THE DATE: 2017 NW Ohio CE Training Days

Businessman hand touching SAVE THE DATE tab on virtual screen , business concept , business ideaWHERE*: Toledo: 4444 Keystone Drive, Suite F | Maumee, OH | 43537
Lima: 3745 Shawnee Road, Suite 104 | Lima, OH | 45806

*Please RSVP to Jenni Henry no later than 2 weeks prior to the event to reserve your space.

WHAT: Four (4) hours of CE available each day with product updates and training from our carrier representatives. There is a 15-minute break between each speaker so you can check emails/phone calls.


 

 

Information for the July 18th (Lima) and July 19th (Toledo) training days will be provided closer to the date of the event.

Contact your Cornerstone representative today for more information.

Medical Mutual Making Claims Adjustments Involving University Hospital Providers

After discovering that two pediatricians at University Hospital Medina Health Center were incorrectly loaded into the SuperMed network, Medical Mutual is working to update the directory so that the 70 members whose in-network claims were rejected will receive revised Explanation of Benefits statements with the correct claim information. Members who already submitted payment for those claims may be entitled to a refund.

For more information, contact your Cornerstone representative today.

RESOURCES

Medical Mutual Broker Update — May 3, 2017

Medical Mutual Requests Count for Total Number of Employees

Per the requirements laid out by CMS, Medical Mutual is requesting that all group health plan officials with 150 or fewer members report their total number of employees to help ensure Medicare accurately coordinates benefits and property pays claims. The total count should include full and part-time employees in each location, but does not include the total number of dependents under the plan.

Contact your Cornerstone representative today to submit your total number of employees.

 

RESOURCES

Letter from Medical Mutual

Medical Mutual Broker Update — May 3, 2017

Medical Mutual Now One of Express Script’s Top Five Health Plan Customers

Medical Mutual’s pharmacy benefit manager (PBM), Express Scripts, will lose Anthem business at the end of the current contract in 2019. Medical Mutual does not anticipate that this change will negatively effect their business with Express Scripts, noting that, due to Anthem’s departure, Medical Mutual is now one of Express Script’s top five health plan customers.

Medical Mutual’s contract with Express Scripts will run through 2020 and their pharmacy and finance departments will conduct a market check to be sure that their rates remain competitive.

RESOURCES

Medical Mutual Broker Update — May 3, 2017

Express Scripts Plunges After Losing Biggest Client Anthem

Ohio Valley Surgical Hospital Joins Aetna Cincinnati/Dayton/NKY Networks

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.

The addition will increase member choice and  improve hospital and physician access.

Questions? Contact your Cornerstone representative for answers.

Anthem Contracts with Hearing Care Solutions

Anthem Blue Cross and Blue Shield has recently contracted with Hearing Care Solutions (HCS) to offer hearing care plans to members covered by Anthem’s HMO and PPO Medicare Advantage plans.

HCS supplemental hearing benefits will provide coverage in addition to Medicare-covered hearing benefits, including a routine hearing exam, hearing aid fitting and evaluation, an allowance toward the purchase of hearing aid(s), and one year of service at no charge after a hearing aid is purchased.

For more detailed information, contact your Cornerstone representative today!

RESOURCES

Clients Benefit From Hearing Care and Hearing Aids

Premier and UHC Extend Network Relationship

In response to Premier Health Network deciding not to renew its participation for employer-sponsored and individual plans with UnitedHealthcare, the two companies will extend their network relationship for Medicare Advantage plans through December 31, 2017.

Premier Hospitals are now considered out of network for commercial health plans, effective April 30, 2017.

 

RESOURCES

Important Information About Our Relationship with Premier Health Network