Aetna | Introducing a new card benefit for 2025, with the Aetna Medicare Extra Benefits Card

Aetna | Introducing a new card benefit for 2025, with the Aetna Medicare Extra Benefits Card

Aetna | Introducing a new card benefit for 2025, with the Aetna Medicare Extra Benefits Card
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Exciting news!

For the 2025 plan year, we’re integrating our current cards (the Aetna Medicare Payment Card and the Aetna Medicare Extra Benefits Card) into one, called the Aetna Medicare Extra Benefits Card, which will be administered by CVS® Health.

The 2025 Aetna Medicare Extra Benefits Card gives qualifying members “wallets” or spending allowances – like the Extra Supports Wallet, OTC Wallet, CVS OTC Wallet, Medical Expense Wallet and Healthy Foods Wallet – to use on certain categories of items. Get the playbook to learn more.

Key points to know

  • We’re offering one payment card across 427 plans nationwide, administered by CVS Health. The wallets included, and the eligibility criteria, vary by plan.
  • The goal is to simplify the experience for our members and partners like you.

What's in it for you and your clients?

    • One number: Members (and you!) will only need to call one number for any card-related service questions.
    • One website: Information on all card wallets will be available through www.CVS.com/aetna.
    • One app: Members can check balances, find participating stores and more through the CVS OTC Health Solutions app*.
    • A broad network: There are over 70,000 retail stores where most card wallets can be used. Only the CVS OTC Wallet, available on some plans, includes a CVS-based network.
    • More choices: Both OTC wallet options on the 2025 card offer members more choice in spending this allowance. They can order items from the CVS catalog either online or by phone, or can purchase additional items from approved categories at participating stores.

Resources

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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Aetna | Introducing a new card benefit for 2025, with the Aetna Medicare Extra Benefits Card

Aetna | New York Special Enrollment Period available to qualifying Medicare beneficiaries

Aetna | New York Special Enrollment Period available to qualifying Medicare beneficiaries
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Special Enrollment Period (SEP) for qualifying Medicare beneficiaries in New York

Overview of SEP during a declared disaster or other emergency 

A special enrollment period (SEP) exists for individuals affected by a disaster or other emergency declared by a federal, state, or local government entity who were unable to, and did not make an election during another valid election period. 

This SEP allows for enrollment and disenrollment elections. For more information, go to CY2024 MA Enrollment and Disenrollment Guidance. [Sec. 34.4(18)].

What you need to know about this SEP 

The SEP information provided below is based on an executive order by the governor of New York on August 9, 2024.The SEP start and end dates are accurate as of the date of this communication.

Disaster or emergency: Severe flooding

Impacted counties: All counties

Incident start & end dates: 08/09/2024 – 09/08/2024

SEP start & end dates: 08/09/2024 – 11/30/2024

Who’s eligible? 

Individuals are eligible for this SEP if they:

  • Reside, or resided at the start of the SEP eligibility period, described in this guidance, in an area for which a federal, state or local government entity has declared a disaster or other emergency. Or, they do not reside in an affected area, but rely on help making health care decisions from one or more individuals who reside in an affected area; and
  • Were eligible for another election period at the time of the SEP eligibility period; and
  • Did not make an election during that other valid election period due to the disaster or other emergency.

Enrollment instructions

IMPORTANT: Remember, you cannot use this SEP opportunity to proactively market to beneficiaries. However, you can assist any clients who contact you about this SEP.

  • If an individual wants to enroll and believes they may qualify for this SEP, you need to ask the beneficiary if they can show proof that they lived/live in an impacted area at the start of the incident period. If they do not have proof, ask them to verbally attest. 
  • When helping eligible clients enroll, please select the weather-related or major disaster option in the Reasons for Special Enrollment Period Eligibility section of the application.  

Additional information 

If the incident end date of an emergency or major disaster is not otherwise identified, the incident end date is 1 year after the SEP start date; or, if applicable, the date of a renewal or extension of the emergency or disaster declaration, whichever is later. The maximum length of this SEP, if the incident end date is not otherwise identified, is 14 full calendar months after the SEP start date or, if applicable, the date of a renewal or extension of the emergency or disaster declaration.

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 | Contract Recertification and Prescription Drug Plan Updates

Wellcare | Contract Recertification and Prescription Drug Plan Updates

Wellcare | Contract Recertification and Prescription Drug Plan Updates
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Important! 2025 Contract Re-certification and Prescription Drug Plan Compensation Updates

We are pleased to announce that 2025 Contract Re-certification will be available in Centene Workbench for your attestation on Sept. 3, 2024! Annually, brokers are required to complete certification requirements to market and sell Medicare Advantage products. All annual certification requirements must be complete by Oct. 1, 2024, to be able to market and sell Wellcare products, avoid suspension, and receive Medicare Advantage compensation.

New in Contract Year 2025

Contract Re-certification will be released independent of Annual Certification Training (ACT) for Contract Year 2025.

By Oct. 1, 2024, you must:

  • Execute the 2025 contract through the 2025 Re-certification Workflow in Centene Workbench (in place of the usual Summary of Changes).
  • Complete 2025 ACT and AHIP or NABIP Medicare Certification training on or before Oct. 1, 2024, as part of the certification requirements to market and sell 2025 Wellcare MA Part D products.

Note: you will still be prompted to confirm your information on file is current and/or make changes, where needed, in Centene Workbench. 

Please be on the lookout for additional communications regarding re-certification.

Prescription Drug Plan (PDP) Compensation

We also wanted to let you know some important information about Wellcare’s PDP products in 2025.

As you may know, the Inflation Reduction Act (IRA) has resulted in significant changes to Part D including:

  • Elimination of the Coverage Gap or “donut hole”
  • A new $2,000 out-of-pocket spending cap
  • A shift in cost-sharing responsibility in the catastrophic coverage phase
  • A new cost sharing smoothing option

To continue providing access to high-quality healthcare and Part D coverage that helps families and individuals, we have made a difficult decision – effective Jan. 1, 2025 – to cease new and renewal commissions for PDP beginning with the 2025 plan year.

This communication serves as notice of termination without cause of your existing TPME marketing services agreements with Centene for Medicare products effective Dec. 31, 2024. As noted above, Medicare Advantage product compensation will continue into 2025, with your new contract once executed.

If you have any questions, please contact your local sales leader.

We thank you for your continued partnership.

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

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

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Wellcare | Contract Recertification and Prescription Drug Plan Updates

Wellcare | 2025 Medicare Advantage Commission Rates

Wellcare | 2025 Medicare Advantage Commission Rates
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As you prepare for the 2025 Annual Enrollment Period (AEP), we want to confirm our commitment to pay commissions for new and existing Medicare Advantage plans.

Wellcare will continue to pay the agent maximum fair market value commission rates for Plan Year 2025 (PY2025) enrollments on all Medicare Advantage health plans: Wellcare, Allwell, Fidelis Care and Health Net.

Medicare Advantage Agent Rates Effective Jan. 1 – Dec. 31, 2025

The contracting period for 2025 will begin on Sept. 3 in Centene Workbench. Please be sure to log in into the system to complete training now, and contracting when it becomes available.


Additional details on 2025 agency compensation will be shared soon. 

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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