AGENCY ACTION ALERT FOR THE WEEK OF MAY 23, 2016

Individual Market

This week's Agency Action Alert covers the following topics:

• Reminder to use new verification forms
• Highmark Marketplace Certification through Sales Sentinel process
• New underwriting process for OFF exchange Special Enrollment Period members beginning May 31, 2016

Please share this information with your sub-agents by forwarding this email, posting this content to your internal website, or copying and pasting the test into another format.

VERIFICATION FORMS

Reminder:  Producers should be utilizing the new Health Insurance Marketplace Producer of Record Confirmation Form for all ON exchange requests. This form can be found in the Resources section of the producer portal.

For OFF exchange, requests should be submitted with a copy of the application and a completed Producer's Certificate, not a verification form. 

MARKETPLACE CERTIFICATION THROUGH SALES SENTINEL

Producers should ensure they have notified Highmark of their Marketplace Certification through Sales Sentinel. 

• If you have not received credit for individual sales, please visit the producer portal and check in the profile settings to see if Highmark recognizes your certification. Follow these steps to confirm certification:
• Log into the producer portal
• Under Account Info, click profile settings
• Scroll to the bottom to view Agent Certification Notification
• Under certifications it should read: 2016 Highmark Marketplace Certification (2016-01-01 to 2017-01-01)
• If Certification for 2016 does not appear, you will need to go to Highmark Sales Sentinel site and complete the steps to notify us of your certification.
• Register/log in on the 2016 Sales Sentinel site
• Complete the steps on Sales Sentinel, through marketplace selection. You do not need to take further action. 
• Highmark will validate your training with CMS and agent credit will be given on contracts written after your certification date. 

NEW SEP UNDERWRITING PROCESS FOR INDIVIDUAL MARKET

Effective May 31, 2016 underwriting will be reviewing all OFF exchange Special Enrollment Period (SEP) applications to ensure eligibility. 

• For applications to be reviewed for underwriting, all paper work must be submitted at time of application, this includes: application, SEP form, and any documentation supporting the special enrollment, e.g. birth certificate, marriage certificate, death certificate, etc. 
• Applications can be submitted to the address or fax listed on the application. You can also email: DP_applications@highmark.com
• If an application is submitted without supporting documentation in their entirety, Highmark membership will be reaching out to producers and/or customers to retrieve the information needed to process the application. 
• Attempts will be made with a phone call, email and written letter.
• Producers and/or member will have 10 business days to provide the missing information. If information is not submitted within allotted time frame the effective date of coverage can be delayed or potentially denied. Denial will occur if missing information is received outside the SEP time frame. 
• If denial occurs the customer will receive a denial letter stating they are ineligible for Highmark coverage for not providing all information required. 

Please contact your Highmark individual sales channel consultant with any questions.