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Anthem | FTC Amended Telemarketing Sales RuleAnthem

Anthem | FTC Amended Telemarketing Sales RuleAnthem

Anthem | FTC Amended Telemarketing Sales RuleAnthem
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New Telemarketing Sales Rule Requirements

The Federal Trade Commission (FTC) has amended the Telemarketing Sales Rule to impose some additional record-keeping and prior-express-written consent requirements.

Here is a quick walkthrough of some of the primary new legal requirements for telemarketing:

  1. Telemarketing records must be retained for 5 years, including vendor contracts, scripts, and promotional materials (Sections 310.5(a)(1) and 310.5(a)(9)).
  2. Consent records for sales calls must encompass name, phone number, a copy of the consent request in the same format it was given to the consumer, the purpose/scope of the request, a copy of the consent provided, and the date consent was given.
  3. For sales calls that require prior express written consent, the consent will need to identify the specific seller(s) for whom consent is being given by their legal name, as well as brand names if needed to ensure the consumer is aware of which entity they are giving consent to. For calls on behalf of Elevance Health-affiliated plans or advertising one of our plans, the consent request should name Elevance Health Inc. and its subsidiaries, including the specific local affiliate brand and its legal name whose plans are being marketed.
  4. As of October 15, 2024, telemarketers are required to preserve call detail records for sales calls. The call detail records must include all of the items set out in Section 310.5(a)(2).

We thank you in advance for acquainting yourself with these requirements. Please share this information with your internal teams as needed. The FTC’s explanation of the changes and full amended rule can be found here: https://www.govinfo.gov/content/pkg/FR-2024-04-16/pdf/2024-07180.pdf.

IMPORTANT REMINDER Agencies that sell Medicare Advantage plans should already be keeping selling and marketing materials, scripts, and tapes for 10 years and should continue to do so per CMS regulations as summarized here: agent-broker-marketing-faqs-10-19-2022.pdf (cms.gov).

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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Anthem | FTC Amended Telemarketing Sales RuleAnthem

Anthem | NY State December SEP

Anthem | NY State December SEP
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Your Clients May Be Entitled to a Special Election Period

The Centers for Medicare & Medicaid Services (CMS) provides for a Special Election Period (SEP) for beneficiaries impacted by a Federal Emergency Management Agency (FEMA) Emergency or Major Disaster Declaration. This SEP is for Medicare beneficiaries who were prevented from submitting a Medicare Advantage (MA/MAPD) or Prescription Drug (PDP) plan enrollment request during another valid election period due to a declared disaster. This includes both enrollment and disenrollment elections. This SEP applies to beneficiaries who reside in the following NY counties:Bronx, Dutchess, Kings, Nassau, New York, Orange, Putnam, Queens, Richmond, Rockland, Suffolk, Ulster, Westchesterwho were impacted by Severe Weather.

In addition, the SEP is available to those individuals who do not live in the affected areas but rely on help from friends or family members when making healthcare decisions and those individuals were impacted by the emergency declaration. The SEP is available from the start of the incident period 09/29/2023 and continues through the end of the eligibility period 12/31/2023.

Only those beneficiaries who did not make an election during another eligible enrollment period are eligible for this SEP. An individual can use this SEP one time for each election period they missed.

When there are questions about eligibility, CMS will make the determination. A beneficiary may contact CMS if they want to know all plans in their area for enrollment assistance, or if they have any questions. They can reach CMS by calling 1-800-MEDICARE (1-800-633-4227) anytime, 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048. If the beneficiary knows what plan they want to select, they can call the plan or their broker/agent directly to enroll. To review up-to-date information, you may go to the FEMA Disaster Declarations website. This Information is updated at least weekly.

CMS expanded the eligibility guidelines for SEPs effective for any disaster declaration made 1/1/2021 and after. The declaration can come from any level of government – Federal, state or otherwise. Therefore, in addition to the FEMA website, you should also reference any relevant governor executive order and/or state emergency disaster info page for this detail.

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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Anthem | CMS Announces Marketing and Communication Changes

Anthem | CMS Announces Marketing and Communication Changes
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It’s time to review marketing guidance in preparation for AEP 2024.

CMS recently published its 2024 Policy and Technical Changes which includes new marketing and communication regulatory requirements. These changes impact all agencies and brokers selling Medicare Advantage and/or Part D plans.

We are sharing this information to ensure you are aware of the impacts to your marketing and selling strategies, and so you can make the necessary changes to be in full compliance with AEP 2024.

Don’t delay as these changes are applicable to all 2024 marketing and communications beginning September 30, 2023.

We will share additional information as it becomes available.

Need more information or have questions?
Contact your Regional Sales Manager.

Our Medicare Agent Support team is also available to answer your questions. Email medicareagentsupport@anthem.com or call 1‑800‑633‑4368

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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Anthem | Medicaid Redetermination Information for D-SNP

Anthem | Medicaid Redetermination Information for D-SNP
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Anthem will help your dual eligible clients navigate the Medicaid Redetermination process.

States are beginning to resume Medicaid renewals to confirm eligibility, a process that was suspended during the Public Health Emergency (PHE). As of April 1, 2023, states are able to disenroll Medicaid beneficiaries that no longer qualify. As a result, some of your D-SNP clients may lose their dual eligible status and need to find a new Medicare Advantage plan.

What your clients can expect.

  • State agencies will notify Medicaid beneficiaries when it is their turn to renew.
  • Anthem will also be notified and will call members to offer assistance during the renewal process.
  • If the member does lose Medicaid coverage, we also have a team that will call and helps them find another Anthem Medicare Advantage plan that fits their needs.
  • Reminder: when a member loses SNP status they will continue to be covered by their current plan for 90 days (up to 6 months in Indiana) while they re-qualify for Medicaid or look for a new Medicare Advantage plan.

How you can help.

There is no need to contact your D-SNP clients during this process; the assistance noted above will occur automatically. However, if you wish to reach out, or if they contact you:

  • Remind clients to update their contact information with the state and Anthem. This will help ensure they receive all communications and updates.
  • Encourage clients to watch for the mail and to follow all directions in the renewal notice. Also let your clients know that our vendor will call them to offer assistance with the renewal process.
  • Reassure your clients that while losing Medicaid eligibility will impact their D-SNP coverage, they will continue to be Medicare-eligible. Anthem has non-SNP Medicare Advantage plans with rich benefits to fit their needs.

Your Agent of Record (AOR) status will not be impacted.

At no time will the help we provide to your clients, during the Medicaid renewal process or to enroll in a new non-SNP Medicare Advantage plan when needed, change your Agent of Record status.

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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Anthem | Easy Access to OTC Benefits, Account Balances & MORE

Anthem | Easy Access to OTC Benefits, Account Balances & MORE

Anthem | Easy Access to OTC Benefits, Account Balances & MORE
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Easy Access to OTC Benefits, Account Balances & MORE from a Single Benefits Prepaid Card!

AEP 2023 is bringing big changes to how your current & prospective clients access popular benefits like OTC, Healthy Grocery, Flex Accounts, and MORE! Now all their spending allowance-based benefits and funds will be accessible through ONE Benefits Mastercard® Prepaid Card! Your clients will enjoy using a proven and familiar benefits prepaid card they can use as debit or credit (no PIN required). *

This easy-to-use card is automatically loaded with the monthly, quarterly, or annual benefits included in their Medicare Advantage plan. That means they can begin shopping as soon as their plan is effective.

One, integrated call center supports your client’s questions about all of their plan’s spending allowance-based benefits.

*Note – Benefits vary by plan and member eligibility. Members will still have a separate member ID card for their Medicare Advantage plan medical benefits.

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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Anthem | Register Now for AEP 2023 Roadshows in Missouri

Anthem | Register Now for AEP 2023 Roadshows in Missouri
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Don’t miss your chance to learn about Anthem Medicare Advantage Plans for AEP 2023!

    Our Medicare Advantage Strategy for AEP 2023 has been designed to better support your clients and help you achieve record sales! Each AEP Roadshow is tailored to show you what’s new for AEP 2023 and how to sell more in your state. Reserve your spot TODAY to learn more about:

    • Planned county expansions (where applicable)
    • New product offerings and plan improvements (where applicable)
    • Expanded Insulin Savings Program
    • Improved Dental offerings
    • Simplified Social Determinants of Health offerings
    • Single Pre-Paid Benefits Card on a proven MasterCard platform for plans with OTC, Flex Account, or Healthy Grocery benefits
    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

    Contact Us

    Contact a Pinnacle Financial Service representative today for assistance.

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