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Special Notice Regarding Anthem’s Enhanced Choice Short-Term Product
To help members losing Anthem Enhanced Choice coverage due to recent regulations surrounding short-term plans, Anthem will accept applications for members currently covered by an AEC plan to enroll in an Anthem off-Marketplace plan within 60 days of their AEC coverage ending.
ACTION REQUIRED: UnitedHealthcare Now Requiring NPNs in FormFire
Ensure your NPN is updated in FormFire before submitting medically underwritten quotes with UnitedHealthcare.
Sign Up for Medical Mutual’s 2025 Continuing Education Courses
Throughout the state of Ohio, Medical Mutual will host continuing education courses covering ICHRAs and Telehealth Trends. Attending a course will give you two free continuing educations credits.
Anthem SOCA Benefit Plan Product Dues Increase
Beginning with all participating employers that have active enrollment in May 2025, the product dues will increase from a per employee per month rate of $2.50 to $3.00 for each employee listed on the product dues invoice.
UnitedHealthcare uBundle Available to All 5 to 50 Level-Funded Opportunities
UnitedHealthcare uBundle is available to all 5 to 50 UnitedHealthcare level funded opportunities, which gives your client the opportunity save up to 4 percent on your UnitedHealthcare Level Funded medical premiums when you bundle with ancillary lines.
Medical Mutual 1095-B Tax Forms Will Be Available on My Health Plan in Mid-Late February 2025
Medical Mutual members may download their 2024 1095-B tax forms directly from My Health Plan, their secure member portal, starting in mid-late February 2025.
Surest is Coming to 2 to 50 Groups on UnitedHealthcare Level Funded Effective May 1
Surest plan options will automatically be included in all level funded quotes starting with May 1 effective dates.
Carrier Information for 2024 Prescription Drug Data Collection Submissions
This reporting process is referred to as the “prescription drug data collection” (or “RxDC report”). The first RxDC report was due by December 27, 2022 (covering data for 2020 and 2021); however, the Departments provided a submission grace period through January 31, 2023, for this first report. Subsequent RxDC reports are due by June each year covering data for the previous calendar year. Here are the requirements by carrier for data collection with deadlines as soon as March 1. Please review and reach out to your Cornerstone broker advisor with any questions:
Medicare Part D Disclosures Due by March 1 for Calendar Year Plans
The plan sponsor must complete the online disclosure within 60 days after the beginning of the plan year. For calendar year health plans, the deadline for the annual online disclosure is March 1, 2025.
UnitedHealthcare Nondiscrimination, Languages, and Accessibility Notice Available for Use
Please furnish the attached Nondiscrimination, Languages and Accessibility Notice to your employees who have selected a UnitedHealthcare plan. This notice covers the most recent requirements under the Affordable Care Act (ACA) nondiscrimination rule.
Update Your SummaCare Commercial Product Knowledge and Receive Three Free Hours of Continuing Education
Join SummaCare as they present a commercial product-focused continuing education event with key topics that will refresh and expand your knowledge, including self-funding, employee benefits captive products, and trends in commercial drug spends and impacts to employers.
Southern Ohio Chamber Alliance Benefit Plan Participating Business Acknowledgement: Notice of Product Dues Change
Effective May 1, 2025, the Southern Ohio Chamber Alliance Benefit Plan's product dues program will be changing for all participating employers. Beginning with all participating employers that have active enrollment in May 2025, the product dues will increase from a per employee per month rate of $2.50 to $3.00 for each employee listed on the product dues invoice.
Medical Mutual COSE Benefit Plan Annual Notices Mailing
Medical Mutual's annual notice of health benefits will be mailed to all COSE Benefit Plan group officials in early February. The letter instructs group officials to distribute copies of the accompanying member annual notice flyer to all plan participants.
Important Changes to Anthem’s Life and Disability Systems
Earlier this week, a communication was sent to Anthem Life & Disability policyholders informing them of a significant change to our systems. Specifically, the email addresses and Compassi Online Employer Self Service systems URL have been updated to align with The Standard.
Medical Mutual Member ID Cards Delayed for Some MEWA Members
Medical Mutual member ID cards for approximately 22,000 MEWA (1 to 50) members have been delayed. Cards have been ordered and are expected to arrive to members via U.S. mail by the end of January.
Medical Mutual Reaches Agreement to Make Kroger Part of Individual and Commercial Pharmacy Networks for 2025
As of January 1, 2025, all Kroger pharmacy locations, including nearly 200 across Ohio, are now in-network for all Medical Mutual individual/ACA, commercial and Medicare members for the 2025 plan year.
Anthem KY ChamberAdvantage Plans: Upcoming Annual Rate and Census Reconciliation
Anthem KY's ChamberAdvantage Benefit Plan will be collecting Annual Rate and Census Reconciliation (ARC) data from January 21 to February 28, 2025. This data is used by the plan manager, Consoliplex, to satisfy underwriting requirements and IRS documentation.
Pivot Breathe Announced as Medical Mutual’s New Tobacco Cessation Vendor
Members will be able to use this service at no additional cost with features like a handheld SmartSensor, 12 weeks of free nicotine replacement therapy (NRT), an easy-to-use mobile app, a personal health coach, and access to Pivot’s support community.
IMPORTANT: ACA 1094/1095 Reporting Requirements for 2024
The guide linked below is updated for 2024 and illustrates how each carrier handles the completion of forms, distribution to employees, and as we know it to be law now, in the case where employers are required to prepare their own forms, how to obtain the data from the carrier website.
Medical Mutual Announces Pivot Breathe as New Tobacco Cessation Vendor
Pivot Breathe offers an innovative digital experience to help their members quit smoking, vaping, and using other tobacco products.
UPDATE: January 1 Deadline Approaching for Reporting Beneficial Ownership Information
A federal court recently ordered a nationwide preliminary injunction halting enforcement of a law requiring the filing of private business ownership information with the federal government.
IRS Releases New PCOR Fee for Policy or Plan Years Ending On or After October 1, 2024 and Before October 1, 2025
The IRS recently announced in Notice 2024-83 that the adjusted applicable amount for the Patient-Centered Outcomes Research (PCOR) Fees is $3.47 for policy or plan years ending on or after October 1, 2024, and before October 1, 2025.
Principal Removes Missing Tooth Clause
Principal recently made an update to dental policies effective January 1, 2025, to remove the “Missing Tooth Clause,” which is a provision in the Dental contract that states it will not cover any dental treatment that replaces a tooth (or teeth) that was extracted or missing prior to the date the insurance coverage started, including crowns, bridges or implants.
Easy-to-Use Cheat Sheets for Anthem OH Small Group
Anthem OH recently released all the details of a small group platform in one place. Each page has live links to things like pharmacy network, formulary, plan charts, well-being resources and more!
Anthem SOCA MEWA and Ohio Farm Bureau MEWA to File 1094/1095 Data Electronically
Based on popular broker request, Anthem will prepare the 1094B and 1095B forms for the 2024 tax filing year and post to Employer Access.
Gag Clause Attestations are Due December 31! Here is Your How-To Guide
The annual Gag Clause Prohibition Compliance Attestation is a new requirement that prohibits group health plans and health insurance issuers offering group health coverage from entering into an agreement with a provider or TPA that would restrict the plan from providing cost or care information to plan participants, accessing de-identified claims data, and sharing information per privacy regulations with a business associate.
Download Anthem KY’s Broker Cheatsheet for Essential Information
Anthem KY has created a comprehensive broker cheat sheet that provides essential information to address client inquiries, including links to plan grids for ACA, Anthem Balanced Funding (ABF), and ChamberAdvantage (MEWA) portfolios.
SummaCare Updates: Large Group and MEWA Broker Bonuses and a New Captive Product
Earn more for your sales and enhance your group product portfolio with these SummaCare updates for 2025.
Important October Medical Mutual Updates: New Small Group Dental Plans
This update includes upcoming mailings, coverage limit updates, and new small group dental plans effective January 1, 2025.
REMINDER: Important Marketplace System Changes
Understanding these changes listed below can empower you to implement an actionable plan to ensure you’re ready to assist consumers this Open Enrollment.
Increase in New Sale Commission for Medical Mutual COSE Benefit Plan Groups with January 1 Effective Date
Medical Mutual recently announced an increase to the health commission rates on new COSE Benefit Plan accounts with an effective date of January 1, 2025.
Humana Dental Network Crosses Over 135,000 Providers
Offering a broader network with greater convenience and cost savings is a key differentiator that you can highlight when speaking to your clients.
Medical Mutual’s SmartShopper is Now Included for Fully Insured, MEWA and Balanced Solutions Groups
Medical Mutual's SmartShopper (a product of Zelis) is now automatically included for all fully insured, MEWA, and Balanced Solutions groups starting October 1, 2024.
Review Medical Mutual’s Reducing Deductible Plan Grid
Medical Mutual’s Reducing Deductible health plans provide organizations with 51 to 99 employees the opportunity to lower their annual deductibles by completing wellness activities.
Enhanced One Healthcare ID Security Coming Soon from UnitedHealthcare
Users will have to set up there of the four options: set up a password, add a passkey through web authenticator, set up MS or Google Authenticator on your phone, or add a phone number.
Earn More with Humana’s Small Group Bundling Bonus Enhancement!
Humana recently announced an enhancement to their 5 to 49 Small Group Bundling Bonus program that doubles the payout for a disability sale, increasing the line bonus from $200 to $400.
Delta Dental of Kentucky’s New System Date for Individual Clients and Brokers
Effective the end of this month, Delta Dental will be implementing a new Individual Enrollment Portal for individual plans and a new Producer Portal for brokers selling individual plans. These new portals will be fully administered by Delta Dental and will allow you to easily enroll subscribers as well as maintain subscriber eligibility throughout the year.
Anthem KY’s Small Group and Individual MLR Rebates Update
Anthem pays annual rebates to fully insured groups when their medical loss ratio (MLR) is less than 80 percent for small groups and individuals. For 2023, the KY small group and individual market is in a rebate position.
Anthem Cornerstone Vision Plans Available for January 1 Effective Dates
Enrollees added between November 25, 2024, and December 13, 2024, will become effective on the vision plan January 1, 2025.
Aetna Announces County Expansions in Ohio and Indiana in 2025
Aetna recently announced it will be expanding to 15 counties in Ohio and 15 counties in Indiana for their 2025 individual and family plans. Download their full county list and register for our upcoming webinar!