IN THIS ISSUE
1. Updated Information: Individual Market:  Additional Documentation Now Required with SEP Enrollments
2 . More information located on our Resources page
3. DELAYED: 
Small Group Plan Year Change Information
4. Successful Spring Training
5. Small Group:  Changes to Job Service Report (JSR)
6. Wellmark COOP Dollars Available
UPDATED:  INDIVIDUAL MARKET:  ADDITIONAL DOCUMENTATION NOW REQUIRED WITH SEP ENROLLMENTS
Changes to take effect for Special Enrollment Periods (SEPs)
 
Wellmark is changing the paperwork required for Special Enrollment Periods (SEP) in the Individual Under 65 market. Individuals who enroll during SEPs will need to provide proof of eligibility to ensure they are qualified for coverage. The documentation requirement change takes place for SEPs with a signature date of 4/1/16 or later for an effective date of 5/1/16 or later. This change is being made not only for new SEP contracts, but also SEP contract changes. In order to ensure adherence to the documentation requirements, Wellmark will also be instituting an audit process of individuals enrolled through an SEP.  

Updated Information Below:
 
Read here information on the Audit process and what will happen when Wellmark transitions from QUE to HPS (Health Plan Systems) in July 2016.


Read here the full initial communicate on the SEP changes that Wellmark released at the end of March.

Please note that if Partners Health Insurance helps you enroll applications or change forms, the applications cannot be submitted until we also have the additional documentation on file.
  
Across the industry, the individual market continues to be financially challenging. We know you support our goals to encourage a stable market and to keep coverage affordable for our members. By working together, we can manage the risks that our members are exposed to. Thank you in advance for your support of these updates that can help us accomplish our mutual goals.
 
For additional questions, please contact your Individual Account Rep:
Tonya Helmers - tonya@mtcnet.net
Jamie Kamerman - jamie@veinsurance.com

MORE INFORMATION NOW ON OUR RESOURCES PAGE
We have added more helpful information to our Resources page!
 Along with applications and forms, we now have our monthly newsletters and special alerts published.  Also included is a monthly events calendar.  The calendar will include items such as training dates, certification dates, and enrollment period dates.

Check it out using the following link:  

 


DELAYED:  SMALL GROUP PLAN YEAR CHANGE INFORMATION
Wellmark has made the decision to further extend small group transitional policies until 12-31-17.
 
In May, Wellmark is offering current, pre-Affordable Care Act (ACA) non-grandfathered (also known as transitional relief or grandmothered) small group customers the opportunity to change their plan year and renewal date to January 1, 2017. This change means they can keep their plans and have the full transitional relief period through December 31, 2017 to evaluate their ACA health plan options.
 
How will the Plan Year Change be communicated to affected groups?
The first week in May, letters will be sent to small group administrators eligible to change their plan year and renewal date. Listed below is the final FAQ and letter versions you need to help your group clients through the plan year change process. 
 
Plan Year Change FAQ  - to assist agents with plan year change questions.
 
Iowa Plan Year Change Letter for All Renewals Except October - letter sent to eligible small groups with a current  renewal month of January - September and December.
 
Iowa Plan Year Change Letter for October Renewals - letter sent to eligible small groups with a current renewal month of October.
 
When is the response due from Small Groups?  
Responses due by May 27, 2016.
 
How will I know if my small groups have submitted a response?
Wellmark will assemble a customized list of impacted groups for each agent of record. Through May, these lists will continuously be updated and redistributed, so impacted producers know which of their groups have submitted response forms. Expect to receive your group lists in emails from Partners Health Insurance.  

SUCCESSFUL SPRING TRAINING!
 
Our Spring Training on April 26 went well.  Thank you to all who could make the morning work.  We know your work is busy, and taking the time to learn and educate is a great attribute that your clients sure do appreciate.

If you were unable to attend our Spring session, a Fall training session will also be scheduled sometime in August/September.  We highly encourage you to attend this training once scheduled.  This training will be much more in depth and cover a lot of important product and rate changes for 2017.
 
We are in the process of trying to obtain the slides for the presentation from Wellmark, however, they most likely will not be released until later in May once all scheduled trainings have been complete.

Attached are additional documents given during the training for your reference:


**PLEASE NOTE THESE ARE FOR AGENT REFERENCE ONLY, NOT TO BE DISTRIBUTED TO YOUR CLIENTS**
 

SMALL BUSINESS:  CHANGES TO JOB SERVICE REPORT (JSR)
For May 1 effective dates, starting April 1, all new small business sales will require a full reconciled Job Service Report (JSR), also known as a Quarterly Wage Report. Wellmark will no longer accept just the first page of the report. New sale paperwork for small business sales will not be processed without the reconciled JSR, so it's important that the form is filled out correctly.

Key reminders on reconciling JSRs:
  • Each employee who is enrolling in the group plan must be represented on the submitted JSR.
  • Employees who are not included on the printed JSR must be added in writing.
  • Consult the administrative guide if the group does not have a JSR for additional paperwork that may be accepted in lieu of the JSR.
See the table below to review the JSR codes and their uses.

Codes for JSR Reconciliation
Meaning of Code
Interpretation
NE Not Eligible Not Eligible
C or COBRA COBRA COBRA employee
R or Retiree Retiree Retired employee
E or ETC Eligible - taking coverage Enrolling in coverage
W, EW, EWC, or Waive Eligible - waiving coverage Waiving coverage when eligible
T Terminated Terminated employee

WELLMARK COOP DOLLARS AVAILABLE
Want to advertise, but don't want to pay the full cost?  Partners Health Insurance Agents have access to Wellmark COOP dollars - up to 50% reimbursement!
 
What items are eligible? 
Print ads, radio commercials, out-of-home ads (i.e. billboards, gas pump toppers, transit ads), digital ads.

What items are not eligible?
Telephone directory advertising, television advertising, community or event sponsorships, including signage on scoreboards, office and building signage, sales promotion materials, specialty items (golf items, pens, etc.) or trade show or event exhibits.

Where can I find Wellmark Ads?
Wellmark COOP ads, signage, Blue Store is all located in the Marketing Toolkit on your Producer Connection page.

What is the deadline to get reimbursed?
All reimbursements for 2016 ads are due by December 15, 2016.  Partners Health Insurance has a budgeted amount from Wellmark, so don't delay your reimbursement request!

Who can help me with my questions?
All questions regarding COOP ads and reimbursement should be directed to:

Tonya Helmers located in our Sioux Center location
tonya@mtcnet.net
712-722-3333
800-722-2578
RESOURCES AVAILABLE TO HELP YOU GAIN AN ADVANTAGE
Agent Resources
You can access Wellmark BCBS of Iowa forms on our website.   Click Here
http://partnershealthinsurance.com/resources-2/
Coop Advertising
Did you know you could be eligible for 50% reimbursement on eligible Wellmark BCBS advertising?  Login in to your Wellmark.com Producer Connection page - locate the Sales Tookit - N ew ads are now available! Contact Tonya to find out more information about this program.
tonya@mtcnet.net           712-722-3333
TRAINING
Wellmark Annual Agent Certification
SCHEDULED FOR: June 1 - July 1, 2016
 This is an annual training specific to Wellmark BCBS and must be completed each year in order to continue to sell Wellmark BCBS group and individual products.  This is a separate requirement from the Medicare PDP certification.  
WELLMARK SPRING TRAINING
FALL 2016 - TBD
Agenda Items to Include: TBD
WHERE:  TBD
TIME: TBD

RSVP Now to:
Jamie Kamerman - jamie@veinsurance.com
Tonya Helmers - tonya@mtcnet.net


MedicareBlueRx (PDP) Certification
This is an annual training that needs to be completed each year in order to service and sell MedicareBlueRx products.  
Access 2016 Training Guide  here

WELLMARK NEW AGENT TRAINING

Newly appointed agents with Wellmark BCBS are required to go to New Agent Classroom Training within 180 days of appointment date.  Register for training in the Blue Learning Center located under your Wellmark.com agent login.  Click herefor a Job Aid to assist in the registration

Contacts:

Ben Van Engelenhoven

122 Central Ave SW
Orange City, IA 51041
800-856-6001
712-737-6000

 

Kelly Snieder
906 S Main Ave
Sioux Center, IA 51250
800-722-2578
712-722-3333  

 

Our Advantages:

Partners Heath Insurance is an AUTHORIZED WELLMARK GENERAL AGENCY located in Western Iowa. We invite you to review our website, consider our advantages, and give us a call today!





Our Locations:

906 S Main Ave
Sioux Center, IA 51250

122 Central Ave SW 
Orange City, IA 51041



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