FAQS

Where to Submit Enrollments*:
Via Medicare Select-a-Plan – Garity’s Virtual Enrollment Platform
Have an MSAP account? Log in here
Don’t have a log in? Request access here.

Via the Agent Dashboard
Log in to our Agent Dashboard to Upload and Track your enrollments. Watch the video to learn how.

Via Carrier Online Enrollment Tools/Apps
Visit our grid to access carrier direct enrollment app links and user guides.

Via Fax: 781-982-1887
Faxing: Please be sure to include an Enrollment Cover Sheet for each application.
Use a separate cover page for each enrollment.

All Medicare Advantage and PDP enrollments should be submitted electronically. Do not mail the originals.

Important Downloads:

Application Submission Time-Frames

**ALL APPLICATIONS MUST BE SIGNED & DATED PRIOR TO THE REQUESTED EFFECTIVE DATE**

Carrier Name/ Product Type	Fax Number/ Email Address	# of Days Garity has to submit applications to the carriers	Additional Notes

Aetna-MA - MAPD (HP)	(888) 554-7668	2
Aetna-MA - MAPD (MA & PD)	(866) 441-2341	2
Aetna-MA - MAPD (NG, JV & DS)	(866) 756-5514	2
Aetna-MA - DSNP GA (US)	(844) 984-0393	2
Aetna-Rx	(866) 415-2232	2
Aetna Silver Script	(866) 552-6205	2
Aetna BOR Change	BrokerSupport@Aetna.com	2	*Must be received, by the carrier, prior to the requested effective date.
Aetna-Med Supp	(877) 380-2777	30
Anthem- HMO/DSNP/PPO	(800) 833-8554	3
Anthem - PDP (CT Only)	(866)-342-7048	3
Anthem - PDP (CA & GA Only)	(800) 833-8554	3
Anthem-Extras	(877) 238-1107	3
Anthem-PDP	(866) 342-7048	3
Anthem BOR change	Senior_Salescomp@Anthem.com	3	*Must be received, by the carrier, prior to the requested effective date.
Anthem-Med Supp	(844)-236-7967	7
BCBSRI	Medicareenrollmentintake@bcbsri.org	3	All application types - if MUST fax use 1-401-459-5025
Cigna-Med Supp	(877) 704-8186	30
Clover	Enrollment site - https://www.cloverhealth.com/en/brokers/plan-documents-enrollment Fax - (732) 993-6650	2
Combined-Med Supp	(866) 545-8076	30
CTCare	medicarepe@emblemhealth.com	3
Denver Health	dhmpsales@dhha.org	2
Emblem Health	(866) 890-7722	3
Fallon	MedicareSalesBrokers@fallonhealth.org	3	*Must be received, by the carrier, prior to the requested effective date.
Fallon BOR Change	MedicareSalesBrokers@fallonhealth.org	3	*Must be received, by the carrier, prior to the requested effective date.
Fallon - Navicare SCO	ESR.mailbox@fallonhealth.org	3	*Must be received, by the carrier, prior to the requested effective date.
HPHC - Med Supp	Medicarebroker@Harvardpilgrim.org	7	*Must be received by the carrier no later than 7 days after the requested effective date
HPHC - STRIDE	Medicarebroker@Harvardpilgrim.org	3
Humana - MAPD/PDP	(877) 889-9936	3
Health New England - Med Supp	sfernandes@hne.com	7
Mass Advantage	ONLINE ENROLLMENT ENCOURAGED. IF NEED TO EMAIL TO: brokers@massadvantage.com
Molina	(844)-541-6848	3
Mutual of Omaha - PDP	(855)-867-6711	3
Optima	(757) 648-1367	3
Tufts	(617) 972-9475	3	medicarebrokersupport@tufts-health.com
UHC AARP - Med Supp	(888) 836-3985	30
UHC - HMO, PPO, RPPO, PFFS	MandRenrollment@uhc.com	3
UHC - Preferred Dade	MandRenrollment@uhc.com	3
UHC - Senior D	MandRenrollment@uhc.com	3
UHC - PDP	MandRenrollment@uhc.com	3
UHC - SCO	(855) 250-2168	3	*Must be received, by the carrier by 1:00 P.M. on the last day of the month.
United American-Med Supp	(972) 569-3678	30
Virginia Premier	vpeenrollment@virginiapremier.com	3
Wellcare - MAPD	(866) 473-9124	3
Wellcare - PDP	(866) 388-1521	3
WellCare BOR Change	julianna.kaveney@wellcare.com	3	*Must be received, by the carrier, prior to the requested effective date.

2022 CARRIER SCOPE OF APPOINTMENT RULES

CARRIER	IS THE SCOPE OF APPOINTMENT FORM REQUIRED TO BE SUBMITTED WITH THE APPLICATION?	WILL A CMS APPROVED GENERIC SCOPE OF APPOINTMENT FORM BE ACCEPTED?	WILL ANOTHER CARRIERS’ SCOPE OF APPOINTMENT FORM BE ACCEPTED?	**IMPORTANT INFORMATION
AETNA	YES	YES	YES
ANTHEM	YES	YES	YES
BCBSRI	Yes, if paper app.	YES	YES	Scope not required for Sunfire applications. Paper, Docusign form, or bcbsri.com enrollment SOA required. SOA ALSO REQUIRED FOR PLAN CHANGES
CPCT	CPCT requesting SOA be emailed separately from app	YES	YES	Scope should be emailed to CPCTBrokerSupport@CarePartnersCT.com at earliest convenience
CTCARE	Requested, but not required	YES	YES
EMBLEM	YES	YES	YES
FALLON	YES	NO	NO
FALLON NAVICARE SCO	YES	YES
HPHC STRIDE	NO	YES	YES	If SOA not submitted agent must keep SOA for required 10 yrs per CMS guidelines
HEALTH NEW ENGLAND	YES	YES	YES
HUMANA	YES	YES *SEE NOTE		If generic SOA form used, agent must be able to produce the document upon request and retain copies for 10 yrs
MUTUAL OF OMAHA PDP	NO	YES		FAX SOA TO 402-599-5822
OPTIMA	YES	YES	YES
TUFTS	YES	YES	YES
UHC	NO
VA PREMIER	YES
WELLCARE	YES	YES	NO

2022 BROKER OF RECORD CHANGE RULES

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	NO FORM ACCEPTED	YES	Members info and ID#, signed & dated. Include new agent name & NPN#	Email: brokersupport@aetna.com Mail: Broker Services Department Aetna, Inc. 2222 Ewing Road Moon Township, PA 15108 In addition to a written request, the client is able to call the member services number on the back of their ID card to request this change.
ANTHEM MEDADV & PART D as of 3/1/2021	When writing a Plan Change eff 3/1/2021 or after, you will be automatically designated as AOR.	NO FORM	NO			The effective date for the AOR change will match the effective date of the plan change. AOR change requests submitted apart from a plan change will not be accepted for Med Adv & Part D business. As of 3/31/21
ANTHEM MEDSUPP & EXTRAS	YES	NO FORM	YES	Members info, signed & dated. Include new agent name & encrypted ID	E-mail (Recommended): Senior_salescomp@anthem.com Fax: 818-234-1358	Med Supp & Extras will still require a signed hand-written letter from the member.
BCBSRI	NO	N/A	N/A	N/A	N/A	N/A
CPCT	YES at CPCT discretion	YES	NO	N/A	Email to: CPCTBrokerSupport@CarePartnersCT.com	CPCT will review and follow up with the client requesting agent change before assigning any change.
CTCARE	NO	N/A	N/A	N/A	N/A
EMBLEM	NO	N/A	N/A	N/A	N/A
FALLON	YES	YES – BOR FORM AVAILABLE FOR DOWNLOAD ON THE FALLON WEBSITE	NO	N/A	E-Mail to: MedicareSalesBrokers@fallonhealth.org
HEALTH NEW ENGLAND	YES	YES	NO			HNE accepts one change per calendar year, and will only process this change on January 1st of the following year. HNE does have a specific HNE Agent of Change form. Request as needed.
HPHC STRIDE	YES	YES	NO	N/A	E-mail to: broker_relations@harvardpilgrim.org	Only accepts Harvard Pilgrim BOR form
HUMANA	N/A	N/A	NO	N/A	Member can call Member Services at 1-800-457-4708 to speak wit Rep about their options	Humana will only accept Agent Business Transferal Form Submissions
MUTUAL OF OMAHA	NO	N/A	N/A	N/A	N/A
OPTIMA	NO	NO FORM after 8.1.21	YES, request must be initiated by member from his/her own email address. Agents cannot submit BOR changes on behalf of member or sign a pre-written doc of any kind.	Date, member’s full name, policy# or dob, agent name, a statement indicating they wish for new agent to represent them.	Email: MABrokerSupport@optimahealth.com or Fax: 1-866-700-1852 ATTN: MA Broker Support.
TUFTS	NO	N/A	N/A	N/A	N/A
UHC	NO	N/A	NO	N/A	N/A	Agent can submit an AOR appeal via email to phd@uhc.com
WELLCARE	YES	NO	YES	Date, agent name & ID, Member name, ID, MBI# & signature	Agent can submit through Agent Connect Portal by a Support Ticket	BOR requests can be submitted by Garity office to our WellCare contact (BORs will not be processed during AEP)

2022 CODED ENROLLMENT FORMS

CARRIER	PLAN TYPE	CODED – (AS OF 2020)	CAN A PDF OF THE APPLICATION BE DOWNLOADED/SAVED?
AETNA	MAPD/PDP	NO	YES
ANTHEM	MAPD/PDP	NO	YES
BCBSRI	MAPD/PLAN65/PDP	NO	YES
CCA		NO	YES
CLOVER		NO	YES
CPCT	MAPD/PDP	NO	YES
CTCARE		NO	YES
EMBLEM	MAPD	NO	YES
ETERNAL		NO	YES
FALLON	MAPD/PDP	NO	YES
FALLON NAVICARE	SCO	NO	YES
HEALTH NEW ENGLAND		NO	YES
HPHC STRIDE	MA	NO	YES
MASS ADVANTAGE		NO	YES
HUMANA	MAPD/PDP	NO	YES
MOLINA		NO	YES
MUTUAL OF OMAHA PDP	PDP	NO	YES
OPTIMA		NO	YES
TUFTS		NO	YES
UHC	MAPD/PDP/SCO	NO	YES
VA PREMIER		NO	YES
WELLCARE	MAPD/PDP	NO	YES

NO MEDICARE SUPPLEMENT APPLICATIONS ARE CODED

CARRIER PCP RULES FOR 2022 ENROLLMENTS

CARRIER	PCP NAME REQUIRED?	PCP ID # REQUIRED?	IMPORTANT INFORMATION
AETNA	Preferred but not required	Preferred but not required	PCP may be auto assigned if none listed
ANTHEM	REQUIRED FOR HMO & DSNP PLAN	REQUIRED FOR HMO & DSNP PLAN	Not required for PPO plans
BCBSRI	REQUIRED FOR HMO PLAN	Not required	NO PCP REQ FOR HEALTHMATE PLAN. IF NO PCP LISTED FOR HMO BC WILL AUTO ASSIGN
CCA	PCP info optional, per app.	PCP info optional, per app.
CLOVER	PCP info optional, per app.	PCP info optional, per app.
CPCT	Preferred but not required for HMO and PPO	Not required	If no name listed, PCP will be auto assigned
CTCARE	YES	YES	NOT REQUIRED IF NOT AN HMO PLAN
DENVER HEALTH	PCP info optional, per app.	PCP info optional, per app.
EMBLEM	YES	YES	PCP & ID REQUIRED even if not an HMO
ETERNAL	PCP info optional, per app.	PCP info optional, per app.
FALLON	Preferred but not required	Not required
HEALTH NEW ENGLAND	YES	Not required	PCP not required for new PPO product
HPHC STRIDE	YES	YES
HUMANA	Required on HMO, LPPO, some RPPO	Required on HMO, LPPO, some RPPO	Not required for PFFS plans
MASS ADVANTAGE	PCP info optional, per app.	PCP info optional, per app.
OPTIMA	Not required	Not required	If no name or ID# listed, PCP will be auto assigned
TUFTS	YES	YES
UHC	Preferred but not required	Preferred but not required	UHC will auto assign network PCP if none listed. PPO apps will still be auto assigned a PCP, but are free to see any PCP they choose.
WELLCARE MAPD	YES	YES
STAND-ALONE PDP PLANS	A PCP is not required on ANY Stand-Alone PDP plans	A PCP is not required on any Stand-Alone PDP plans	A PCP is not required on any Stand-Alone PDP plans

RxBIN.PCN #'s

THIS INFORMATION IS ONLY TO BE PROVIDED TO A CLIENT IF THEY NEED TO PICK UP THEIR PRESCRIPTIONS, BUT HAVE NOT YET RECEIVED THEIR MEMBER ID CARD IN THE MAIL. BEFORE PROVIDING THIS INFORMATION TO ANY CLIENT PLEASE BE SURE THEY UNDERSTAND THAT THEY MUST BE CURRENTLY ACTIVE/ENROLLED WITH THE CARRIER & KNOW WHAT THEIR CARRIER MEMBER ID NUMBER IS, IN ORDER FOR THESE NUMBERS TO BE ACCEPTED BY THE PHARMACY.

CARRIER	Plan Type	RX PCN	RX BIN	RX GROUP
AETNA	MAPD	MEDDAET	610502	RxAETD
	PDP – SILVERSCRIPT	MEDDADV	4336	RXCVSD

ANTHEM	MAPD
	MA ONLY
	STAND-ALONE PDP
	DSNP
	MAINECARE

BCBSRI	PPO	BCRIMA	6104555	BCRIMA2
	BLUECHIP	BCRIMA	610455	BCRIMA
	GROUP BLUECHIP	BCRIMAG	610455	BCRIMA

CPCT	MAPD-HMO	MEDDADV	004336	RX8659
	PPO	MEDDADV	004336	RX8752

CTCARE	Part D	MEDDPRIME	610014	NKYA
CTCARE	Part B	A4	003858	TKYA

CLOVER

DENVER HEALTH

EMBLEM				EMBLEM CANNOT PROVIDE

ETERNAL

FALLON	MAPD

HEALTH NEW ENGLAND		HNEMEDD	610593	HNEMEDD

HPHC STRIDE	MA only	03200004	610649

HUMANA	MAPD	03200000	015581	N/A
	STAND-ALONE PDP	03200000	015581	N/A

UHC	MAPD	9999	610097	REFER TO ENROLLMENT RECEIPT, LOCATED IN BACK OF 2022 ENROLLMENT GUIDE, FOR EACH SPECIFIC PLAN
	STAND ALONE PDP	9999	610097	REFER TO ENROLLMENT RECEIPT, LOCATED IN BACK OF 2022 ENROLLMENT GUIDE, FOR EACH SPECIFIC PLAN
	DSNP	9999	610097	REFER TO ENROLLMENT RECEIPT, LOCATED IN BACK OF 2022 ENROLLMENT GUIDE, FOR EACH SPECIFIC PLAN

WELLCARE	MAPD			not available yet for 2022
	STAND-ALONE PDP
	DSNP

NEW MBI # RULES

CARRIER	OPTION 1	OPTION 2	IMPORTANT REMINDERS

AETNA	We would advise having the correct Medicare Number prior to submitting an enrollment, fake/incorrect MBIs can cause issues/delays with enrollment.	If a client doesn’t have their Medicare Number or has lost their card, they can access their Social Security account at https://secure.ssa.gov/RIL/SiView.action to obtain this information.

ANTHEM	Contact Medicare Agent Support to search for MBI on medicare database. Can be used for new MBI, or existing (lost card).

BCBSRI	App can be submitted with SSN and the application will pend for 21 days till the MBI can be verified.	Submit with SSN and the bcbsri enrollment team can look up member MBI with SSN for verification.

CPCT	Have broker contact 860-996-7096, we can retrieve that information

CTCARE	Use SSN if MBI not available, then contact carrier when MBI available.	For lost cards, Broker Support can be contacted & look up the MBI

EMBLEM	Per Emblem: they can lookup MBI with client name, DOB & SSN.

FALLON	Fallon is requiring the client’s MBI # in order for them to enroll the member. Now that the HICN #’s are no longer searchable in MARX they can no longer process the applications unless the MBI # is provided.	If the MBI # is not noted on the application, or if the client’s HICN # is used, Fallon will send an E5 letter (missing information) to the client. The client will need to provide their MBI # within 21 days or Fallon will reject their enrollment. If the MBI # is not available at the time the broker takes an application it is strongly encouraged that they follow-up with their clients & obtain their MBI #, so they can provide it to Fallon within 21 days & ensure their member will be enrolled. This information can be sent to MedicareSalesBrokers@fallonhealth.org

HEALTH NEW ENGLAND

HPHC (Stride & Supp)	The New Medicare Card Project transition period is scheduled to end on December 31, 2019. When the transition period ends, the MARX system will only accept the MBI #’s. Plans will no longer be able to use/view the HICN’S for MARX batch processing, nor for the display of information on the MARX User Interface. If a carrier submits a HICN # after the transition period has ended, the transaction will reject with an invalid Beneficiary ID response.	***HPHC will not stray from CMS’ rules, which are noted in the previous column.	2021 New MBI is required. Under some circumstances the agent can ask HPHC for assistance for MBI lookup by providing clients name, DOB and SSN.

HUMANA	Beginning January 1, you must use the new MBI number on all Medicare applications. Electronic applications will be locked down to only accept the new MBI. If you submit a paper application with a client’s HICN # it will cause an error. Humana will attempt to obtain the client’s MBI # via current outreach processes during the grace period. If the MBI is not received within their grace period the application will be denied. Using the wrong number could also result in the system assigning that enrollment to the wrong member which would lead to a bad consumer experience and potential CTM complaints.	2022 UPDATE: Call and obtain the MBI from Agent Support with the client’s first and last name, DOB, and SSN. 1-800-309-3163

UHC	With client’s permission they can call the Eligibility Line at 888-381-8581 option 2	Will need clients first, last name, DOB, old HICN or SS#, and complete address that Medicare has on file, along with plan they are writing, election period and date they rec’d permission to place the call.	UHC can provide new MBI# and Part A & B dates and even LIS/MCD eligibility

WELLCARE	CMS issues a temp MBI, the application will go into RFI status waiting for the correct/permanent MBI number

Q: What SEP should be used when a client’s current Medicare Advantage plan is being terminated in their county?
Q: What SEP should be used when a client is coming off their employer/group plan or their spouse’s employer/group plan (voluntarily or non-voluntarily)?
Q: What do I do if I am unsure of which election to use?

A: If you are not sure of what election you should be using, please refer to the Election Period Guidelines. If you are still unsure, call or email our enrollment department and we will be happy to assist you. It is never a good idea the “guess” what the election type is. If the wrong election is chosen the application can be denied by the carrier and a new application may be required to proceed.
Q: What about Scope of Appointment Changes?

CMS added requirements to the Scope of Appointment (SOA) regulation in 2011.

In addition to retaining a copy, agents will be required to fax or email a copy of the SOA directly to the Carrier. View SOA Rules.

All agents are required to fill out SOA forms and send them to the carriers prior to meeting with consumers– If it is not feasible for the scope of appointment form to be executed prior to the appointment, an agent may have the beneficiary sign the form at the beginning of the marketing appointment. However, the agent must document why it was not feasible to obtain the scope of appointment prior to the appointment. *Applies to all Scope of Appointment forms.

The Scope of Appointment Form is required for cancelled appointments, no-shows, appointments not resulting in an enrollment, etc.
Q: What is the average time for Medicare Supplement enrollments to become active?
Q: How do I submit Medicare and PDP enrollments?
Q: How do I submit Medicare Supplement enrollments?

No Live Check Live Check Mail

All Carriers Except HPHC Fax or Email Mail Y

HPHC Fax or Email N/A* N

* Please fax or email all your HPHC Medicare Supplement applications directly to our office to be processed. HPHC does not accept collection of first month’s premiums with their Medicare Supplement applications, members are billed after enrollment approval.

Medicare Advantage / PDP Enrollment Submission Chart

PRODUCT ENROLLMENT TYPE	EMAIL	FAX OK	ORIGINALS NEEDED (Must Mail)
HMO-HMO/POS	YES	YES	NO
RPPO	YES	YES	NO
PDP	YES	YES	NO
SCO	NO	NO	Original PSI Form Only

Medicare Supplement Enrollment Submission Chart

	No Live Check	Live Check	Mail
All Carriers Except HPHC	Fax or Email	Mail	Y
HPHC	Fax or Email	N/A*	N

* Please fax or email all your HPHC Medicare Supplement applications directly to our office to be processed. HPHC does not accept collection of first month’s premiums with their Medicare Supplement applications, members are billed after enrollment approval.