Editor’s Note:  Click here for an update on agent use plan data.

You can now download a coverage map for Universal American in the Agent Protected Downloads section of the Ritter Insurance website.

To find the maps, click here.  You will be required to log in to view the maps.  Select “Universal American Today’s Options Med Advantage” as the company, select the state you want and click submit to view the file!

Because this information is for Agent’s Use Only and cannot be shared with a Medicare Beneficiary prior to October 1st, 2009, this recording is password protected.

To request a password, please e-mail me.  To view the recording, you must be a registered user of my website (we verify the licensing status of our website registrants).  If you are not a user, you can register here.

Once you have the password, you can view the recording here.

For more information about the company, you can visit our Universal American Page.

Universal American will be conducting almost 40 live training meetings starting on August 5th and running through September in the states of AR, GA, IN, ME, MO, NC, NE, NY, OK, PA, SC, TX and VA.  For details, visit our Certification Page for Universal American.

In addition to live training, you will have 2 other options:  2010 AHIP will be accepted, or you can certify for free using their Online Portal.

If you are an insurance agent and you would like to learn about Universal American (including Pyramid, American Progressive, Today’s Options and TexanPlus) plans for the upcoming plan year (2010), please join one of the three Online Webinars we will be hosting with Elizabeth Benz, Assistant Vice President of Universal American as our guest speaker.

Universal American has filed Network Based products (PPO/HMO) in 43 Markets in the states of Arkansas, Georgia, Indiana, Iowa, Maine, Mississippi, Missouri, Montana, North Carolina, Nebraska, New York, Oklahoma, Pennsylvania, South Carolina, Texas, Virginia and Wisconsin.  Additionally, Universal American will have Private Fee for Service options in ALL counties in 46 States for 2010 (including 625 “zero premium” counties).

The webinars will be held at 10 AM Eastern Time on Thursday July 16th, at 2 PM Eastern Time on Thursday July 16th and at 10AM Eastern Time on Friday, July 17th.

Registration is limited to only 100 agents/session, so register early to save your spot!  To register, simply visit our “Events Calendar” and page down to July 16th/17th and click on the Registration Link.

For more information on getting appointed with Universal American Companies, please e-mail Dave.

Universal American is committed to providing affordable Medicare Advantage (MA plans, its Today’s Options Private Fee-  (PFFS) plan, and Medicare Prescription Drug Plans (PDP) Community CCRx and PrescribalRx to today’s senior market.

Here is the link to the article.

Universal American renewed it’s commitment to the Private Fee for Service Marketing for 2010.  According to the CEO, Richard Barasch, speaking in a recent investor call, “For 2010, we expect to bid in all of our current MA markets, including PFFS counties.  We go into this bidding season with a favorable trend in our benefit ratios and an improving G&A structure.”

To assist you in looking up Doctors and Hospitals for Universal American HMO’s and PPO’s, including Generations, Texan Plus, Today’s Health and Today’s Options.

Visit our Provider Network page for Universal American for a link to the provider lookup tool.

Generally, my guidance for agents who are enrolling Dually-Eligible individuals (those with BOTH Medicare and Medicaid) is to use a Dual-Eligible Special Needs Plan (SNP), if one is available in the county of residence.  You can easily search for Dually-Eligible SNP’s by using our Medicare Quote Engine and selecting “SNP” as the plan type for 2009 Medicare Advantage Plans.

In some circumstances, where there is not a Dual-Eligible SNP available, another type of Medicare Advantage plan may better suit the individual’s needs versus Medicare and Medicaid or MediCal.

Universal American put out a nice guide to help the agent determine if an alternate plan might better suit the client and some of the pitfalls to look out for if you are considering enrolling a dually-eligible individual in a non-SNP Medicare Advantage plan. 

You can find this guide in our Resources page by selecting “Agent Guides” as your resource and any one of the Universal American Companies (American Progressive, Pyramid, Generations Healthcare or AmbriHealthPlan) as your company.

Today’s Options will be hosting Conference Calls beginning January 5th to answer questions about the Open Enrollment Period which runs from January 1st through March 31st.

They will be holding calls every other week on Monday’s at 11AM Eastern Time.

For details on how to attend, Visit our “Events Calendar“.

From Today’s Options:

The Centers for Medicare & Medicaid Services (CMS) recently issued a memo requiring Medicare Private-Fee-for-Service (PFFS) plans that permit balance billing to include additional disclaimers in members’ Evidence of Coverage explaining the full impact of balance billing on members’ costs.  We are proud to say that our PFFS plans do not allow balance billing, saving the member from out-of-pocket cost that they may be subject to in certain other plans.

From Craig:  How to tell if a plan can balance bill?  This is located in the “Premium and Other Important Information” section of the Summary of Benefits.  You can see this by running a quote with our Medicare Quote Engine and click on the “Click Here” column under “Summary of Benefits” and reading the first section.  For example:  If you see wording like this from “guess who” (below), you’ll know that the providers are allowed to balance bill:

Premium and Other Important Information
General
$18 monthly plan premium in addition to your monthly Medicare Part B premium.
Balance billing means that a provider may charge and bill you more than the plan’s payment amount for services. There is a limit on what providers may charge for Medicare-covered services.
Providers may balance bill 1 % to 15 % of the plan payment amount for the following services:
$6,000 out-of-pocket limit.
All Medicare services covered under the out-of-pocket limit

• Doctor Office Visits
• Chiropractic Services
• Podiatry Services
• Other Health Care Professional

Here is the message from Today’s Options.  You can see our Calendar of Events for the Scheduled.:

During the hectic holiday season, any time spent with consumers is truly precious. For this reason, we’ve decided to conduct our Ask Today’s Options conference calls on a limited schedule for the month of December. This reduced schedule will allow you to spend more time with your busy clients.

Please note that our December 15 and 29 conference calls have been canceled.

Our next Ask Today’s Options conference call will be held on Monday, December 22, at 11 a.m. ET.

Until we speak again, please feel free to e-mail your questions to us at asktodaysoptions@UniversalAmerican.com . We will reply promptly.

Here is a link to the AM Best story from Market Watch.

Here is a link to the AM Best news release of 12/3/08.

There will be two presenations on this Friday, November 14th to review the online enrollment process for the Universal American companies (Pyramid, American Progressive and HMO’s).  The times are 9am and 3pm.

In using this process, you will still take a paper application which will be sent into the company, however, the online process will improve the speed of issue, speed of commissions and will also immediately assign a policy number for your client.

Here is a link to the Events calendar to attend the meeting (page down to 11/14)

I attended the meeting on 11/12.  I will post the instructions on the submitting business page for Universal American.

Here is the earnings report for Universal American which includes Pyramid, American Progressive, CCRX and PrescribaRX.

Here is my Today’s Options Products page for more details.

Here is the general info from Today’s Options:

We’re bringing you even more reasons to sell Today’s Options for 2009

•          Sell Year Round — to eligible beneficiaries!

•          Available in select counties in NY, NC, and PA.

•          Designed for but not limited to Fully Medicaid Eligible and Full Low Income Subsidy Medicare Beneficiaries.

•         There is a premium associated with the Today’s Options Access Plan. However, full dual eligibles will have no net premium cost, since their premium will be offset by the Medicaid premium credit.*

•          Dental – 1 Exam & 2 Cleanings per year (up to $125 per year in preventive dental services).

•          Hearing – 1 Exam (up to $50) and a $500 hearing aid allowance per year.

•          Vision – 1 exam (up to $50) and $200 for frames and lenses per year.  

Please note, the Today’s Options Access Powered by CCRx plan does not coordinate directly with Medicaid.  Doctors will have to bill Today’s Options the amount that they would bill Medicare and then bill Medicaid separately.  Similar to the standard Today’s Options plans, doctors have to agree to accept the plans terms and conditions of payment.  Our provider relations representatives are in the process of educating doctors in the select Today’s Options Access Powered by CCRx plan counties now. 

You will log into Agent Link first.  Here is our page on Universal American Websites.  Click on “Agent Link Website to go there.  Also, I’ve included some information on how to log in, first time users, training manual, etc.

Once in the site, you will see a menu to the left of the page, a welcome message in the center, and a link to a tutorial at the bottom of the page.  To take the tutorial, click on the link and follow the instructions that appear on the screen. This will give you a complete tour, and you may explore all of the many features.  Instructions on how to complete Online enrollments will be part of the tutorial prior to November 15, so you can learn it before it goes live!

Here is a guide to what types of marketing you can engage in during the “pre-selling” season, and what you need to avoid doing.

Todays options preselling season 2009

Refer back to the previous blog post for information on how the first year v. renewal will be treated.

Here is the latest, I expect to learn a lot more today and may update this at the end of the day.  I have talked with every company as of Friday, so if there is no news, that means nothing official has been released, even verbally.

• Aetna – No news
• Bravo – No news
• Cigna – Paper Commission Schedules are Available.
• Coventry and Subsidiaries (including Health America) – Agent level commission was given out verbally.  Paper commission levels were to be distributed early this week for agents.
• Geisinger – No news
• Humana – Verbally released agent level commissions.
• Optima – No news
• Unison – Same as United Healthcare
• United Healthcare – Released agent level commissions.  Broken into 3 geographical areas, commissions are based on region.
• Universal American – Released agent level commissions.
• WellPoint (Anthem, Empire and Unicare) – Released agent level commissions.

If you would like to know commissions or would like to get contracting, please e-mail Chuck Durcharm.  Let him know which company you are interested in.

Universal American requires phone verification for all Medicare Advantage apps for 2009.  Here is the procedures for how to complete the verifications for their Private Fee for Service, PPO and HMO business.

See 2009 Verification Call at the bottom of the page.