May 1st, 2012

UPMC Employee Count Form

As part of the Patient Protection and Affordable Care Act (PPACA), UPMC Health Plan is required to comply with certain new medical loss ratio (MLR) standards.  In order to meet the requirements, UPMC Health Plan needs your clients’ response to the information included on their Employee Count Form.  This form will be mailed to all clients, whether current or terminated, within the next couple of days.

The information gathered from the form will quantify the average number of people employed in both 2010 and 2011.  After receiving this information, UPMC Health Plan will classify each employer group as a “large employer” or “small employer” in its annual MLR report.

These new MLR standards may also require UPMC Health Plan to issue premium rebates to certain employers and their employees.  In order to determine the amount of any such rebates, UPMC Health Plan must collect accurate employee counts from all employer groups.

Please help to answer any questions that your clients have about this form.  Clients are required to respond within 14 days of the date of the letter.  If UPMC Health Plan does not receive a prompt response, UPMC Health Plan will follow up with your clients.

Should you have any questions, please call Mary Ann Cannon, Patti DeSimone, or Christine Kaercher at 800-562-7733.

April 30th, 2012

New Medico DVH Product Now Available in More States

Medico Insurance Company is pleased to announce the introduction of their NEW (A48) Dental, Vision and Hearing Product (DVH) in the states of  Delaware, Maine, North Carolina and Tennessee.  The new A48 DVH product is replacing their A18 DVH product, effective April 23, 2012. Medico will accept applications for the old A18 DVH product if the applications are signed and dated on or before May 12, 2012.

NEW Dental, Vision & Hearing Product Highlights:

  • Fast, Simple and Predictable – Guarantee Issue
  • No Provider Network Requirements – See Any Provider!
  • Low Rates and High Persistency
  • Online Application Available
  • Pays in addition to any other coverage
  • Competitive Commissions
  • No Policy Fee

The new Dental, Vision & Hearing product features include:

  • Issue Ages – 18 through 89.
  • Deductible – $100 Policy-Year Deductible.
  • Maximum Benefit – the applicant can choose between a $1,000 or $1,500 Policy-Year Maximum.
  • Annual Vision Benefit – $200
  • Day One Covered Expenses:
    • X-Rays
    • Examinations (dental, vision & hearing)
    • Fillings
    • Extractions (except “full mouth”)
    • Periodontal Maintenance (2 times per year)
    • Dental Cleaning
April 23rd, 2012

Medco & Express Scripts Merge

Medco, HealthAmerica‘s pharmacy benefit manager, merged with Express Scripts on April 2, 2012.  The combined company is called Express Scripts; however, HealthAmerica members will continue to see the Medco name for now.  A few important points about this merger:

  • Pharmacy benefits will not change
  • Members will get their prescriptions in the same way they did before.
  • The retail pharmacy network has not changed.
  • No action is needed by members; it is business as usual.
  • Members can continue to call the phone number on their HealthAmerica ID cards.

Should you have any questions on the merger, please contact Mary Ann Cannon, Patti DeSimone, or Christine Kaercher at 800-562-7733.

April 20th, 2012

Highmark Releases Pre-Approved Marketing Materials

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April 19th, 2012

New Era Increases Rates for Pennsylvania

New Era Life Insurance Company has obtained rate increase approval from the Pennsylvania Department of Insurance for their Modernized Medicare Supplement plans effective July 1, 2012.  The rate increase will be as follows:

  • Modernized Plans A, B, & C will have a rate increase of 9%
  • Modernized Plans G & N will have a rate increase of 6%

Some items to note for our brokers:

  • Applications with effective dates prior 7/1/12 will receive the 2011 rates
  • Applications with effective dates after 7/1/12 will receive the 2012 rates

To review these rate changes, please see the attached document.

2012 - New Era - Rate Increases - 7.1.12 (26)

 

April 17th, 2012

New Medico DVH Product in Additional States

Medico Insurance Company is pleased to announce the introduction of their NEW (A48) Dental, Vision and Hearing Product (DVH) in the states of Alaska, Idaho, Oklahoma and West Virginia.  The new A48 DVH product is replacing their A18 DVH product, effective April 16, 2012. Medico will accept applications for the old A18 DVH product if the applications are signed and dated on or before April 23, 2012.

NEW Dental, Vision & Hearing Product Highlights:

  • Fast, Simple and Predictable – Guarantee Issue
  • No Provider Network Requirements – See Any Provider!
  • Low Rates and High Persistency
  • Online Application Available
  • Pays in addition to any other coverage
  • Competitive Commissions
  • No Policy Fee

The new Dental, Vision & Hearing product features include:

  • Issue Ages – 18 through 89.
  • Deductible – $100 Policy-Year Deductible.
  • Maximum Benefit – the applicant can choose between a $1,000 or $1,500 Policy-Year Maximum.
  • Annual Vision Benefit – $200
  • Day One Covered Expenses:
    • X-Rays
    • Examinations (dental, vision & hearing)
    • Fillings
    • Extractions (except “full mouth”)
    • Periodontal Maintenance (2 times per year)
    • Dental Cleaning
April 17th, 2012

UPMC Announces Bonus Programs

UPMC announced today that they will be offering a bonus program to their agents for both Indivdual and Group products!

UPMC Group agents are able to earn up to $50 per small market member renewed.  To qualify for the $50 bonus, agents must return the signed renewal sheets to us by May 20, 2012 for June 1 effective dates or by June 20, 2012 for July effective dates.  Agents who return the signed renewal sheets to us after the 20th of each month will earn a $30 per member bonus for each member renewed.  See UPMC’s agent release for more information regarding the group renewal bonus eligibility and requirements.

UPMC Individual Advantage agents are able to earn a $20 per member bonus for all plans sold with July, August, and September 2012 effective dates.  See UPMC’s agent release for more information regarding the Individual Advantage sales bonus eligibility and requirements.

For questions on the UPMC bonus programs, please contact Mary Ann Cannon, Patti DeSimone, or Christine Kaercher at 800-562-7733.

April 17th, 2012

Highmark Agents to Attend July Renewal Seminar

Highmark has invited all appointed agents to attend their July Renewal Seminar.  This seminar will focus on new products as well as other important information relating to July renewals.

For more information on this webinar, please see our Training Calendar.

Should you have any questions, please contact Mary Ann Cannon, Patti DeSimone, or Christine Kaercher at 800-562-7733.

April 16th, 2012

Coventry’s Ad Builder Helping Agents Find Prospects

Agents looking for ways to find new prospects for Medicare Advantage & Prescription Drug Plans need to check out Coventry’s great resource, Ad Builder.  This tool, which launch initially during 2011, offers contracted agents the ability to create CMS approved marketing pieces with their contact information.  These pieces will help agents:

  • Position their name and deliver the right messages to connect Medicare-eligible customers
  • Stay in touch with existing clients
  • Win more business

Agents who are appointed and certified receive an email directly from StrategyBay, our partner host for the Ad Builder website. The email includes a pre-assigned User ID and “confirmation code” and outlines instructions for setting up your password. If you have questions or need assistance, or if you need to set/reset a secure password, email Toolkitassist@strategybay.com.

Interested agents can also take a look at the Medicare Advantage Materials Catalog or the Prescription Drug Plan Materials Catalog.

April 16th, 2012

Highmark Adds Orthopedic Group to New Network

Highmark, Inc. announced on Tuesday that they have added a private practice of orthopedic surgeons, Orthopedic Associates of Pittsburgh, to the new medical provider network that they are creating.

The five-surgeon group, who has offices in East Liberty, Monroeville, and White Oak was acquired on April 1st by Highmark.  Orthopedic Associates’ surgeons, Arnold S. Broudy, Michael Levine, David C. Neuschwander, Robert G. Liss and Gregory L. Hung, specialize in hip, knee, foot, ankle, spine, shoulder, and upper extremity surgery, and total joint replacement and sports medicine.

This is the third private physician practice purchased by Highmark in 2012.  In January, Premier Medical Associates, a 60-doctor practice out of Monroeville joined the provider network.  April 4th, Arthritis & Rheumatic Disease Associates, a three-doctor specialty group with offices in Monroeville, Brackenridge, and Greensburg joined the provider network.

Highmark’s new medical provider network is anchored by the five-hospital West Penn Allegheny Health System.

For questions, please contact Mary Ann Cannon, Patti DeSimone, or Christine Kaercher at 800-562-7733.

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