Medicare Application Submission Deadlines

Online Application Submission Deadline (All Regions)

• ‍‍Online applications will be accepted through the Producer Portal until 11:59 p.m. on Thursday, December 7. Agents will be unable to submit AEP applications after midnight.

Paper Application Submission Deadline

• All AEP paper applications for a January 1, 2024 effective date must be completed, signed, and dated no later than 11:59 p.m. on Thursday, December 7. Please use the "Date Received" box in the upper right hand corner of the application to document the date the agent receives/accepts the enrollment request from the beneficiary. Per CMS guidelines, all applications must be submitted within 48 hours of the agent's receipt of the application. 
• Please double check any paper applications to make sure there is no missing or incomplete information as this can cause a delay in processing.
• Paper applications for Pennsylvania, West Virginia, and Delaware will only be accepted via fax to 1-888-663-0258.
• Paper applications for Western New York and Northeastern New York may be submitted via email to maandmedigapebny@highmarkhealth.org

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Checking Application Status

• If you submitted an application online through the Producer Portal, you can confirm the status by logging in and reviewing the applications listed below your dashboard. For faxed applications, visit medicare.highmark.com and select "Application Status" at the top of the web page. 
• For additional assistance, feel free to contact Highmark Senior Markets via e-mail or phone Monday through Friday, 8:00 a.m.- 4:00 p.m. 
• Pennsylvania, West Virginia, Delaware: Phone: 1-800-652-9459, Option 1 (Senior Markets), then Option 1, Email: PRODEM@highmark.com
• Western New York, Northeastern New York: Phone: 1-844-946-6305, Option 1 (Senior Markets), then Option 1, Email:albany.liaison@bsneny.com

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Resources

If you're looking for a quick product refresher, it may be helpful to check out the one-sheet sales resources found in the Producer Portal. These focused materials are designed to inform you about our products and business practices, and provide helpful sales tips.

As always, enrollment and marketing materials can also be acquired through Marcom, via the Producer Portal!

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2024 Agent Field Guide

One of our most comprehensive resources is our Agent Field Guide. This document is a comprehensive source of information about how to do business with Highmark, and includes detailed plan information for our products in all of our sales regions.

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One Sheet Sales Resources

These regional one page product highlight overviews offer proven benefit value propositions, sales conversation starters, and other helpful talking points!

• Pennsylvania Plan Highlights: click here
• Highmark Wholecare Plan Highlights: click here
• New York Plan Highlights: click here
• West Virginia Plan Highlights: click here
• Delaware Plan Highlights: click here

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Updated Scope of Appointment Forms

In all sales situations, you're required to capture a Scope of Appointment (SOA). You are not required to submit an SOA with an application but you must retain a copy per CMS' record retention guidelines. For 2024, Highmark has updated the look and feel of their Medicare Advantage SOA. Click below to download!

• Medicare Advantage: click here
• Wholecare D-SNP: click here

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Multi-Factor Authentication and Single Sign-on Capabilities in Cavulus MedicareCRM (Highmark Wholecare)

In an effort to enhance the security of its products, Cavulus has upgraded its MedicareCRM system with multi-factor authentication and single sign-on capabilities. This change is effective immediately, and impacts anyone attempting to access Cavulus (the Highmark Wholecare CRM).

For an overview of this change, including instructions on how to login using this new single sign-on system, click here.

If you continue to have trouble logging in, please contact Agent Support at 1-888-871-0417 for assistance.

Note: You must be certified to sell Highmark Wholecare products to access Cavulus. If you need help contracting to sell Wholecare, please contact your local Channel Sales Representative.

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HRA Submission Guidelines

Highmark has recently received questions about submission of Health Risk Assessments (HRAs). Here are some guidelines to help you submit both traditional Highmark MA and Wholecare D-SNP HRAs!

Traditional Highmark MA HRA Submission

• Submissions will only be accepted online via the Producer Portal. You will not be compensated for any paper submissions of the HRA Survey. To view and download a hard copy of the questionnaire to capture responses, and then submit them online,  click here.
• $50 compensation per completed HRA will be provided only for New to Medicare and Replacement policies.
• New to Medicare and Replacement is defined as those who have not had Medicare coverage with Highmark at the start of AEP. This does not include any current member that is making a plan change to a different Highmark Medicare plan.
• Reimbursements for 1/1 effectives will be paid after January 1, 2024.  They will be paid monthly thereafter.
• HRAs must be submitted within 72 hours of application submission to be eligible for compensation.
• HRA assessments will only be compensated for MAPD or MA only plans.  Compensation will not be provided for HRAs completed for Medicare Supplement or PDP enrollments.
• Agents are responsible for completing the HRA survey and submitting the information to Highmark.  Surveys cannot be completed online by a beneficiary

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Wholecare DSNP HRA Submission

• Submissions will only be accepted online via Cavulus. You must be certified to sell Highmark Wholecare products to access Cavulus.
• $125 compensation per completed HRA will be provided only for new or replacement policies.
• Agents are encouraged to submit HRAs within 72 hours of application submission.
• Agents are compensated if the member remains enrolled for 90 consecutive days from the effective date of the policy. For example, for a member whose effective date is 6/1, the agent will be compensated during September payouts.
• To view and download a hard copy of the Wholecare D-SNP questionnaire to capture responses, and then submit them online, click here for Blue Cross Blue Shield, or click here for Blue Shield .
• In order to be paid for completing a Health Risk Assessment (HRA) for Highmark Wholecare D-SNP business, brokers must complete and attest to the approved HRA / Model of Care (MOC) training module. To access the HRA / MOC Sales Training, including the required attestation link, click here.

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