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2021 UnitedHealthcare First Look

2021 UnitedHealthcare First Look

2021 UnitedHealthcare First Look
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UnitedHealthcare is the latest carrier to release their first look information for the 2021 plan season. The first look documents will have the generic benefit information available, such as Primary Care, Specialist, and Inpatient Hospital copays.

It’s very important that you introduce yourself to a local Agent Manager to get full product information in the counties where you work. Be sure to visit the calendar page of our website to find and register for webinars in your area that discuss the plans in more detail. We will also be holding webinars about UHC and all of the plans for 2021.

2021 UnitedHealthcare First Look Plan Certification

You must be certified and ready to sell before you can offer or discuss plans for 2021. Fully certified agents are the only ones who can receive UnitedHealthcare receive first look information. As always, to be compliant, remember that nothing can be shared with Medicare beneficiaries prior to October 1st. Refer back to our AEP Toolkit to stay up to date with both certifications and plan benefit information. UnitedHealthcare will accept AHIP as your generic Medicare training however, they are the only company that also offers this training through their portal at no cost to the agents. That training only counts for UnitedHealthcare, but it acts as a good introduction to Medicare Advantage without having to pay for AHIP. They also require their product-specific certifications. Make sure to certify early so that you can pre-order supplies as early as August 7th.

2021 UnitedHealthcare First Look Product Info

UnitedHealthcare is ranked #6 in the Fortune 500 world rankings. They are the #1 Medicare carrier in the United States. They carry the full weight of both the UnitedHealthcare and AARP brands. This means that you, as the agent, will be able to take advantage of plan stability, growth, and superior brand recognition. There are expansion counties, new PPO options, and a National network in 2021. UnitedHealthcare continues to grow its ancillary benefits, such as Dental and Transportation. With the current COVID-19 situation, there will be a greater emphasis on telehealth, which UnitedHealthcare offers with increased emphasis.

For more Information on 2021 UnitedHealthcare First looks and one-on-one support, click here to contact your Sales Director.

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Jeff Palo

Jeff Palo

Senior Sales Director - Health

x7716 | jpalo@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

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Contact a Pinnacle Financial Service representative today for assistance.

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2021 Medicare Advantage First Looks

2021 Medicare Advantage First Looks

2021 Medicare Advantage First Looks
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The 2021 Medicare Advantage Season has officially begun! With the launch of the AHIP program for 2021 on June 22nd, we have officially started the process for the upcoming Annual Enrollment Period. It is important to note that, although certifications are out and product info is coming, nothing can be communicated or dispersed to beneficiaries until 10/1/2020. We will be constantly updating our AEP Toolkit with available certification information as well as product rollout details. Keep an eye out for upcoming webinar information with a detailed product first looks.

2021 Medicare Advantage First Look Certification Information

The first step in becoming ready-to-sell, as well as receiving product information, is certifying. Most agents will begin with the AHIP test. Be sure to access the training through one of the carriers providing a $50 discount. We previously covered certification in more detail. Below are carriers that have released dates for the current year.

Aetna/ Coventry 7/1 Humana 6/30
AHIP 6/22 IBC/ AmeriHealth Mid August
Allwell/ Centene 7/7 Mutual of Omaha PDP 6/29
Anthem/ Empire 6/30 Select Health TBD (July)
BCBSM Mid July Silverscript/ CVS 7/1
Emblem/ ConnectiCare August UnitedHealthcare 6/29
Health First TBD (Late August/ Early September) Wellcare 7/7
Cigna/ HealthSpring 7/1 HealthNet 7/7

2021 Medicare Advantage First Look Product Information

Each year around June-August the carriers release first looks of their plans for the upcoming year. These first looks will contain the basic plan details, such as PCP and Specialist copays, Deductibles, and Inpatient Hospital costs. These are what the carrier filed, but could be subject to change as they need to be approved by CMS. These will not include more detailed information, so it’s important to be aware of each carrier’s rollout meetings. Be sure to review our calendar, which will have updated information on meetings in your local market. There will most likely not be in-person meetings this year, so it’s more important than ever to make sure you pay attention to carrier email or follow our posts to receive the information. The current release date information is below.

Aetna/ Coventry 7/22 Humana 7/15
Allwell/ Centene 8/1 IBC/ AmeriHealth 8/3
Anthem/ Empire Available Now UnitedHealthcare 7/29
Cigna/ HealthSpring 8/3 WellCare 8/1

Be sure to “follow” us on our desktop or cell phones for immediate updates by clicking on the bell icon in the lower right.

Click here to request First Looks.

For more Information Medicare Agent Training one-on-one support, click here to contact your Sales Director.

Click Here to Contract.

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Jeff Palo

Jeff Palo

Senior Sales Director - Health

x7716 | jpalo@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

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Contact a Pinnacle Financial Service representative today for assistance.

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2021 Medicare Advantage Training

2021 Medicare Advantage Training

2021 Medicare Advantage Training
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Believe it or not, the 2021 Medicare Advantage Annual Election Period (AEP) is almost upon us. Don’t forget that the SEP for COVID-19, code SEP-DST is still in effect until June 30th. Anyone who had a previous SEP available, such as OEP, and had not used it yet, can still enroll until the end of the month. Open Enrollment Period (OEP), followed by the COVID-19 epidemic, has carried us right into certification season. The first step for selling in 2021 is to become certified. New agents would do well to remember that most carriers will accept the 2021 AHIP and product certifications as viable to sell for the remainder of the current year. Keep an eye out on our Medicare Toolkit, found on our homepage. We will be posting up to date information on carrier certification and product previews all the way up to AEP.

2021 Medicare Advantage Training instructions

Medicare Advantage and Prescription Drug Plans are both governed by the rules and subject to the oversight of CMS. As an agent, you need to be fully certified to offer those products to your clients. Certification and Ready-to-Sell status typically requires two pieces. First, Medicare basics training, including information on fraud, waste, and abuse. Second, training specific to each carrier and its products. The most common, and widely accepted, Medicare basics certification is through AHIP. AHIP consists of 5 training modules for agents taking the course for the first time or 2 modules in subsequent years. These modules will contain multiple mini-quizzes after each lesson, many of which will also appear on the final exam. The AHIP concludes with a 50-question final exam, followed by Fraud, Waste, and Abuse modules. You must score 90% or better on the final exam in order to pass. You get 3 chances to pass, after which you will have to pay again for an additional 3 chances. Be careful as some carriers will not allow you to write for them in the current year if you fail the AHIP test 3 times. The second most common standard basics course is through Gorman. Gorman is not accepted by every carrier. New for this year is a course and training through the National Association of Health Underwriters (NAHU).

2021 Medicare Advantage Training tips and extras

The only cost to certify is that of the Medicare basics test. AHIP has stayed at $175 again this year, with many companies offering a $50 discount through their portal. Certain carriers, like Aetna or Humana, will pay for your AHIP after writing a certain number of applications. The AHIP test will typically take between 2-6 hours to complete in full, so be sure to allow enough time. Many carriers will not allow their certifications to open until the AHIP is completed, so don’t waste until the last minute to finish. The company certifications will all be accessed through their agent portals and can vary greatly in terms of length of time as well as difficulty. Every test will have a study guide available either before or during the training process. You will want to download and keep those handy to help with your test preparedness. Carrier certifications will open beginning next week, starting with Anthem. They will continue to roll out up through August. There are only a few carriers who still require face-to-face certifications in certain situations, but most of those have allowed online training due to COVID-19. Be sure to contact us for more tips and tricks in the certification process.

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Jeff Palo

Jeff Palo

Senior Sales Director - Health

x7716 | jpalo@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

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Contact a Pinnacle Financial Service representative today for assistance.

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CMS’ Change to Medicare Online Enrollment

CMS’ Change to Medicare Online Enrollment

CMS’ Change to Medicare Online Enrollment
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Original Medicare is available for those who qualify, based on age or disability status.  Typically, those who apply need to be 65 years of age or older, or under 65 with a disability or End-Stage Renal Disease. People are eligible to receive Medicare Part A for no premium if they or their spouse has worked and paid taxes for Medicare for 10 years. Additionally, there are other situations where these people may be able to get Medicare Part A at no premium. The Medicare Eligibility tool can help determine a client’s status. New Medicare beneficiaries can enroll in Medicare through Social Security.

Changes to Medicare Online Enrollment After Age 65

Prior to the COVID-19 pandemic, those who retired after age 65 and decided not to enroll in Medicare Part B, had two options to enroll:

  1. Go to their local Social Security office, (which was often the most expedient) or;
  2. Call Medicare

With the new social distancing measures in place, Social Security offices are closed down or left with limited hours, leaving potential beneficiaries with only the option to call. Beneficiaries can call 1-800-772-1213, say the word “Medicare”, and then wait for assistance. The issue is that the wait time is often extreme and frustrating for some. Fortunately, SSA/CMS has implemented an online enrollment tool for those Beneficiaries enrolling after age 65.

Changes to Medicare Online Enrollment’s New Tool Implementation

The new online enrollment tool has essentially taken the Medicare Part B enrollment form, and the Request for Employment Information form, and created an online application that the beneficiary can submit on their own. The applicant can complete the new online form, then upload proof of coverage and employment, (such as an ID Card and Paystub.)  They will need to e-Sign to finalize the enrollment, but the employer will not need to sign.

Full details are below:

SSA has a new online service option that beneficiaries can utilize to complete the forms CMS-40B, Application for Enrollment in Medicare – Part B (Medical Insurance) and CMS-L564, Request for Employment Information applications for enrollment in Medicare Part B. The online process will expedite the handling of those beneficiaries requesting enrollment in Medicare Part B under the Special Enrollment Period (SEP) provisions.
Effective Tuesday, May 26, 2020, based on the collaborative efforts between the Centers for Medicare & Medicaid Services (CMS) and SSA, the new online process for handling Medicare Part B SEP enrollment will be available online. The online process provides beneficiaries the option to complete the Medicare enrollment forms under a SEP for SSA to process. The online Medicare Part B SEP enrollment.
Medicare Part B SEP will be available on both SSA and CMS websites effective Tuesday, May 26, 2020. Once the beneficiary completes the online enrollment forms, the forms will automatically be transmitted to the SSA Field Office of jurisdiction.

Eligibility Overview

As a requirement, regardless of the service channel, in order to enroll for Medicare Part B during a SEP, the following are required:

  • The individual must be covered under a group health plan (GHP) based on his or her own or a spouse’s current employment status, or covered under a large group health plan (LGHP), and the coverage must be based on his or her own, or a family member’s current employment status.
  • The individual can enroll:
    • During any month (including a partial month) in which they are enrolled in a GHP or an LGHP based on current employment status, or
    • In any of the 8 consecutive months following the last month, during any part of which, the individual was enrolled in the GHP based on current employment status,
    • Or beneficiaries are eligible for equitable relief if:
      • The beneficiary had a SEP during the period from March 17, 2020, through June 17, 2020; and
      • The beneficiary did not apply for Part B during that SEP.
      • Eligible beneficiaries who wish to take advantage of the equitable relief must file their enrollment request by June 17, 2020.
  • The beneficiary must complete the CMS-40B enrollment form, paper, or online to request enrollment. In addition, he or she must complete the CMS-L564 form, paper, or online.
  • Form CMS-L564 has two sections:
    • Section A – the applicant completes Section A.
    • Section B – the employer, the GHP or LGHP completes Section B of the form. The information in Section B provides evidence of GHP or LGHP coverage and dates of employment.

NOTE: If the employer cannot sign the CMS-L564, the beneficiary can provide other evidence of previous employment or coverage of GHP or LGHP, or other documents for evidence of employment. Refer to HI 00805.295 – Evidence of GHP or LGHP Coverage Based on Current Employment Status.

Online Enrollment Guidelines

  • The online enrollment process will require beneficiaries to complete the CMS-40B, CMS-L564 (one combined online application), and submit any required evidence during one online session.
    NOTE: The online enrollment process does not offer beneficiaries the option to save and revisit the application.
  • Failure to complete and submit the correct documentation may result in a delay in processing the Medicare enrollment.
  • If the beneficiary fails to complete the forms or submit the correct evidence, Field Offices should follow the normal business processes and develop for the missing information.

During the COVID-19 pandemic, CMS waived the wet-signature requirement; however, the online option will require beneficiaries to provide an eSignature (digital signature) and a valid email address.

For more information on the new Medicare online enrollment tool, and for one-on-one support, contact your sales director.
For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Jeff Palo

Jeff Palo

Senior Sales Director - Health

x7716 | jpalo@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

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How to Enroll Clients in Aetna Medicare Electronically

How to Enroll Clients in Aetna Medicare Electronically

How to Enroll Clients in Aetna Medicare Electronically
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The current COVID-19 Epidemic has accelerated the need for agents to learn how to both find and enroll clients using telephonic and electronic means.  All Pinnacle agents have free access to Connect4Medicare, an online platform that can put most carriers together in one easy portal.  This takes the place of the Medicare website, giving you the ability to lookup doctors, enter prescription drug info, and enroll clients in one place. 

There may be situations where you need to use each individual carrier’s enrollment tools, such as when a client does not have access to a computer or email address.  Aetna currently has two separate entities for Medicare, Medicare Advantage/PDP, and Medicare Supplement.  In order to offer both, you will need to be contracted with each separately, as well as be appointed in any state that you wish to sell.  Once you are ready-to-sell, you have full access to all means of enrollment.

How to enrollment in Aetna Electronically for Medicare Advantage

Aetna Medicare Advantage has many tools available to agents, including both the Ascend and Rate tools, which act as their electronic enrollment tools.  Aetna uses its Producer’s World website as a home for agents.  This is where you can do anything from accessing commission statements to downloading enrollment tools. The first part of every Medicare sale is the Scope of Appointment.  You can complete a scope of appointment during lockdown electronically by email or text using the Ascend Application, telephonically using Aetna’s line 844-334-2247, or through the mail.  Each non-paper option provided by Aetna will maintain the scope for the required 10 years. The application itself can also be completed in several ways.  First, you may email an E-kit for the client to complete using Ascend.  To complete the application completely by phone, you need access to the RATE tool, which requires training and a quiz by your local broker manager.  Finally, you can mail an application, or do curbside drop off/pick up.

How to enrollment in Aetna Electronically for Medicare Supplement

As mentioned earlier, Aetna Medicare Supplement is a separate operation, accessed through the Aetna Senior Products division.  Your writing number for Aetna supplements will begin with GNW, rather than your National Producer Number.  The supplemental products can be enrolled using the Aetna Quote and Enroll system.  One great feature of Quote and Enroll is the ability to show the client multiple product lines and enroll them all in one place with one application.  The other products include Final Expense, Cancer/Heart/Stroke, Dental/Vision/Hearing, Home Care, Hospital Indemnity, and more.  All products can be viewed and added to the quote in a shopping cart like experience.  Once you have chosen the products and completed the application, the client has multiple options to sign.  They can get an email, sign in person, or complete a phone call.

No matter the product or plan that best fits the needs of your client, you have the tools needed to enroll them compliantly and safely distanced.  Pinnacle Financial Services offers webinar and one-on-one training for all our agents, as well as free access to our website and online enrollment system.

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Jeff Palo

Jeff Palo

Senior Sales Director - Health

x7716 | jpalo@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

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