Carriers

Aetna

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BCBS of South Carolina

  • BlueCross BlueShield and BlueChoice HealthPlan COVID-19 Over-the-Counter Tests Reimbursement Process
    • To increase access to free tests, the federal government is now requiring insurance companies and group health plans to cover the cost of over-the-counter COVID-19 diagnostic tests effective Jan. 15.
    • Beginning Jan. 15, BlueCross and BlueChoice will reimburse eligible members for the purchase of over-the-counter COVID-19 diagnostic tests that have been authorized, cleared or approved by the U.S. Food and Drug Administration. See the list of qualifying tests here.
    • The plans will cover eight over-the-counter tests per covered individual per 30-day period. Members can purchase tests at local retailers or online. Members will pay for their tests out of pocket and file for reimbursement. See the attached FAQs for details about how members can file their reimbursement claims.
    • If you have questions, please contact your marketing representative.

COVID-19 OTC Tests FAQs

BlueCross BlueShield of South Carolina’s COVID-19 website

BlueChoice HealthPlan

  • BusinessADVANTAGE
    • BusinessADVANTAGE is an affordable and comprehensive series of health plans with options to suit employers with 2 − 50 employees. We can work with you to determine which features and benefits best fit the needs of your clients. No matter what the health coverage objectives may be for your clients, we have them covered! If you have questions or need more information, call your Sales Representative.
  • The BlueChoice Advantage
    • BlueChoice HealthPlan’s Advantage Plus product is an affordable and comprehensive series of health plans with options to suit employers with more than 50 employees. These plans allow your clients to manage costs, maximize quality and stimulate employee engagement in clear and measurable ways. BlueChoice has the capability and flexibility to meet the needs of your clients.
    • We offer:
      • Flexible funding arrangements, including ASO, alternate funding, retro arrangements, gain share and more.
      • Customized plan designs.
      • Market-leading provider discounts and value-based networks in the future.
      • Superior case and disease management programs.
      • Comprehensive detailed reporting package for groups with more than 100 enrolled lives.
      • Award-winning member service experience.

Contact a member of your account management team or visit www.BlueChoiceSC.com for more information.

Allsavers

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Allstate

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Cigna+Oscar (TN & GA)

  • $3 Prescriptions
    • Did you that Cigna + Oscar members pay the cost of their prescription OR the copay, whichever is less? In addition, there are almost 300 covered drugs at just a $3 copay. Click here for the list!
  • See All of Your Stuff in One Place
    • Did you know that members have access to their benefits, ID card and dedicated care team in just a few clicks? Click here to share information with your groups on how to download their app and create an online account.
  • Tennessee:
    • Cigna + Oscar has added 8 plan designs to our 2022 TN product portfolio and will be rolling out PPO based products to our TN small group clients starting with 1/1/2022 effective dates of coverage! PPO based products will be automatic for any group offering a plan design on our Open Access Plus Network.   Check our 2022 product portfolio HERE
  • Georgia:
    • Cigna + Oscar has added several new plans to our 2022 GA product portfolio including women plans with Virtual Primary Care. Virtual Primary Care comes with several benefits including convenience, $0 labs, a vitals monitoring kit and $0 to the first specialist visit when recommended by the Virtual Primary Care Physician. Check out our 2022 plans HERE
  • New Plans in 2022
    • Cigna + Oscar has added several new plans to our 2022 TN & GA  product portfolio including women plans with Virtual Primary Care. Virtual Primary Care comes with several benefits including convenience, $0 labs, a vitals monitoring kit and $0 to the first specialist visit when recommended by the Virtual Primary Care Physician. Check out our 2022 GA plans HERE.  Check out our 2022 TN plans HERE.

Companion Life

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Guardian

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Humana

  • Humana Smart Insights will be replacing the Plan Pulse Report
    • Launching November 1st will be the new Humana Smart Insights reporting. Just like the Plan Pulse, it will provide crucial information to help educate your groups on appropriate level of car, RX utilization and importance of preventative care.
  • Temporary ID Cards for LMG
    • The Launch My Group post-submission member status screen will now provide frequently requested member information and temporary ID cards! This information will be available for new business from the time of enrollment through the first 30 days of the group’s active coverage.
  • Don’t Miss Out! Enroll New LFP Groups, Get Admin Fee Credit!
    • Write new Level Funded Premium (LFP) groups with September 1 through December 1, 2021, effective dates.
    • Enroll via Launch My Group.
    • Earn a $300 per subscriber administrative fee credit.
  • Learn about Humana’s Community Rated Portfolio for 2022
    • Their 2022 Community Rated (CR) portfolio will go live for quoting on October 1, 2021 with a January 1, 2022 effective date. Some states may be eligible for early quoting as state approvals are received.
    • CR for 2022 will offer choices with competitive differentiation and price points without unnecessary confusion or administrative costs.
    • What’s new for CR 2022 portfolio?
      • ACA allowable MOOP of $8,700
      • Ultra-lean option
      • On Hand copay: new plan design!
        • Pharmacy – Rx5 Blended
        • Copays offered on select services
      • On Hand FL, GA, KS, MO, TX: richer options $4,500 and $6,500 DED/OOP and leanest option of $8,700 DED/OOP
      • Rx5 Blended benefit design on select Canopy (FL, GA, MO, KS, TX) and Copay plans (GA, MO, KS)
      • No additional reductions will occur in 2022 in MI and UT
  • Humana’s 2021 Humana Producer Guide is available to download, click here >>> Humana Producer Guide. This great resource is full of very useful information on doing business day-to-day with Humana.  It covers everything from quoting through installation, including HRAE underwriting and Launch My Group tool.

Kansas City Life

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Principal

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Sun Life

  • New Partnership with TeleDentsitry.com
    • Teledentistry allows dentists to consult with a patient on oral health issues when they can’t be seen in person. This new service is automatically incorporated into members’ dental coverage and provides a safety net for those who need dental care in emergencies, while traveling, or at night or on weekends. Click here to learn more or contact your Sales Representative.
  • Legislative Updates
    • From webinars to shareable whitepapers, Sun Life focuses in on the important details you should be sharing with your clients. Bookmark this page as they are actively updating all changes.
  • Get more with Sun Life’s Hospital Indemnity plan
    • Sun Life has expanded their Hospital Indemnity product to include even more features and benefits! Their plan still includes all the basics that are essential for coverage, but you now have the option to add on the following:
      • More coverage for pregnancy and childbirth – plans can now include routine well baby nursery care
      • More benefit options that cover a broader range of a hospital experience like intermediate step-down unit stays, inpatient surgery and emergency room treatment
      • More flexibility in high/low plan options for employee choice
      • More first day benefits
      • More benefits that can be paid on the same day

      Watch this short video to learn more about their expanded Hospital Indemnity plan. And, for even more details, check out their new brochure.

UnitedHealthCare

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  • New All Savers Level Funded Opportunities
    • UnitedHealthcare is offering simplified underwriting (member level census) down to 5 enrolled for 4/1 and 5/1 eff dates.
    • They will be giving groups a $200 Admin Credit per employee enrolled that will be applied to their bill if they add at least one line of specialty coverage.
      • ***Can be a voluntary line of coverage. Voluntary dental requires 2 enrolled employees, voluntary vision requires 1 enrolled employee.
  • 2-50 Quote Process:
    1. Complete the 2-50 All Savers Quote Request Form
    2. Email the completed form to sesub@uhc.com and copy Samantha Andrews (samantha_andrews@uhc.com) to the email.
  • UHC Renews Network Relationships with Catawba Valley Health System
    • UnitedHealthcare and Catawba Valley Health System (CVHS) reached a long-term agreement that will renew its network relationship with Catawba Valley Medical Center and its affiliated physician group for employer-sponsored, individual and Medicare Advantage members.
    • Click here to read the full press release.
  • North Carolina – Small Group Fully Insured Commission Update
    • New base commission rate schedule for fully insured small medical groups up to 50 eligible in North Carolina with effective dates on or after October 1, 2021.
    • This new commission schedule is effective for new fully insured medical groups with up to 50 eligible employees in North Carolina with effective dates on or after October 1, 2021, and existing fully insured medical groups with up to 50 eligible employees in North Carolina on their first renewal on or after October 1, 2021.
    • Click here for more information.
  • Insurers and Health Plans to Cover COVID-19 at Home Tests

Unum

  • Unum Vaccine Verifier
    • Unum Vaccine Verifier will include solutions for both employers and their employees. The new digital product will go beyond a software-only system and help companies:
      • Verify employee vaccination status – Providing a self-service portal for employees to report vaccination status and upload documentation.
      • Manage employee vaccine exemptions – Handing intake of all medical and non-medical exemption requests, sensitive documents
      • Manage testing compliance – Managing test result documentation for employees who are not vaccinated, sending weekly reminders and employer notification.
      • Click here to learn more and contact your Sales Rep for additional information and pricing.
  • Go Digital with Unum’s EOI Solutions
    • Fast
      • EOI doesn’t have to be a long and drawn-out process. Their fully digital and mobilized solutions allow for swift approval and transfer of information, with 85% of applicants getting a decision instantly – so they can get the coverage they need, painlessly.
    • Simple
      • They make things easy for plan administrators and applicants, no matter their size of their enrollment process. With three digital options to choose from, every one of their clients will find a simple, digital EOI solution that fits their needs.
    • Transparent
      • Their EOI dashboard provides quick and transparent information on decision status for plan administrators, and applicants receive clear information directly from their EOI portal when they complete their online statement of health.
  • Unum’s Enhanced Supplemental Health Offering:
    • Unum’s supplemental health offering includes Accident, Critical Illness, & Hospital coverage. Health plans and disability insurance help employees in times of need, but this coverage may have gaps that lead to out-of-pocket expenses. Unum’s supplemental health benefits add financial protection for employees in the event of a serious health issue. The following enhancements are included in Unum’s offering:
      • Accident, Critical Illness, & Hospital:
        • Enhanced Be Well benefit: includes all existing screenings, annual exams by a physician (dental & vision visits qualify), child physicals, well baby visits, and immunizations
        • No cap in the number of child claims (3 children with 3 wellness claims = $150 payout)
      • Critical Illness:
        • New covered conditions: Dementia (including Alzheimer’s), ALS, Functional Loss (version of LTC rider), Multiple Sclerosis, Parkinson’s, Infectious Diseases, and minor coronary artery disease are covered at 100%
        • Enhanced Cancer Coverage: Unum treats all stages of Breast Cancer as Invasive, resulting in a 100% benefit.
        • Recurrence Benefit: Paid at 100% with 6 month separation
      • Accident:
        • New covered benefits: x-ray, prescription drug, short stay hospitalization, knee cartilage (meniscus) injury, ruptured/herniated disc injury, injection benefit for tetanus, rabies, antivenom, dental filling/chip repair, general anesthesia, transfusion, and internal injuries
      • Hospital:
        • New benefits that are considered HSA-compatible: rehab unit, substance abuse facility, mental/nervous facility, lodging, and short stay