INFORMATION ON INDIVIDUAL SALES PROCESS AND SALES SUPPORT MATERIALS

The process to quote 2016 Highmark individual under age 65 products has changed.

For off-Marketplace plans, producers will no longer use the producer portal to complete the quote and application; rather, you can use the pdf application, or download a pdf of the application from the producer portal. All off-Marketplace applications will follow this paper process. Plans and rates for plans available directly through Highmark are provided in the 2016 Health Insurance Plans and Rates brochure. Both of these documents can be found on the  2016 Open Enrollment Materials website.

For on-Marketplace plans, producers will be directed to www.healthcare.gov and will not have the ability to quote or enroll through the Highmark portal. Once a Marketplace application is complete, the Marketplace will return you to a Highmark website to make a payment. Producers could also use other third-party sites offering access to Marketplace products. Plans available through the Marketplace are listed in the 2016 Health Insurance Plan Comparison Guide on the 2016 Open Enrollment Materials website.

Please review the Individual Market Sales Process Reference Guide for more details on the sales process.

Quick Links: 

• Individual Market Sales Process Reference Guide
• 2016 Open Enrollment Materials website (corrected link)

If you have any questions, please contact your individual sales channel consultant.

MEMBER LETTERS FOR AUTO-ENROLLMENTS AND RENEWALS

Letters will arrive in homes next week for ACA individual market members who are in the following scenarios:

• Plan is discontinuing and members are being auto-enrolled into a different plan for 2016
• Letter will vary based on whether members enrolled on- or off-Marketplace and if they are being auto-enrolled into an on- or off-Marketplace plan
• Members will receive the required CMS letter along with an insert from Highmark. The letter depends on the scenario:
• Members in an off-Marketplace plan being auto-enrolled into an off-Marketplace plan - preview letter
• Members in an on-Marketplace plan being auto-enrolled into an on-Marketplace plan - preview letter
• Members in an on-Marketplace plan being auto-enrolled into an off-Marketplace plan - preview letter
• Plan is renewing and members are being renewed into the same plan for 2016
• Members will receive the required CMS letter along with an insert from Highmark. The letter depends on the scenario:
• Members in an off-Marketplace plan being renewed in the same plan off-Marketplace - preview letter
• Members in an on-Marketplace plan being renewed in the same plan on-Marketplace - preview letter

As a reminder, ACA individual members who currently have a plan that is discontinuing but will not be auto-enrolled into a new one were notified in early October.