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CARRIER ARE BOR/AOR CHANGES ACCEPTED? DOES THE CARRIER REQUIRE A SPECIFIC FORM TO BE COMPLETED? WILL THEY ACCEPT A HAND WRITTEN LETTER FROM THE CLIENT? WHAT IS REQUIRED ON THE MEMBERS HANDWRITTEN LETTER? HOW & WHERE ARE THEY SUBMITTED TO? **IMPORTANT INFORMATION AETNA YES- PLEASE SEE NEW RULES FOR 2020, UNDER IMPORTANT INFO TAB NO YES – PLEASE REVIEW “IMPORTANT INFORMATION COLUMN” *FIRST & LAST NAME OF MEMBER
*DOB
*MEMBERS AETNA ID # & MEDICARE ID #
*NEW AGENT’S NAME & NPN #
*REQUEST TO CHANGE THE AGENT OF RECORD
*REASON THE MEMBER IS MAKING REQUEST1. Phone call to Member Services @ 1-800-282-5366
2. Mail a handwritten request to 2222 Ewing Road, Coraopolis, PA 15108
An individual agent of record update must be member initiated. The member has a few options to request this change:
1. The member can call the TFN number on the back of their ID card.
2. They can write, sign and date a letter & mail to Aetna, C/O Broker Support Department, 2222 Ewing Road, Moon Township, PA 15108.ANTHEM YES ALL BOR REQUESTS ARE REQUIRED TO BE HANDWRITTEN BY THE CLIENT. ***HAND WRITTEN LETTERS ARE REQUIRED*** *FIRST & LAST NAME OF MEMBER *MEMBERS ANTHEM POLICY #
*NAME & ENCRYPTED TAX ID, OR AGENT ID, OF THE NEW AGENT OF RECORD
*SIGNATURES & SIGNATURE DATES MUST BE NOTED ON HANDWRITTEN LETTER
E-mail (Recommended): Senior_salescomp@anthem.com
Fax: 818-234-1358
Mail: Anthem INC. Attn: Sales Compensation CAAC10-010A Van Nuys, CA 91470
*ALL BOR CHANGE FORMS MUST BE RECEIVED PRIOR TO THE LAST DAY OF THE MONTH IN WHICH IT WAS RECEIVED
1. For LIKE-TO-LIKE plan changes, such as a change from a Medicare Advantage (MA) plan to a different MA plan, Anthem will maintain the original Agent of Record associated with the new policy, even when a new agent submits the new application.
A. Exceptions will only be made if a member specifically requests a new AOR by submitting a hand written & signed Agent of Record letter to Anthem requesting that their AOR be changed. Once Anthem confirms/verifies the request from the member, then the AOR change request will be honored.
2. For UNLIKE plan changes, such as a member choosing to move from a Prescription Drug Plan to an MA plan or an MA plan to a Medicare Supplement plan, the Agent of Record as indicated on the new application will be assigned as the Agent of Record for the member.
BCBSRI NO N/A N/A N/A N/A N/A CPCT YES NO N/A *FIRST & LAST NAME OF MEMBER , ADDRESS, PHONE # & DOB **MUST BE SUBMITTED TO GARITY OFFICE EMBLEM NO N/A N/A N/A N/A ENVISION YES
**SEE COLUMN H FOR RULES**YES NO N/A E-Mail to: EnvisionAgentSupport@envisionrx.com A policyholder, agent, or agency may request to change an agent of record due to the termination, death, or retirement of an existing agent of record, or for any other reason deemed appropriate by the policyholder.
This policy documents the process that Envision Insurance Company will follow when they receive an agent of record change request.
FALLON YES YES – AVAILABLE FOR DOWNLOAD ON THE FALLON WEBSITE N/A N/A E-Mail to: MedicareSalesBrokers@fallonhealth.org FALLON NAVICARE SCO YES YES – AVAILABLE FOR DOWNLOAD ON THE FALLON WEBSITE N/A N/A E-Mail to: NaviCareBrokerServices@fallonhealth.org HPHC SUPPLEMENT YES YES NO N/A E-mail to: broker_relations@harvardpilgrim.org or medicarebroker@harvardpilgrim.org Fax to: 617-509-4262 HPHC STRIDE YES YES NO N/A E-mail to: broker_relations@harvardpilgrim.org or medicarebroker@harvardpilgrim.org Fax to: 617-509-4262 HUMANA NO N/A N/A N/A N/A Going forward Humana will only accept Agent Business Transferral Form Submissions UHC NO N/A N/A N/A N/A **IF AN AGENT STATES THEY WERE TOLD THAT UHC WILL ACCEPT A BOR CHANGE, PLEASE NOTIFY THEM THAT IT ONLY APPLIES TO AN AGENT WHO IS MOVING THEIR ENTIRE BOOK OF BUSINESS OVER TO UHC WELLCARE YES NO YES *FIRST & LAST NAME OF MEMBER *MEMBERS WELLCARE ID OR MEDICARE ID #
*REQUEST TO CHANGE THE AGENT OF RECORD
*REASON THE MEMBER IS MAKING REQUEST
Fax to: 1-866-473-9124
