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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 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-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 | (877) 270-4084 | 30 | |
| Cigna-Med Supp | (877) 704-8186 | 30 | |
| Combined-Med Supp | (866) 545-8076 | 30 | |
| Emblem Health | (866) 890-7722 | 3 | |
| Fallon | MedicareSalesOperations@fallonhealth.org | 3 | *Must be received, by the carrier, prior to the requested effective date. |
| Fallon BOR Change | MedicareSalesOperations@fallonhealth.org | 3 | *Must be received, by the carrier, prior to the requested effective date. |
| HPHC- Med Supp | Medicarebroker@Harvardpilgrim.org | 20 | *Must be received by the carrier no later than 7 days after the requested effective date |
| HPHC- STRIDE | Strideenrollment@harvardpilgrim.org | 3 | |
| Humana | (877) 889-9936 | 3 | |
| 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 | |
| WellCare | (866) 473-9124 | 3 | |
| WellCare BOR Change | (866) 473-9124 | 3 | *Must be received, by the carrier, prior to the requested effective date. |
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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 NO 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 EMBLEM YES YES YES FALLON YES YES 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 HUMANA YES YES *SEE NOTE YES If generic SOA form used, agent must be able to produce the document upon request and retain copies for 10 yrs MUTUAL OF OMAHA NO YES FAX SOA TO 402-599-5822 TUFTS YES YES YES UHC NO WELLCARE YES YES NO
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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 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 E-mail (Recommended): Senior_salescomp@anthem.com
Fax: 818-234-1358
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
no change
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 YES NO N/A Email to:
CPCTBrokerSupport@CarePartnersCT.comEMBLEM NO N/A N/A N/A N/A FALLON YES YES – AVAILABLE FOR DOWNLOAD ON THE FALLON WEBSITE NO 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 HEALTH NEW ENGLAND 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 Only accepts Harvard Pilgrim BOR form HUMANA N/A N/A NO N/A N/A Humana will only accept Agent Business Transferal Form Submissions MUTUAL OF OMAHA NO N/A N/A N/A N/A 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 & signature
Agent can submit through Agent Connect Portal by a Support Ticket BOR requests can be submitted by Garity office to our WellCare contact
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CARRIER PLAN TYPE CODED – (AS OF 2020) CAN A PDF OF THE APPLICATION BE DOWNLOADED/SAVED? AETNA MAPD/PDP YES NO ANTHEM MAPD/PDP NO YES BCBSRI MAPD/PLAN65/PDP NO YES CPCT MAPD/PDP NO YES EMBLEM MAPD NO YES FALLON MAPD/PDP NO YES FALLON NAVICARE SCO NO YES HEALTH NEW ENGLAND HPHC STRIDE MA YES NO HUMANA MAPD/PDP YES NO UHC MAPD/PDP/SCO NO YES WELLCARE MAPD/PDP NO YES NO MEDICARE SUPPLEMENT APPLICATIONS ARE CODED
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CARRIER PCP NAME REQUIRED? PCP ID # REQUIRED? IMPORTANT INFORMATION AETNA YES – for HMO plans YES – for HMO plans For HMO plans that require referrals the PCP Info is Required. For Open Access HMO plans & PPO plans the PCP Info is not required but strongly recommended. 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 CPCT Preferred but not required Not required If no name listed, PCP will be auto assigned EMBLEM YES YES PCP & ID REQUIRED even if not an HMO FALLON Preferred but not required Not required FALLON NAVICARE SCO HEALTH NEW ENGLAND Preferred but not required Not required HPHC STRIDE YES YES HUMANA Required on HMO, LPPO, some RPPO Required on HMO, LPPO, some RPPO Not required for PFFS plans TUFTS YES YES UHC REQUIRED ON HMO APPS REQUIRED ON HMO APPS RECOMMENDED ON ALL MA/MAPD & SNP APPS 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
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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 AETNA CANNOT PROVIDE PDP – SEE SILVERSCRIPT ANTHEM MAPD IS 020115 WM2A 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 EMBLEM EMBLEM CANNOT PROVIDE FALLON MAPD HEALTH NEW ENGLAND HPHC STRIDE MA/MAPD not available till 10/15/2020 HUMANA MAPD N/A STAND-ALONE PDP N/A SILVERSCRIPT PDP UHC MAPD 9999 610097 REFER TO ENROLLMENT RECEIPT, LOCATED IN BACK OF 2020 ENROLLMENT GUIDE, FOR EACH SPECIFIC PLAN STAND ALONE PDP 9999 610097 REFER TO ENROLLMENT RECEIPT, LOCATED IN BACK OF 2020 ENROLLMENT GUIDE, FOR EACH SPECIFIC PLAN DSNP 9999 610097 REFER TO ENROLLMENT RECEIPT, LOCATED IN BACK OF 2020 ENROLLMENT GUIDE, FOR EACH SPECIFIC PLAN WELLCARE MAPD not available yet for 2021 STAND-ALONE PDP DSNP
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CARRIER OPTION 1 OPTION 2 IMPORTANT REMINDERS AETNA If the MBI # is not known the Medicare section of the application should be left blank. Aetna does not want the client’s HICN #’s noted on their enrollments, due to it will slow down the process of identifying the client’s MBI #. When the Medicare section of the enrollment is left blank Aetna will automatically mail a letter to the client, along with their policy information, asking them to verify their MBI #. ANTHEM If you send an application in with the Medicare section left blank they will pend the application for 21 days in their system. As soon as the client’s MBI # is obtained the agent must call into Broker Support so the client’s file can be updated and the application sent for processing. BCBSRI If the enrollment is submitted without the MBI #, or in the old HICN format, the enrollment will go into pending status. A letter will then be mailed to the applicant to provide BCBSRI with their MBI #. The application will only remain in pending status for 21 days, from the date it was received. within 10 days of receipt of enrollment, BC will notify us unless they can obtain the missing information thru CMS systems CPCT Have broker contact 860-996-7096, we can retrieve that information 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. Procedure same as 2020 per Humana UHC with clients 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 All applications must contain the client’s MBI # in order for the enrollment to be processed. If the client’s HICN or SSN is used WellCare will not process the application. SPOP (Special Populations team can verify Caid eligibility and provide assistance with MBI#. 866-211-0544
FAQs
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A: SEP- TERMINATED/NON-RENEWAL
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A: SEP – LEC (Loss of Employer Coverage)
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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.
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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.
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A: Med Supplement applications are mailed into the carriers and it takes up to 10 business days, from the day of receipt of the application at the carrier’s home office, for the processing to be completed.
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If the enrollments are listed as accepted by email or fax this is the preferred method!
Once you have emailed or faxed an enrollment please DO NOT SEND IN ORIGINALS (this can cause duplication and delay the processing of the first enrollment submitted). -
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. -
UnitedHealthcare Medicare Advantage and PDP applications have an additional agent received date “signature date” that must be completed.
Medicare Advantage / PDP Enrollment Submission Chart
PRODUCT ENROLLMENT TYPE | FAX OK | ORIGINALS NEEDED | |
| 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 | ||
| All Carriers Except HPHC | Fax or Email | 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.