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Wellcare | AEP Edition: Important Updates and Reminders

November 29, 2023

Important Updates & Reminders for Wellcare Agents

During AEP, we continue to deliver the Wellcare Insider: AEP Edition to you each week. This weekly bulletin is your source for important updates and reminders, with AEP news you can use to provide excellent service and grow your business.

Today’s edition has information on the following topics:

  • Compliance Reminder – Review the Medicare name and image use guidelines
  • One-Stop Resource Spot – Take full advantage of the Digital Resource Center
  • Key Highlighted Plans – Learn how our Push Plans match beneficiary needs
  • Important Links – Bookmark the tools you need throughout AEP and beyond

CMS Guidelines for Use of Medicare Names and Changes

As a reminder, beginning September 30, 2023, new CMS guidelines prohibit the misleading use of the Medicare name, CMS logo or any products and information issued by the Federal Government, including the Medicare card.

Action Steps

  • Review all materials, advertisements, resources, vehicles, clothing, etc. for the use of the Medicare name or card image. Cease using all resources that do not have CMS approval for the use of the Medicare card or contain any information using the Medicare name that could be construed as misleading.
  • Revise any misleading Medicare or Medicare card information. If a Medicare card is proposed for use, add a disclaimer in the vicinity of the card image that indicates there is no affiliation or endorsement from CMS, HHS, or the Federal Government.
  • Use of the Medicare card is only permissible with prior CMS approval. Approval may be obtained by following these steps:
  1. Send an email to the CMS marketing mailbox at Marketing@cms.hhs.gov with an attached copy of the material that has the Medicare ID card image on it. An email must be sent for both marketing and communication materials.
  2. Wait for approval to be received from the CMS marketing mailbox before using any communication material or submitting marketing materials for approval in Health Plan Management Systems (HPMS).
  3. After receiving a marketing material approval, log on to HPMS and upload a zipped file containing both the approval email and the marketing piece, using the assigned Specified Material Identification (SMID). Warning: Uploading a marketing piece without the accompanying email approval will result in CMS disapproval and/or Plan opt-out and resubmission requirement.

Special Considerations for Third-Party Marketing Organizations (TPMOs)

As referenced above, CMS is suggesting that TPMOs add a disclaimer in the vicinity of the Medicare card image that indicates they are not affiliated or endorsed by CMS, HHS or the Federal Government as well. A missing disclaimer near the Medicare card image may indicate that the approval process was bypassed resulting in additional follow-up by the reviewer.

You may review the complete details for the marketing guideline changes in the current CMS Marketing Regulations.

Digital Resource Center Offers Easy Access

From searching a plan-specific formulary to quickly accessing a Scope of Appointment or sales presentation, the Digital Resource Center (DRC) on WellcareFirstLook.com provides easy access to all the resources you need for AEP and beyond, in one convenient location.

Take a moment to bookmark the DRC, and ensure simple, one-click access to these resources and more:

  • Benefit highlights
  • Enrollment forms
  • OTC Catalogs
  • Scope of Appointment
  • Sales presentations
  • Formulary search tools
  • Pre-Enrollment guides
  • Evidence of Coverage
  • Summary of Benefits

Key Highlighted Plans

Wellcare continues to provide the plans and benefits that best serve a variety of member needs. Did you miss our recent Product Pointers feature on 2024 Key Highlighted Plans? Be sure to give it a read! Take note of the key features of our “Push Plans” and learn how they can be used to drive your business to a successful finish with benefits that match specific member needs.

Note: Not all plans are available in every state.

Please visit WellcareFirstLook.com to view the plan details and individual key selling features, found at the top of each sub-region page, for the plans available within a specific market.

Broker Resources

Save these important resources for help in easily accessing the enrollment platform, ordering sales materials, marketing and sales guidance, and much more.

Click on each topic for detailed information and bookmark for easy access

We hope that you find these resources helpful for all of your sales activities throughout AEP and beyond.

As always, thank you for your continued partnership!

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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

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