|
2010 PDP Summary of Benefits and Plan Comparison Guide Revised Revised Language in 2010 PDP Plan Summary of Benefits and Plan Comparison Guide In an effort to ensure that our prescription drug plan information is accurate, we have revised language found in our 2010 Summary of Benefits and Plan Comparison Guide booklets for both Community CCRxSM PDP and PrescribaRxSM PDP plans. Specifically, we have revised a statement used to describe the dollar amount limit and how that limit is reached when a Part D Prescription Drug Plan member transitions from the Initial Coverage phase to the Coverage Gap phase (donut hole). · The current statement indicates: Amount you pay for prescriptions until you reach $2,830 in out-of-pocket covered prescription drug costs. · The revised statement states: Amount paid for covered prescriptions by you and your plan (not including plan premiums) until the $2,830 limit is reached. This revised statement will appear in these materials upon reprint. The original sentence can be located in the Summary of Benefits as follows: · Community CCRx: Page 23 · PrescribaRx: Page 17 Note that this language change does not affect statements appearing in the 2010 Evidence of Coverage (EOC), on the Community CCRx or PrescribaRx Web sites or in 2010 Welcome Kit materials. What is the difference between the two statements? The current statement implies that the limit is reached when the member alone has paid $2,830 in out-of-pocket covered drug expenses. By comparison, the revised statement more accurately reflects that the $2,830 limit is reached by totaling what the member AND THE PLAN pay together in covered drug expenses. In addition, the revised statement also clearly indicates that covered drug expenses DO NOT include monthly plan premiums. This language change may seem minor. However, we believe it is important to you and our clients that our plan information is presented clearly and stated accurately. Should you have questions regarding this issue, please contact your sales department.
A Special Message to All Agents From Universal American Chairman & CEO Richard Barasch Exciting things are happening at Universal American as we prepare for the 2010 Medicare selling season. Recently, we began airing three new DRTV commercials starring Pat Summerall as our spokesperson for Community CCRxSM and Medicare Advantage products - the products you may offer Medicare beneficiaries for the 2010 plan year. With the addition of Pat Summerall, we now have a strong selling partner who carries a reputation for plain talk, hard work, everyday values and common sense. We can think of no better way to highlight our value proposition than with such an American icon. Pat has already strengthened our ground game in the Houston and Beaumont markets, taking part in our TexanPlus Wii Bowling Championship events in early October, where we set a Guinness World Record for the largest Wii Sports Bowling Tournament. And you can expect an even stronger air attack with our targeted direct TV ads. The three TV spots - in both 60-second and 120-second formats - were created around the theme, "We've Got You Covered." Two of the commercials, "Big Card" and "Decisions", support our Medicare Advantage products and will air in our HMO and select PFFS/PPO markets. The third commercial, "Every Day", supports our Part D Community CCRxSM Prescription Drug Plan. It will air on national cable TV networks such as American Movie Classics (AMC), TV Land, and The History Channel. Already we are getting positive signs that the commercials are working, with good lead volume and positive feedback from viewers. You can view all three commercials, and a segment about the Wii bowling event in Houston, by clicking on this link. There's also a short message recorded for you from Pat Summerall. We have entered the 2010 Medicare season with a competitive product line, a compelling value proposition and enhanced sales and marketing support. The addition of Pat Summerall as our spokesperson and your selling partner reaffirms our commitment to our Universal American Medicare products, to our potential customers and to you - a valued member of our Healthy Collaboration. As part of the retention program this year, we are beginning to reach out to all Medicare Advantage members to encourage continued membership for the 2010 Plan year. We feel that educating members is the best way to assist you with retaining these members! Regards, Richard
We're Working to Help You Retain Medicare Advantage Members in 2010! Outbound courtesy calls are starting to be conducted to all Medicare Advantage members1. These calls remind plan members that they will soon be receiving their 2010 Annual Notice of Change (ANOC), if they haven't already, assist in reviewing their benefit changes for this year, and answer any questions they may have. Click here for the 2010 Medicare Advantage Outbound Retention Call script . Within the consultation, we will also help members to evaluate their benefit needs for the coming plan year to determine if any other Today's Options plan would be a better fit for their health needs or their budget so they can make an informed decision. (Note: If a member decides to make a plan change, we will assist them in this transaction. The original writing agent, if actively contracted, will continue managing the account and will receive all due commissions. Commissions within the agent hierarchy will not be impacted. Call center representatives are not licensed agents and are not paid any commission or incentive for these calls.) Also, throughout the Annual Enrollment Period, we will be reaching out to members through various mailings to further strengthen retention. PFFS members will soon receive a mailing that assures them that Today's Options will be available in 2010. The goal of the mailing is to communicate the stability of our PFFS plans for 2010 and help conserve business. Samples of member communications are attached here ( Core Market Letter; Non-Core Market Letter ) for your viewing. These efforts help reinforce the kind of support, coverage and care members can count on as a result of yours and our services. So be sure to remind clients that you are there for them now and, if they so choose, in 2010 to help them meet their healthcare needs.
Medicare Supplement/Medicare Select Deductibles and Coinsurance Amounts Will Increase Effective January 1, 2010, Medicare Part A and Part B deductible and daily coinsurance amounts will increase. (These amounts are updated annually with formulas set by law.) As a result, our Medicare Supplement plans will automatically be adjusted to cover those increased amounts. Please let Medicare Supplement clients know that their plan coverage will be raised. For Medicare Supplement plans in 2010, deductibles have increased as follows: Medicare Part A Deductible: $1,100 per benefit period Medicare Part B Deductible: $155 per year Click here for a detailed chart of the coverage increases.
Medicare Education An Informed Consumer Makes Better Choices. When you conduct Educational seminars, you may discuss the basics of Medicare and available Medicare Advantage and Prescription Drug Plans since people with Medicare may get health care coverage in several ways. The Centers for Medicare & Medicaid Services (CMS) has provided two presentations, one about Medicare in general and another about Medicare Advantage plans and other Medicare plans, to help clear any confusion regarding Medicare options. Click the links below to access these helpful guides and feel free to present them to consumers at Educational events. The presentations may also be used at Marketing events, provided the specific plans are discussed following the general presentations. Remember: You may not discuss specific plans or conduct any marketing at Educational events. Medicare 101 Medicare Advantage Plans and Other Medicare Plans
Verification Calls - When the Client Says "I wish to cancel" New Member Verification Calls are made to enrollees to confirm that the enrollee or applicant understands the plan. If an enrollee should decide that he/she does not want to continue to enroll in the plan, a notification email will be sent to the writing agent. The agent may then contact that enrollee, complete another Scope of Appointment Form to meet with the Medicare beneficiary and address the enrollee's concerns and continue to complete another application if he/she decides to re-enroll. As a friendly reminder, please be aware of the New Member Verification Call Changes: - Agent scheduling of Verification Calls is no longer required for enrollments with 2009 or 2010 effective dates.
- Reference numbers are no longer provided and do not need to be written on the New Member Acknowledgement form.
- Agents must inform enrollees of the pending Verification Call and may not be with the enrollee during the verification call.
- When spouses enroll together, a designated spouse may complete the call on the couple's behalf.
Verification Calls are now being conducted through a domestic call center. Outbound calling hours are 8 a.m. to 8 p.m., Monday-Saturday in all time zones.
Online Certification Now Available! 2010 MA and PDP Training & Certification Program Now available online: Universal American's 2010 training and certification program for Medicare Advantage (MA) and Medicare Part D Prescription Drug (PDP) plans. Online training is ideal for agents who have not attended a 2010 onsite training/certification session, or who have not yet successfully completed their exam. The online training program is available at no cost, 24/7. For even greater convenience, the site offers easy access to the study materials and the 50-question certification exam; just let your fingers do the walking! You must get recertified with us for 2010 in order for us to Pay Your Renewal Commission and for you to be able to sell our very competitive 2010 Medicare Advantage and Part D products. We have expanded our product line and revised our rates for 2010. Please Note: If you do not get recertified Your Commissions Will Stop. That is the CMS rule. Please also be sure that you have an active state license with the states in which you sell Universal American's subsidiary products, including Medicare Advantage. If you do not hold an active state license, you cannot be certified to sell our MA or PDP products. To initiate your training, please visit our AppointMyAgent online training site at certify.appointmyagent.com.* Or you may log-in through AgentLink and go to the Training and Certification section, which is located in the InfoCenter. Upon successful completion of the certification exam, you will receive an e-mail notification. Certification for the 2010 enrollment season will be achieved with a passing grade of 85%, as mandated by CMS. Agents will be notified immediately within the testing process if they fail to achieve a passing grade.** *Please note: if using the online contracting system, AppointMyAgent, to contract new agents for the 2010 selling season, the prospective agents may complete their training and certification during the contracting process. Once these agents are activated, they may begin working with consumers as of October 1. **Agents must pass the exam in no more than three (3) attempts in order to sell MA and PDP plans during the 2010 enrollment year.
|
