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IMPORTANT TRAINING & SEP INFORMATION ATTACHED - please read through this newsletter carefully. We suggest keeping this newsletter for reference.
1. All trainings at a glance
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. Annual Agent Certification - June 1-30
3.
New IFP Quoting & Enrollment System Training
4. REVISED: Upcoming SEP & Effective Date Changes
5. SEP Commission changes
6. 2017 Proposed ACA Individual Rate Increase
7. Plan G is coming in 2017
8. 2017 IRS limits released
9. More information located on our Resources Page
10. Training information
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ALL TRAININGS AT A GLANCE
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Below is all the upcoming trainings at a glance. Please keep reading the whole newsletter for more details on each. We suggest you keep this newsletter saved so you can reference at later dates.
Wellmark Trainings:
1. Annual Agent Certification
WHO: REQUIRED FOR ALL WELLMARK AGENTS
WHEN: June 1 - 30
WHAT: Must pass final assessment with a 90% passing grade - 3 attempts only
-failure to pass or attempt the assessment will result in loss of Wellmark appointment for 2 years.
2. Individual & Family Plan Quoting & Enrollment System Training - REQUIRED FOR AGENTS SELLING INDIVIDUAL & FAMILY PLANS AFTER 7/15/16
WHO: Open to Agents and/or OFFICE STAFF that will work with Individual & Family Plans
WHEN: June 22 - July 6
WHERE: Classroom trainings held throughout the state between June 22 and July 6
-Agents should have received a direct invite last week (May 27) from Wellmark
3. Certification for Wellmark Synergy Health & Wellmark Value Health Plan
WHO: For agents that are going to sell these new Individual & Family plans for 2017
-A separate appointment and passing of certification will be required
WHEN: Certification will start in August and be offered through first quarter of 2017
WHERE: TBD
Federal Marketplace Training:
4. CMS/FFM Certification
WHO: Agents wishing to sell policies on the federal Marketplace
WHEN: TBD watch for more details towards the fall.
WHERE: Agents can certify direct with CMS or other certified vendors online (Wellmark does not offer these trainings).
-Required in order to sell policies on the federal Marketplace - will need to be certified annually.
Medicare Training:
5. CMS/Medicare Certification for 2017
WHO: Agents selling/marketing MedicareBlueRx drug plans in 2017
WHEN: TBD watch for details towards the fall
-Annual certification - required to take every year in order to sell/market MedicareBlueRx and to continue to receive commissions on current PDP business
WHERE: Online
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AGENT CERTIFICATION JUNE 1 - 30: REQUIRED TRAINING TO KEEP YOUR APPOINTMENT WITH WELLMARK
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IMPORTANT: ALL Wellmark appointed agents are required to take and pass the final assessment. Passing score is 90%. You are allowed 3 chances only. If you fail attempt #2 - PLEASE CONTACT YOUR ACCOUNT MANAGER AT PARTNERS HEALTH INSURANCE FOR ASSISTANCE. There will be no exceptions granted for failing the assessment.
The 2016 Wellmark Agent Certification program will have the following requirements:
- The program has been modified this year so there is only one module that covers both states and all segments with a corresponding assessment. The module is focused on Wellmark's value proposition and newly modified Special Enrollment Period (SEP) guidelines. The answers to the assessment can be found within the module.
- A practice test is available. Agents can test knowledge prior to taking the final assessment. The pre-test can be taken as many times as needed until a passing score has been achieved.
- The final assessment will have questions based on the module. Each agent must achieve a minimum score of 90 percent to pass. There are three chances to pass.
- Failure to complete certification or to pass the exam in three attempts will result in a loss of Wellmark Agent appointment for two years.
- Certification will apply throughout the calendar year 2016 until the 2017 Agent Certification period begins.
WHO: All Wellmark active appointed agents in our system as of May 23, 2016
WHAT: Wellmark annual Agent Certification
WHEN: June 1 through June 30
First time users: Click Forgot Password to generate a password reset link. An email will be sent to the email address on file in Wellmark's agent record. Use the link in the email to create a password.
Returning users: Use your National Producer Number (NPN) as your username and your
previously created Blue Learning Center password
HOW:
Complete assigned module and assessment with
90 percent pass rate in 3 or fewer attempts.
Key Dates:
- Certifcation period: June 1, 2016 - June 30, 2016
- Weekly reports will be provided on Mondays showing the agent progress. The data will reflect those who have certified through 2:30 p.m. Central Standard Time as of the previous day.
- Change of Assigned Agent (COAA) form collection period: July 1, 2016 - Aug. 1, 2016
- Agent termination date: Sept. 1, 2016
- Commissions: adjustments/changes completed by Sept. 2016 commission cycle
Wellmark's agents are some of the best in the business. They understand the customer and strive to provide quality service. As an agent, you are vital to our success, and we rely on you as an integral part of our future accomplishments.
One of the reasons our agents have been so successful is because they are among the most knowledgeable in the field. The health insurance industry is complex. Wellmark realizes the need to increase their efforts to ensure agents have the base knowledge necessary to represent us, explain our products and continue to serve members after they purchase a Wellmark policy or group plan.
With that goal in mind, Wellmark will continue the Wellmark Agent Certification program in 2016.
Coming in August - Wellmark Synergy Health, Inc., and Wellmark Value Health Plan, Inc.
Agents who wish to sell business through either one of the new issuers, Wellmark Synergy Health or Wellmark Value Health Plan that were announced in the May 12th News Alert will need to be appointed with one of these new companies. A separate certification for each company will need to be passed, in order to be appointed. This certification will start in August and be offered through the first quarter of 2017. Look for more information to come this summer on the new issuer certifications.
Wellmark Synergy Health & Wellmark Value Health Plan Certification
We will also be introducing a Certification for agents wishing to be appointed to sell the new Wellmark Synergy Health, Inc., and Wellmark Value Health Plan, Inc. products. This will take place in August and is separate from general agent certification. Finally, for agents choosing to sell exchange business, they will need to certify with the Federally Facilitated Marketplace (FFM).
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| NEW IFP QUOTING AND ENROLLMENT SYSTEM TRAINING |
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Providing a new shopping and enrollment experience will be one of the key ways in which we transform the IFP U65 market in these coming months. It will make application submission easier and more efficient for you and our members. Before our new system goes live, we will need all producers with IFP U65 business to attend a two-hour, in-person training session to become familiar with how to use it to the full extent of its capabilities.
Each eligible producer should have received a system training event invite last week. The actual training sessions will be offered at a variety of locations throughout Iowa and South Dakota beginning June 22 and running through July 6.
Click Here
to view a sample of the invite email with instructions on how to register
-Register right away as sessions will fill up fast - follow registration link on email
-You will be required to take a laptop or tablet that has the ability to connect to wi-fi
Click Here
to view all the training dates available
It is important that you and/or someone who assists you in your office attend one of these sessions in order to interact with the system before it goes live.
You can choose to attend any session that best meets your scheduling needs. Please be on the lookout for your invitation and contact your authorized General Agency or Wellmark account manager if you have any questions.
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UPDATED: INDIVIDUAL MARKET: UPCOMING SEP PROCESS AND EFFECTIVE DATE CHANGES
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In last week's News Alert regarding the ACA U65 rate filing, Wllmark outlined how they will work to transform the market to prevent similar future rate increases. One of those updates to the way they do business is improving the shopping and enrollment experience. Changes to this process will be communicated to you during a training period starting later in June. However, as Wellmark has been letting you know about recent changes to the SEP enrollment and auditing process, they thought it would be important to highlight how the new enrollment system will specifically affect SEPs. These changes concern SEP documentation submission as well as SEP effective dates.
Any SEP enrollments submitted after July 1, 2016, and with an effective date of August 1, 2016, or later will fall under these new guidelines unless otherwise noted.
SEP documentation changes (
ACA only - grandmothered/grandfathered to be effective later in 2016)
Beginning July 1, 2016, the documentation submission process will change for ACA SEPs. A benefit to the new process will be that agents will not have to retain the supporting SEP documentation after submission. Instead, documentation will be provided during the application/change process and reviewed prior to the policy/change request being effective.
For grandmothered/grandfathered SEPs, the current process of the agent retaining the documentation and being subject to a random audit will remain in effect until this business is transferred to the new quoting and enrollment system.
More detailed information regarding the updates to the process will be provided during the system training that is scheduled to begin later in June. Wellmark hopes these changes will make things more efficient and easier.
SEP effective date changes
(all SEP - ACA, grandmothered, and grandfathered business)
Beginning July 1, 2016, Wellmark will change SEP effective dates to match those from the Centers for Medicare and Medicaid Services (CMS). This is to provide clarification between on-exchange and off-exchange business in the market.
If an SEP application is received between the 1st and 15th of the month, the coverage will be effective the first of the month following the receipt date. If the SEP application is received between the 16th and the end of the month, that coverage will be effective the first of the second month following the receipt date.
The effective date changes do not change the rules regarding the event notification timeframe for SEPs; in general, those remain at 60 days prior to or after the event. A couple examples can be seen in then chart below:
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SEP Event
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Event notification timeframe |
Date that SEP application is received |
Date that coverage goes into effect |
| Marriage on 7/16/16 |
60 days prior to event and within 60 days of event |
9/5/16 |
10/1/16 |
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Dependent turning 26 on 8/17/16
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60 days prior to event and within 60 days of event
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9/16/16
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11/1/16
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Note: These effective date rules apply for all SEP enrollment events except for birth, adoption/foster care, legal guardianship, and court ordered coverage. The guidelines for the effective dates of those events will remain the same (the date of the birth, adoption, guardianship, or court order). If the standard effective date would cause a gap in coverage, please call to discuss the possibility of an exception/earlier effective date (documentation will be required to receive it).
A comprehensive PDF outlining the different SEP events and rules that apply to can be found here, and should be used beginning July 1, 2016. It will also be placed on the SEP page that has been created on Producer Connection. The SEP guidelines charts that should be used between now and July 1, 2016 can also be found on that page.
For additional questions, please contact your Individual Account Rep:
Jamie Kamerman - jamie@veinsurance.com
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SEP COMMISSION CHANGES (INDIVIDUAL MARKET)
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Effective for Aug. 1, 2016 effective dates and after, commissions for new SEP policies will match the renewal commission rate.
SEPs are one of the cost drivers creating the need for larger rate increases. Members who enroll as an SEP and then cancel coverage after receiving care have an adverse effect on the entire Wellmark insured population.
Many of the largest carriers across the United States have already announced plans to suspend or, in many cases, eliminate commissions for SEP policies. Wellmark evaluated this trend and has made the decision to take a balanced position. Wellmark believes in the value of an agent and they will pay a commission for SEP policies. Wellmark also needs to balance our overall market position relative to agent commissions. Wellmark believes it is appropriate to reduce the commission amount for SEP policies.
Wellmark will continue to evaluate commissions for agents to ensure they are market competitive.
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2017 PROPOSED INDIVIDUAL RATES (ACA MARKET)
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(ORIGINALLY RELEASED FROM WELLMARK AS NEWS ALERT MAY 12, 2016)
Recently, Wellmark filed the base premium change for the 2017 ACA Individual and Family Plans with the Iowa Insurance Division.
Before the proposed rates are made public, please take a minute to review and understand the medical trends and rate drivers in our ACA populations. Our individual members continue to need more services - and ones with higher costs - than other segments of our business. Some of the main challenges we have seen in this marketplace include:
- Large claims are skyrocketing - the cost and frequency of claims over $100,000 continue to increase at alarming rates. There has been a 200 percent increase in the overall cost of care for conditions costing greater than $100,000. In addition, the number of members with cost of care exceeding $100,000 doubled from the prior year.
- Special enrollment periods are a concern - members who enroll through special enrollment periods are incurring claims that cost nearly double the amount of other members. In addition, these members often cancel coverage after receiving services.
- Continued increase in volume and cost of specialty drugs - the cost and volume of prescription specialty drugs continue to be primary drivers of medical trend and increased by 100 percent over the prior year. These drugs are treating and managing chronic and complex medical conditions like hemophilia, multiple sclerosis and hepatitis.
- A few drive costs for everyone - the purpose of insurance is to pool premiums to help pay for everyone's health care services. For this group of members in 2015, we have seen that 300 members are driving 25 percent of the costs for the entire group, equaling $47 million.
All of these issues contribute to the continued rise in medical trend that has resulted in increases for our members.
The proposed rates
If approved, the proposed premium change increases will not be effective until Jan. 1, 2017:
2017 Proposed Iowa IFP (Individual and Family Plan) ACA
Base Premium Change Average
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42.6 %
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PPO Plans
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37.8 %
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HMO Plans
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Transforming the individual market
We know continued premium increases are not sustainable for anyone. Members have let us know that they want relief from the rising premiums, they want simpler plans and they want cost transparency. We have listened. We will transform the producer and member experiences and the way we do business in the individual marketplace in 2017. Our plan includes:
- New joint ventures with Mercy Health Network and University of Iowa Health Systems
- New, simplified plan designs unlike anything else in the market today
- An improved shopping and enrollment experience for agents and members
You can find detailed information about each one of these elements in the four-page paper included in the toolkit noted below. Also, please know you will receive training on the new products and how to sell them at fall training. In addition, training will be held in June for the new shopping and enrollment system.
Tools to help you answer member questions
To prepare you for member inquiries about their health plan benefits or premiums, we've created tools for your reference. These include:
- A video that discusses the continued trends in the marketplace and highlights our 2017 strategy for transforming the individual marketplace
- An infographic that explains the reasons behind the premium increases
- A four-page paper that includes information about the premium increases but also what we are doing to address it
- An FAQ document that will give you the answers to questions clients may have
You can find these items in the 2017 ACA Premium Change Information Center on the secure
Producer Connection.
It's important to remember in your conversations with clients that these proposed changes do not take place until the beginning of 2017, so no immediate decisions need to be made by clients until open enrollment. Open enrollment begins Nov. 1, 2016, and runs through Jan. 31, 2017.
Member notice/letter
Wellmark will mail public hearing letters today to our Iowa ACA Individual and Family Plan policyholders to inform them of their base premium change amount and the upcoming public hearing process.
Samples of the Individual ACA letters are attached below:
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| MEDICARE MARKET: PLAN G IS COMING 1/1/17 |
| Wellmark will offer Medicare supplement Plan G to members in 2017. Currently, Wellmark offers five Medicare supplement plan options: Plans A, D, F, High Deductible Plan F and N. |
| 2017 HSA LIMITS RELEASED BY IRS |
The Treasury Department and Internal Revenue Service (IRS) announced the 2017 indexed cost-of-living adjustments (COLAs) to the minimum deductibles, maximum out-of-pocket (OPM) amounts and contribution limits for health plans linked to Health Savings Accounts (HSAs). The announcement was made through Revenue Procedure 2016-28.
Revenue Procedure 2016-28 can be found here. The Treasury Department states that the 2017 levels for HSA-qualified health plans are as follows:
Individual coverage
Minimum deductible: $1,300 (same as 2016)
Maximum out-of-pocket amount: $6,550 (same as 2016)
Maximum annual contribution amount: $3,400* (a $50 increase from 2016)
Family coverage
Minimum deductible: $2,600 (same as 2016)
Maximum out-of-pocket amount: $13,100 (same as 2016)
Maximum annual contribution amount: $6,750* (same as 2016)
* Effective 2007, the maximum contribution is the indexed amount and is no longer capped by the deductible of the high-deductible health plan (HDHP) if it is lower than the indexed amount. In addition, the catch-up amount for individuals over 55 is fixed by statute and will continue to be $1,000 per eligible account.
The deductibles and OPMs for the HSA-qualified health plans in the small business and individual markets will not require any changes as a result of these 2017 index amounts since they remain the same as 2016.
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| MORE INFORMATION NOW ON OUR RESOURCES PAGE |
We have added more helpful information to our Resources page!
Along with applications and forms, we now have our monthly newsletters and special alerts published. Also included is a monthly events calendar. The calendar will include items such as training dates, certification dates, and enrollment period dates.
Check it out using the following link:
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Agent Resources
You can access Wellmark BCBS of Iowa forms on our website.
Click Here
http://partnershealthinsurance.com/resources-2/
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Coop Advertising
Did you know you could be eligible for 50% reimbursement on eligible Wellmark BCBS advertising? Login in to your Wellmark.com Producer Connection page - locate the Sales Tookit - N
ew ads are now available! Contact Tonya to find out more information about this program.
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Wellmark Annual Agent Certification
WHEN: June 1 - June 30, 2016
This is an annual training specific to Wellmark BCBS and must be completed each year in order to continue to sell Wellmark BCBS group and individual products. This is a separate requirement from the Medicare PDP certification.
WHERE: Online - Blue Learning Center
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WELLMARK FALL TRAINING
FALL 2016 - TBD
Agenda Items to Include: TBD
WHERE: TBD
TIME: TBD
RSVP Now to:
Jamie Kamerman - jamie@veinsurance.com
Tonya Helmers - tonya@mtcnet.net
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NEW! IFP Quoting & Enrollment System Training
This new system will replace QUE for the Individual Under 65 Products.
WHO: For agents who will sell Individual Under 65 Products after 7/15/16.
Training will also be offered to NON-APPOINTED OFFICE STAFF
WHERE:
TBD Classroom training sessions will be scheduled throughout the state from June 22 through July 6.
Please watch for an invitation direct from Wellmark BCBS.
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FFM/Marketplace Certification
WHO: Agents wishing to sell policies on the federal Marketplace
WHEN: TBD watch for more details towards the fall.
WHERE:
Agents can certify direct with CMS or other certified vendors online (Wellmark does not offer these trainings).
-Required in order to sell policies on the federal Marketplace - will need to be certified annually.
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MedicareBlueRx (PDP) Certification
This is an annual training that needs to be completed each year in order to service and sell MedicareBlueRx products.
Access 2016 Training Guide
here
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| WELLMARK NEW AGENT TRAINING Newly appointed agents with Wellmark BCBS are required to go to New Agent Classroom Training within 180 days of appointment date. Prior to registering, agents will be required to complete a pre-curriculum online module and assessment on Medicare & ACA. Once appointed, Wellmark Sales Training will send out an email with the pre-curriculum instructions. Once the pre-curriculum is complete, you as the new agent will be prompted to Register for training in the Blue Learning Center located under your Wellmark.com agent login.
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