Humana |  Reminder to use 2022 Plan/Star Rating Documents. Learn More.

Humana | Reminder to use 2022 Plan/Star Rating Documents. Learn More.

Humana | Reminder to use 2022 Plan/Star Rating Documents. Learn More.
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2022 Plan/Star Rating Documents (PRDs)

For your current inventory, you will need to replace your 2021 PRDs with the new 2022.

Future orders for Enrollment books:

  • AIO Enrollment Books:  Will continue to have 2021 bound in and must be removed when you receive them.  2022 PRD will be associated with all enrollment book orders so you will get the new one with your order.
  • Enrollment Books with plan booklet assembled in the back pocket: 2021 PRDs will no longer be in the pocket.  2022 PRDs will be included in the pocket.
  • Individual PRDs:  Are updated so you will be able to order these to replace your stock. 

2022 PRDs CANNOT be used until 10/25 but must be in place by no later than 10/29.

Download 2022 Plan/Star Ratings →

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 | 2022 Centene Star Ratings – Wellcare Plans

Wellcare | 2022 Centene Star Ratings – Wellcare Plans
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CMS Star Ratings have been released and Centene has received a 5-Star rating on a Wellcare of California plan!

Additionally, Centene saw an increase in performance for 18 plans between Rating Years (RY) 2021 and 2022. Overall, RY2022 resulted in nearly 95% of Centene MA-PD members being enrolled in a 3.5+ Star rated plan, with more than half in a 4+ Star rated plan.

Immediate Action Required

  • 2021 CMS Star Rating documents within your existing inventory of sales enrollment kits MUST be replaced with the 2022 CMS Star Ratings documents, no later than November 1, 2021.
  • Be sure to dispose of any outdated 2021 CMS Star Rating documents.

Click to Download

2022 CMS Star Ratings

CMS Star Rating Measures:

Each year, the Centers for Medicare & Medicaid Services (CMS) issues objective ratings on all Medicare Advantage and Medicare 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 detailing how well plans did in various categories. Using a one through five-Star rating system, CMS evaluates nearly 50 measures, broken into multiple areas.

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 #24 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: https://fortune.com/company/centene/fortune500/

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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Healthfirst | Key 2022 Plan Design Updates

Healthfirst | Key 2022 Plan Design Updates

Healthfirst | Key 2022 Plan Design Updates
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Flexible options. Enhanced benefits. Cost savings. Healthfirst Signature (HMO) helps members live a healthier life so they can do the things that make them happy.

Healthfirst Signature (HMO) has enhanced benefits and greater flexibility for those who want an added level of choice, plus a dedicated member services team.

Members can select one of the following Healthfirst Signature Choice Extras benefits each year:

  • $35/quarter OTC allowance, OR
  • Free transportation to doctors for covered services (up to
    12 one-way trips), OR
  • $0 dental deductible for comprehensive dental services.

Additional talking points on Healthfirst Signature (HMO) 2022 updates:

  • Service area expansion to Staten Island, and to Orange, Sullivan, and Rockland counties
  • $0 PCP copay
  • Lower cost-sharing for Part D, including our $250 deductible, plus 90-day scripts for the same cost as 30-day scripts at pharmacies and via mail (applies to Tier 1-3 drugs)
  • Coverage of supplemental drugs, including prescription vitamins and erectile dysfunction (ED) medication
  • $2,500 maximum benefit coverage for dental (up from $1,500); limitations and exclusions apply
  • $250 allowance for eyewear every two years (up from $100)

We know you’ll be excited to share these enhanced benefits and
cost-savings with clients.

Questions? Don’t hesitate to contact your Healthfirst  Broker Sales Manager, or call Broker Services at 1-855-456-3668, Monday to Friday, 9 am – 5 pm.

Thank you for working with Healthfirst.

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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Humana |  Reminder to use 2022 Plan/Star Rating Documents. Learn More.

Humana | FDR Marketing and Communication Guardrails

Humana | FDR Marketing and Communication Guardrails
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In response to the CMS memo issued October 8th regarding Third-Party Marketing materials, Humana issued clarifying guidance and an accompanying FAQ on October 11, 2021.

Humana has since updated related guidance to further support compliant sales experiences.  Attached please find Humana’s FDR Marketing and Communication Guardrails. 

Please review all marketing materials, including those created by lead source vendors, to ensure all marketing is consistent with established regulations.  

In the event that opportunities are identified, the materials must be revised to meet expectations.

The information transmitted is intended only for the person or entity to which it is addressed
and may contain CONFIDENTIAL material. If you receive this material/information in error,
please contact the sender and delete or destroy the material/information.

Humana Inc. and its subsidiaries comply with applicable Federal civil rights laws and
do not discriminate on the basis of race, color, national origin, ancestry, age, disability, sex,
marital status, gender, sexual orientation, gender identity, or religion. Humana Inc. and its subsidiaries do not
exclude people or treat them differently because of race, color, national origin, ancestry, age,
disability, sex, marital status, gender, sexual orientation, gender identity, or religion.

English: ATTENTION: If you do not speak English, language assistance services, free
of charge, are available to you. Call 1‐877‐320‐1235 (TTY: 711).

Español (Spanish): ATENCIÓN: Si habla español, tiene a su disposición servicios
gratuitos de asistencia lingüística. Llame al 1‐877‐320‐1235 (TTY: 711).

繁體中文(Chinese):注意:如果您使用繁體中文,您可以免費獲得語言援助
服務。請致電 1‐877‐320‐1235 (TTY: 711)

Kreyòl Ayisyen (Haitian Creole): ATANSION: Si w pale Kreyòl Ayisyen, gen sèvis èd
pou lang ki disponib gratis pou ou. Rele 1‐877‐320‐1235 (TTY: 711).

Polski (Polish): UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej
pomocy językowej. Zadzwoń pod numer 1‐877‐320‐1235 (TTY: 711).

한국어 (Korean): 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로
이용하실 있습니다. 1‐877‐320‐1235 (TTY: 711)번으로 전화해 주십시오.

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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Pinnacle Financial Services | Updated CMS Guidance on Third-Party Marketing of MA Plans

Pinnacle Financial Services | Updated CMS Guidance on Third-Party Marketing of MA Plans

Pinnacle Financial Services | Updated CMS Guidance on Third-Party Marketing of MA Plans
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On October 8, 2021, the Centers for Medicare & Medicaid Services (CMS) issued updated guidance pertaining to the compliance and regulations of third-party marketing of Medicare Advantage plans. Please note that while this update does not reflect any new guidance, it does have implications to our current compliance practices.

Pinnacle Financial Services has clarified this new guidance and ensure our collective activities continue to uphold the highest standards.

For details on the announcement please click here:

Please do not hesitate to contact the team at Pinnacle Financial with any questions.

800-772-6881 or compliance@pfsinsurance.com

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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Clover | Teleapp Process

Clover | Teleapp Process

Clover | Teleapp Process
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3 Ways to Enroll Members

Online Via CloverHealth.com

Go to our Plan Documents & Enrollments section to see all the plan documents and easily enroll your clients.

Via Clover’s Telephonic Enrollment

If you do not have access to a computer, use our Clover Telephonic Enrollment

  • Call (855) 993-5636 for our telephonic enrollment option
  • Be sure to read our instructions before calling, found here.

Your Agency’s 3rd Party Tool

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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