Compliance

If you receive questions from your clients regarding SSBCI benefit eligibility, you can use the following information to validate eligibility and determine if a member call to Wellcare Customer Service by your client is needed.

Please be advised that a state of emergency was declared, impacting individuals in New Jersey. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in Virginia. This declaration allows for a one-time Special Enrollment Period (SEP).

Beginning Jan. 15, BlueCross and BlueChoice will reimburse eligible members for the purchase of over-the-counter COVID-19 diagnostic tests that have been authorized, cleared or approved by the U.S. Food and Drug Administration. View post to see the list of qualifying tests and FAQs.

Please be advised that a state of emergency was declared, impacting individuals in Virginia. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in New Jersey. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in Kentucky. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in all Maryland counties. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in all Maryland counties. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in Nevada counties. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in certain California counties. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in Washington. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in all Oregon counties. This declaration allows for a one-time Special Enrollment Period (SEP).

UPDATED 1/10: Please be advised that a state of emergency was declared, impacting individuals in Colorado. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in certain Alabama counties. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in Washington. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in Tennessee. This declaration allows for a one-time Special Enrollment Period (SEP).

Three new states have adopted the Birthday Rule for Medicare Supplement Plans for 2022. Here’s what you need to know if you are licensed to sell in Nevada, Idaho, or Illinois.

With Medicare Part B monthly premiums set to increase in 2022, now is the time to discuss the rising costs with your clients. Here’s what you—and they—need to know.

Please be advised that a state of emergency was declared, impacting individuals in Kentucky. This declaration allows for a one-time Special Enrollment Period (SEP).

The Centers for Medicare & Medicaid Services (CMS) provides for a Special Election Period (SEP) for beneficiaries impacted by a Federal Emergency Management Agency (FEMA) Emergency or Major Disaster Declaration.

Please be advised that a state of emergency was declared, impacting individuals in Hawaii. This declaration allows for a one-time Special Enrollment Period (SEP).

Medicaid, Child Health Plus and Essential Plan cases with a coverage end date through 1/31/22 will be extended for an additional 12 month period.

It's business as usual in Florida - this is the 4th year in a row Cigna has received a 5-star rating from CMS in Florida. Click the post to learn more.

The Centers for Medicare & Medicaid Services (CMS) provides for a Special Election Period (SEP) for beneficiaries impacted by a Federal Emergency Management Agency (FEMA) Emergency or Major Disaster Declaration.

Please note, Molina is providing additional clarification on the 12/3/2021 notice of updated eligibility criteria for their Michigan Medicare Plans. They apologize for any confusion and appreciate your continued support and partnership.

Please be advised that a state of emergency was declared, impacting individuals in Connecticut. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in New Jersey. This declaration allows for a one-time Special Enrollment Period (SEP).

If your sales region includes Westmoreland County, you may have already heard about UnitedHealthcare terminating their access to Excela Health for 2022.

This issue has been corrected. Please review the 2022 Wellcare Benefit Highlights Impacted Plans document for quick reference of plans included in the issue resolution.

Please be advised that a state of emergency was declared, impacting individuals in Rhode Island. This declaration allows for a one-time Special Enrollment Period (SEP).

Based on the group's feedback, BlueChoice® will make changes to their prescription drug coverage and utilization management program for large groups and CarolinaADVANTAGE legacy small groups.

During the past few weeks, Molina has received several questions concerning eligibility for the Molina DSNP plans in Michigan. Click the post to view an update from the carrier.

CareValue can help brokers get certified - NY State of Health Announces 2022 Enrollment is Open – New Yorkers Urged to Enroll in a Health Plan or Renew Their Coverage Starting Today!

Click the post to view a detailed product availability chart from Cigna Supplemental Benefits for all states.

Inside, find an article from CMS regarding the Social Security COLA increase, Medicare premiums and deductibles, along with an article from Bloomberg regarding one of several reasons for the increases and more.

You may have recently heard that Cigna announced an agreement with Molina Healthcare, allowing Molina to acquire Cigna’s Texas Medicaid contracts and certain operating assets.

Please be advised that a state of emergency was declared, impacting individuals in New Jersey. This declaration allows for a one-time Special Enrollment Period (SEP).

The University of New Mexico Hospital is now in the Wellcare Network and can be found in the Find A Provider Tool.

Wellcare has identified an issue with the printed version of the 2022 Wellcare Benefit Highlights. The PPO In-Network Hearing Services benefit reflects a misprint of a lower benefit amount for both packages.

As of 10/7/2021, Centene has discontinued the sales of the Hearing, Vision, and Dental buy-up packages linked with Health Net Medicare Supplement plans. View post for a snapshot of the packages.

Please be advised that a state of emergency was declared, impacting individuals in certain NY counties. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in New Jersey. This declaration allows for a one-time Special Enrollment Period (SEP).

You must swap out the 2021 Star Ratings sheets in all your enrollment kits with the 2022 Star Ratings Sheets as of this communication. Please see the 2022 Star rating PDFs attached (EN- English, SP-Spanish).

Please see inside for a list of 2022 UHC 5-star plans. There are quite a few! These will be able to be sold year-round in 2022.

Click the post to view the Northeast plans in the 2022 Star Rating document for Humana. States include New York, Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont.

Independent agents are some of the most common targets for cybercriminals who target data to sell, hold for ransom, or exploit for monetary gain. As a trusted guardian of your members’ personal and health information, protecting data in the age of cyber insurance is crucial.

Highmark Blue Shield of Northeastern New York is pleased to announce that they are maintaining a 5 STAR CMS Rating for their PPO products throughout 2022.

Please be advised that a state of emergency was declared, impacting individuals in Hawaii. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in Hawaii. This declaration allows for a one-time Special Enrollment Period (SEP).

Wellcare has identified an issue with the printed version of the 2022 New Jersey Wellcare Dual Liberty Summary of Benefits documents contained within the 2022 Enrollment Guide.

UPMC for Life earned an excellent 5 out of a possible 5 overall star rating for its HMO and PPO plans from the Centers for Medicare & Medicaid Services (CMS) for 2022. And that’s not all. View the flyer inside for details.

Please be advised that a state of emergency was declared, impacting individuals in Michigan. This declaration allows for a one-time Special Enrollment Period (SEP).

The 2022 Star Ratings are now available to order. Once you receive them, please replace the 2021 Star Rating in your MA and Dental kits with these 2022 Star Ratings.

UPMC for Life earned an excellent 5 out of a possible 5 overall star rating for its HMO and PPO plans for 2022 from the Centers for Medicare & Medicaid Services (CMS).

Cigna's Medicare Advantage plans rank better than ever. For 2022, they expect 89% of their Medicare Advantage and Prescription Drug Plan (MAPD) customers will be in a 4 Star rated plan or higher – up 12% in just three years.

UHC is updating the Benefit Highlight Brochures and Shopping Sheets for all Medicare Advantage Plans to ensure accurate benefit information is available for consumers.

In an effort to better assist you, WellCare has shared PDF's of their 2022 benefit highlights for the state of Massachusetts. Click the post to view & download.

The Centers for Medicare & Medicaid Services (CMS) released the 2022 Star Ratings for Medicare Advantage (Medicare Part C) and Medicare Part D prescription drug plans to help people with Medicare compare plans ahead of Medicare Open Enrollment, which kicks off on October 15.

CMS is particularly concerned with national advertisements promoting MA plan benefits and cost savings, which are only available in limited service areas or for limited groups of enrollees, as well as using words and imagery that may confuse beneficiaries or cause them to believe the advertisement is coming directly from the government.

Effective 10/20/2021, premiums for the Grow-Up plan will increase. Electronic applications submitted on the Gerber Life Agent Portal on or after 10/20/2021 will be issued with the new rates.

Humana identified additional information to be included within the Part D Savings Model or Humana’s Insulin Savings Program page within applicable MAPD and PDP Premier Enrollment book plans.

If you were unable to attend a LIVE or Virtual AEP Rollout, attached are the slides that were presented for UnitedHealthcare's 2022 Medicare Plans.

Please be advised that a state of emergency was declared, impacting individuals in North Carolina. This declaration allows for a one-time Special Enrollment Period (SEP).

To get Ready to Sell Prescription Drug Plans (PDP) for Mutual of Omaha Rx, you have two options. View the post to learn about these options and download a flyer for full details.

CMS has extended the Open Enrollment Period! You now have until January 15th to work with your under 65 clients so you can focus on your Medicare clients throughout the whole of AEP (October 15 - December 7, 2021).

Please be advised that a state of emergency was declared, impacting individuals in all Louisiana counties. This declaration allows for a one-time Special Enrollment Period (SEP).

Cigna is excited to announce that Starting October 1, Cigna Health and Life Insurance Company (CHLIC) will implement the following rate adjustments for Medicare supplement in Virginia...

Please be advised that a state of emergency was declared, impacting individuals in certain Texas counties. This declaration allows for a one-time Special Enrollment Period (SEP).

While you prepare for a busy Annual Enrollment Period (AEP), remember to check your MyEnrollerSM status. If you haven’t logged in during the last 90 days, your account will be locked, and you won’t be able to submit applications.

Please be advised that a state of emergency was declared, impacting individuals in Pennsylvania. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in Virginia. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in West Virginia. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in New Jersey. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in New York. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in certain California counties. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in Mississippi. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in all Alabama counties. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in all Louisiana counties. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in Connecticut. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in Connecticut. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in all Alabama counties. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in all California counties. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in all Oregon counties. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in certain NY counties. This declaration allows for a one-time Special Enrollment Period (SEP).

Please be advised that a state of emergency was declared, impacting individuals in certain Florida counties. This declaration allows for a one-time Special Enrollment Period (SEP). See post for details.

Effective 08/11/2021, the policy form number for Guaranteed Life in New York will change. For a list of policy form numbers and product state availability, view the full post.

‍There are 2 types of Marketing Events that Agents can host: Molina Healthcare Marketing Events, and CVS Pharmacy Events(temporarily suspended until further notice). Click the post to learn how to do so compliantly.

Empire BCBS is releasing a newly revised Medicare Supplement enrollment application! In addition to other enhancements that will speed the enrollment process, the new application is designed to make it easier on you and your client(s) when medical underwriting* is required.

Please be advised that a state of emergency was declared, impacting individuals in a Nevada county. This declaration allows for a one-time Special Enrollment Period (SEP), in the event beneficiaries were unable to make an election during another qualifying election period. Please reference the following guidelines for the incident period. This SEP applies to the impacted county in Nevada listed below.

Please be advised that a state of emergency was declared, impacting individuals in certain California counties. This declaration allows for a one-time Special Enrollment Period (SEP), in the event beneficiaries were unable to make an election during another qualifying election period.

You're extremely busy preparing for AEP with First Looks every week - to help, Ascension Complete has created a reference GRID to help you identify their footprint and the plans available in each market! See post for details.

Individual Medicare Supplement policies (ACI*) currently available in New Mexico will have a rate adjustment effective October 1, 2021. Click the post to learn more.

Last year, Mutual of Omaha began implementing new rates and benefit option changes to the MutualCare® Solutions Portfolio in approved states. Effective August 1, 2021, they will be implementing these changes in three additional states.

With the Aetna PDP acquisition transition period ending, Wellcare is reducing the number of PDPs offered to align with CMS allowable plan limits.

Please be advised FEMA has declared that individual and public assistance is available in areas impacted by Fires in certain counties.

This declaration allows for a one-time Special Enrollment Period (SEP), in the event beneficiaries were unable to make an election during another qualifying election period. Please reference the following guidelines for the incident period.

Please see included list of declined and postponed situations and impairments to the Underwriting Guide in order to assist agencies and advisors in their field underwriting and for consideration before submitting business for clients with these conditions.

Please be advised that a state of emergency was declared, impacting individuals in certain Hawaii counties. This declaration allows for a one-time Special Enrollment Period (SEP), in the event beneficiaries were unable to make an election during another qualifying election period.

Please be advised that a state of emergency was declared, impacting individuals in certain California counties. This declaration allows for a one-time Special Enrollment Period (SEP), in the event beneficiaries were unable to make an election during another qualifying election period.