Humana to Purchase Arcadian Health Plans

August 30, 2011

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:


Check the Status of Your Medicare Advantage and Medicare Part D Enrollments

December 30, 2010

As the Medicare Advantage Annual Enrollment Period (AEP) draws to a close, it is vital that you review all of your submitted enrollments to ensure that they were received and are being processed correctly. Below we have provided information for each of the companies on how to check the status of your enrollments:

America’s 1st Choice

To check the status of enrollments, you will need to contact Agent Support at 877-877-0539

Anthem/WellPoint

Please refer to the Excel spreadsheets that we have been emailing out over the past few weeks. If you have any questions, you can contact our enrollment team at 800-962-4693 ext: 243

Care Improvement Plus

Please contact Care Improvement Plus Sales Support at 1-800-711-1656 to check on the status of enrollment applications.

Cigna

  1. Go to CIGNAMedicare.com and click on the “Producers” link
  2. Log in using your assigned username and password. If you need this information, please contact us at 800-962-4693
  3. In the section titled “Compare Plans & Enroll Online”, click on “Compare Plans-2011”
  4. Click “Accept”
  5. Log in again using the same information that you used to access the CIGNAwebsite
  6. On the right hand side, you will see “Search Your Enrollments”. Enter the required information and select “Search”

Coventry

  1. The Application Tracker System can be accessed through the Coventry Broker portal at Coventry-Medicare.com.
  2. Once logged in, you will see App Tracker is an easy-to-use online tool for you to check application status, review your commission payments, run reports and more. Click Here  
  3. Once you select the link from the broker portal for App Tracker, you will be transferred to the log in screen where you enter your AWN and password.

NOTE: For “first time users”, agents will enter your AWN as your User ID. Enter Password – the word Coventry and the last 4 digits of your Social Security Number. Example: Coventy1111

  1. Once logged in, you will be taken to the App Tracker Home Screen where you can set the parameters for your search. The required fields will be highlighted.
  2. When a pie chart graph is generated for a report you can click on any portion of the chart to generate its’ respective report. Reports can be exported in Excel, PDF or CSV formats.

If you have any questions or need help using App Tracker, you can contact Coventry’s Broker Support Unit at 866-714-9301.

HealthSpring

Agents will be able to view copies of their applications in an online system called FileBound. Applications will not be able to be viewed immediately. Applications are only able to be viewed once they are processed by our Enrollment department, and during times of heavy volume, this may take three or four days. 

  1. You can access FileBound at: https://healthspring.filebound.com/v5/
  2. Your username is your Agent ID without the dash (for example XY0123)
  3. Your password has been previously sent to you. All existing agents received the password in an email sent to all agents on November 15, 2010. All new agents received it shortly after receiving your Agent ID. You will be asked to change your password the first time you access the system
  4. When asked to change it, please create a password that meets the following guidelines:
    1. Password must be a minimum of eight characters long
    2. Password cannot contain any part of your Agent ID
    3. Password must contain at least two letters, and one must be a capital letter
    4. Password must contain at least two numbers.
  5. If you are unable to change your password or otherwise unable to access FileBound, please contact the HealthSpring Technical Support Help Desk at 866-780-8553. If the Help Desk is unable to assist in finding a solution, they will escalate it to our vendor to contact you with an answer. You can also contact David Smith at david.smith@healthspring.com
  6. Once you access FileBound, you will be able to search and view all of the applications you have submitted from November 15, 2010 forward.
  7. After you login each time, you will be taken to the Select Project page. Please click on the available project that corresponds to your state (Alabama/Texas or Tennessee/Illinois). 
  8. You will then be taken to the Home page. Click on the Search tab (with the little binoculars) to go to the Search page (once you get there it will say Search in the top left corner). The Home page and the Search page look very similar, but you cannot search from the Home page. Make sure you are searching from the page that says “Search” in the upper left corner.
  9. Then, key in your Agent ID into the Sales Agent field and click search at the bottom of the page. You should be able to see all of your sales.

If you search for an application and do not see it six days after submitting it, please send an email to david.smith@healthspring.com, and please include your name, AgentID, and phone number. They will research it at that point to see if they can find it.

Humana

  1. Go to http://www.humana.com/agents/.
  2. If you have not registered on the agent portal website you will need to do so.  At the top of the page there will be a hyperlink in blue “register”.  Click on this word and register your agent number.
  3. If you have already registered – click on the “Login” link located at the top of the page and login.
  4. Click on the “Medicare Agent Workbench” link located at the bottom of the page – should be right beside a picture of two people.  This will take you to a new page. 
  5. “Track Applications and Enrollments” is the first category on the page.  Click on “ Enter Search Tool”.
  6. You will then be taken to a page where you can enter search criteria to search enrollments.
  7. The best way to search is by using “Signature Date” – enter a beginning signature date and use today’s date for the ending signature date.  Leave all of the other fields as they are.
  8. Then go to “Member State” and select your state or the state where your enrollments were written.
  9. Then Click “Request Report”. 
If you need assistance or cannot locate some of your applications, you can contact Humana Agent Support at 800-309-3163.  

Sterling Health Plans

To verify Sterling enrollments, please contact their Agency Support Desk at 888-268-9658. They will be open 9:00 am – 8:00 pm EST, Monday – Friday.

Universal American

  1. Log into the Medicare Prescription Drug Agent Website at http://www.uafcinfopdp.com/
  2. Under Report Menu click Production
  3. Enter the required information and select Search. You can choose to either view the report on your computer screen (Screen View) or in an Excel spreadsheet

If you have any questions, please contact Agent Sales Support at 866-316-6051

United HealthCare

  1. Go to http://www.unitedhealthproducers.com/ and log in with your username and password.
  2. Click on tab titled Applications & Enrollments then click on the Applicant Search tab
  3. Under applicant search you are able to search applicants by date received, sate, or applicant name.
  4. To view a complete list of all enrollments submitted you may search by sate.  If you have written over 100 enrollments, it is best to search your clients by applicant name. 
  5. When searching, you will be able to click on individual clients and view selected demographics and issued policy information

If you need assistance you can contact the Producer Help Desk at 888-381-8581.

Universal HealthCare

  1. To access the Agent/Broker Portal, go to http://www.univhc.com/ and select ‘Login’ under the Agents and Agencies Heading.
  2. Login to the site or Register if you are a new user. You will need to make sure that you select the ‘Agent’ radio button before submitting your username and password.
  3. This will redirect you to the Agent Home Page. You will need to select the Enrollment tab at the top of the page.
  4. Enter the required information and select Search.

If you have any questions, please contact Universal HealthCare Agent Support at 866-616-6396.


Humana’s Top Ten Agent Tips for the Annual Enrollment Period (AEP)

December 17, 2010

Since a large number of our readers are licensed Humana agents, I thought these tips would be very helpful as you finish out the Annual Enrollment Period.  Below is a list of agent tips Humana recently published.  I hope these help.

December 17, 2010

The following tips will help you though the AEP:

1. Use your correct SAN number on the enrollment application. Using the wrong SAN number or writing illegibly may give another agent credit for your application. Write clearly, use black ink, and check the SAN number before submitting the enrollment.

2. Abbreviated Enrollment Form (AEF) – Do not use an AEF when enrolling a member from a non-renewing Humana plan. A full enrollment application should be used in this situation. When in doubt, use the full Enrollment Application.

3. Scope of Appointment (SOA) – the “Scope of and Appointment” (SOA) must be agreed to and documented either by IVR or paper form prior to the appointment taking place unless it is not feasibly possible. IVR (866-945-4471) Using SOA paper forms
• The form must be a CMS approved form
• Print clearly and complete both pages of the form accurately
• Use an original form – do not make copies of copies
• Do not modify the Humana form in any way – do not “shrink” or “enlarge”
• Make sure the beneficiary initials the boxes. Checkmarks, Xs, etc are not acceptable and the form will be rejected

4. PDP Combinations – Only a PFFS that does not offer Rx can be combined with a stand alone PDP. CMS does not permit the combination of a PPO-no Rx plan with a stand alone PDP plan like our new Humana-Walmart plan.

5. Sales Brochure Insert -Include the new “insert” outlining hours of operation for Humana MA and PDP phone numbers with each Sales Brochure

6. Verification – all new MA enrollments will receive a verification call from Humana. Cover the verification process with the beneficiary when they enroll so they won’t be caught off guard.

7. Licensing – all agents must be licensed and have a Humana appointment in the resident state of the applicant at the point of sales. Humana must have a copy of your valid license on file.

8. Sales Materials – Agents can order all Medicare sales materials through the Agent Support Unit (ASU) 800-309-3163

9. Agent Flyers – Agent can view Humana branded flyers and postcards that are available for them to have produced on the Agent Portal. PDFs can be prepared by calling Delegated Operations at 800-788-9020

10. Delegated Reporting Tool – Want to view submitted applications, active enrollment or commissions. Use the Delegated Reporting tool on the Agent Portal.

These tips are for agent use only and are not intended for the general public.


2011 Medicare Advantage and Mediare Part D Star Ratings

November 14, 2010

On Wednesday (11/10/10), CMS released its 2011 Medicare Advantage and Medicare Part D Star Ratings.  Below is a quote from the release:

The 5-star rating system is used by CMS to monitor plans to ensure that they meet Medicare’s quality standards.  The ratings provide Medicare beneficiaries with a tool to compare the quality of care and customer service that Medicare health and drug plans offer. In addition, a “low performer” icon is to be placed next to the names of plans that have received less than three stars for the past three years.  CMS’ star rating system considers 53 quality measures, such as success in providing preventive services, managing chronic illness, and keeping consumer complaints to a minimum. 

When you compare plans on Medicare.gov you’ll see each plan’s star rating.  To some extent, you can use it as a guide to decide the best plans for your clients.  One thing to remember, the star ratings are not based on current year benefits.  One Medicare Advantage plan could have a high star rating, but have less than desirable benefits.

How would I look at star ratings?  Use it only as a guide for 2011.  I would still look at plan benefits and provider networks as the standard when comparing plans.  This will change in 2012 and beyond.  Below is CMS’s description of each star rating level:

  1. ★ = poor performance
  2. ★ ★ = below average performance
  3. ★ ★ ★ = average performance
  4. ★ ★ ★★ = above average performance
  5. ★ ★ ★★★ = excellent performance

Beginning in 2012, plans will start receiving “Quality Bonuses” from CMS based on their star rating.  CMS will bonus plans that have a 3 star rating or above.  The higher the star rating the higher the quality bonus.  These bonuses will be key when it comes to benefit design.  Top performing Medicare Advantage or Part D companies will be able to develop better benefit (or lower cost) plans because they are receiving more money from CMS per beneficiary. 

This could mean 100s of millions of dollars for the big boys (UHC, Humana, Anthem/Wellpoint, etc.).   Companies are extremely focused on every aspect of the star ratings.   As an example, we have one company that planned to move into twelve new markets for 2011, but decided to put the brakes on expansion and focus all of its resources on improving its star rating.

Stay tuned.  Medicare Advantage and Medicare Part D star ratings will become much more important in the coming years.

Here are a couple additional resources on CMS’s press release and the current 2011 star ratings:


Scope of Appointment Resources

October 29, 2010

CMS requires agents to obtain a Scope of Appointment (SOA) before they meet with a prospect on Medicare Advantage and Medicare Part D plans.  There are a few exceptions.  UnitedHealthcare produced a pretty comprehensive job aid for agents (UHC SOA Job Aid).  On the last page, it lists three situations when a SOA is not required. 

My advice: Obtain an SOA every time.

Branded vs. Generic SOAs – Agents like to use a generic SOA because they need the flexibility of presenting any number of plans based on the prospect’s needs.  Some companies allow agents to use a generic SOA and others do not. 

Below are a list of MAPD & PDP companies and links to their approved SOAs:

  • Aetna – Not available yet
  • Anthem (WellPoint) – Generic SOA & Generic Guidelines: Anthem only uses a generic SOA
  • ArcadianSOA English & SOA Spanish: They will accept the generic Scope of Appointment
  • Care Improvement PlusSOA: CIP will accept the generic SOA (Updated 11/15/10)
  • CarilionSOA: They will accept the generic SOA
  • CIGNASOA: They will NOT accept the generic SOA
  • CoventrySOA PDFs: They will accept the generic SOA. This link is to Coventry’s website.  You can download the SOA and other useful tools.
  • HealthSpringSOA: They prefer their company specific SOA
  • HumanaSOA: They prefer their company specific SOA
  • OptimaSOA: They prefer their company specific SOA
  • Today’s OptionsSOA: They will accept any CMS approved SOA
  • Sterling Health Plans - SOA: They will accept the generic SOA
  • UnitedHealthcareSOA, Generic SOA, Generic SOA Fax Cover Sheet
  • Universal Health CareSOA, Automated Scope of Appointment Line: They will accept any CMS approved SOA

I’ll post additional updates and links as they become available.  I hope this helps!


Humana – Agent Certification Required for Renewal Commission

October 26, 2010

Humana announced today that agents will need to recertify each year in order to receive renewal commissions.  Humana references the following CMS guidance in its announcement:

 “Plan sponsors must not pay agents who are no longer appointed to sell in the State (if required), agents who have not been annually trained and tested per the plan’s policies and procedures with a passing score of eighty-five percent or agents who have been terminated for cause by the plan.”

The Good News – Humana originally closed recertification on October 15th.  If a current agent didn’t recertify by that date, they were not able to sell Humana’s MAPDs or PDPs for twelve months.  Now agents will be able to recertify through November 30th.

Don’t miss this chance to recertify!

Here is the link to our Humana Agent Compliance Alert.


Medicare Basics – Humana Videos

October 25, 2010

Humana has created several YouTube videos to help seniors (or anyone for that matter) better understand Medicare and its different parts.  These videos are a great resource for agents and their clients or prospects.  Most of them are less than five minutes and super easy to understand.  I know of a few agent websites that use these videos to help their clients better understand Medicare. 

Below are four videos I think you’ll like. 

Stay Smart Stay Healthy is the new media venture producing these videos.  Here is a quote from their YouTube site…

“Stay Smart Stay Healthy is a Humana new-media venture designed to deliver guidance, and to support awareness and understanding of the healthcare industry.

Our goal is simple: to educate consumers on the healthcare system by removing the usual complexities and replacing them with an informative and engaging series of videos.”

Enjoy!


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