The Centers for Medicare and Medicaid Services (CMS) recently announced new restrictions on marketing for Medicare Advantage Plans and other health care policies. With the new rules, it is more important than ever for Agility agents to understand the Medicare Advantage marketing guidelines and the policies associated with them. In this blog post, we’ll explore what the new rules mean for agents selling Medicare Advantage plans and the strategies available to stay compliant with these plans.

Under the new CMS guidelines, agents selling Medicare Advantage plans can no longer use promotional materials that could mislead, confuse, or exaggerate the benefits of their plans. This means that all marketing materials must be clear, and accurate, and not promote any plans inappropriately. Additionally, agents selling Medicare Advantage plans must provide consumers with detailed information about each plan, including out-of-pocket costs, services covered, and formulary information.

In addition to the new restrictions, CMS now requires that all Medicare Advantage plans to adhere to the same ethical standards as traditional Medicare plans. This restricts agents from offering any gifts, rewards, or other incentives to customers in order to encourage them to enroll in a particular plan. Agents selling Medicare Advantage plans are also prohibited from aggressive sales and marketing tactics, such as cold calling or door-to-door marketing.

It is important for Agility agents to note that they also must abide by all local and state laws regarding marketing and advertising for Medicare Advantage. For example, some states may have laws regulating the use of telemarketing or direct mail campaigns by Medicare Advantage plans.

The new restrictions from CMS are designed to protect consumers from deceptive marketing practices and ensure that they are fully informed about the benefits of Medicare Advantage plans. It is important for Agility agents’ consumers to understand the new rules and the policies associated with these plans in order to make the best decisions for their healthcare needs.

By following the Medicare Advantage marketing guidelines, Agility agents can be sure their customers are getting the most accurate and helpful information about the plans available. Moreover, agents should also take the time to thoroughly research each plan and understand all of the costs, benefits, and limitations associated with Medicare Advantage. With a little research and knowledge of the new rules, agents can help consumers make informed decisions and navigate the Medicare Advantage landscape with confidence and integrity.

Stay up to date with Medicare Marketing Guidelines by attending our Medicare Training Series live events!

Agility Producer Support
(866) 590-9771
support@enrollinsurance.com

CMS will provide updates and information agents and brokers need to successfully operate in the marketplace.

CMS will host a webinar training on the Plan Year (PY) 2022 Marketplace Registration and Training for Returning Agents and Brokers on August 26 2021.  Please visit www.REGTAP.info to register. 

Checkout the available ACA Certifications & ACA Contracting

 

Agility Producer Support
(866) 590-9771
support@enrollinsurance.com

CMS News Room Fact Sheet

The Centers for Medicare & Medicaid Services (CMS) reports that since the Special Enrollment Period became available on HealthCare.gov on February 15, more than 1.5 million Americans have enrolled in health coverage at HealthCare.gov. 

 Additionally, more than 2.5 million current
enrollees have returned to the Marketplace to find average savings of
over $40 per month, compared to their premiums prior to the ARP
implementation. The table below shows the average premiums and savings
by state before and after additional American Rescue Plan subsidies
became available on April 1 through June 30.  

Current Marketplace enrollees can review their
application anytime to make any needed changes to their current
information, submit their application, and reselect their current plan,
to ensure they maximize their savings for Marketplace coverage for the
rest of 2021.

There are several ways to apply and enroll into affordable health coverage:

  • Use HealthCare.gov to apply online.
  • Call the Marketplace Call Center at 1-800-318-2596, which provides
    assistance in over 200 languages. TTY users should call 1-855-889-4325.
  • Find local help through an agent/broker or assistant in your area at Healthcare.gov/find-assistance/
Premium Savings for Returning Consumers’ DUE to the American Rescue Plan (through 6/30/2021)
State Average Pre ARP Net Premium Average Post ARP Net Premium Average Savings Due to ARP
HeathCare.gov Total $104 $62 -40%
AK $154 $87 -44%
AL $120 $70 -42%
AR $168 $96 -43%
AZ $179 $110 -39%
DE $197 $118 -40%
FL $73 $41 -44%
GA $93 $51 -45%
HI $198 $124 -37%
IA $146 $74 -49%
IL $217 $148 -32%
IN $229 $150 -34%
KS $158 $97 -39%
KY $185 $112 -40%
LA $192 $125 -35%
ME $165 $98 -41%
MI $167 $108 -35%
MO $139 $83 -40%
MS $79 $39 -51%
MT $184 $113 -39%
NC $107 $61 -43%
ND $126 $71 -44%
NE $109 $53 -51%
NH $206 $135 -35%
NM $175 $110 -37%
OH $210 $139 -33%
OK $89 $50 -44%
OR $217 $145 -33%
SC $116 $72 -37%
SD $133 $73 -45%
TN $129 $77 -40%
TX $84 $52 -38%
UT $75 $44 -42%
VA $142 $82 -42%
WI $177 $103 -42%
WV $262 $178 -32%
WY $111 $61 -45%    

 

 Medicare Contracting & Certifications are Available here!

Agility Producer Support
(866) 590-9771
support@enrollinsurance.com

CMS Proposed Rule to Increase Americans’ Access to Health Coverage for 2022

The Centers for Medicare & Medicaid Services (CMS) today proposed
a series of provisions to follow through on President Biden’s
commitment to build on the Affordable Care Act (ACA), expand health
coverage access and advance health equity. These provisions are the
third installment of the payment notice for 2022.

 


The proposed rule includes a
variety of provisions to protect and expand Americans’ access to
high-quality, affordable health insurance. This includes proposals to
lengthen the annual open enrollment period for 2022 by an additional 30
days, create a new special enrollment period opportunity for certain
low-income consumers, and expand the duties of Federally-facilitated
Exchange Navigators to offer additional help to consumers enrolling in
plans. These actions demonstrate a strong commitment by the Biden-Harris
Administration to extend health insurance coverage to more Americans
and make it easier and more affordable to get covered.

“With the ACA and American Rescue
Plan, the Biden-Harris Administration is expanding access to affordable
health insurance coverage for millions – for many, perhaps for the first
time. The success of the special enrollment period opportunity clearly
shows the demand for quality, affordable coverage,” said CMS
Administrator Chiquita Brooks-LaSure. “These latest steps aim to better
fund outreach efforts and eliminate barriers to coverage. We’re making
high-quality, low-cost coverage more accessible than ever.”

These updates build upon and
revisit several of the policies in the Notice of Benefit and Payment
Parameters for 2022 (or “2022 payment notice”), which was finalized
in
two phases. Today’s proposed rule furthers CMS’s work to provide
greater access to coverage, improve affordability for consumers and
reduce burden for issuers and consumers.

Strengthening the Exchanges and Improving Issuer Billing
The
proposed rule would give Exchanges the option of offering a new special
enrollment period to provide additional opportunities for certain
low-income consumers to access premium-free or very low-cost coverage
available to them because of
the enhanced advanced premium tax credit (APTC) provisions included in
the American Rescue Plan Act of 2021. The proposed monthly special
enrollment period would align with President Biden’s Executive Order
14009 (issued January 28, 2021), which requires federal agencies to
identify and appropriately address policies that create barriers to
accessing ACA coverage.

Several other provisions in the proposed rule
would streamline operations for the Federally-facilitated Exchanges,
health insurance issuers, and other stakeholders who facilitate access
to coverage. For example, the proposed rule would streamline issuer
billing by repealing certain requirements that could have resulted in
burdensome and costly changes to issuer billing systems. It also
proposes to lengthen the annual open enrollment period for 2022 and
future coverage years by an additional 30 days, allowing consumers more time to review plan choices.

Additionally, the rule proposes modifications
to policies related to State Innovation Waivers (sometimes called
“section 1332 waivers”), which empower states to pursue new strategies
for providing residents with access to coverage. This includes proposals
related to the interpretation of the statutory guardrails and
flexibilities in public notice and post-award public participation
requirements under future emergent circumstances, if certain criteria
are met. The rule also includes proposals regarding the process for
amending or extending approved section 1332 waivers.

Advancing Accessibility

The proposed rule would enable CMS to collect
and dedicate additional revenue to fund consumer outreach and education
through modest increases in user fee rates for issuers in
Federally-facilitated Exchange states and State-based Exchanges on the
Federal platform. The proposed user fee rates, which are levied on
issuers each year, are still lower than the current 2021 benefit year
rates. The rate change for issuers on the Federally-facilitated Exchange
would also make additional revenue available that can be used to fund
Navigators, who help consumers – particularly the uninsured – understand
their options and enroll in health insurance plans. CMS
recently announced its plan to support Navigators and their important
work with the largest-ever funding allocation for Federally-facilitated
Exchange Navigators for the 2022 plan year.

The proposed rule would also reinstitute
expanded duties applicable to Navigators in the Federally-facilitated
Exchanges to ensure that consumers have access to skilled assistance
beyond applying for and enrolling in health insurance coverage. These
include, for example, assistance with the process of filing Exchange
eligibility appeals, understanding basic information about
reconciliation of premium tax credits, and understanding basic concepts
and rights related to health coverage and how to use it, such as
locating providers and accessing care. Raising such awareness and
supporting Navigators’ responsibilities remain key to reaching
underserved communities, where access to health insurance coverage has
been low and disparities in health outcomes continue to rise.

These actions demonstrate a strong commitment
by the Biden-Harris Administration to extend health insurance coverage
to the uninsured and improve Exchange operations. They also align with
the Administration’s commitment to protect and expand Americans’ access
to comprehensive, affordable health insurance, and to ensure that systemic
barriers to opportunities and benefits for people of color and other
underserved groups are not perpetuated, as described in President
Biden’s
Executive Order 13985 on Advancing Racial Equity and
Support for Underserved Communities Through the Federal Government.
These proposals also will further support the Administration’s efforts
to build on the successes of the ACA to meet health care needs created
by the COVID-19 public health emergency, reduce individuals’ health care
costs and make our health care system less complex to navigate.

For further information on these and other provisions in the proposed rule, consult the fact sheet available at: https://www.cms.gov/newsroom/fact-sheets/updating-payment-parameters-section-1332-waiver-implementing-regulations-and-improving-health

Affordable Care Act Contracting Available Now

by: CMS News Room Press Release

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(866) 590-9771
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