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The Centers for Medicare & Medicaid Services (CMS) is hosting two webinars on August 11 and August 14.

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The August 11 webinar will review the plan year 2021 registration and training process for those who did not complete the Marketplace registration and training requirements for plan year 2020.

Agents and brokers who successfully completed plan year 2020 Marketplace registration and training and are returning for plan year 2021 may complete a shorter training, which will be reviewed in the August 14 webinar.

As a reminder, if you’ve registered for any webinars in the “Health Insurance Marketplace Plan Year 2020 Updates for Agents and Brokers” series, you’re automatically registered for this webinar and no action is required. You’ll receive a reminder the day before the session. If you haven’t attended a webinar before, click here for steps on how to register. Registration closes 24 hours before the event.

Contact the REGTAP Registrar for assistance at registrar@REGTAP.info or 800-257-9520.

Oscar, the first tech-driven health insurance company, today announced plans to launch its new $0 Virtual Primary Care product and expand to a total of 19 states and 47 markets in 2021. The company will offer health insurance to individuals and families in four new states and 19 new markets during the upcoming Open Enrollment period, pending regulatory approvals.

  • Plans to expand individual and family plans to 19 states and 47 markets, including 19 new markets, pending regulatory approvals.(1)
  • Announces Virtual Primary Care, bringing longitudinal telehealth and a suite of additional incentives to members for just $0.(2)
  • Virtual Urgent Care offering expanded to include $0 drugs and labs.

Virtual Primary Care is the latest addition to the suite of Oscar Care features that provide a personalized experience for Oscar members. Oscar Care, which includes access to Oscar designated virtual primary and urgent providers, offers our members with Individual and Family Plans:

Virtual Primary Care: $0, unlimited virtual visits with a dedicated team of Oscar primary care providers.(3) Tier 1 prescriptions, DME, labs, diagnostic imaging orders(4) and initial specialist referrals prescribed by an Oscar Primary Care provider are also $0.(5) Oscar Primary Care also will bring some care directly to members in their homes, by offering $0 vitals monitoring kits and in-home lab draws,(6) when ordered by an Oscar Primary Care provider.

Virtual Urgent Care: 24/7 access to Oscar Virtual Urgent Care Providers at $0 for whenever a member needs to see a doctor quickly.(7) Tier 1 prescriptions and labs are $0 when prescribed by our virtual urgent care providers, too.(8)

Care Teams: Dedicated Care Guides, including a nurse, who know the member’s medical history, help them navigate their plan, and connect them with in-network providers.

“With the launch of Oscar Primary Care, Oscar is making even more unprecedented, cost- effective plans available,” said Oscar Co-Founder and CEO Mario Schlosser. “Americans consistently cite cost, quality and convenience as their biggest struggles with the healthcare system – our new offering solves for all of them.”

Oscar Expansion Markets

2021 will mark the fourth consecutive year Oscar expands its footprint to offer affordable care designed around members’ health, budget, family, and community needs.

As a part of the 2021 expansion, Oscar will offer Individual and Family Plans for the first time in: Arkansas (Little Rock and Fayetteville), North Carolina (Asheville), Oklahoma (Oklahoma City), and four markets in Iowa, including Des Moines and Sioux City.

We also will expand our existing state footprints to Boulder, Colorado, three markets in Northeast Pennsylvania, multiple markets across Florida, including Jacksonville, Sarasota, and Tallahassee, and across new counties in Phoenix, AZ, San Francisco, CA, and Columbus, OH.

Oscar Virtual Primary Care Markets

The COVID-19 pandemic is transforming how Americans access health care and accelerating demand for virtual services. While just 11% of U.S. consumers used telemedicine in 2019, 76% are interested in using virtual care following the outbreak, according to McKinsey.

Oscar will offer Virtual Primary Care in 10 markets in 2021: Miami, FL, Fort Lauderdale, FL, Palm Beach, FL, Houston, TX, Dallas, TX, Austin, TX, Los Angeles, CA, Orange County, CA, Denver, CO, and New York, NY, pending regulatory approval.

The specifics of Oscar’s 2021 insurance plan portfolio are still being reviewed by regulators. Details regarding pricing, network partners, and added benefits will be available closer to the open enrollment period this fall. In the meantime, more information can be found at www.hioscar.com.

About Oscar

Oscar is the first health insurance company built to make health care easy. Headquartered in New York City, Oscar has been challenging the health care system’s status quo since our founding in 2012, developing seamless technology and providing personalized support to help our members navigate their health care. Oscar was the first insurer to offer $0, 24/7 telemedicine to members and to integrate direct scheduling with providers through our app.

Oscar plans also include access to a network of first-rate physicians and hospitals, as well as a personalized Care Team that supports members every step of the way, from finding a doctor to navigating costs. Oscar is known for its easy-to-use digital tools, including a website and mobile app that let members view their health history, speak directly with their Care Teams and virtual providers, and access their account information.

All products and services are provided exclusively by or through operating subsidiaries of Mulberry Health Inc., including Oscar Insurance Company and its affiliates. Say hi or learn more at https://www.hioscar.com or follow us at https://twitter.com/OscarHealth.

Media Contact: Jackie Kahn, Head of Communications; jkahn@hioscar.com; 202-538-0128

Footnotes

  1. (1) Market numbers are based on Metropolitan Statistical Areas (MSAs); Oscar entrance into and disclosure of all specific cities and counties within each MSA are pending regulatory approvals.
  2. (2) Not available in CA.
  3. (3) Oscar Virtual Primary Care providers are employed by Oscar Medical Group and are not employed by Oscar Insurance.
  4. (4) Some prescriptions and orders are unavailable via virtual visits. Other exclusions apply.
  5. (5) Not available in CA. Some exclusions apply.
  6. (6) Not available in all markets, including Los Angeles, CA or Denver, CO.
  7. (7) Available on most Oscar plans.
  8. (8) Some Tier 1 prescriptions are unavailable via virtual visits. Other exclusions apply.

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As social media soars… It’s up to you as modern day, professional Life & Health Insurance Agents to stay up-to-date with marketing in a digital world.  Agility Insurance Services’ all-in-one platform; enrollinsurance.com is happy to provide you with some general social media stats, tips, facts and guidelines.

In this downloadable eBook, you will find key guidelines, tips and tricks, best posting times, content strategy and more. Along with Medicare and ACA compliance to make sure you follow when creating ads and posts for all social media platforms.

Whether you’re new to social media marketing or you’re a expert, this eBook has something for you.

Download the Social Media PDF eBook Now >>

Agility Insurance Services is proud to introduce yet another game changing tool for our agents. When you join the Agility team, you get free access to our all-in-one Digital Medicare App through ConnectureDRX. Making virtual quoting and enrollments easier then ever for your Medicare clients.

Provide them ease of use with quoting, enrollment, shop and compare plans, scope of appointment, Text to Sign features and so much more. Learn more with the eBook guide below.

Download the Medicare Quoting & Enrollment eBook Guide >>

With so many people staying home and staying safe due to the Covid-19 pandemic, there has never been a better time to learn and use Virtual Enrollments.

In this PDF eBook you will learn to:

  • Identify your prospects and how you will reach them.
  • Meet with them virtually. Contact without contact.
  • Follow through the sale to effectuation.

CLICK TO DOWNLOAD VIRTUAL ENROLLMENTS PDF >>

Cigna Takes Action To Combat Systemic Racism And Improve Equity And Equality:  Cigna Corporation today issued a statement on systemic racism and a commitment to equity and equality:

“Racism and discrimination are destructive forces in any society,” said David Cordani, Cigna President and Chief Executive Officer. “We, as a global health service company, firmly and unequivocally denounce racism and discrimination in all forms and are committed to confronting these issues with intensity, empathy and accountability.”

In furtherance of this commitment, today we proudly launch our new Building Equity and Equality Program, a five-year initiative to expand and accelerate our efforts to support diversity, inclusion, equality and equity for communities of color.  Our mission is to improve the health, well-being and peace of mind of those we serve.  Below are key components of our program that are designed to fulfill this mission as we address these pressing issues.

Improve Health

There are striking differences in health outcomes in communities with poor social determinants of health, such as unstable housing, low income, unsafe neighborhoods or education.  It is well documented that these disparities disproportionately impact communities of color and, as a result, their health outcomes are worse than those of their white counterparts.

As part of our program, we are committing to closing these gaps in health outcomes by:

  • Eliminating barriers to health and improving access to care. Through the Cigna Foundation, we will continue to make grants available and convene a broad range of stakeholders – businesses, government entities, nonprofits, providers, delivery systems and community residents – all in an effort to eliminate barriers to health and improve access to care. This includes addressing needs amplified by COVID-19, such as food insecurity and mental health through our Healthier Kids For Our Future® program that specifically focus on the needs of our children. Additionally, we have been actively engaged with Congress and the Administration in efforts to address and eliminate racial and ethnic disparities in health care delivery and outcomes. We will continue to use our seat at the table to share insights and solutions that address social determinants of health and improve our results to strengthen the health of all communities. For more information on our efforts to combat health disparities, please see our 2019 corporate responsibility report, Cigna Connects.
  • Expand Cigna’s Health Equity Council. Our team of multi-disciplinary leaders has collaborated on research, testing and solutions to prevent chronic diseases and improve health outcomes in minority communities since 2008. We will further accelerate these efforts to address clinical care, social determinants of health and health behaviors.

Improve Well-Being

Racism and bias not only impact health; they take a toll on overall well-being.  We believe that it is critical that no one feels the need to confront racism and bias alone and that everyone feels safe in their environment.  Therefore, as part of our program, we are taking the following actions:

  • Standing Together. We are inviting our 75,000+ employees to sign a commitment to embody inclusive behavior in their professional and personal lives. We are also inspiring and enabling our team members to collectively donate 100,000 hours of volunteerism annually for programs related to social justice, health equity, diversity and inclusion and community outreach.
  • Creating Inclusive Environments. We will now require unconscious bias training for all employees, and are planning cultural competency training for all managers, as a supplement to our existing training requirements. We will also continue to advance authentic and inclusive conversations about systemic racism in America. For example, in June, over 8,000 Cigna employees joined virtual, safe space facilitated discussions, which are now offered regularly. Additionally, we partnered with DiversityInc for a virtual panel on systemic racism in our communities, which was attended by more 12,300 clients and partners. The replay is available here.

Improve Peace of Mind

We recognize that financial health is a key element of peace of mind and that racism has a negative economic impact on people of color. We are taking steps to advance a positive trend for current and future generations by:

  • Creating Educational Opportunities. Education is the path to economic prosperity for many. Cigna is partnering with Howard University and the School Superintendent Association to bolster the effectiveness of school district leadership in our nation’s urban areas by funding fellowships for those on a career path to becoming an urban public school superintendent. We are also furthering Cigna Scholars, a program assisting dependents and grandchildren of employees who plan to pursue post-secondary or vocational education.
  • Promoting Equity and Equality in Career Advancement. We are committed to compensating our employees equitably and competitively, regardless of race, gender, age or sexual orientation. We will continue to proactively monitor our compensation programs for potential disparities, including conducting a regular annual review of pay equity, and diligently addressing disparities as warranted. Additionally, we will continue to support our mentoring program, including a key focus on creating cross-cultural pairings; we are committed to achieving increased diversity among leadership across the enterprise.
  • Supporting Minority Businesses. We are on track to achieve $1 billion in diverse supplier funding by 2025. We will also expand the Cigna Supplier Mentor Protégé Program, established in 2016, to assist minority suppliers by pairing them with Cigna executives for 18 months to help participants develop strategies to strengthen and grow their businesses.

Governance

Accountability is a key foundation of our overall program and we are establishing a governance process to oversee the program elements, while tracking and reporting on progress.

  • Enterprise Diversity & Inclusion Council. This Council will oversee all elements of our program and will regularly report progress to the Chief Executive Officer and Chief Human Resources Officer. Those executives will in turn regularly report progress to Cigna’s Board of Directors.
  • Diversity Scorecard. We will also develop and publish an annual diversity scorecard to advance the principles of diversity, equity and equality.

For more information on Cigna’s Diversity and Inclusion strategy, click here.

About Cigna
Cigna Corporation is a global health service company dedicated to improving the health, well-being, and peace of mind of those we serve. Cigna delivers choice, predictability, affordability and access to quality care through integrated capabilities and connected, personalized solutions that advance whole person health. All products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Cigna Life Insurance Company of New York, Connecticut General Life Insurance Company, Express Scripts companies or their affiliates, and Life Insurance Company of North America. Such products and services include an integrated suite of health services, such as medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products including group life, accident and disability insurance. Cigna maintains sales capability in over 30 countries and jurisdictions, and has more than 180 million customer relationships throughout the world. To learn more about Cigna®, including links to follow us on Facebook or Twitter, visit www.cigna.com.

 

Get Contracted with Cigna Health Today:

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We’ve worked closely with our customers throughout the pandemic to understand the economic and health challenges they, their employees and our communities face. Every decision we’ve made as a company during these extraordinary times is through the lens of a long-term commitment to our members and our communities, with the goal to support our customers and members, just as we always have. In many cases, we have been actively working with our customers on a one-to-one basis to identify solutions that will provide short-term relief.

Now, as a result of our ongoing discussions with customers, we’re excited to announce the COVID-19 Economic Response Program, which is designed to help new and existing fully insured employer group customers during this unprecedented national emergency.

Briefly, we’re offering a premium deferral to existing fully insured customers and a two-year rate guarantee to new fully insured customers.

The charts below provide more detail.

COVID-19 Economic Response Program for Existing Insured Customers

Customers Option Method Recoupment Plan Decision
  • Fully insured
  • Size 51+ enrolled employees*
Defer 50% of July billed medical and dental monthly premium

 

 

Line item credit on future Customer Statement**

Example: Client X deferred one monthly premium in 2020 = $240,000

 

Spread evenly across 12 monthly invoices in 2021 as a line item charge (regardless of anniversary date).

Impact is approx. 4.2% increase additional premium in 2021.

Example: Client X’s 2021 monthly invoice line item deferred premium charge = $240,000/12 = $20,000

*Account executives will help customers determine if an employer is eligible.
**Actual invoices credited will be subject to opt-in decision timing by customer. If opt-in signed form is received and processed by July 31, 2020, then credit will appear on the September Customer Statement. If received and processed after July 31, 2020, or signed opt-in form is received by Aug. 15, 2020, then credit will appear on the October Customer Statement.

COVID-19 Economic Response Program for New Insured Business (New Employer Group to BCBSTX) with effective dates from July 2020 through January 2021

Customers Option Method Recoupment Plan Decision
  • New customers with effective dates from July 2020 through January 2021
  • Fully insured
  • Size 51+ enrolled employees
Default Option 24-month rate guarantee at first 12 months rates for medical and dental No rate increases in the first 24 months. Policy year limited to 12 months and a renewal will be provided. No recoupment needed Decision and criteria will be indicated in the additional provisions of the BPA, which must be signed prior to the effective date.
Alternate Option Defer 30% of first 3 months of medical and dental premiums* Line item credits** for first 3 months will appear on customer statements for months 2-4 and recoupment over the last 8 months will appear on customer statements for months 5-12. Recoup the deferment in the remaining eight months as a line item charge with maximum 9.9% first-year renewal increase for medical and maximum 5.0% first-year renewal increase for dental

 

Decision and criteria will be indicated in the additional provisions of the BPA, which must be signed prior to the effective date.

Exceptions will be made for July and August 2020 effective dates to process and sign a revised BPA given the timing of the release of the COVID-19 Economic Response Program.

*Account executive to work with underwriter to capture and document.
**Actual invoices credited will be subject to opt in to this option and decision timing by customer.

Who’s eligible?
Most fully insured groups 51+ enrolled employees will be eligible.

Who isn’t eligible?

  • Self-funded groups, MPP, Cost+, ACA-rated small groups, Blue Balance FundedSM, student health, ADM, MEWA/PEO, association health plans, retrospective premium accounts, customers on private multi-carrier exchanges, and prospective retention accounts.
  • Accounts in stage two of delinquency are also not eligible, but those groups will be given a chance to rectify that status by July 31, 2020, so that they may qualify. (Stage two delinquency is defined as accounts with payments that are 30 days past due.)

 

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Agility Insurance Services is pleased to announce their partnership with HealthSherpa: An innovative healthcare technology and the country’s largest ACA agent enrollment platform.
HealthSherpa is a CMS-approved entity for Enhanced Direct Enrollment (EDE). Through a HealthSherpa account, you can track, enroll, and service all of your ACA clients — without going to healthcare.gov.

EDE (Enhanced Direct Enrollment) is a powerful new technology that simplifies the enrollment process and provides complete policy management functionality— without going to Healthcare.gov.

Download the HealthSherpa eBook Guide >>

Applies to: All Groups, All Markets: We have signed a new multi-year contract with Kelsey-Seybold Clinic Leaving site icon. The new agreement will provide access to value-based care for our members in the Houston area. Members in our Blue Essentials HMOSM and Blue Choice PPOSM provider networks can receive in-network care at Kelsey-Seybold Clinics starting Jan. 1, 2020.

“We are pleased that we have reached an agreement with Kelsey-Seybold Clinic, enabling us to again offer their exceptional care to our members,” said Dr. Dan McCoy, president of Blue Cross and Blue Shield of Texas. “The contract reflects our mutual commitment to meeting the needs of our members and their patients.

“Kelsey-Seybold’s model of care aligns with our resolve to contract with providers that embrace a high-quality, value-based, collaborative and holistic approach to care for their patients and our members while working to reduce overall health care costs.”

“We are excited to be in-network with BCBSTX and offer our proven model of Accountable Care to patients, families and employers in the region. Our physicians and clinic staff look forward to welcoming BCBSTX health plan members beginning Jan. 1 at our expanding network of multispecialty care locations,” said Dr. Tony Lin, chairman of Kelsey-Seybold Clinic. “At Kelsey-Seybold Clinic, our Accountable Care model is delivering value by increasing access to care, improving quality and patient satisfaction, and directing care to appropriate settings, which helps to lower the total medical cost.”

 

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Open Enrollment: Tools for Success: Here are some essential tools for marketing and selling our 2020 qualified health plans in the individual market to existing members and new prospects.

Plan Information:

Get links to 2020 Plan Comparison Charts, Summaries of Benefits and Coverage and Benefit Highlights in this new flier PDF.

Renewal Packets:

Active members of retail plans should be receiving their renewal packets for 2020. Here are the details PDF, including links to sample packets.

Retention Call Center:

Your clients can access a special retention call center for producer sold business PDF to help renewing members through open enrollment. When your clients use the call center, you remain the producer of record.

Retail Producer Portal:

The portal allows you to complete and submit enrollment applications for your clients. Control the entire sales cycle from quote to effectuation. For details, see our guide PDF.

Agency Alert Re: Marketplace Registration:

Writing producers must be registered with the Marketplace before helping clients enroll in Marketplace policies. See our Agency Alert for details PDF.

SMALL GROUP (1-50)

2020 No Contribution/No Participation Option Period Starts Nov. 1

If your new ACA/small group (1-50 employees) wants to elect the No Contribution/No Participation Option,

follow these directions and deadlines.

 

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