Group Benefit Updates

BCBS of South Carolina

• Machine Readable File Link and Information:
  • Please click here to learn more. The machine readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.

BlueChoice HealthPlan

• Machine-Readable File Link and Information
  • Please click here to get the machine-readable files that are made available on BlueChoice HealthPlan of South Carolina’s website. The machine-readable files are formatted to allow researchers, regulators, and application developers to access and analyze data more easily.

• BusinessADVANTAGE
  • BusinessADVANTAGE is an affordable and comprehensive series of health plans with options to suit employers with 2-50 employees. You can offer dual options in any combination from any of these plans, including Blue Dental. All of their plans are comprehensive, open-access plans that are health reimbursement arrangement (HRA) compatible. Six of their plans are health savings account (HSA) qualified.
  • BlueChoice 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, they’ve got you covered! If you have questions or need more information, contact your local sales rep.

• 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.

• Click here to view information relating to the BlueChoice HealthPlan BA Primary Choice Sales Bonus Challenge.

• Continue to Grow with BlueChoice Health Plan! 
  • Large Group (51+) Retention and Sales Growth Incentives
    • Effective Dates: November 1, 2022 – January 1, 2023
    • Earn more while growing your large group book of business with BlueChoice. Their large group retention and sales growth incentives will be counted from November 1, 2022 – January 1, 2023
  • New Business Incentives
    • Receive additional compensation incentives for new large groups written for November 1, 2022 – January 1, 2023 effective dates. Your large group sales for BlueChoice products will be compensated as outlined below:
      • Receive $150 per contract per group regardless of the size of the group for a medical sale
      • Receive $500 per group for adding a dental product
      • The maximum payment on any single group is $25,000
      • Incentives will be paid the month following the effective date if all signed contracts have been received by BlueChoice HealthPlan and all premiums have been paid.
  • Early Renewal Incentive
    • Want to receive a $1,000 early renewal bonus for all large group medical policies scheduled to renew on January 1, 2023? Simply submit all required and signed renewal paperwork by November 30, 2022.
  • Dental Incentive for Existing Groups
    • Receive $500 per group for adding a dental product to an existing group. If you have any questions, please contact your local sales rep.
• Small Group (2-50) Sales & Retention Incentives
  • Earn more while providing the best products and services to your small group customers from December 1, 2022 – January 1, 2023.
    • New Sales Incentives: Complete these sales goals and receive the compensation bonus per contract as outlined:
      • December (Minimum of 5 New Contracts): $100 per enrolled contract
      • January (Minimum of 5 New Contracts): $100 per enrolled contract
      • BONUS: For every NEW group with ten or more contracts enrolled, receive a $250 bonus per group
    • Retention Incentives: Retain 95% of small groups or contracts each month during the incentive period and receive an additional bonus payment of $50 for each enrolled contract. Check out this flyer for complete details.
    • Dental Incentives: BlueChoice HealthPlan’s small group dental sales contest is also taking place from December 1, 2022 – January 1, 2023. Receive a one-time $25 bonus for each new BlueChoice HealthPlan dental contract with an effective date of December 1, 2022, through January 1, 2023. Check out this flyer for complete details.

• Earn More When You Sell Choice Level Funded
  • You now have even more reasons to sell BCHP’s Choice Level Funded (10+) product. Receive $100 per enrolled contract each month from December 1, 2022 to January 1, 2023. Plus, for every NEW group enrolled, receive a $250 bonus per group. Check out this flyer for complete details. Here are some of the benefits your clients get with Choice Level Funded:
    • No surprise medical costs
    • Access to the doctors your clients know and trust
    • Coverage for everything they need

Allsavers

Click here to view this carrier’s COVID-19 website

Allstate

Click here to view this carrier’s COVID-19 website

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 added Sumner Regional Hospital and Synergy Healthcare into their LocalPlus Network effective 5/1. Check out their updated TN LocalPlus Nashville hospital listing here.
  • Effective 7/1, they are expanding LocalPlus nationally to both in and out of area employees who live and work in one of the LocalPlus service areas across the US will be able to enroll in Cigna + Oscar LocalPlus plans, as long as they and their family members live in eligible service Ares. Click here for more information.
  • Looking ahead to 2023? Join Cigna + Oscar for one of their upcoming webinars to learn more about their 2023 product portfolio and network. You can register here to save your spot.
  • Did you hear about the Cigna + Oscar TN Q4 – 1/1 Broker Bonus offering? They are offering a tiered and compounding bonus offering for new groups with 4+ enrolling employees with either 12/1/22, 12/15/22, or 1/1/23 effective dates of coverage. Brokers can earn up to $1,750 in bonus money. Check out the flyer with full details here.
  • Do your groups currently have a Telemedicine program in place? Cigna + Oscar members are able to take advantage of 24/7 $0 Virtual Urgent Care (there is a cost share for HSA plans) by simply logging into Oscar smartphone application! Members can talk to a board-certified physician in as little as 20 minutes!

• Georgia:
  • As a reminder, Cigna + Oscar allows new members to apply their previous group health plan’s calendar year deductible and max out-of-pocket credits to the new Cigna + Oscar plan. This information needs to be forwarded to Cigna + Oscar no later than 30 days after their effective date. Here is the form, contact your dedicated TCG rep for more information!
  • As we move into peak season, please be reminded that Cigna + Oscar does not offer 4th quarter carry over, but they do provide prior carrier deductible and maximum out of pocket crediting within the SAME calendar year. Please keep in mind that they need this information no later than 30 days after the effective date.
  • Looking for 2023 plan information? Here are some quick links:
    • View sold case forms, SBCs, etc.
    • View 2023 Plan Grid, Rates
    • View 2023 Forms
  • For the best onboarding experience, please be sure that groups pay their binder premium via ACH. They do not have to remain on ACH, however, the binder payment effectuates the coverage (including eligibility) and triggers the production of ID cards.

• 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.

• Georgia and Tennessee:
  • Learn more about Cigna + Oscar’s differentiated customer service model, simple and easy broker tools, and the post-enrollment process. You can learn more by watching some quick webinars at THIS link and selecting your state.
  • Planning for 2023? Join Cigna + Oscar at one of their upcoming webinars to hear about their small group plan offerings. Click here to register to save your spot!

Companion Life

Click here to view this carrier’s COVID-19 website

• Partnership with Employee Navigator
  • Companion Life Insurance Company is pleased to announce its partnership with Employee Navigator! Their products are now eligible to sync with the Employee Navigator Data Exchange. The Navigator connection assists with enrollments and may eliminate billing errors by pushing all changes in Navigator directly into Companion Life’s system. Updating both systems will no longer be needed! Additionally, Employee Navigator supports all Companion Life insurance products.

• Ward’s 50 Life-Health Companies
  • The business consulting firm, Ward Group named Companion Life Insurance Company one of its top 50 performing life and health insurance companies for the eleventh consecutive year. Cincinnati-based, Ward Group, a provider of benchmarking and best-practices services to the insurance industry, annually analyzes the financial performance of hundreds of life and health insurance companies in the United States to identify the top performers. It recognized Companion Life for achieving results in the areas of safety, consistency, and performance.

• Companion Life Leaders Conference
  • Click here to learn how to experience Florence, Italy

• Companion Life 2024 Leaders Conference
  • Companion Life is pleased to announce the location of their 2024 Leaders Conference: Athens, Greece! For your sales of Companion Life products, you and a guest will enjoy six days and five nights at the ultra-luxurious Four Seasons Astir Palace Athens. Mark your calendars now! The trip is June 23 – 28, 2024. Join them for the experience of a lifetime as they explore one of the oldest and most spectacular cities in the world.

• Partnership with Beacon Benefits Solutions
  • Companion Life Insurance Company now has a direct data feed connection with Beacon Benefits Solutions (Beacon) – a benefits administration platform used primarily in the 2-100 employee arena.
  • The integration allows data to flow from Companion Life to Beacon without manual intervention. This connection is typically defined as “single-client”, meaning that data may be reviewed and processed more efficiently without Companion Life making manual changes before the data reaches the Beacon platform.
  • Agents selling Companion Life insurance products have access to near virtual real-time eligibility review, processing, and implementation for groups varying in size. Talk to your local sales rep today about the array of Companion Life insurance products available and how Beacon may facilitate the process!
• New Portal Enhancements
  • Companion Life’s portal now includes a “Chat Now” feature that connects users to a member of their service team. It’s a simple way to get answers to questions regarding an enrollment, bill or ID card. Try it out today!

Guardian

• STD/Supplemental Health Claims Integration

Humana

• Dental PPO/TRP Flex Plan Options
  • Humana’s Dental PPO and Traditional Preferred (TRP) options (PPO 2/TRP 2 or “FLEX” plans) are now be available in four additional markets. These options provide greater affordability and flexibility in our portfolio, meeting a wider variety of employer group needs.
  • Phase 1 launched in 13 states on March 1, 2022. Beginning June 12, 2022, these options will be available to quote in Florida*, Georgia, Tennessee, and Virginia, with a September 1, 2022 effective date.
• Humana Ranked Best Overall Dental by JD Power
  • JD Power Ranks Humana #1 In Overall Plan Satisfaction
  • The study was fielded in March-April 2022. The study measures customer satisfaction with dental plan providers based on five factors, in order of importance: cost; coverage; communications; customer service; and claims and reimbursement.
• Humana Market Dental Plan Improvements
  • 3 cleanings per year (instead of 2)
  • 4 periodontal cleanings per year in preventative (as opposed to standard 2 per year)
  • Extended annual max in place of carryover account
    • Extended annual max can be used in Year 1
    • No thresholds or limitations are applied to this benefit
    • This benefit continues to pay after annual max has been exhausted
• On Hand Customization for Fully Insured 101+
  • Humana allows limited customizations of standard On Hand^®  plans for Fully Insured 101+ groups to include a $50 copay for certain types of in-person office visits. If you need to quote a customized On Hand plan, please follow these guidelines:
    • Fully insured 101+ only
    • Customizations built off an existing, standard On Hand plan design
    • Customization requires PSQ approval
• CR and LFP Medical Portfolio Refresh
  • Humana has modernized and simplified their medical portfolio to offer more competitive plans that better manage healthcare costs in all Level Funded Premium (LFP) and Community Rated (CR) markets. These refreshed portfolio offerings will be available:
    • Level Funded Premium: September 1, 2022 quote date & October 1, 2022 effective date
    • Community Rated: October 1, 2022 quote date & January 1, 2023 effective date
• Small Business Net Growth Bonus
  • Earn a bonus when you grow your Humana medical business
    • To earn a bonus, grow your Humana fully insured and LEvel Funded Premium case count between October 1, 2022 and January 1, 2023. To be eligible for the bonus, cases must have <101 eligible employees and at least two enrolled employees.
  • Net medical case count growth of:
    • 0-2 cases – No bonus
    • 3-4 cases – $2,000
    • 5-7 cases – $4,000
    • 8-10 cases – $8,000
    • 11-14 cases – $15,000
    • 15+ cases – $30,000
• Humana Q4 Bundling Bonus
  • Sell a bundle, earn a bundle! To earn a bonus, place new specialty lines of coverage standalone, or with a new or existing Humana medical plan – with the same employer and initial effective date of coverage of August 1 through December 31, 2022.
    • 5-99 enrolled size groups:
      • $500 for dental + vision
      • $1,000 for dental + vision + life
    • 100+ enrolled size groups:
      • $3,000 for dental + vision
  • Click here for more information on Specialty Bundling.
• Quoting has opened for 1/1/23 for Community Rated, LFP, and 51+ for both medical and specialty lines. Here are a few reminders and updates to help get you through the season:
  • *NEW* Humana is now accepting competitor apps for Level Funded quoting. The attached questionnaire must be completed by the plan sponsor and submitted with the apps. If the group sells, LMG must be used for installation.
  • *NEW* LFP Admin Credit – $200 Admin credit per subscriber, available for SELECT New Business or Renewal groups. Talk to your local sales rep to see if your group qualifies.
  • *NEW* 51+ Administrative Service Agreement – $15,000 administrative service agreement for SELECT new business 51+ groups. This is a one time $15,000 credit that will appear on their 3rd month’s invoice. Groups must have at least 51 enrolled and less than 100 eligible employees.
  • Renewal and Claims experience reporting is still required for an underwritten quote. Groups that are virgin, through a PEO/Association, or Community Rated do not need to submit the renewal.
    • 2023 Community Rated Plan Grid
    • 2022 LFP Plan Grid
• Launch My Group enrollment is KEY to a successful 4th quarter!
  • Experience fast turnaround times for 2-99 sized groups, 24-48 hours
  • Access temporary Dental ID cards within hours after enrollment
  • Gain 1×1 guidance with Humana’s dedicated Launch My Group team.
    • View the Launch My Group guide here

• Small Business – CR, LFP Sales Kits Refreshed
  • Marketing materials supporting Community Rates (CR) and Level Funded Premium (LFP) updates have been added to the Medical sales kit, as well as embedded within the LFP and On Hand sales kits. These kits now include:
    • Updated spotlight flyers for CR and LFP
    • New plan comparisons for Simplicity, Copay, Copay II and On Hand plans
    • New benefit comparisons for CR and LFP plans
    • All-options one-pager for easy access to material for each portfolio
    • Updated LFP brochure
• Humana Vision PLUS Continues Market Expansion
  • As previously communicated, Humana Vision is partnering with EyeMed to offer this exciting tiered network product providing enhanced benefits to their members. Humana Vision PLUS plans will not replace their current vision plans but will be an additional option available to fully insured large and small groups.
• HSI Reporting Incorporates Pharmacy Stats
  • Great news! In response to internal and external feedback, Humana has revised their Humana Smart Insights (HSI) Small Business Plan Snapshot reporting. Including additional pharmacy information assists in explaining current plan utilization to groups. In turn, this can provide support for renewal increases, as well as recommended plan changes. This change is effective immediately.

Kansas City Life

Click here to view this carrier’s COVID-19 website

Principal

Click here to view this carrier’s COVID-19 website

Sun Life

• Mployer Insights Benchmarking Report
  • As a Platinum MVP Broker, you are eligible for unlimited benchmark requests for your downstream brokers throughout 2022! Sun Life’s strategic partner, Mployer Advisor offers comprehensive cost-contribution benchmarking from everything from healthcare to employee priorities when purchasing benefits. Click here to see a sample report and to request a customized offering for your clients please bookmark this link and fill out form on request page. Only TCG reps should be using the link for benchmark requests.
  • Please watch their report overview video here. All requests are returned within 48 hours. If you have any questions please reach out to Marissa.eaton@sunlife.com
• New Partnership with TeleDentistry.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.

• Sun Life Onboard
  • Client onboarding just got easier. Sun Life Onboard is the new fully digital and centralized place for clients to complete implementations tasks and upload information securely, making it seamless to set up Sun Life benefits. Check out the demo experience here!
• Sun Life has enhanced the claims integrations process for Supplemental Health products. Currently they auto-notify today for Supplemental Health claims – so, if you file an accident claim and also have Hospital Indemnity, they will notify you that you also qualify for that product and start your claim. In November, the functionality will go into place for notification from an STD claim to file a Supplemental Health claim. For Stop Loss – if a cancer claim is received, they will notify a covered member that they should file their Critical Illness claim. To learn more about how they are streamlining the claims process with one claim to get paid faster click here or contact your local sales rep.
• Sun Life Disability Check Up
  • Sun Life created a disability check up to help consultants gain a deep understanding of the factors within a Client or Prospect that are necessary to design a disability plan that actually meets an employers needs.

United HealthCare

• Machine-Readable Files (MRFs) – UHC Approach
  • An employer may locate and view their Machine-Readable File information.  To do so:
    • Access transparency-in-coverage.uhc.com
    • Hit Ctrl-F on keyboard to bring up a search bar.
    • Type in the employer name and the associated MRFs will display.
    • Example:  2022-07-01_customer name_Choice-Plus_in-network-rates.json
      • Multiple files may appear
      • Select those with the specific company name, plan and area of interests (network rates, allowed amounts, etc.)
      • Files will be updated monthly in accordance with the requirements
• United HealthCare + Mineral
  • Looking to keep your business ready and resilient for whatever lies ahead? Mineral™ is included as part of your UnitedHealthcare plan to help you handle even the most complex compliance issues with confidence.
  • What can Mineral help you with?
    • Keeping track of new laws and regulations
    • Reducing your administrative burden
    • Operating successfully in multiple states
    • Addressing harassment, diversity and inclusion
    • Supporting and motivating your employees
  • For more information on Mineral, click here.

• UnitedHealthcare and WakeMed Agree to Multi-Year Contract
  • UnitedHealthcare and WakeMed have agreed to a new multi-year relationship that restores network access to WakeMed’s hospitals, employed physicians and specialists for people enrolled in UnitedHealthcare employer-sponsored and Medicare Advantage plans. The long-term agreement is effective November 15, 2022, meaning people enrolled in employer-sponsored and Medicare Advantage plans can receive in-network care at WakeMed effective immediately.

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

• Disaster Event: Florida – Hurricane Ian
  • Customers situated in Florida are being given special accommodations by Unum in the wake of Hurricane Ian, more details are included here around employee hours worked eligibility, grace period for payments, and additional support available.