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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

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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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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Contact a Pinnacle Financial Service representative today for assistance.

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Wellcare | Contract Recertification and Prescription Drug Plan Updates

Wellcare | 2025 Market Realignment

Wellcare | 2025 Market Realignment
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Wellcare is grateful for your partnership in support of our managed care products and the members we serve nationwide. Over the years, your partnership has enabled Wellcare to focus on our mission of transforming the health of the communities we serve, one person at a time. Each year, as part of our normal course of business, we conduct a comprehensive review of our market operations and footprint.

Based on this year’s review, we have decided to discontinue offering Medicare Advantage (MA) products in six states beginning with the 2025 Annual Enrollment Period. We will be exiting Alabama, Massachusetts, New Hampshire, New Mexico, Rhode Island and Vermont. Wellcare will continue to offer Prescription Drug Plans in these states, and this decision does not impact our Marketplace or Medicaid contracts in these markets.

While our state footprint is changing, our commitment to delivering quality care and services to our members remains strong. The changes outlined above do not impact current members’ plans or benefits, and Wellcare will continue serving MA members in these six states through the end of 2024 and beyond for any contract run-out functions. Members will be notified in accordance with the Centers for Medicare and Medicaid Services (CMS) guidelines as part of the annual notification of change process. All enrollment materials related to these plans have been removed from Wellcare sites and enrollment platforms, and materials are no longer available for downloading, printing or ordering.

Importantly, our commitment to all of our other Medicare markets remains strong and unchanged.

We want you to know this difficult decision was not made lightly but will enable us to better focus our strategy and resources, so we can continue transforming the health of the communities we serve, one person at a time – for years to come. 

It has been our privilege to partner with you in support of our members and these communities. We know there will be questions and want to assure you we will work through next steps together. If you have questions, please contact your local sales leader.

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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Wellcare | Contract Recertification and Prescription Drug Plan Updates

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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Contact a Pinnacle Financial Service representative today for assistance.

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Wellcare | Contract Recertification and Prescription Drug Plan Updates

Wellcare | Important PY2025 Medicare AEP Launch Dates – AHIP, ACT, First Looks

Wellcare | Important PY2025 Medicare AEP Launch Dates – AHIP, ACT, First Looks
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Key Dates for PY2025 Medicare AEP Readiness – AHIP, ACT and First Looks

We are excited to announce that we are one week away from kicking off the Plan Year 2025 (PY2025) Annual Medicare Certification process!

In preparation for the PY2025 Medicare selling season, we want to provide you with some key dates to be aware of moving forward.

Key Dates – Plan Year 2025 (PY2025)

Please mark your calendars for the following important launch dates:

Date

Activity

June 24, 2024

2025 AHIP Medicare Training

·     New! Accessible through Centene Workbench within the Medicare Certifications section of the new Training menu.

·     Note: The last day to complete 2024 AHIP training is June 20.

July 15, 2024

2025 Wellcare First Look

·     Accessible through WellcareFirstLook.com

July 16, 2024

2025 Wellcare Annual Certification Training (ACT)

·     New! Accessible through Centene Workbench within the Required Training section of the new Training menu.

·     Note: Last day to complete the 2024 Wellcare ACT is June 21. Access to 2025 AHIP will continue to be available until July 12 and will resume on July 16.

Coming Soon!

2025 Required Annual Contract Recertification/Acknowledgement

·     Temporary Centene Workbench onboarding Blackout Period – dates forthcoming

Required component that must be completed to be deemed Ready to Sell for 2025.

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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Wellcare | Contract Recertification and Prescription Drug Plan Updates

Wellcare | DST-SEP Best Practices and Reminders

Wellcare | DST-SEP Best Practices and Reminders
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With AEP quickly approaching, we wanted to take this time to communicate some important reminders, best practices and eligibility requirements when it comes to Special Enrollment Periods (SEP).

As a reminder, an SEP is a time outside of the Initial Coverage Election Period (ICEP), Medicare Advantage Open Enrollment Period (MA OEP) and Annual Enrollment Period (AEP), during which a member can make changes (enroll in, disenroll from or switch) to their Medicare Advantage (MA) or Medicare Advantage Prescription Drug (MAPD) plans.

A DST-SEP may be granted to individuals who reside in an affected service area where a federal, state, or local government entity has declared a state of emergency, impacting individuals in a specific geographical area. The declaration allows for a one-time SEP, in the event an individual was unable to make an election during another qualifying election period.

Eligibility Requirements

An opportunity for a DST-SEP is ONLY available to beneficiaries who:

  • 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 healthcare 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.

Wellcare will communicate any changes or updates to these SEPs, if necessary, when they become available.

Important Reminder

In order for a member to benefit from an SEP, the agent and member must both acknowledge that the beneficiary was impacted by the DST-SEP. Agents cannotassume that using the DST-SEP is compliant because the member resides in a county included in a disaster declaration; rather, the member must state what SEP was missed because of the disaster declared by FEMA or the state.

Please reach out to WellcareSEP@centene.com with any questions and visit the DST-SEP Landing Page to see all current DST-SEP information.

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

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

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