Enrollment

OEP: Do’s and Don’ts

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Are you ready for the Open Enrollment Period (OEP)?
OEP Cheat Sheet

When is OEP?      January 1 through March 31 each year.

Who is Eligible?

Individuals enrolled in an MA-Only or MAPD plan CAN:
  • use the OEP to switch to or get a different MAPD plan, an MA-only plan, or Original Medicare (with or without a PDP).

Individuals enrolled in Original Medicare CANNOT:
  • use the OEP to join an MA or MAPD plan, add a PDP, or change their PDP.
In addition, the OEP is not available to those enrolled in Medicare Savings
Accounts or other Medicare health plan types (such as cost plans or PACE).

Broker Do’s and Don’ts

Producers May NOT:
    • Send unsolicited materials advertising the ability/opportunity to make an additional enrollment change or referencing the OEP
    • Specifically target beneficiaries who are in the OEP because they made a choice during AEP, by purchase of mailing lists or other means of identification
    • Engage in or promote agent/broker activities that intend to target the OEP as an opportunity to make further sales
    • Call or otherwise contact former enrollees who have selected a new plan during the AEP
    • Use marketing pieces that highlight the OEP or the opportunity to change plans during the OEP
    • Make assumptions on which election period to use.
red x
green check

Producers May:
    • Educate consumers about the OEP if you are enrolling them into a plan, or they have reached out to you about their dissatisfaction with their current plan
    • At a beneficiary’s proactive request, send marketing materials, have one-on-one meetings, and provide information on the OEP
    • Market to age-ins (who have not yet made an enrollment decision)
    • Market to dual-eligible and low-income subsidy (LIS) beneficiaries who, in general, may make changes once per calendar quarter during the first nine months of the year

PRODUCERS MUST:

Determine if the consumer has a valid election period and which election
period is best for the consumer’s circumstances.

We hope you take advantage of this additional enrollment period happening in Q1 2020. Below are links to carrier information sheets to further clarify the do’s and don’ts you need to follow to ensure you remain compliant. Happy New Year!
What is OEP
Educational Flyer
OEP Job Aid
Listen to UHC's Podcast for more in depth information!

Contact Broker Support if you have any questions!
800-234-9488
GarityAdvantage Agencies

Special Office Hours Thurs 12/19 – Fri 12/20

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NOTICE:
Special Office Hours Due to our
Holiday Company Event

Season's Greetings

Office hours at the GarityAdvantage offices in Norwell and
North Haven will be adjusted this week due to our annual
holiday event for our staff.

Please note the following special office hours:

 

Thursday, Dec 19th:
Norwell, MA office will close at 3:30pm
North Haven, CT office will be closed all day
*CT Staff Members will be available by phone on Thursday
Friday, Dec 20th:
Norwell, MA office will be open regular hours
North Haven, CT office will open at 12pm

NOTE: Carrier deadlines for enrollments still apply.
  • Enrollments sent to GarityAdvantage prior to 3pm on Thursday Dec. 19th will be processed that same day.
  • Enrollments sent to GarityAdvantage AFTER 3pm on Thursday, Dec 19th will be processed on Friday, Dec. 20th.
  • If your enrollment requires same day processing after 3pm on Thursday, Dec. 19th, please submit directly to the carrier.

 

Direct Carrier Submission Information

 

Note: The Agent Dashboard and Enrollment Fax lines
are open 24 hours to accept your enrollments.
We will resume processing on Friday, December 20th.

Submission Deadlines for AEP 2020

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PLAN AHEAD!

Medicare AEP ends on December 7th!

Thank you for all of your hard work this Annual Election Period.

Please follow these reminders to make sure your final selling days go smoothly.

ENROLLMENT DEADLINES

Per CMS, as an agent, you must receive and sign the consumer’s AEP enrollment application No Later than Saturday, Dec. 7, 2019 to fulfill AEP election.

All Enrollments MUST BE *Received at GarityAdvantage or directly to the carriers NO LATER THAN the guidelines below. If submitting directly to carrier, all submissions need to be received by midnight on December 7th.

Please refer to our website for submission methods directly to carrier.

Carrier Name
(Med Advantage & PDP Only)

Deadline for Enrollments to be
Received at GarityAdvantage:

Aetna/Coventry

Monday, December 9th by 12PM (noon)

Anthem

Saturday, December 7th by 3PM

* Any enrollments taken later
MUST be faxed direct to Anthem:
PPO/HMO/DSNP: 800-833-8554
PDP: 866-342-7048
no later than 11:59PM on 12/7

(Please send a copy to our office for commission tracking)

BCBSRI

Monday, December 9th by 12PM (noon)

CarePartners of CT

Monday, December 9th by 12PM (noon)

Envision PDP

MUST be faxed direct to Envision:
844-645-0583
no later than 11:59PM on 12/7

Fallon

Saturday, December 7th by 3PM

* Any enrollments taken later MUST be emailed direct to Fallon: MedicareSalesBrokers@fallonhealth.org
No later than 11:59PM on 12/7

HPHC Stride HMO

Monday, December 9th by 12PM (noon)

Humana

Saturday, December 7th by 3PM

* Any enrollments taken later MUST be faxed direct to Humana:
877-889-9936
No later than 11:59PM on 12/9

Silverscript

MUST be faxed direct to Silverscript:
866-552-6205
no later than 11:59PM on 12/7

Tufts MA

Saturday, December 7th by 3PM

UnitedHealthcare

Saturday, December 7th by 3PM

Wellcare/ Today’s Options

Monday, December 9th by 12PM (noon)
Submit Through the Agent Dashboard

GarityAdvantage Fax: (781) 982-1887

For Other Carrier Enrollment Deadlines, Call Us: 800-234-9488

IMPORTANT REMINDERS:
• This year’s Annual Enrollment Period (AEP) ends Saturday December 7, 2019 and all AEP marketing efforts must cease after that date
• Beneficiaries that enroll after December 7th, must have a Special Election Period (SEP) or an Initial Election Period (aging in)
• We encourage you to check the enrollment status, carrier approval and enrollment effective dates of applications via the Carrier’s agent portals

Questions?
Call us: 800-234-9488

  Thank you for a successful AEP!
GarityAdvantage Agency
www.garityadvantage.com

2019 Thanksgiving Hours and Enrollment

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Thanksgiving background with various pumpkins, gourds and fallin

Enrollment Processing over Thanksgiving

~ Fax and Website will be open 24/7 ~

Both our Norwell, MA and North Haven, CT Offices will be closed on
Thanksgiving, Thursday, November 28th and Friday, November 29th.

WHAT YOU NEED TO KNOW
Medicare enrollments dated on or before Tuesday, November 26th MUST be sent to us no later than Wednesday, November 27th during business hours (9AM-5PM). 

Tuesday enrollments sent after hours
on Wednesday risk being LATE to the carrier.

We will be providing limited staff to process your enrollments on Friday afternoon, November 29th, and Saturday morning, November 30th. 

To ensure compliance with CMS enrollment time-frames, you should always submit your enrollments the day they are received. This requirement becomes especially important now because CMS requirements Do Not allow additional days for weekends and holidays.

Submit Through the Agent Dashboard

ENROLLMENT FAX: 781-982-1887

Please use the link below for directions on how to
submit your applications to the carriers directly
between 5:00 PM, Wednesday, November 27th
and all day Thursday, November 28th:

Carrier Submission Information

Answers to other enrollment questions: Enrollment FAQs

GarityAdvantage Agencies
800-234-9488
www.garityadvantage.com

Aetna’s 5-Star Plan in Maine is HOT!

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aetna HMO 5 star

Have you heard the news???
Aetna Medicare Value HMO is now a 5-Star Plan!
That means year-round sales for you!

CMS has released 2020 star ratings for Medicare Advantage plans and the Aetna Medicare Value Plan in Maine has achieved 5 Stars, the highest possible rating!

This rating reflects the commitment Aetna has made to the Medicare-eligible population in Maine to provide them with exceptional benefits and services they need to stay healthy.
When it comes to your clients’ health, you want the best health plan possible. Some of the key features of the plan include:

    • $0 premium in Southern and Mid-Maine counties
    • $0 annual medical deductible
    • Low PCP and Specialist Co-pays
    • Annual Allowance for comprehensive & preventive dental services
    • $50 per quarter for OTC items
    • SilverSneakers fitness benefit
    • Travel Advantage benefit and more!

5-Star Special Enrollment Period

Having a 5-Star plan opens new doors to your selling efforts throughout the year. Click here to learn how and when you can offer the Aetna Medicare Value Plan before, during and after AEP!

5 Star Special Enrollment Period Guideline

Download the 2020 Star Ratings sheet and insert into your enrollment kits and offer this plan today!

2020 Star Ratings Sheet

As a broker in the Maine market, you need to have

Aetna as part of your Medicare Advantage portfolio.

New to Aetna?

Get Contracted

Contracted with Aetna through another FMO?

Move to Garity

GarityAdvantage is the largest Medicare FMO in New England and can offer you the personal service and tools you need to succeed, from targeted product and sales training, to best-in-class marketing services (including our $1,000 co-op marketing program) to free leads during AEP and exceptional support throughout the year. Our brokers are paid full commissions directly by the carriers and own their renewals. Let us help you succeed!

Enrollment Do’s and Don’ts 2020

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Enrollment Do's and Don'ts

Follow These Helpful Enrollment Reminders for a Successful AEP

As you know, Medicare Enrollments are subject to strict submission time frames implemented by CMS. To ensure a smooth process every time, please follow this helpful list of Do’s & Don’ts when submitting your applications.

Electronic Submissions
DO: Submit your apps though the NEW Enrollment Submission Tool on our Agent Dashboard

DON’T: Email your enrollments! We no longer accept enrollments via email for security reasons.

DO: Track your submissions via the Agent Dashboard

Fax Submissions
DON’T: Submit more than one application per upload or fax transmission.

DO: Use the Fax Cover Sheet and mark if the submission is NEW or a CHANGE/CORRECTION. This cuts down on duplicate submissions!

Ensure Accuracy
DON’T: Forget to submit ALL pages of the enrollment application.
For example; we have noticed many Aetna apps coming in without the first page. Aetna requires this page for the submission to be considered a full enrollment.
Double check your submissions!

DO: Check client zip codes for accuracy.

DON’T: Forget to complete ALL of the required information on the application.
For example; UHC applications for Medicare Advantage and PDP have an additional agent received date “signature date” that must be completed. Double check your submissions!

DO: Double check that you received a confirmation of your enrollment submission. If you enroll by fax, check your fax confirmation pages. If you enroll through the online submission tool, make sure your enrollment shows on the submitted apps page.

DO: Contact us with any questions/issues: 800-234-9488 or brokersupport@garityadvantage.com