Medical Mutual’s SuperDental Network Expands Provider Options

Effective January 1, 2020, Medical Mutual will combine Superior Dental Care’s dental network with their DenteMax network to create the SuperDental Network, which will provide dental members with nearly 1,600 more dental providers than the current network. This network will give members access to more than 4,000 dentists, orthodontists, periodontists, and other dental professionals.

Members can view the expanded selection of participating SuperDental dentists and specialists in their area by visiting ProviderSearch.MedMutual.com.

Emergency Medicine Physicians of Cincinnati is Leaving Anthem’s Networks

Pending final negotiations, Emergency Medicine Physicians of Cincinnati will leave Anthem’s networks effective December 24, 2019. Consequently, Emergency Medicine Physicians of Cincinnati may choose to balance bill Anthem members for amounts above and beyond Anthem’s reimbursement. Because Anthem members do not have a choice of emergency room doctors at these hospitals, Anthem will apply the equivalent of any member liability amounts such as copays, deductibles, etc., at the member’s in-network level (rather than the out-of-network benefit level equivalent). In most circumstances, payment for services will be issued directly to the member, who will then be responsible for paying Emergency Medicine Physicians of Cincinnati.

The Emergency Medicine Physicians of Cincinnati is a group of emergency room doctors that provides emergency services at Mercy Health’s Anderson, Fairfield, West, and Clermont hospitals and Mercy Health’s Rookwood, Mt. Orab, Queen City, and Harrison medical centers.

Contact your Cornerstone representative with any questions.

Grow your Business With The Standard’s Partnership Rewards Producer Bonus Program

The Standard

The Standard’s Partnership Rewards producer bonus program offers incentives for small business sales, as well as large cases, and rewards new and retained business. You can qualify for the program based on the total lines of coverage sold, as well as the level of premium, starting with a $25,000 minimum in new business and six lines of coverage. Or, for large cases, qualify with as few as three lines of coverage with total premium of $750,000 or more.

Note: Agility products will count towards the bonus!

Click here to learn more about the program.

Contact your Cornerstone representative with any questions.

Take Advantage of Principal’s Broker Bonus Program

Increase your earning potential with Principal. Place new business and retain business and you may be eligible for their group benefit bonus programs.

There are two types of bonus programs.

  1. Production bonus—Rewards you for placing business with Principal. The more you sell, the higher the bonus factor. You can qualify for a production bonus based on new sale credits.
  2. Premium persistency bonus—Rewards you for placing and keeping business with Principal. The more premium you retain, the higher the bonus factor.

Click here to learn more about Principal’s 2020 Bonus Programs.

Click here to learn more about Principal’s Privileged Partner Program

Contact your Cornerstone representative with any questions.

Quoting the Ohio Chamber MEWA for Current UHC and AllSavers Group Customers

UnitedHealthcare (UHC) is not requiring applications at this time to review the suitability of current cases for the Ohio Chamber MEWA. See the linked PDFs below on migrating current business. Your Cornerstone representative submits these quote requests on your behalf to the UHC renewal contact. Please feel free to contact us with any questions.

Ohio Chamber MEWA Fully Insured Migration Checklist

Ohio Chamber MEWA All Savers Migration Checklist

October Medical Mutual Updates: Changing Payments, Deadlines, and Individual Market Updates

Medical MutualUpdating Medical Mutual Payments to Huntington Bank

Medical Mutual recently switched from PNC Bank to Huntington Bank for processing of premium and ASO-related payments. Group customers should now send payments to Huntington. Reminder letters will be sent to all affected groups ahead of shutting down the PNC Bank accounts prior to the end of the year.

COSE MEWA Columbus Territory Change

Effective November 1, 2019, the exclusive territory for the Columbus Chamber MEWA plan will expand beyond Franklin County and will include Union, Delaware and Licking counties. Any new group sold in those counties must be a member of the Columbus Chamber in order to enroll in the COSE MEWA health plan.

Two-Year Moratorium on Re-Entry to the COSE MEWA

Small groups choosing to leave the COSE MEWA and obtain other coverage will not be able to return to the COSE MEWA for two years. If a group wishes to return to the COSE MEWA before two years have elapsed, they will be charged a one-time fee of $1,000 per subscriber.

Pre-Submission Checklists

To help with submissions during the busy season, please complete your pre-submission checklist and send it in with your sold case documentation. Any submissions that are made after December 5, 2019, may not receive approval letters prior to the January 1, 2020, start date.

Health Insurance Tax

The federal government has not suspended the Health Insurance Tax for 2020, as they did in 2019. That means Medical Mutual will need to pass this tax along to their customers.

Medical Mutual Individual Market Updates

Medical Mutual will be offering ACA coverage in 12 new counties during plan year 2020. Click here to review the updated service area map. They have also added new $5,000 silver and $8,000 bronze deductible options that include office visit and Rx copays. Click here for the 2020 Plan Highlights flier for full details.

In addition, Medical Mutual has added statewide convenience walk-in clinics across Ohio and has expanded their Mercy HMO network with the addition of St. Luke’s hospital and more physicians.

Medical Mutual will discontinue the Promedica HMO network in Northwest Ohio. All members of that network will be moved to the Mercy HMO network.

Lastly, Knox Community hospital will no longer be a part of the OhioHealth HMO in Central Ohio.

Don’t forget to re-certify by the end of 2019 to receive renewal compensation for on-exchange plans!

Federally Mandated Fee Updated for 2020 Renewals

Since the Affordable Care Act went into effect in 2014, Medical Mutual has been subject to the Health Insurance Providers Fee, often referred to as the Health Insurance Tax or the Market Share fee. As a result, Medical Mutual has applied the Health Insurance Providers fee to all 2020 renewals.

Contact your Cornerstone representative with any questions about these updates.

Medical Mutual’s 2020 Small Group ACA Plan Grids Are Now Available

Medical Mutual’s updated plan grids, benefit highlight sheets, and Summary of Benefits and Coverage (SBC) documents are now available for the 2020 Small Group ACA rollout.

Updates to these plans include:

  • The elimination of the 1750 HSA plan. Current 1750 HSA members will be mapped into the 2800 HSA plan.

The addition of two HRA plans below:

  • Gold 5000 HRA with employer first contribution.
  • Silver 5000 HRA with employer second contribution.

Additionally, quoting for first quarter 2020 is now available in QRS. January 2020 renewals will be released soon.

MedFlex HMO Plan Options

2020 ACA Plan Options (Off Exchange)

Contact your Cornerstone representative for more information.

State Anthem Individual and ACA Groups Rx Change Coming

Members of Anthem’s Individual and Small Group Affordable Care Act health plans will move to their new pharmacy benefit manager, IngenioRx. Clients will receive letters regarding the change in November.

All Anthem members will use IngenioRx on January 1, 2020. Their pharmacy benefits don’t change as a result of the move to IngenioRx.

Members in most other plans, including grandfathered and/or grandmothered plans, already switched to IngenioRx.

Contact your Cornerstone representative with any questions.

Earn Up to $25,000 With Oscar’s National Open Enrollment Broker Bonus Program

With Oscar’s National Open Enrollment Broker Bonus Program, you can earn a one-time bonus of up to $25,000 on top of your regular commission. Here’s how it works:

  • Enroll or renew 50 to 249 policies and earn $20 per policy.
  • Enroll or renew 250 policies or more and earn $40 per policy for all policies.

That means that enrolling 250 policies can get you a bonus of $10,000!

Click here to learn more about the program.

Contact your Cornerstone representative with any additional questions.

October The Dental Care Plus Group Updates

The Dental Care Plus Group Deadlines for 1/1 Business

To ensure member ID cards for January 1, 2020, groups are in the mail by January 1, DCPG must be in receipt of the group’s complete sold case submission, including employee enrollment forms or enrollment spreadsheet, by Friday, December 6, 2019.

2020 Dental Shelf Rates: Two-Year Rate Guarantee

DCPG’s 2020 dental shelf rates for your small (2-50) groups are now available for January 1, 2020 effective dates. New this year: shelf rates are guaranteed for a period of two years on new sales. There is no impact to the renewal strategy. All shelf rate documents can be accessed here.

Groups that have terminated coverage with DCPG are not eligible for the new sale shelf rates for two years from the date of termination.

DCPG Vision Shelf Rates for 2020

DCPG’s vision shelf rate plans are available to groups with 2 to 200 eligible employees for January 1, 2020 effective dates. These rates are guaranteed for a period of two years (on new sales):

Vision benefits are offered through their partnership with Avesis and accessible through a nationwide network of more than 76,000 access points. The network is made up of both independent and retail providers (Walmart, Sam’s Club, Costco, etc.). Additionally, benefit frequencies are based on plan year versus date of service.

Groups that have terminated coverage with DCPG are not eligible for the new sale shelf rates for two years from the date of termination.

Contact your Cornerstone representative with any questions.