Clover Health | Jefferson Health System Contract Termination

Clover Health | Jefferson Health System Contract Termination

Clover Health | Jefferson Health System Contract Termination
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Clover’s contract with the Jefferson Health System’s hospitals, primary care and specialist providers will terminate as of August 5, 2023. This network change may affect your clients if they have accessed care with the Jefferson Health System.

As always, it is important to Clover that our members’ healthcare is not affected by this change. This includes their ongoing medical care and authorizations for services.

We are sending letters to members identified as having received care from a Jefferson Health System provider or hospital advising them of this network change. In an effort to further put members at ease, we will be making outbound calls to these members that will include helping them find other providers, schedule alternate appointments, and provide any support they might need.

Of course, members may continue to use Jefferson Health System hospitals and providers (if the provider/facility agrees to accept Clover Health members). But please make sure they understand that after the August 5th date, they may have to pay higher costs.

Please reach out to your clients who might be affected by this change and help them navigate to alternate care options. We will provide them with a list of in-network primary care providers in their area and our online Provider Directory is available on-demand to help as well.

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 Health | Jefferson Health System Contract Termination

Clover Health | Weekly Updates

Clover Health | Weekly Updates
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The Medicare Advantage (MA) Open Enrollment Period (OEP) takes place from January 1 – March 31 each year. Any time you speak to a beneficiary, please keep CMS rules in mind. Agents cannot market themselves or have the ability to make plan changes during OEP – a beneficiary must initiate the conversation.

What can a beneficiary do during OEP if they are in a Medicare Advantage plan (with or without drug coverage)? 

  • Switch to another Medicare Advantage plan (with or without drug coverage)
  • Drop a Medicare Advantage plan and return to Original Medicare (also able to join a separate Medicare drug plan)

What can a beneficiary not do during OEP?

  • Switch from Original Medicare to a Medicare Advantage plan
  • Join a Medicare drug plan if in Original Medicare
  • Switch from one Medicare drug plan to another if in Original Medicare

Client Retention: Best Practices

The first 30 days of enrollment are the most important to your client as it is when they will be receiving most of the information associated with their Clover Health plan and benefits. Learn more about our touchpoints below.

Commissions Updates

The 1st run of JAN 2022 commissions has been approved and was released at the end of last week. This run included all CMS-approved 01/01/2022 effective applications and the JAN 2022 monthly residual payment for all currently active membership in your Book of Business. Please review your statements carefully and let us know if you have any questions.

Log into the broker portal here

  • Need help? Utilize the Broker Portal Guide
  • Do you have an issue with your commissions or residual payments
  • Fill out this form for assistance

    Does your client need help to find a dentist?

    Use DentaQuest’s directory search to help your members find a dentist in their area!

      OTC Cards

      If your clients need assistance with their OTC card – please call Clover Health’s OTC partner, LiveHealthy at 1-844-529-5869.

      The Health Risk Assessment

      The HRA Survey is still live. Submit the HRA Survey within 72 hours of application submittal to receive an easy $50!

        Clover Health’s Helpful Resources

        Need help with understanding benefits, parity, enrolling members, the broker portal, & more? Check out our quick reference guides!

          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.

          CallEmail

          Clover Health | Jefferson Health System Contract Termination

          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.

          CallEmail