The Centers for Medicare and Medicaid Services (CMS) recently issued a proposed rule that advocates for additional oversight to protect both the issuer and consumer. The rule, called the “Patient Protection and Affordable Care Act (PPACA): Exchange Program Integrity”, would safeguard taxpayer dollars by ensuring that people are accurately determined eligible for premium subsidies they receive through the Exchange.
Last month, the Centers for Medicare & Medicaid Services (CMS) launched a new tool that enables you to look up your Marketplace registration status using your National Producer Number (NPN) and ZIP Code.
The tool shows you a summary of your Marketplace registration status.
In addition, the tool displays details of the Marketplace training and registration steps you have completed.
It also shows the status of CMS’ validation of the NPN you provided in your Marketplace Learning Management System (MLMS) profile.
The Trump Administration issued a final rule Wednesday morning regarding short-term plans (or STPs) that is expected to go into effect 60 days from today. The rule will end a policy from the Obama Administration that restricted the length of time for STPs. The final rule restores the maximum duration of STPs to up to 364 days, with the ability to renew for up to 36 months at the carrier’s discretion.
The rule was created in response to an executive order passed by President Trump in October that directed federal agencies to expand the availability of Association Health Plans, short-term policies, and HRAs.
Contact your Cornerstone representative for any additional details.
The Centers for Medicare and Medicaid Services started mailing new Medicare cards to people with Medicare who live in Wave 4 states: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, and Vermont. CMS will continue to mail new cards to people who live in Wave 3 states, as well as nationwide to people who are new to Medicare.
CMS finished mailing cards to people with Medicare who live in Wave 1 and Wave 2 states and territories (Alaska, American Samoa, California, Delaware, District of Columbia, Guam, Hawaii, Maryland, Northern Mariana Islands, Pennsylvania, Oregon, Virginia, and West Virginia). If someone with Medicare says they did not get a card, print and give them the “Still Waiting for Your New Card?” handout (in English or Spanish) or instruct them to:
- Sign into MyMedicare.gov to see if we mailed their card. If so, they can print an official card. They need to create an account if they do not already have one
- Call 1-800-MEDICARE (1-800-633-4227). There might be something that needs to be corrected, such as updating their mailing address.
via Medicare Learning Network
CMS recently released a report outlining the current condition of the operational and programmatic
aspects of the Exchanges.
- For plan year 2018, 49,100 agents and brokers registered with Federal platform Exchanges, supporting 42 percent of overall enrollments.
- The cost breakdown for registration/training, technical assistance, and oversight is $2.40 per enrollee.
- The biggest concerns for agents and brokers are lack of competition in the individual market and availability of commissions from insurance carriers.
- To date, CMS has implemented 93 percent of recommendations from our agent and broker partners
The Centers for Medicare & Medicaid Services announced that a months-old federal court ruling will force it to suspend risk-adjustment payments, worth about $10.4 billion for 2017. These payments are meant to help balance the insurance markets when some insurers had to take on sicker, more costly patients.
For more information, click here.
The Marketplace Learning Management System (MLMS) will be closed starting July 18 at 6:00 PM ET until training for plan year 2019 goes live.
Before this “go-dark” period begins on July 18 at 6:00 PM ET, you should:
- Check that your MLMS profile is up-to-date.
- Print your Registration Completion Certificate(s) to document your plan year 2018 registration for the Individual and/or Small Business Health Options Program (SHOP) Marketplace.
Certificates showing you have completed plan year 2018 registration and training will not be available after the MLMS closes.
To print your plan year 2018 Registration Completion Certificate(s), follow these three steps:
- Log in to the CMS Enterprise Portal.
- On the “My Status” page, the “Complete Agent Broker Training” entry will show “Complete” in the “Status” column if you have completed training.
Select the “Print Certificate(s)” link and follow the prompts.
During the go-dark period, the Centers for Medicare & Medicaid Services (CMS) will be preparing for plan year 2019 registration and training. Stay tuned for updates, or visit the Resources for Agents and Brokers webpage.
Contact your Cornerstone representative with any questions.
CMS recently issued the HHS Notice of Benefit and Payment Parameters for 2019, generally for plan years beginning on or after January 1, 2019. The rule is designed to improve affordability for those with high premiums.
The rule includes provisions in the following key areas:
- Essential Health Benefits (EHB)
- Qualified Health Plan (QHP) Certification Standards
- Risk Adjustment
- Advance Premium Tax Credit (APTC) Program Integrity
- Special Enrollment Periods (SEPs)
- Medical Loss Ratio
- Small Business Health Options Program (SHOP)
- Rate Review
In addition, CMS has extended the transitional policy for one additional year, allowing for the transition to fully ACA-compliant coverage in the individual and small group Health Insurance Marketplaces until 2019.
Click here for more information or contact your Cornerstone representative.
On March 15, 2018, CMS will host a webinar that provides an overview of the Agents and Brokers Resources webpage, as well as a new search tool that facilitates finding the appropriate resources on that page. The webinar will review other online resources, like Help Desks, and Call Centers, that are available to Marketplace agents and brokers, and will cover best practices for troubleshooting technical issues.
To register for this webinar, please visit www.REGTAP.info and register for “2018 Health Insurance Marketplace Updates for Agents and Brokers.”
DATE: Thursday March 15, 2018
TIME: 2:00 pm–3:00 pm ET
Medicare has a major change coming this year and I want to make sure you are aware. The Centers for Medicare and Medicaid Services (CMS) will be replacing all members’ cards starting in April 2018. They are replacing the cards based on a provision in the Medicare and CHIP Reauthorization Act of 2015 (MACRA). MACRA section 501 requires CMS to remove Social Security numbers (SSN) from Medicare cards and to replace the use of SSNs with new, randomly generated Medicare beneficiary identifiers, or MBIs by April 2019, to protect the individual’s identity.
This massive card replacement will affect clients who use Medicare Supplement Insurance to fill in the gaps in their Medicare Part A and Part B coverage. Individuals insured with a Medicare Advantage plan will also get new original Medicare cards, but they should continue to use their Medicare Advantage plan cards when seeking medical care.
The new cards will look just like they have in the past with a red, white, and blue palette, except these cards will not include the individual’s SSN, and will instead have a Medicare number. The MBI on their Medicare card includes both numbers and letters for optimal security. See below what the new cards will look like with the new MBI number:
Starting April 2018, newly eligible beneficiaries will get a card with a unique number regardless of where they live. For those individuals who currently have a Medicare card, CMS will begin mailing new Medicare cards over a period of approximately 12 months based on geographic location and some other factors. Ohio and Kentucky will be of the last states to get the new cards. Below is a chart that shows, based on the area, when individuals will receive their new card:
Beginning in April 2018, individuals with Medicare will be able to go to Medicare.gov/newcard to sign up for emails about the card mailing and to check the card mailing status in their state. Individuals may use their card immediately upon receiving it. They will be able to use either the SSN-based or the new random alphanumeric-based numbers through December 2019. Beginning January 1, 2020, only the new cards will be accepted.
With any change in Medicare comes confusion. This is a great opportunity to reach out to your clients to explain any changes and what they can expect. Click here for a one-page flyer from CMS that outlines the details of the new Medicare card. This is a great reference for your clients.