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Devoted |  Important reminders for CMS Special Election Period Rules

Devoted |  Important reminders for CMS Special Election Period Rules

Devoted |  Important reminders for CMS Special Election Period Rules
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Adhering to CMS Guidelines for Special Election Periods (SEPs)

As we continue to serve our beneficiaries with the highest standards of care and compliance, we want to take a moment to remind you of the critical importance of adhering to the Centers for Medicare & Medicaid Services (CMS) guidelines regarding Special Election Periods.

Importance of Verifying SEP Eligibility

It is imperative that all agents fully understand and comply with the guidelines established by CMS regarding SEPs. This is to ensure that we uphold the integrity of our Medicare Advantage Plan and provide our beneficiaries with the services they need during their time of transition.

CMS Marketing Guidelines for Special Election Periods

As a reminder, before enrolling a beneficiary during an SEP, agents must determine if the individual qualifies for such a period by reviewing specific qualifying events that allow for enrollment outside the standard enrollment periods. SEPs may occur due to a variety of qualifying events, including: 

  • Moving out of the service area
  • Losing current health coverage
  • Gaining new eligibility (e.g., through Medicaid)
  • Other qualifying life events as specified by CMS

Agents will typically ask questions about the beneficiary’s current situation and recent events to determine if they meet the criteria for an SEP. It is important for the agent to verify the specific dates and conditions of these events to ensure eligibility and compliance with CMS Medicare requirements. Agents must provide clear, accurate information to beneficiaries regarding their eligibility for SEPs and the implications of their choices. 

Consequences of Non-Compliance

CMS continuously monitors marketing practices. Devoted takes the adherence to these guidelines very seriously. We will be closely monitoring agent activities regarding SEP eligibility verification. Any misuse identified may lead to corrective action, up to and including termination, depending on the severity of the violation. 

We are committed to ensuring that our agents have the necessary resources and support to navigate these guidelines effectively. It is crucial that we operate transparently and ethically while providing beneficiaries the care they deserve.

We encourage you to familiarize yourself with the CMS marketing guidelines on SEPs available on the CMS website and to refer to theDevoted guide on Eligibility and Enrollment Period.  

Please do not hesitate to reach out to your local sales leader if you have any questions or need further clarification regarding SEP eligibility requirements. 

Thank you for your continued dedication to compliance and for serving our beneficiaries with integrity.

For more information, contact a Pinnacle Financial Services representative today 1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

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

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Wellcare |  2025 TPME Reminders

Wellcare |  2025 TPME Reminders

Wellcare |  2025 TPME Reminders
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As we prepare for AEP, we’d like to send out a few reminders regarding the Third Party Marketing Entity agreement (TPME).

If you have completed the 2025 AHIP & ACT required training, you will still need to log back into Centene Workbench to complete the 2025 TPME agreement when the 2025 TPME becomes available. This step of completing the 2025 TPME agreement is crucial to ensure you are ready and authorized to sell for the 2025 AEP season. You will not be ready to sell for 2025 until you complete the 2025 TPME contract, 2025 America’s Health Insurance Plans (AHIP), and 2025 Wellcare Annual Certification Training (ACT) training. Please ensure that you have completed each action item.

Note: In addition to AHIP, Wellcare now accepts Medicare certification completed through the National Association of Benefits Insurance Professionals (NABIP).

Please keep an eye out for further communications regarding the availability of the 2025 TPME and instructions on how to complete the signing process. For more information regarding 2025 training, please refer to this previous communication.

We appreciate your attention to this matter. Should you have any questions or need assistance, feel free to reach out to our Broker Support Team at 866-822-1339.

As always, thank you for your continued partnership!

For more information, contact a Pinnacle Financial Services representative today 1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

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

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IBX | 2024 Star Ratings: Action Required

IBX | 2024 Star Ratings: Action Required

IBX | 2024 Star Ratings: Action Required
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Independence Edge

News for Medicare Brokers

Medicare

2024 Star Ratings: Action Required

The Centers for Medicare and Medicaid Services (CMS) has released the 2024 Star Ratings and Independence Blue Cross (IBX) Medicare Advantage plans have earned four stars on the Keystone 65 HMO, and 4.5 stars on the Personal Choice PPO. Inside each enrollment kit is a Star Rating Insert for that plan. You must replace the 2023 Star Rating Insert with the 2024 Star Rating Insert.  FULL ARTICLE

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@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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Protective | A Strong Foundation that Clients Can Rely On

Protective | A Strong Foundation that Clients Can Rely On

Protective | A Strong Foundation that Clients Can Rely On
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PROTECTIVE® LIFETIME ASSURANCE UL

A strong foundation. BUILT FOR LIFE

When building any property, laying your foundation on solid ground ultimately offers more stability.

The same is true in the current life insurance landscape. In a year of GUL reprices and product updates, make sure you’re guiding clients to life insurance solutions — and carriers — that are built for life.

Protective Lifetime Assurance UL is built to last and specifically designed for those seeking stability. It offers:

  • Guaranteed protection that can last a lifetime
  • Level-pay, predictable premiums so they know what to expect
  • A track record of resiliency, with more than 100 years of company growth

Discover how Protective Lifetime Assurance UL can deliver a solid foundation of protection to your clients.

For more information, contact a Pinnacle Financial Services representative today

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

Contact a Pinnacle Representative if you have any questions.

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

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NGL Communications | Introducing Enhancements to EssentialLTC

NGL Communications | Introducing Enhancements to EssentialLTC

NGL Communications | Introducing Enhancements to EssentialLTC
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A product that can now do more

We have been listening to your feedback and are excited to announce your suggestions were used to enhance EssentialLTC! The changes are geared toward making it easier to sell, and the new features will allow you to offer your clients a product that can do more.

We’ve enhanced its features, options, underwriting classes and the rider selection has been streamlined! These changes will be effective for all new business applications received on or after April 1, 2021 in the following 38 states: AK, AL, AR, CO, GA, IA, ID, IL, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, NC, NE, NH, NM, NV, OH, OK, OR, PA, RI, SC, TN, TX, UT, VA, VT, WA, WI, WV, WY.

This information will be distributed in a field communication on March 19, 2021. Please see below for the details on these enhancements.

New Features

  • For joint policies, when one insured passes away the premium will now decrease to an amount specified on the illustration and Policy Schedule for each person.
  • The Waiver of Premium Rider for Home and Community Care Services is now built into the policy and premium when Comprehensive Coverage is selected.
  • The 10-Year Premium Payment Option is now fully guaranteed and will never be subject to a rate increase.
  • The underwriting rate classes will be consolidated into single gender-distinct rate class called “Premier”. It is a simplified competitive offering with clearer underwriting expectations. 
    • The Employer Group rate class will still be available to approved employer groups in the states where it is available.

Streamlined Rider Selection

  • Removed: The Step-Rated Compound Inflation Protection Rider
    • Still Available: The Compound Inflation Protection Rider with 3% and 5% options
  • Removed: The Full Return of Premium Rider
    • Still Available: The Limited Return of Premium Rider
  • Removed: The Full Return of Premium with Optional Policy Surrender Rider
    • Still Available: The Limited Return of Premium with Optional Policy Surrender Rider
  • Removed: The 0-Day Elimination Period
    • Still Available: The 30, 90 and 180-Day Elimination Periods and the First Day HCCS Benefit Rider

All available riders can be found in our EssentialLTC Product Summary.

Adjustments

Due to pricing for the new features and historically low interest rates, the premium for the product has changed. EssentialLTC’s rates will remain very competitive compared to the other Long Term Care insurance products on the market. See the chart below or Click here to see how National Guardian Life Insurance Company’s (NGL) EssentialLTC stacks up against some of those products.

Updated Materials

Updated materials will available on the Agent Resource Center beginning April 1, 2021. 

New Business

Applications written in the 38 states listed above, must be dated and received in good order by the LTC Administrative Office on or before March 31, 2021 to use the current features and premium structure.

This is applicable to the E-APP, mailed paper applications and uploaded PDF applications. Applications dated or received by the LTC Administrative Office on or after April 1, 2021 must use the updated forms applicable to the client’s resident state. No exceptions will be made.

E-APP

E-APP, the illustration program and the quick quote calculator will reflect the enhancements beginning April 1, 2021.

To use the current version of the product, all parties must complete their signatures in DocuSign and the E-APP must be submitted, in good order prior to April 1, 2021. For BGAs using the E-APP stopover feature, E-APPs must be reviewed and submitted prior to April 1, 2021 to be considered received before the deadline.

Please note, any E-APP where signatures are not complete and/or not submitted prior to April 1, 2021 will need to be rewritten using the updated forms, premium structure and rate class. No exceptions will be made.

At NGL our purpose is to help people face life’s financial challenges with confidence, dignity and grace. Along with our enhanced, easier to sell Long Term Care insurance product, we look forward to continued collaboration with you to protect your clients’ future.

Please contact your dedicated wholesaler with questions.

Larry Moore
Phone: 206.321.7737
Email: ljmoore@nglic.com

Lawrence Vivenzio
Phone: 608.443.4799
Email:
 lgvivenzio@nglic.com

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x6003 | lifesales@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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