Author Archives: Reeve Conover

New Medicare Cards introduced

To address the risk of medical identity theft, Section 501 of Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) mandates the removal of the Social Security Number (SSN)-based Health Insurance Claim Number (HICN) from Medicare ID cards.

The Centers for Medicare and Medicaid Services (CMS) uses HICN with multiple parties including Medicare providers and plans. Security for Medicare members should be strengthened by using an ID number that does not contain the member’s SSN.

Timing
CMS will mail new Medicare ID cards from April 1, 2018 through April 1, 2019. The HICN, which contains the SSN, will be replaced with a Medicare Beneficiary Identifier (MBI).

Note:  UnitedHealthcare does not use SSNs or HICNs on our health plan ID cards and will not be sending new cards; UnitedHealthcare plan ID cards for active employee or retiree members will not change.

Impact to Employers
Employers do not need to make any changes unless they capture and use the Medicare HICN for active employees or retirees.

Impact to Medicare Beneficiaries
Medicare beneficiaries who have a Medicare ID card will see the new number used on Medicare-related documents.

Annual Medicare Part D Notification Requirements

Every year groups are required to notify anyone that is Medicare-eligible regarding if the prescription plan they provide meets Medicare Creditable Coverage requirements.

Language from the notification memo from CMS is below.

Notification needs to go to Medicare eligible members by October 15th.  Additionally, you must go the CMS site each year and report on your plan.  Use the link below for more information and helpful links.

Here is the CMS notice in part:

Reminder – Medicare Part D Employer Notification Requirements

Update 09/22/17: The Medicare and You 2018 handbook is now available.
The 2018 Annual Election Period (AEP) for Medicare Part D begins October 15, 2017 and ends December 7, 2017.
The Medicare Modernization Act of 2006 provides access to prescription drug coverage to all Medicare-eligible persons under Medicare Part D. Plan sponsor notice regarding the organization’s prescription benefits must be provided to any Medicare-eligible person whether due to age or disability and is required for employees, spouses, dependents, those on Federal COBRA or New York, New Jersey, Pennsylvania, and Delaware continuation including retirees. Notice must be provided before Open Enrollment begins.

Employees will use that information to help them formulate their personal decision of whether or not they will enroll in Medicare Part D prescription coverage outside of the employer plan. This decision is critical as penalties apply when Part D is not timely in place.
Medical insurance carriers typically notify policyholders regarding the Creditable versus Non-Creditable status of the prescription coverage plan. It is the plan sponsors’ (typically the employer) responsibility to notify their groups’ members.

Please keep in mind that this determination is the employer’s responsibility when the employer is the plan sponsor. If the carrier states that the health plan is non-creditable, the benefits may still be creditable if the employer has an HRA arrangement. The employer would have to override the carrier notice. Therefore, it is the employer’s responsibility to examine all of the benefits that the employer is providing and determine the creditability of the prescription coverage. The carrier is only providing notification regarding the creditability of the coverage that the carrier provides.

Enrollment Period Dates for “ObamaCare”

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States using the Federal Enrollment platform, healthcare.gov, only have from November 1 – December 15 to enroll this year.  No “late stragglers” will be allowed, unlike prior years.

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Emblem Health increases small group network

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Beginning January 1, Emblem will change small group plans to its new, larger PRIME network. 

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Formulary Exclusions for 2018… Was your drug dropped?

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An article in LowestMed this past month claims that 60 medications are being dropped from various formularies in 2018. 

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Reeve Conover is a Registered Representative. Securities offered through Cambridge Investment Research, Inc., a Broker/dealer member FINRA/SPIC. Cambridge and Conover Consulting are not affiliated. Licensed in SC, NC, NY, CT, NJ, and CA.
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