Medicare Broker Update • Vol. 3 No. 9 • 2021

Univera Healthcare 2022 Medicare Star Ratings

Last month, Univera shared the exciting news that Univera Healthcare 2022 Medicare HMO plans were awarded 5 stars out of a possible 5-star rating. These annual ratings measure a variety of health benchmarks, such as:

• Keeping members healthy - whether Medicare members are receiving their preventive screenings
• Addressing chronic conditions - how a Medicare member’s chronic conditions such as diabetes and high blood pressure are being managed
• Member experience – overall member satisfaction with the health plan, taking into consideration occurrences and frequency of member complaints, disenroll rates, access to necessary services, and plan improvements year-over-year
• Customer care – the quality of call center services, including the efficiency of new enrollments and appeals processing

More Information

Medicare 5-Star Special Enrollment Period
Achieving a 5-star rating for our HMO plans is great news for members. Not only does it confirm the top-quality benefits and service they can expect with a Univera Healthcare Medicare HMO plan, but it also creates an extended opportunity to enroll in them.

During the Annual Enrollment Period, if a member enrolls in a plan that is rated as fewer than five stars, they may utilize the Medicare 5-Star Special Election Period to disenroll from their current plan and enroll in a 5-star Medicare plan, such as a Univera Healthcare Medicare HMO plan.

For 2022 plans, this special enrollment period runs from December 8, 2021 to November 30, 2022, which gives members almost an entire year to make the switch from a lower-rated plan to a 5-star HMO plan.

Fall Member Newsletter

In an effort to ensure you are aware of Univera's Medicare Member Communications, here is the latest edition of the quarterly Member Newsletter.

This quarter’s edition covers topics such as:

• 2022 plan features
• Tips for coming home following a hospital stay
• Positive aging – the happy, healthy way to grow older
• Staying safe with fall prevention strategies

NOTE: There was one small error in the newsletter that the carrier wanted to clarify for their broker partners. In the supplemental dental grid on page 2, the last column of the table previously stated, “Annual OOP Max”, but it should actually be titled “Maximum Plan Benefit Coverage”. You can obtain a copy of the newsletter with this correction below.

Fall Quarterly Member Newsletter (PDF)

REMINDER: Enrollment Tips - Ensuring A Seamless Application Approval

Univera has compiled a detailed tip sheet for their broker partners that describes the enrollment process, timelines, and suggestions for submitting completed applications to help alleviate and minimize any delays in processing.

If you experience a business delay due to missing information on your client’s application, one of the common issues we see is related to the Primary Care Physician (PCP) details. When adding the PCP to the application, please use the first and last name only with no prefix, title, or suffix.

• When do members need to provide a PCP?

• When electing to enroll in HMO coverage, please ensure the PCP’s full first and last name is spelled correctly. Do not include a prefix of Dr., Doctor, NP.

Additional information can be found in the full Broker Tip Sheet.

Broker Tip Sheet (PDF)