Are you ready for some OEP?

Medicare OEP – October 15, 2014 through December 7t, 2014Affordable Care Act OEP – November 15, 2014 through February 15, 2015

Participants

• The phone lines will be muted• You may type you questions in the GoToMeeting box on the right• All Q&A will be sent in a follow up email• Recorded webinar will be posted at www.TheBrokerageInc.com

Agenda

• ACA• BCBSTX• New carrier surprise!

• Certification• ACA – FFM & CMS Enterprise portal• Medicare – AHIP & FWA

• Medicare • New carrier surprise!• Plus, a new regional MAPD from the Houston area!

Agenda

• Marketing• Community, Provider, Faith Based• Retail

• Walmart• H.E.B.

• Leads• Looking forward, what to expect?

What was our August 2013 mindset?• www.HealthCare.gov – “we are ready for enrollments”• Who is a Navigator?• What is a subsidy? And what will my penalty be if I do not enroll?• How will the DHHS and CMS be able to handle two open enrollments at

once?• What is a health insurance exchange?• What is a SHOP exchange?• What is a SHOP exchange tax credit?• What will BCBSTX pay the agents?• What does “pay or play” Mean?

And what is our August 2014 mindset?• What did we learn for the first OEP in 2013?• Is www.HealthCare.gov really ready this time?• What other health insurance companies will jump off the sideline,

and where will they jump?• Will the SHOP Exchange function, and if so when?• How will the IRS collect back all of the subsidies that were over paid?• Am I ever going to get paid on all of my cases?• Why will my doctor not accept Obamacare? (What does this mean?)

BCBSTX Updates

• “POR” - Producer of Record Letters• For cases July 2014 and forward, but commissions will not be paid retro-active

to original effective date• Currently being accepted

• “AOR” - Agent of Record Letters• From January 1, 2014 effective dates that were not connected to an agent• No longer being accepted

BCBSTX Updates

• Deadlines for 2015 certification• FFM Certification deadline for current agents is September 15, 2014

• Re-contracting – make sure you have received your link!• You must have completed your re-contracting by September 1, 2014• Call Producer Services if you have not received your link at 855-782-4272

• Commissions – email Belynda@TheBrokerageInc.com on the clients you have not been paid for• Snap Shot Bonus – September 2014 payment

BAP Enhancements

• Seeing your production made easier• Commissions• Quotes• Online apps• Status

BCBSTX 2014 OEP Stats

• Off Exchange = 375,000 apps• representing 550,000 lives

• On Exchange = 100,000• representing 150,000 lives

• Total 475,000 apps

• 56% Female / 44% Male• 80% received a subsidy• Average age off exchange was 36• Average age on exchange was 42

BCBSTX ACA Enrollment Statistics

Bronze = 32% of total sales

Silver = 59%

Gold = 9%

Catastrophic = 0.6%

Platinum – not offered

Biggest issue with BCBSTX

• List bill – has to be paper for now; no electronic enrollments• “Qualifying Events” must be paper app only for now• The HMO network• Were doctors “auto-assigned”?• Did they know they were “auto-assigned”?

• Solutions being worked on:• New systems are being developed to verify if the premium has been paid

when checking in at the provider’s office

Opportunities

• In Texas, only 10% of the potential marketplace was enrolled• 39% of the existing uninsured population is Hispanic• 3,100,000 uninsured left in TX • BCBSTX wants the Hispanic population

Certification

• Instructions are online at www.TheBrokerageInc.com • ACA• Federally Funded Marketplace

• BCBSTX• New carrier surprise!• Medicare & FWA• AHIP• $125 if you register via a specific company Medicare Advantage website

AHIP Reimbursement up to $125

Write 5 MAPD applications with any combo of the following carriers:

We are super proud to announce our new affiliation with Humana!

Humana

• H1• Individual and Family coverage

• Medicare• Medicare Advantage• Medicare Supplements• Prescription Drug Plans

New Regional plan: Memorial Hermann MAPD

• Lead program to move up to 44,000 Medicare Shared Savings Plan enrollees in the 2015 Memorial Hermann MAPD• 100% iPad enrollment = 100% compliant!• Provider marketing opportunities

Leads

Marketing

• Contact Tanya or John at 800-442-4915 for store assignments• H.E.B. (up to 70 stores so far)• Walmart (up to 160 stores nationwide so far)• Memorial Hermann leads – up to 44,000!• New website to develop consumer leads for our “Marketing Partners”• Coming soon!• Medicare and ACA leads via SEO, compliments of TBI!

H.E.B. for ACA and Medicare Marketing

The Brokerage has been

awarded 70 H.E.B.

locations

DirectHealth.com (new Walmart opportunity)

• New rules, strict protocols!• $500 buy in• May be reimbursed up to 100% by

TBI with production

• Branded shirts to be purchased by participants

What to expect moving in the 2015 OEP• Annual redetermination of subsidies• Many will keep the plan they have from 2014• Per CMSs’ wishes to make things smoother from 2014 to 2015

• “IRS come to Jesus meeting in April 15, 2015”• CMS prefers to keep the disruption to a minimum and focus on

getting more people insured

Questions and Comments

Please type your questions or comments in the Q&A box to the right of your screen. We will answer all questions and send a follow up email to

all participants.