FAQS

Where to Submit Enrollments*:
Via the Agent Dashboard
Log in to our Agent Dashboard to Upload and Track your enrollments. Watch the video to learn how.

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 – ONLY REQUIRED WITH LONG FORMS & PDP’S	YES	YES	***SOA IS NOT REQUIRED TO BE SUBMITTED WITH PLAN CHANGE FORMS OR PLAN65 FORMS
CPCT	YES	YES	YES	ALTHOUGH THEY PREFER TH CPCT SOA FORM IS USED THEY WILL NOT REJECT ANOTHER SCOPE, SO LONG AS IT IS CMS APPROVED
EMBLEM	YES	YES	NO
FALLON	YES	YES	NO
FALLON NAVICARE SCO	YES	YES
HPHC STRIDE	NO**	YES	YES	**HPHC Stride does not require the SOA to be submitted with the applications, but all agents are required to keep a copy of the SOA Forms for 10 years.
HUMANA	YES UNLESS THE AGENT NOTES THEY HAVE ALREADY SUBMITTED IT DIRECTLY TO HUMANA	YES	YES	**IF NO SOA IS ATTACHED & THE AGENT DID NOT SPECIFY IT WAS SENT DIRECTLY THEY WILL NEED TO BE CONTACTED TO CONFIRM WHY NO SCOPE IS ATTACHED.
UHC	NO**	YES	NO	**UHC NO LONGER WANTS/NEEDS A COPY OF THE SOA FORMS, BUT AGENTS ARE REQUIRED TO OBTAIN A COPY (FOR THEIR RECORDS) FOR AT LEAST 10 YEARS.
WELLCARE	YES	YES	YES

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	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

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
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	YES – ONLY REQUIRED ON HMO & SNP HMO PLANS	YES – ONLY REQUIRED ON HMO & SNP HMO PLANS	THE PCP INFORMATION IS NOT REQUIRED FOR PPO PLANS
BCBSRI	YES – BUT IF AUTO-ASSIGN IS NOTED THE APP CAN BE SUBMITTED “AS IS”	NO – THERE IS NO PLACE ON APP TO NOTE A PCP ID #	DO NOT SUBMIT IF PCP SECTION IS BLANK / APP CANNOT BE SUBMITTED WITHOUT A PCP NAME OR AUTO-ASSIGN NOTED
CPCT	YES	NO	ALTHOUGH THE PCP ID # IS ENCOURAGED IT IS NOT REQUIRED
EMBLEM	NO	N/A
FALLON	YES	NO
FALLON NAVICARE	YES	NO
HPHC STRIDE	YES	YES	NO
HUMANA	YES PLEASE SEE ADDITONAL NOTES (IMPORTANT INFORMATION COLUMN) REGARDING PPO PLANS**	YES PLEASE SEE ADDITONAL NOTES (IMPORTANT INFORMATION COLUMN) REGARDING PPO PLANS**	ALL HMO PLANS REQUIRE PCP AND PCP ID#. SOME PPO PLANS MAY REQUIRE A PCP AND PCP ID#. (Refer to Summary of Benefits to determine if plan requires a PCP).
UHC	YES	YES	IF THE AGENT NOTES, IN WRITING, THAT THE CLIENT IS AWARE THAT THEIR PCP IS NOT IN NETWORK THEN THE ENROLLMENT CAN GO “AS IS”
WELLCARE MAPD	NO	NO
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

Q: What SEP should be used when a client’s current Medicare Advantage plan is being terminated in their county?

A: SEP- TERMINATED/NON-RENEWAL
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)?

A: SEP – LEC (Loss of Employer Coverage)
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?

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.
Q: How do I submit Medicare and PDP enrollments?

SEE CHART BELOW

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).
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)

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	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.