Dear broker,
The back-and-forth nature of a Wisconsin spring is upon us! Hang in there - the snow that some of us got last week has all but disappeared and we are gearing up for a great spring season.
Make sure you take note of the Medication Therapy Management resources that will be coming your way in the next month or so - this FREE service for Security Health Plan members can save employers and their employees money by catching prescription medication challenges before they turn into hospital stays, unnecessary costs or ER visits.
Refresh your memories about our new level-funded plans and how beneficial they can be for employers with 10-100 enrollees.
Have you taken advantage of the 2021 agent incentive program yet? It's still happening and you've got a chance to earn an additional 25% or 50% on top of your per contract rate.
And, for IFP brokers, please read the important information about how the recently passed American Rescue Plan Act will affect your individual and family plan clients.
Chris D. Bruni
Vice president of sales strategy
Security Health Plan
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 Health care for teens gets a boost from grant award
"One of my priorities is for the child who does not have a voice, who can't take care of him or herself in an abusive situation," Carolyn Nash, MD, Pediatrics, Marshfield Clinic Health System, said. "As a pediatrician who works with suspected victims of abuse and neglect, I view positive relationships with health care providers as key to their well-being."
Dr. Nash is also a member of the Providers and Teens Communicating for Health (PATCH) Central Wisconsin Community Advisory team. PATCH is a youth-driven program that works to improve the health and well-being of teens. There are PATCH organizations throughout the United States, including three in Wisconsin. Dr. Nash works with the Central Wisconsin chapter based out of Wausau.
PATCH works with schools and organizations to educate, engage and empower young people to take control of their health. They do this by cultivating a panel of 10-12 high school students between the ages of 14 and 18, who will work with the organization for a year-long commitment as a teen educator. Security Health Plan of Wisconsin, Inc., will invest $1,000 in PATCH Central Wisconsin as part of its Employee-Driven Corporate Giving grant program. Dr. Nash nominated PATCH for the grant in 2020.
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 Employer |
Join us in showcasing cost savings and better health employers can realize from using Medication Therapy Management
Security Health Plan is developing several helpful informational resources for employers around the topic of Medication Therapy Management (MTM). We'll be sharing them with employers and with you to help everyone learn more about this great, free service that is available to all Security Health Plan members on plans that include pharmacy benefits.
MTM is a program where our experienced, local pharmacists conduct a 10-15 minute annual medication review over the phone with a member to review their current medication regimens. This review can help find lower-cost drug alternatives, identify duplications or harmful drug reactions, help members stay organized with their medication schedule and answer any questions about prescriptions and over-the-counter drugs.
Over the next month we will have the following items ready for use:
- Article copy employers can use in their newsletters or in an email to their employees, including the phone number for medication review that a member can call to initiate it
- Link to a YouTube video describing Security Health Plan's MTM service
- Social media post templates
- PDF handout for employers
- Security Health Plan hosted Lunch and Learn session for employees with PowerPoint slide deck
- Refreshed talking points document
When we meet with employers to review their Employer Group Reports in April, we'll talk about MTM and the ways we can help them encourage their employees to take advantage of this free service.
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SPH Analytics may be calling your Security Health Plan clients
SPH Analytics is the name of the new company that will begin conducting market research on behalf of Security Health Plan later this spring. They will be conducting outbound calls to members and non-members. They survey consumer perceptions about Security Health Plan. Our Net Promoter Score is derived from these survey results - based on the member's likelihood of recommending the Health Plan to family and friends. We have conducted this survey on a quarterly basis for the past few years.
This means your clients may receive phone calls from SPH Analytics related to this research. SPH Analytics is highly regarded for its health insurance market research nationwide, and is a trusted business partner of Security Health Plan. You can reassure your clients that they can answer those calls confidently.
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Level-funded plans are a smart choice for your clients
Level-funded plans offer the best of a traditional fully-insured plan and a self-insured plan.
Preliminary rates are now available! We've made the process easier to request a quote. For details on what's needed for a preliminary level-funded quote click here.
Level-funded plans have many advantages for your clients including:
- Predictable monthly cost
- Opportunity for refunds
- Protection against catastrophic expenses with stop-loss coverage
- Transparency on how dollars are spent
Level-funded plans also come with either our HMO or POS network - giving your clients access to some of the best providers in our region.
Need a refresher on how level-funding works? These plans have a set, or level, monthly cost throughout the year that consists of three categories.
After the end of the year, if the claims, costs and expenses are less than the employer's contribution for the year, they may be eligible to receive a refund. However, if the total claims, costs, and expenses are more than their contribution, Security covers the shortfall. The greater financial predictability and lower dollar threshold makes level funding a great option for your clients.
Please contact your account manager or MDM for more details on level-funded plans.
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ID cards mailed to subscribers' homes is a permanent change
Last year, due to the COVID-19 pandemic, we changed our ID card mailing process to only send ID cards to the subscriber's home address. In the past, employers could choose to have ID cards delivered to the business address instead. Our new process has gone smoothly over the past nine months, and we will be making this change permanent. All self-funded and fully insured group subscriber ID cards will continue to be mailed only to the subscriber's home address.
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How is the incentive program going for you?
Have you started working toward redeeming your additional 25% on top of your per contract rate as part of our new 2021 agent incentive program?
Remember - once you sell three new fully insured, self-funded or level-funded employer groups with Security Health Plan, you are eligible. The new employer groups must have an effective date between January and December of 2021.
Starting with your fourth group, you will earn an additional 25% on top of your per contract rate for new employer groups in 2021. Starting with your 10th new employer group, you will earn an additional 50% on top of your per contract rate.
New employer groups added to co-op arrangements are included in the program. The agent incentive program is effective for one year from insurance coverage start date.
Contact our sales team to start quoting groups today! And download the broker quoting checklist to help you gather the items you need.
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Monthly deadline for renewal paperwork
Employer groups must return renewal documents by the 15th of the month before the renewal effective date.
If the deadline has passed:
- the group will be auto-renewed based on the renewing plan details provided in the renewal information packet they received
- the group will not be able to make plan changes until the next renewal date (as stated in the group policy)
- the group will be billed
Please return renewal documents via fax to 715-221-9456 or via your account manager's email address. Please retain a copy of all documents. Contact your account manager if an employer group's renewal information has not been submitted before the monthly deadline, or if you expect a further delay.
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Medicare
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Medicare members leaving Security Health Plan
We want to notify our contracted agents who sell Medicare Advantage plans that an unusually high number of our members are being enrolled into another company's Medicare plan during the open enrollment period (OEP) from January 1 - March 31.
We believe many of our members are responding to the onslaught of Medicare-related TV ads telling them they are not receiving all the Medicare benefits they are entitled to. Once they call the phone number from the ad, they are at risk of inadvertently enrolling into a different company's plan. Often our members are not even aware this has happened until they receive the notice of disenrollment from Security Health Plan.
If you have clients who have faced this situation, here is our advice:
- Direct your client to call 1-800-Medicare if they feel they there was misrepresentation of the policy into which they were enrolled.
- Instruct your client to tell Medicare exactly what happened and indicate they did not wish to change their Medicare health plan.
Our experience is that Medicare may offer your client a special enrollment period (SEP) to re-enroll into their Medicare plan from Security Health Plan. Medicare may also pass this along as a complaint with the other company.
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OTC benefit, hearing and vision discounts added to Security's Medicare Supplement plans for 2021-2022 plan year
Effective with the start of the 2021-2022 plan year on July 1, Medicare Supplement members can get $30 of over-the-counter (OTC) health products every 3 months at no additional cost through the OTC catalog. OTC products include allergy and cold medications, sunscreen, pain relievers, vitamins and much more.
In addition, Security's Medicare Supplement members will get a 15% discount on hearing aids and eyeglasses purchased through Marshfield Clinic starting July 1.
Medicare Supplement premiums to increase 5%
Effective July 1, 2021, Security Health Plan's Medicare Supplement basic plan and rider premiums are increasing 5%. The Part B Deductible rider, which is not available to persons first eligible for Medicare on or after Jan. 1, 2020, will increase by 2.5% to match the 2021 Medicare Part B Deductible increase. In addition, some Medicare Supplement subscribers will receive an additional increase due to moving into a new age category.
A few reminders on how premiums are calculated:
- Applicants age 65 pay the age 65 premium.
- For all other applicants and renewals, rates are based on their age on July 1, 2021.
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- Example: If an applicant or renewal will turn 75 on July 5, 2021, he/she will pay the lower age 70-74 premium until July 1, 2022, then move to the age 75-79 premium.
- A 5% household discount is applied if the Medicare Supplement member's spouse also has Security Health Plan coverage; the spouse's coverage can be individual/family, employer group, Medicare Advantage, Medicare Supplement or any other plan type.
- The premium is then reduced an additional $5 per month if the premium is paid automatically from a bank account, debit card or credit card.
Rate increase letters will be mailed in late April to inform subscribers of their 2021-2022 premium if the amount of their increase is more than 25 percent. This could happen to subscribers hitting a milestone year (75, 80, 85) who have not had an age-adjusted rate increase for 5 years. The majority of members with a rate increase in the 5% range will receive the letter mailed in late May.
Our 2021-2022 premium rate sheet will be available to you online in our broker document library. Please print front-and-back and add to your Medicare Supplement sales packets in April. You can then remove the 2020-2021 premium rate sheet in June when you are no longer selling our 2020-2021 plan.
If you have questions, please contact your consumer sales executive.
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Individual and Family Plans
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American Rescue Plan Act will provide relief for those who purchased a 2020 plan on the Marketplace
The American Rescue Plan Act (H.R. 1319) was passed earlier this month. This law includes a one-time provision to provide relief to those who enrolled in individual and family health plans through the Health Insurance Marketplace (Federally-facilitated Exchange) in 2020.
Under this law, your clients who purchased an individual or family plan on the Marketplace in 2020 will not have to repay the Internal Revenue Service (IRS) the excess premium subsidies for 2020. If your client's subsidy amount was too small, they can still claim the additional amount they're owed when they file their taxes. But if their subsidy ended up being too large - even if their income ended up exceeding 400% of the federal poverty level (FPL) - they won't owe any of it back to the IRS.
This should come as a relief to many of your Marketplace clients. The circumstances of 2020 made it difficult for many Marketplace consumers to accurately project their income due to the additional federal unemployment compensation and erratic employment. Without the American Rescue Plan, your clients whose income ended up over 400% of the federal poverty level (FPL) would be facing the prospect of paying back their entire premium subsidy to the IRS this tax season.
It is important to note this is a one-time provision for the 2020 tax year only. So it's still important that your Marketplace clients project their income for 2021 as accurately as possible, and keep their application on healthcare.gov updated if their income changes throughout the year.
What if my client already filed their taxes?
It's not yet clear exactly how the IRS will handle excess premium tax credits for people who filed their 2020 tax returns earlier this year and already repaid some or all of their premium tax credit for 2020. Amended tax returns can always be used to make a change, but the IRS may provide other ways of recouping this money in guidance issued in the near future.
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American Rescue Plan Act will increase premium subsidies for 2021 and 2022 for Marketplace clients
With the passage of the American Rescue Plan Act (H.R. 1319) earlier this month, your clients who purchase an individual or family plan on the Health Insurance Marketplace (Federally-facilitated Exchange) will see increased premium subsidies but they must take action on or after April 1 to redeem them.
This law's adjustment to the premium tax credit guidelines will temporarily - for 2021 and 2022 - eliminate the income cap for premium subsidies. This means that, regardless of income amount, no one will have to pay more than 8.5% of their household income for the second-lowest-cost Silver plan available on the Exchange in a given area. Previous to the passing of this law, the Affordable Care Act (ACA) only provided premium tax credits if a household's ACA-specific modified adjusted gross income did not exceed 400% of the federal poverty level (FPL). To qualify for the enhanced subsidies, your clients must sign up for a plan on the Marketplace.
In addition, this law enhances premium subsidies for Marketplace clients who are already subsidy-eligible. The subsidies increase across the board, making after-subsidy premiums more affordable for most enrollees. At every income level, the legislation will reduce the percentage of income that people are expected to pay for the second-lowest-cost Silver plan, which results in larger subsidies.
By capping premiums at 8.5 percent of income, the American Rescue Plan Act provides targeted premium assistance only where it's needed. And by enhancing the existing premium subsidies, the legislation makes it easier for people at all income levels to afford health coverage.
These premium subsidy enhancements are retroactive to the start of 2021. Current enrollees will be able to start claiming any applicable extra subsidy after they update their application at Healthcare.gov on or after April 1, 2021. The enhanced subsidies will be applied prospectively the month after the application update is complete. Or they can wait and claim it on their 2021 tax return. The additional premium subsidies will also be available for 2022. Beginning in 2023, the enhanced subsidies will no longer be available unless additional legislation is enacted to extend them.
DON'T FORGET! There is still a special enrollment period open through May 15 that will allow your clients to sign up for coverage if they haven't already, or change their current selection.
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| Work with us |
Spring cleaning is here!
Has any of your contact information or agency information changed recently? Please contact us if anything has changed in your professional world, such as:
- Agency ownership
- Principal contact
- New licensing coordinator
- Change in address, phone number, etc.
Contact our Sales Support team and we will update your record.
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Security Health Plan's investment in communities reaches 90,731 people in 2020
Security Health Plan of Wisconsin released the annual review of community investments for 2020-2021: Taking Care: A Community Investment. As a not-for-profit organization, Security Health Plan is focused on helping people and communities achieve their best health. The report highlights many of the ways Security Health Plan achieved that goal in 2020.
In 2020, Security Health Plan invested in community partnerships within 39 counties in the Health Plan's service area. The investments focus on four community health priorities known as the ABCS: Alcohol and other substance use, Behavioral health, Chronic disease and Social determinants of health. By focusing on these areas, Security Health Plan made measurable improvements on the health of the communities we serve.
"Security Health Plan is proud to support local Wisconsin organizations by providing them resources to improve the health of people living in their communities," said Chief Executive Officer of Security Health Plan Julie Brussow. "As a not-for-profit health plan, we not only provide high-quality health insurance to our customers, we are improving the health of communities around our service area, reaching most of Wisconsin. This work is part of our mission, and is another way we care for the communities we serve."
Over the past year, Security Health Plan supported programs to reduce food insecurity, stop prescription drug abuse, and help the emotional well-being of schoolchildren. In addition to these efforts, Security Health Plan and Marshfield Clinic Health System established the COVID-19 Community Support Fund which provided $400,000 to 72 Wisconsin organizations that needed a helping hand during this unprecedented time.
At Security Health Plan we believe people play an essential role in their own health care - and the more they know, the more they can take better care. See how Security Health Plan is helping people take care in our report, Taking Care: A Community Investment, at www.securityhealth.org/communitygiving. You can also use this link to request support and view upcoming grant opportunities.
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Questions and topic suggestions
If you have a question that might be of interest to other agents and brokers, please share it with us. We'll address topics of interest in our upcoming issues of Agent eNews.
8 a.m. to 5 p.m.
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