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:

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.

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!