Client Referral Program Open Enrollment Individual Referral Acceptance Deadline

The Cornerstone Agency Services Client Referral team accepts client referrals from brokers participating in the program. Our licensed Client Care team can assist referred prospects offering guidance and support with plan enrollment in the Individual market.

To ensure we continually provide referred clients with exceptional service during the busy enrollment season, please familiarize yourself with our readiness checklist, which details our submission process, acceptance deadlines, and turn-around times.

INDIVIDUAL

OPEN ENROLLMENT PERIOD

November 1 to December 15, 2018

  • Referrals are managed first in/first out*
  • A minimum of three client outreach attempts will be made
  • Whenever possible, provide two forms of client contact information; cell phone, spouse cell phone, email address, work phone number, or other.
  • Submit referrals via the broker online form (preferred method) or prospective clients may call us at 877-432-8803. The online form can also be downloaded and emailed to referrals@crnstone.com.
  • The following information is required for all referrals**: prospect name, address, county, two client contact information options, and date(s) of birth.

*Priority is given to Individual referrals received on or before December 3, 2018. Client outreach within 48 hours is not guaranteed during peak periods Oct 1 through Dec 15.

**Incomplete submissions will be returned requesting missing information.

 

Due to extremely high volumes of referrals during the open/annual enrollment period, we encourage clients to plan ahead and make decisions early.

If you have questions about referral submission, the referral acceptance deadlines, or other processes, please do not hesitate to contact us.

Be Sure That Your Individual Market Clients Re-Enroll Before December 15

Consumers will be automatically re-enrolled into the ACA Marketplace after December 15

Your clients will be automatically re-enrolled in a 2019 Marketplace plan if they do not update their Marketplace application and enroll in a plan before December 15.

Your clients may be automatically re-enrolled if they…

  1. Received coverage in 2018 through participating issuers but have not selected 2019 coverage by December 15. Note: Re-enrollment in their issuer’s plan for 2019 may be different from their plan enrollment for 2018, depending on plan availability.
  2. Are currently enrolled in plans through issuers that will not be participating in the Marketplace for 2019. These clients will be matched with an alternate plan offered by a different issuer.

Be sure that your clients log in to Healthcare.gov, update their information, and review the plan options available to them for 2019.

Questions? Contact Geoff Beglen for additional information.

Ohio Farm Bureau Health Benefits Plan Update for January 1, 2019 and Later Enrollments

JANUARY 1 DEADLINES

The following dates and deadlines pertain to enrollment for January 1, 2018:

December 10, 2018- Last day to request a January 1, 2019 quote (or re-quote) for any group.

December 17, 2018- Last day to bind coverage for January 1, 2019

Any group making a request after these dates will be able to receive a quote or join the plan on February 1, 2019 but will not have the option to be quoted or enroll for January 1, 2019.

Please share with your clients that due to the high end of year enrollment volume the delivery of paperwork such as employee ID cards may take longer than is normal. Those needing help accessing their benefits can contact Medical Mutual at 800-382-5729.

December 19, 2018- Please have all renewal confirmations and paperwork to Cornerstone no later than December 19, 2018 to allow for processing time in order to meet the Ohio Farm Bureau December 21, 2018 submission deadline.

MANDATORY ELECTRONIC BILLING

Any group sold after January 1, 2019 with ten (10) or fewer employees enrolling is required to sign up for ACH* payments. Groups in this size category will no longer have the option to pay their monthly premium equivalent rate by check.

Any group that is delinquent more than once in a six (6) month period will also be required to sign up for ACH payments as a condition of reinstatement.

These requirements will ensure that every group is able to participate in the Ohio Farm Bureau Health Benefits Plan without administrative difficulties.

ACH (Automated Clearinghouse also known as EFT or Electronic Funds Transfer) allows a group to provide payment details once and have funds debited from their bank account automatically each month to pay for their coverage.


Questions? Get in touch with us by phone or email!

5 Reasons Aetna is Your Choice in Northeast Ohio

 

Cornerstone Senior Marketing & Aetna MA/MAPD want to share some insightful benefit information on Aetna’s plans if you have clients in the Northeast Ohio region.

5 reasons Aetna is your BEST choice in Northeast Ohio:

  1. Access to National Network on PPO and HMO plans. Network includes ALL acute care hospitals in Ohio, with access to a national network which includes Cleveland Clinic, Akron Children’s and Aultman.
  2. Expanded service area into Wayne, Carroll and Tuscarawas counties.
  3. $0 premium HMO Value and $0 premium Value PPO plans.
  4. $0 PPO includes dental, OTC, hearing and meal benefit.
  5. Reduction in MOOP and copays including $0 Tier 1, and Tier 2 Prescription gap coverage.

 $0/MONTH

Two plan options including both medical and prescription drug coverage at $0/month

PROVIDER NETWORK

All acute-care hospitals in Ohio are in-network for Aetna members

(The Ohio State University is in-network for Aetna PPO members only)

NEW BENEFITS ADDED

Plans may include: OTC allowance, transportation, post-discharge meals, and dental, vision, & hearing benefits

If you have questions or want to get contracted with Aetna please contact your Cornerstone Senior Marketing representative.

The Importance of Wrap Documents

Jennifer Agnello

Jennifer Agnello | President

Are you looking to provide even more value for your group clients?

By now most of you are familiar with a Summary Plan Description (SPD) issued for your clients’ medical plan. The SPD is one of the most important documents participants are entitled to automatically receive. This document must be provided and maintained by the plan administrator (typically the employer) and should be distributed automatically to all plan participants no later than 30 days after a written request. It outlines specific details of the health plan, such as a description of the employee benefits that are covered through the plan, participation rules, annual limits, election procedures, eligibility, employer contributions, and the plan year. It also summarizes claim filing procedures and plan sponsorship and administration.

Herein lies the issue. The Employee Retirement Income Security Act (ERISA) requires that the majority of health plans hold a Summary Plan Description. Only three exemptions exist in this ERISA regulation: 1) Indian Tribal Governments, 2) Church Plans, and 3) Governmental Entities subject to the Public Health Service Act. Chances are that the majority of your clients must comply.

Since ERISA not only applies to the medical insurance plan but to surgical, hospital, accident, HRA, FSA, dental, Rx, vision, life and AD&D, disability plans, and many voluntary plans, the health plan SPD does not cover all ERISA requirements for these additional benefits often written through various insurance companies. A written contract of insurance with an insurance company does not normally contain all of the rules required by ERISA and therefore is not a plan document. Estimates from the Department of Labor (who hold authority over employers offering these group benefit plans) show that three out of four plans audited have an ERISA violation. 70 percent of those audits result in monetary fines, many of which are significant, up to $110 per day, per affected individual for failure to comply.

Because most SPDs do not fully comply with ERISA, a wrap SPD is necessary. It is designed to “wrap” around all existing certificates of insurance and benefit plan booklets for each fully insured or self-funded plan and provides the information necessary to comply with ERISA’s reporting and disclosure requirements, HIPAA, and other federal laws. The wrap supplements the SPD with any additional ERISA required documentation, while also combining multiple benefits into a single plan for filing purposes. When a wrap document is used, the insurance policy or contract remains part of the plan document.

Therefore, the wrap and the insurance policy or contract together comprise the complete plan document and consequently meet the requirements of an ERISA plan document.

Various sources are available to prepare these wrap documents with prices ranging from $600 to $1,500. Contact your Cornerstone representative for more information.

If your clients do not currently have a wrap document in place, you have a chance to provide real value by keeping them compliant. Contact us today! Your E & O carrier will appreciate it!

In Honor Of Our Veterans…

On Monday, November 12 (day of observation) Cornerstone will once again pay special tribute to the men and women who so bravely devoted their time to serve in the armed forces. November 11th is a day dedicated to those individuals and a time for us to recognize their sacrifices. In honor of Veterans Day, please take some time to remember that it is because of our veterans that we all enjoy the freedom to express ourselves and the unlimited opportunities for which this country stands. Please pause to recall the sacrifices that our Soldiers, Sailors, Airmen, Marines, and Coast Guardsmen have and will continue to make, serving our Nation where and whenever they have been called. Their service deserves acknowledgement. These courageous and brave individuals have forgone family life, private sector careers, and for many, sacrificed their lives, willingly taking on the greatest responsibility of upholding our freedom. They have voluntarily joined the ranks of America’s Armed Forces, fully aware of their obligations as citizens and the risks they are taking to stand for what our country believes in and founded upon.

Through their courageous and unquestioned sacrifices, they have secured for millions the blessings of freedom, democracy, and unmatched opportunity that we enjoy in the United States today.

Please take the time to PERSONALLY thank these special folks and those who are a part of your lives. They deserve our respect and recognition.

We have chosen to give our Cornerstone Veterans ½ day off on Monday November 12th to show our appreciation corporately.
Thank you to our employees, Eric Pouncy Sr. and Hal Demmerle, as well as our families for making this sacrifice. We are grateful to you for allowing us to continue to live in a thriving, peaceful, FREE country.

Have a safe Veterans Day, and as always, God bless the United States of America. 

What are Association Health Plans?

Gregg Amato

Gregg Amato | Director of Employee Benefits (Cleveland)

The Trump Administration and the United States Department of Labor (DOL) announced new rules for Association Health Plans (AHP). The new rules allow insurance carriers to expand access to the market for fully insured plans beginning September 1, 2018, and on January 1, 2019, for self-funded plans.

What are AHPs?

AHPs are group health plans that employer groups and associations offer to provide health coverage for employees. These plans exist today, and existing plans may continue after the new rule takes effect. The new AHP rule brings additional plans into the market, allowing more small businesses and sole proprietors to join together to create an AHP by either purchasing large group or self-insuring coverage. Business owners with no employees and small businesses that have employees will have access to these plans, and AHPs will now be able to cross state lines. Many AHPs will most likely choose to self-insure, which further reduces regulatory burden since self-insured plans are not subject to state insurance regulations.

A small group is defined in Ohio as having less than 50 employees. Local business groups and industry groups nationally will be able to band together, which will allow the insurance risk to be spread out over a larger group. Spreading out the risk over larger pools gives small businesses access to health coverage at a lower premium, which was only afforded to large groups in the past.

Large group plan underwriting guidelines are much less restrictive than the small group and individual plan rules. Less restrictive coverage would likely attract healthier people and the combination of reduced benefits, healthier enrollment, and administrative costs being spread across a larger group would generally result in lower premiums for an AHP. AHPs as a large group will have better leverage to negotiate premiums as compared to small group and individuals that are set by the insurance industry.

AHP rules available to small groups:

  • For the sole purpose of obtaining health insurance
  • Same geographically located industry and businesses
  • Members of chambers of commerce and nationally affiliated trade industry groups
  • Sole proprietors and non-employer firms

The new rule would give small businesses access to coverage as an alternative to the ACA market.

Number of Businesses and Associations

According to the 2016 U.S. Census Bureau’s Annual Survey of Entrepreneurs, there were 5.6 million employer firms. Employer firms with less than 20 employees made up five million firms and there were 24.8 million non-employer firms. The number of non-employer firms added to the firms with less than 20 employees equals nearly 30 million firms.

In January of 2015 The Power of Associations states, “In 2013, there were 66,985,501 organizations on file with the IRS. This subsection includes chambers of commerce and the majority of the trade associations and professional societies operating in the United States today. Associations are found in every state and territory in the country.”

Considering the number of small firms along with the number of associations that exist in the U.S., the expansion of AHPs has the potential to impact a large number of people.

New Rules/Pre-Existing Conditions

The Affordable Care Act (ACA) requires AHPs that sell health insurance plans to small employers and individuals and small employers must meet the same standards that the ACA applied to these respective markets. The ACA outlined certain essential benefits that have to be included in health insurance plans, including preventive care, ambulatory services, emergency services, hospitalization, mental health services, maternity care, prescription drugs, rehabilitation, laboratory services, and pediatric care. AHPs are exempt from these regulations and may not cover some of these services.

AHP new rules:

  • Do not have to include the ACA’s 10 essential health benefits for plans in the individual and small group market, businesses with fewer than 50 employees
  • Allows different premium rates based on age, gender, and location; charges can vary by industry
  • Does not allow discrimination based on health status
  • Cannot deny coverage or charge more because of pre-existing
  • Cannot cancel coverage due to an employee’s illness
  • Can vary charges, higher rates for high-risk industries compared to low-risk industries
  • Allows dependents on the plan until they reach age 26
  • Cannot charge older applicants more than three times as much as younger applicants
  • Must cover at least 60 percent of average medical costs
  • Subject to the ACA’s risk adjustment program for small group and individual plans
  • Sole proprietors and non-employee firms can get coverage for their family
  • Does not change or affect any existing association health plans
  • Requires AHP to elect a governing body
  • Effective dates for the new rule are September 1, 2018, for fully insured association plans and January 1, 2019, for self-funded association plans

Summary

Providing health insurance as a small business owner can be costly when balancing between growing their business and attracting new talent. The new rules and expansion of AHPs provide small businesses with the opportunity to offer health insurance at lower premiums, giving them the same kind of flexibility that large companies have when selecting a health insurance plan. AHPs can lower health insurance premiums because they are exempt from covering the 10 essential health benefits required by the ACA and the law allows for more flexibility in the way AHP premiums are set. Even though AHPs will most likely have lower premiums, it is important to remember the benefits plan options may not be the same as those in other more expensive health plans. With many small businesses facing rising premiums, having access to a more affordable coverage alternative in AHPs is a viable solution

It is important to research and understand the options before purchasing any health insurance plan, including an AHP. Even though the selection process can be time consuming, the investment is worthwhile to ensure the right health insurance plan is placed. Working with an experienced health insurance broker or consultant can be beneficial, saving both time and money when navigating the selection process.

If you need additional information about AHPs, the experts at Cornerstone can help. We have extensive experience working with AHPs and with understanding the positive impact of the new rules. Please ask your local Cornerstone representative about the available AHP plans offered through our contracted health insurance carriers.

Anthem Commission Increase!

Anthem commission increase! The 2019 SOCA BP/MEWA commissions increase from $22 to $26 on business with original effective dates January 1, 2019, and later. Any groups that move in January from GM to MEWA with Anthem’s push this year, will have this new SOCA BP/MEWA commission.

Lunch Is On Us! Grab Your Humana Medicare Kits On Friday!

End the first week of AEP with your friends at Cornerstone Senior Marketing and Humana and grab some Tommy’s Pizza and Medicare kits on us!

Humana representatives Sandy Bartels and Cyndi Ellis will be at our Columbus office on Friday, October 19 to meet with you, provide plan kits, and serve lunch to our valued brokers.

WHEN: Friday, October 19

TIME: 11:00 am–1:00 pm

WHERE: Cornerstone Columbus Office

9482 Wedgewood Boulevard, Suite 130 | Powell, OH 43065

RSVP here.

*Please register by Thursday, October 18 so we can be sure to provide enough food. Please indicate the specific plan kit numbers you need when registering.

Your Cornerstone Senior Marketing Team Has New Email Addresses!

With Cornerstone Senior Marketing’s recent partnership with Integrity Marketing Group, all Senior Marketing representatives now have new primary email addresses.

Please take a minute to update your contact information with our new email addresses, shown below. You can start emailing us at the new address immediately but not to worry, we’ll still receive emails at our previous addresses for the foreseeable future.

Tim Shook | tim.shook@cornerstoneseniormarketing.com

Ryan Carroll | ryan.carroll@cornerstoneseniormarketing.com

Paul McMillen | paul.mcmillen@cornerstoneseniormarketing.com

Jaime Lebròn | jaime.lebron@cornerstoneseniormarketing.com

Matt Fry | matt.fry@cornerstoneseniormarketing.com

Jim Meyer | jim.meyer@cornerstoneseniormarketing.com

Kelley Myers | kelley.myers@cornerstoneseniormarketing.com

Lila Sohnly | lila.sohnly@cornerstoneseniormarketing.com

Lisa VanSuch | lisa.vansuch@cornerstoneseniormarketing.com

Michelle Kapp | michelle.kapp@cornerstoneseniormarketing.com

Danielle Flesch | danielle.flesch@cornerstoneseniormarketing.com

Karen Brannon | karen.brannon@cornerstoneseniormarketing.com

Martha Klomparens | martha.klomparens@cornerstoneseniormarketing.com

Patrick Wiley | patrick.wiley@cornerstoneseniormarketing.com

 

If you have any questions, please contact your Cornerstone representatives (maybe give those new email addresses a spin!).