Quick Tip: Don’t forget the 48-Hour Rule

No, I’m not talking about the 48 hour “cooling off period” or the new 48 hour requirement regarding when Scope of Appointment Forms must be obtained for a Medicare Advantage or Part D appointment. While CMS applies this time frame to just about everything these days, this is specific to enrollment submissions.

To put it simply, the “48 hour rule” means that all enrollment applications should be submitted to the carrier within 48 hours of receipt by the agent.  It should be noted that the 48 hours are calendar hours, not business hours so weekends and holidays count as well.

Furthermore, if you are working with a carrier that requires you to submit your enrollments to your upline for processing, you need to make every effort to have those submitted within 24 hours so they can submit them to the carrier within the 48 hour window.

The reason behind the “48 hour rule” is to allow the carriers ample time to process the enrollment on their end before they have to send it to CMS. Carriers have seven calendar days to do this. Since Star Ratings are tied to latency for the first time this year, you should expect that carriers will be making a push to get as many enrollments submitted as possible within that 7 day window. This could result in disciplinary action for agents who consistently fail to submit their enrollments within 48 hours.

So, as you are submitting enrollments this AEP, make sure you keep the “48 hour rule” in mind. And again, if your enrollments go to your upline first, submitting them within 24 hours is ideal.

Baby Boomers Increasingly Choosing Medicare Advantage

In a recent Bloomberg Government article, Peter Gosselin lays out the case for continued growth in the Medicare Advantage market in spite of CMS’s plan to reduce payments to insurers.  As a part of his article, Gosselin discusses the reasons why Baby Boomers are choosing Medicare Advantage as they age into Medicare.  Below is an excerpt:

The baby boomer generation aging into Medicare is more acquainted with managed care than its predecessors, having been around that system for a long time. Because of the recent recession, many aging boomers are arriving at retirement with considerably less in savings than they’d expected and perhaps a greater need to economize on health care.

The combination shows up in the share of people turning 65 who sign up for Medicare Advantage. More than 21 percent of 65- year-olds signed up last year, up from 15.2 percent in 2006, according to the Centers for Medicare and Medicaid Services. The trend suggests that the government and insurers could see a growing demand for Medicare Advantage among the new elderly, even in the face of reduced payments from Washington and less generous benefit packages from insurers.

This is great insight for agents who are target marketing Medicare Advantage prospects.  I hope it helps.

Bloomberg Government (BGOV) is a subscription news service.  If you are interested in reading the full article, just email me your contact information and I’ll email you back the share version.  ryan@agentpipeline.com

 

Cigna to buy HealthSpring for 3.8 Billion

Big news in the Medicare market today…

Cigna and Healthspring announced that Cigna will pay around $3.8 billion to buy HealthSpring in a deal that is expected to close in the first half of 2012. In the agreement approved by both companies’ board of directors, Cigna will pay $55 per share in cash for the Nashville, Tennessee based company. Cigna representatives said that the price represents a 37% premium over Friday’s closing price of $40.16.

“HealthSpring is a great fit with Cigna’s growth plans to expand into the Seniors and Medicare segment through a premier business and trusted brand name,” said David M. Cordani, President and Chief Executive Officer. “Our two companies share a common strategic vision and philosophy that we create customer value by partnering with health care professionals, and use information and incentives to deliver high-quality, differentiated programs.”

I’m sure each company will release more information in the coming days.  Typically, everything will stay “business as usual” until the buyout is complete.  I assume that will be the case with HealthSpring’s Medicare Advantage Plans and Cigna’s Part D Plans.

Read the full story here.

How to Order Your 2012 Medicare Advantage Enrollment Kits

We recently sent out several email blasts letting agents know how to pre-order enrollment kits. Below are links to those emails for companies that have provided their order procedure details. Carriers continue to provide us with information.  Be sure to check back for updates.

To view these emails you must be subscribed to our mailing list.  If you are not currently subscribed, Subscribe Today!  We do not share or sell our lists. Once you click subscribe, enter your email address, check your mail and click reply to be activated.

Aetna

Arcadian

Anthem

Coventry

HealthSpring/Bravo

Humana

UnitedHealthcare

WellCare

Windsor/Sterling

Certifying for CIGNA in Time for the 2012 AEP

CIGNA emailed appointed agents instructions on how to certifiy to sell CIGNA Medicare products before the 2012 AEP begins on October 15. As usual, agents must successfully certify prior to marketing or selling CIGNA Medicare products; this means completing the required lessons and passing the exams with a score of 85% or better. CIGNA allows agents to take each exam up to three times in order to certify to sell their products for the 2012 selling season. In their announcement, CIGNA reminded agents that completion of certification is required to receive any commission. Below is a quick list of requirements and what to expect when you visit the CIGNA training and certification site:

Certification Requirements:

1. All agents must complete Lesson 1 or provide his or her 2012 AHIP Certification
2. Agents who wish to sell the National PDP must complete Lesson 2
3. Agents who wish to sell the Arizona MAPD must complete Lesson 3

The lessons for 2012 include:

1. Lesson 1 2012: Medicare Overview and Compliance
2. Lesson 2 2012: National Part D Product Overview
3. Lesson 3 AZ 2012: Arizona MAPD Product Overview

The username and password to access the site is the same as CIGNA’s previous training site. If you need help with the site contact the CIGNA University Help Desk at 1-866-228-1920 between 8:00 a.m. – 8:00 p.m. EST, Monday through Friday, or send an email to CIGNAuniversity@gpworldwide.com.

Once you have completed and passed the 2012 AHIP training, there are two ways to transfer this to CIGNA:

1. Fax your 2012 certificate with your CIGNA Agent ID written on top of the document to CIGNA at (248) 729-2364. Before faxing the certificate, make sure to download the mandatory fax cover located on the website at https://producertraining.cigna.com.
2. Scan and email your certificate to CIGNAuniversity@gpworldwide.com. Again, be sure to write your Agent ID on the certificate before you send it.

Aetna Medicare Announces New October 1, 2011 Certification Reimbursement Deadline

Aetna Medicare has announced that it will reimburse the $100 certification registration fee for those who complete the following requirements by October 1, 2011:

1. Pass all 4 requirements of Aetna’s 2012 Individual Medicare Producer Certification Program, including AHIP certification and an Aetna Individual Medicare product tutorial.  Visit Aetna’s Producer World site to learn more.

2. Complete all Aetna license and appointment requirements.

3. Attend a local or in person training session. Go to Aetna’s certification website to find a training session near you or download the Training Schedule PDF from our website. You must be logged into AgentPipeline.com to view the document.

AHIP certification is one component of Aetna’s Individual Medicare Producer Certification Program. When completed as part of your Aetna Medicare Individual Producer Certification, the cost is $100. That’s $50 savings off the regular price, and there is an opportunity to earn reimbursement for the $100 registration fee.

If you choose to transfer your AHIP certification to Aetna, you will just need to complete the remaining 3 requirements to finish the certification. The $100 registration fee does not apply to those who transfer their AHIP certification to Aetna and reimbursement is only available to producers who complete their AHIP certification with Aetna.

Humana to Purchase Arcadian Health Plans

Arcadian Health Plans announced on Thursday, August 25th, they signed a purchase agreement with Humana, Inc. for an undisclosed amount. With approximately 64,000 members, Arcadian offers Medicare Advantage plans in 15 states throughout the country. This deal will take several months, but should be completed before the end of 2011. Arcadian will operate business as usual and will continue to work with independent brokers to offer competitive Medicare Advantage plans during the upcoming AEP.

Humana is one of the largest companies in both the senior and underage markets and currently has a footprint in all 50 states and Puerto Rico and had nearly $33.9 billion in revenue in 2010.

I am including a few links below to news articles posted by the Wall Street Journal and Forbes related to the upcoming acquisition.  I’ve also included a link to Humana’s Press release:

• Wall Street Journal Article
• Forbes Article
• Humana Press Release