Update: Electronic payments for large-group commissions

ConnectiCare is shifting electronic large-group sales commission payments from one bank to another. (See last month's SalesCall for a recap.)

To make sure brokers are paid on time, we will send September’s commission payments as paper checks in the mail for large-group sales (new business and renewals) with effective dates of Aug. 1 and Sept. 1. Note: You may receive multiple checks – one for each underwriting entity of products sold (e.g., CCI HMO, CICI PPO).

This does not affect commissions associated with business effective before Aug. 1, 2020 or for groups that have not yet transitioned based on the schedule shared in the June issue of SalesCall. Brokers will continue to receive EFT payments for that business.

We apologize for the inconvenience. Electronic payments will resume in October for new business and renewals effective Aug. 1, 2020 and later.

Commission statements on our secure website

Broker commission statements in September will be available on our website after Sept. 30, when we plan to launch our new secure broker website.

Remember, to ensure successful sign-in when the website is launched, we need you to update your email address and mobile phone number. Sign in now and follow the prompt to make these updates. If possible, please do this by Tuesday, Sept. 1, 2020.

Express Scripts now responsible for commercial drug utilization management

Express Scripts (ESI), ConnectiCare’s pharmacy benefit manager, assumed utilization management for most drugs for ConnectiCare commercial plan members, including members enrolled through Access Health CT, on Aug. 3, 2020.

Providers now submit requests for preauthorization, quantity limits, and step therapy for commercial members to ESI. Note: This does not apply to Medicare pharmacy utilization management requests or adult chemotherapy and supportive agents. There are no changes for these services.

ESI lets our providers submit preauthorization requests electronically, which is the fastest way to get approval. This means our members, your clients, can get the drugs their doctors prescribe sooner.

Updated information on changes for large-group employers

Here is updated information to share with your large-group clients on changes they can expect as they renew. These changes will also be in effect for new groups as they enroll.

Administrative services only (ASO) groups

Fully-insured groups

No-cost benefit changes and extensions for Medicare Advantage members

Here is an overview of benefit extensions to help our Medicare Advantage members stay well during the public health crisis:

Primary and behavioral health care – Medicare Advantage members can visit in-network primary care providers (PCPs) and in-network behavioral health clinicians for covered services in person or using telehealth from Aug. 1, 2020 through Dec. 31, 2020 at no cost.*

Telemedicine - Members whose plan benefits include Teladoc^® telemedicine visits will also have no cost share for Teladoc services through Dec. 31, 2020.

Medical specialist care – Medicare Advantage members can continue telehealth visits with medical specialists for covered services without a cost share through Sept. 9, 2020. After that date, members will be responsible for cost shares for medical specialist visits that take place through telehealth.*

COVID testing coverage – Visits, including telehealth visits, by Medicare Advantage members for a COVID-19 test continue to have no cost share for both in-network and out-of-network health care providers through the declared national public health emergency. Members also have no cost share for the lab test during the public health emergency.

We hope that providing no-cost visits to in-network primary care doctors will encourage members to get needed preventive care, medication management, screenings, and immunizations, including the flu shot.

NOTE: Members with a Choice Dual (HMO-DSNP) plan already have no cost-share responsibility for services covered by their plan. Providers who accept this plan are directed to bill Medicaid for costs not covered by the members’ Choice Dual plan.

Please share these benefit extensions with your Medicare Advantage members and encourage them to take advantage. The information is currently available on our website. We will also share it with members in the next Housecall email and in the printed Housecall newsletter slated to be in members' homes next month.

*This assumes the Centers for Medicare & Medicaid Services will continue to allow health plans to adjust benefits mid-year during the public health emergency. As a result, the end date of the waiver is subject to change.

Pharmacy network changes for Medicare Advantage

We’re making some updates to our pharmacy network, effective Jan. 1, 2021. The changes will only affect a few hundred ConnectiCare Medicare Advantage members. Express Scripts, our pharmacy benefit manager, will send letters to affected members with the names of alternative network pharmacies and information on how they can get their medications filled at a new pharmacy.

Materials available for virtual Medicare Advantage enrollment sessions

The coronavirus (COVID-19) outbreak is making it hard to meet with seniors in person. That means enrollment will look different this year. We’re here to help. Use our digital and interactive sales and enrollment materials to host virtual meetings this year. Talk to your account manager today for information on the print and digital assets available to help you grow your business.

New secure broker website launching at end of September

We depend on you, and you depend on us to make it easy to quote business, help your customers, track your commissions, and more. Coming soon: a better way to do all that.

Launching at the end of September will be a new secure website for brokers. It will let appointed brokers:

Be ready…

To sign in as soon as the new site is up and running. Update your email address and mobile phone number now by signing in and following the prompt. Please do this by Tuesday, Sept. 1, 2020.