Operational updates

Please review the information below.

Medicaid ID on TotalCare customer applications

When enrolling a customer in a TotalCare plan, please make sure to include the customer's Medicaid ID number on the application. The Social Security Number (SSN) should only be used if the Medicaid ID is not available.

Completing Prescription Drug Plan (PDP) applications

When submitting PDP applications, please use your National Producer Number (NPN) as your agent identifier in all the fields that require it (e.g. the fourth line on page six of the application). Want more tips on completing PDP applications? Click the link below.

• PDP application tips

Late Enrollment Penalty (LEP)

When enrolling a customer, make sure to inquire if they have had Prescription drug coverage since they became eligible for Medicare. If they have not, advise the customer their premiums may increase because of a LEP. If the plan identifies that the customer has a LEP, a letter will be sent to the enrollee post enrollment.

Background: A LEP will be assessed if the customer is without Part D drug coverage for any continuous period of 63 days or more since becoming eligible for Medicare. If it is determined that the customer has a LEP, they will receive a letter from the plan with next steps. It is important that customers complete and sign the Attestation form and return it to Cigna Healthcare within 30 days. 

Contacting customer service on behalf of customers

Please note that agents cannot contact customer service and act on behalf of the customer. Only the customer or their legal representative can request changes or get information from the customer's account. If you need to escalate an issue, please contact our Cigna Agent Resource Line (CARL) using the contact information listed at the bottom of this message.

Reducing/filing customer complaints

One of our primary objectives is to proactively prevent and address complaints to enhance the member experience. By doing so, we can foster greater customer loyalty and contribute to improved Medicare Star Ratings. As an agent, you play a crucial role and can effectively reduce complaints by following the steps outlined in the link below. Please take some time to review these steps and learn how to file customer complaints if needed by clicking below.

• Learn more

Using your NPN on Medicare Advantage (MA) applications

Starting on January 1, 2026, the Centers for Medicare and Medicaid Services (CMS) will require agents to include their NPN on the enrollment application if they assisted the customer in completing it. Agents are also encouraged to share their NPN information with customers that they assist before the enrollment is submitted, especially if the customer is submitting the enrollment request themselves through 1-800-MEDICARE or Medicare.gov.

Update to Medicare enrollment forms

CMS is removing the Sexual Orientation Gender Identity (SOGI) and race and ethnicity questions from its 2026 model enrollment form. This change will be effective beginning January 1, 2026, when all related fields must be removed from the enrollment transaction. Updated enrollment forms will be available by AEP. In the meantime, you can skip completing these fields on the current enrollment forms.

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