NAHU’s Washington Update

NAHU’s Washington Update

NAHU’s Washington Update
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November 4, 2022

Fast Facts

  •  CMS released a final rule late last week that implements many of the Medicare-specific provisions included in the Consolidated Appropriations Act of 2021. These policy changes include adjustments to the Medicare enrollment process, the establishment of new SEP-triggering life events, and more.
  • The Senate Finance Committee, Chaired by Senator Ron Wyden (D-OR), released a report on deceptive marketing practices by Medicare Advantage plans this week. 
  • Senate Intelligence Chairman Senator Mark Warner (D-VA) released a healthcare cybersecurity policy paper this week.
  • In this week’s mergers and acquisition news: Walgreens-backed VillageMD is exploring a potential deal to merge with medical practice Summit Health, the parent company of urgent care clinic chain CityMD.
  • The Colorado Division of Insurance (DOI) released final rates for 2023 fully insured health plans, including the Colorado Option, plans this week. In many cases, traditional commercial health plans will offer significantly more affordable premiums that are 5% to 10% lower than competing Colorado Option plans.
  • This week’s Healthcare Happy Hour podcast provides a preview of next week’s midterm election detailing the key races that will determine Senate and House party control.

CMS Releases Final Rule on New Medicare SEPs, Enrollment Window Changes and More

CMS released a final rule late last week that implements many of the Medicare-specific provisions included in the Consolidated Appropriations Act of 2021. Earlier this year, NAHU submitted comments on the proposed rule to support many of the changes included in the final rule… Read More

Senate Finance Committee Release Report on Deceptive Marketing Practices by Medicare Advantage Plans

Yesterday, the Senate Finance Committee, Chaired by Senator Ron Wyden (D-OR), released a 27-page report on Medicare Advantage marketing practices detailing that fourteen states have found “evidence that beneficiaries are being inundated with aggressive marketing tactics as well as false and misleading information”… Read More

Senate Intelligence Chairman Senator Mark Warner Releases Policy Options Paper Addressing Cybersecurity in the Healthcare Sector

Senator Mark Warner (D-VA), chairman of the Senate Select Committee on Intelligence, released a policy paper detailing cybersecurity threats to the healthcare sector and ways the federal government can improve security standards in the industry this week… Read More

Mergers and Acquisitions: Walgreens-backed VillageMD is exploring a potential deal to merge with medical practice Summit Health

VillageMD, a Walgreens Boots Alliance majority-owned corporation, is exploring a deal to merge with medical practice Summit Health, the parent company of urgent care clinic chain CityMD… Read More

State Spotlight: Higher Prices and Fewer Carriers Highlight First Year of Colorado Option

Last year, a bill creating the Colorado Public Option passed in the Colorado legislature. HB21-1232 mandated that health insurers reduce monthly premiums by five percent in the first year for consumers who buy the plan… Read More

Healthcare Happy Hour: 2022 Midterm Election Preview

On this week’s episode of the Healthcare Happy Hour, NAHU Vice President of Congressional Affairs John Greene and NAHU HUPAC Manager Nathan Makla provide a preview of next week’s midterm election discussing the key races that will determine Senate and House party control…

 Read More

HUPAC Roundup: House Democrats Still Fighting for Victory

The democratic collapse in the House may not be as draconian as some predict.  Nate Cohn, the chief political analyst at The New York Times, argues in a recent article that their polls in four House races offer democrats some hope stating… Read More

What We’re Reading

With the 2022 Midterm election less than a week away, take a break from all of those campaign commercials and check out what we’re reading this week… Read More

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Nationwide | In this month’s issue: Inflation insights from Nationwide(R)

Nationwide | In this month’s issue: Inflation insights from Nationwide(R)

Nationwide | In this month’s issue: Inflation insights from Nationwide(R)
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Nationwide Annuity Notes

Offer clients growth and protection for the future

To learn more about recent enhancements to Nationwide Peak® 10 fixed indexed annuities, and how they can help clients grow and protect their retirement savings, visit our site.

For agents who are contracted to sell in AK, CT, IA, ID, MN, MS, MO, NH, NJ, NV, OH, OK, PA, RI, SC, TX, UT, VA, WA and WY.

For agents who are contracted to sell in AL, AZ, AR, CO, DC, FL, GA, HI, IL, IN, KS, KY, LA, MA, MD, ME, MI, MT, NC, NE, ND, NM, SD, TN, VT, WV and WI.

Check out this month’s timely insights and resources

NATIONWIDE THOUGHT LEADERSHIP

Using an income laddering strategy with an FIA to hedge against inflation

Offer clients an efficient, flexible solution by laddering FIA income.

DOING BUSINESS WITH NATIONWIDE

Real-time tracking for annuity pending business

On-demand annuity client data is now available. Get it when you need it most! Use our guide to get started.

NATIONWIDE ECONOMICS TEAM

Cycle Watch for October 2022

Read our latest thoughts about the factors driving economic and financial market performance.

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THE ADVISOR ADVOCATE® BLOG

A Rising Tax Environment? What to Watch For.

Get an updated look at the tax landscape this year and beyond.

Access your dedicated resources

Visit our Thought Leadership Library to:

  • Watch and download previous webinar presentations
  • Download related educational materials
  • Register for upcoming webinars
For more information, contact a Pinnacle Financial Services representative today

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Global Atlantic | Mandatory Training Requirement

Global Atlantic | Mandatory Training Requirement

Global Atlantic | Mandatory Training Requirement
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Global Atlantic is undergoing a business transformation, which includes updating our product portfolio. On October 17th, we will be transitioning our annuity products from the Choice series to the Fore series and updating Income 150+ SE. These changes require NAIC product training for all financial professionals.

lease make sure that you have completed the appropriate annuity product-specific training prior to submitting the business.

Click the link below, log in and Enter the Product Code. Once you enter the code for the product you will be selling click submit.

  • INC150 – Income 150+ SE Fixed Index Annuity
  • ALLFIA2 – ForeAccumulation II and ForeIncome II Fixed Index Annuities
For more information, contact a Pinnacle Financial Services representative today

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WellCare | 2023 Centene Star Ratings

WellCare | 2023 Centene Star Ratings

WellCare | 2023 Centene Star Ratings
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2023 Centene Medicare Advantage Star Ratings

We are pleased to share Centene’s 2023 Medicare Advantage Star Ratings.

Immediate Action Required:

  • 2022 CMS Star Rating documents within your existing inventory of sales enrollment kits MUST be replaced with the 2023 CMS Star Ratings documents, no later than November 1, 2022.
  • Be sure to dispose of any outdated 2022 CMS Star Rating documents.

Access PDF Downloads

CMS Star Rating Measures:

Each year, the Centers for Medicare & Medicaid Services (CMS) uses a Stars Rating system to measure the performance of all Medicare Advantage Part C and Part D Prescription Drug Plans to determine if they provide high-quality care for their members.

These quality scores include several factors, such as the clinical care members receive, their service experience, and member feedback gathered annually detailing how well plans did in various categories. Using a one to five Star Rating system, CMS evaluates nearly 40 quality and performance measures.

Centene oversees CMS Star measures and performance within five chapters:

  • Admin/Ops (service quality)
  • CAHPS (member satisfaction)
  • HEDIS (clinical services)
  • HOS (Health Outcomes Survey)
  • Pharmacy (taking prescribed medications)

Achieving positive quality ratings is vital. These ratings are crucial to our members, brokers, and partners, and to our overall growth at Wellcare. With CMS’ increased focus on patient experience and access to care, we must continue to put our members first and empower them to partner with their providers to make good healthcare decisions.

As always, we thank you for your continued partnership!

Centene ranks #26 on the Fortune 500 List

Our company provides programs and services to government healthcare programs. We are the country’s largest Medicaid-managed care organization. See our current standing.

Important Broker Links

Single Sign-On Portal

Archived Agent News

Click here to read archived Wellcare communications.

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
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NGL | EssentialLTC – Long Term Care Awareness Month

NGL | EssentialLTC – Long Term Care Awareness Month

NGL | EssentialLTC – Long Term Care Awareness Month
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NGL is dedicated to helping you get the most out of Long Term Care Awareness Month. We have the consumer materials you need to help you increase your client’s knowledge of this month. Click the links below to download a PDF version of the material.

Downloadable Social Media Posts

There are 14 different social media infographics you can use on your social media platforms to inform your customers why they should consider long-term care planning. Click here to download the posts.

Consumer Brochure*

This brochure can help you comprehensively explain the benefits of this crucial insurance to your clients. It takes consumers through why long-term care is important, payment options, product features, and optional benefit features. Click here to download a PDF copy.

Consumer Presentation*

We’ve taken our Consumer Brochure and made it into a presentation that you can show your clients! It gives a high-level breakdown of why LTC insurance is so important. Click here for a PDF version.

Consumer Flyer*

Perfect for a handout or a leave-behind, the Consumer Flyer is a quick way to introduce the concept of LTC and NGL as a company. Click here to download a PDF of the flyer.

Employer Brochure*

Like the Consumer Flyer, the Employer Brochure is a great introduction to how NGL EssentialLTC can benefit employers. Click here to download a PDF of the brochure.

Claims Flyer

This step-by-step flyer is a great tool to help you explain the NGL EssentialLTC claims process to your clients. It lays out eligibility for claims and the steps your clients can expect when filing for benefits. Click here to download a PDF of the flyer.

For agent inquiries contact your dedicated Agent Services Team at 1 (888) 505.2332 or status@ngl-essentialltc.com. For sales questions contact the Long-Term Care Sales Team at LTC@nglic.com.

*Available for use in 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.

Check the Agent Resource Center for versions available for AZ, CA, CT, DC, DE, FL, HI, IN, ND, NJ, SD.

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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WellCare | 2023 Centene Star Ratings

WellCare | Weekly News

WellCare | Weekly News
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With AEP underway, we want to provide some important updates that will help you throughout AEP and beyond.

This Weekly News communication will provide information on the following topics:

  • Grocery Benefit– Important update clarifying differences between 2022 & 2023 benefits
  • TPMO Requirements Update – FAQ updates to Call Recordings and Oversight & Monitoring sections
  • BoB Effective Dates – Understanding termination and new effective dates in Centene Workbench
  • SEP Reminders – SEP guideline reminders and Wellcare active SEP resource

Grocery Benefit

As a reminder, there are different grocery benefits in 2022 and 2023 under the Wellcare Medicare plans:

2022

Members enrolled on a plan with the Special Supplemental Benefit for the Chronically Ill (SSBCI) Grocery Delivery benefit must qualify before receiving access to their online Shipt account. It is not an automatic benefit and is not a grocery card. Qualified members may use this benefit through 12/31/2022.

2023

A Healthy Foods Card has been added to most Wellcare D-SNPs. All members on these D-SNPs will receive automatic access to a Healthy Foods Card, which will be mailed to them beginning the first week of December. The Shipt grocery delivery benefit has been removed from the SSBCI program for 2023.

TPMO Requirements Update

We remain committed to providing you with timely updates on the new TPMO requirements. The CMS Call Recording and Disclaimer Requirements for TPMOs FAQ has been updated to provide additional information in the Call Recordings and Oversight & Monitoring sections. Please take a moment to review the updates so you are familiar with all requirements and expectations of TPMOs.

Book of Business Effective Dates

When reviewing Book of Business information within the Centene Workbench broker portal, you may notice instances where non-terming members reflect a 12/31/2022 Termination Date. At the same time, there will be a corresponding record for the member that reflects a 01/01/2023 Effective Date. This is normal and happens when a plan change is processed for a member, removing them from the prior plan and enrolling them into the new plan.

When reviewing your Book of Business, ensure that you refrain from filtering only on the Termination Date. This will ensure you are able to see the full view of activity for members within your Book of Business.

Special Enrollment Period (SEP) Reminders

Wellcare continues to receive SEP enrollments even when a valid SEP is not available for the member. As a reminder, SEPs are election periods outside of IEP, AEP, and MA OEP where a qualifying individual may enroll into or disenroll from a plan or change their current plan election. Please note the following SEP guidelines stated below:

  • There are various types of SEPs, each with specific eligibility criteria, time frames, and effective dates. Please ensure that these are fully met before placing a SEP enrollment request.
  • An individual might be eligible for a SEP but would also have to meet the eligibility criteria of the plan selected for enrollment.
  • For SEPs related to disaster declarations, the individual must actually be impacted by the disaster AND would have otherwise qualified for an election period during the impacted timeframe.
  • Unless stated otherwise, an individual meeting the SEP and plan eligibility criteria can only make a one-time change to their plan election.
  • The SEP for the individual ends when the individual elects a new plan or when the SEP time frame ends, whichever comes first unless specified otherwise within a SEP.

You are encouraged to view the SEP section in the CMS Enrollment and Disenrollment Guidance for Medicare Advantage (MA) (Section 30.4) and/or Prescription Drug Plan (PDP) (Section 30.3) for detailed descriptions of the various types of SEPs and their eligibility criteria.

Our SEP FEMA / State Declarations Resource provides a comprehensive list of all active SEP communications sent as well as recently expired SEPs. Be sure to add this link as a bookmark in your internet browser to ensure you never miss a SEP that may be active in your area.

We look forward to supporting you through another successful AEP. As always, thank you for your continued partnership!

Centene ranks #26 on the Fortune 500 List

Our company provides programs and services to government healthcare programs. We are the country’s largest Medicaid-managed care organization. See our current standing.

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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