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:
- Enrollment Fax Cover Sheet
- Generic Scope of Appointment Form w/ Hospital Indemnity
- Election Period Booklet (2019/2020)

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.

2020 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	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

2020 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- 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 REQUEST	1. 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	NO FORM	YES	Members info, signed & dated. Include new agent name & encrypted ID	E-mail (Recommended): Senior_salescomp@anthem.com Fax: 818-234-1358
BCBSRI	NO	N/A	N/A	N/A	N/A	N/A
CPCT	YES	YES	NO	N/A	Email to: CPCTBrokerSupport@CarePartnersCT.com
EMBLEM	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			NO	N/A
MUTUAL OF OMAHA	NO	N/A	N/A	N/A	N/A
TUFTS	NO	N/A	N/A	N/A	N/A
UHC	YES	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

2020 CODED ENROLLMENT FORMS

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

CARRIER PCP RULES FOR 2020 ENROLLMENTS

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

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			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

NEW MBI # RULES

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

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.
Q: What's NEW for 2019? (UHC)

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.