ALERT FOR THE WEEK OF JANUARY 16, 2017

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

• Find a Doctor Provider Directory Changes
• Minimum Essential Coverage Reporting Updates
• Individual Market Update
• Highmark 2017 FFM Certification Requirement Reminder
• Proposed Short Term Blue Product Discontinuation

FIND A DOCTOR PROVIDER DIRECTORY CHANGES

Effective January 1, the Highmark Find a Doctor tool on the Highmark member website has been enhanced to allow the use of natural search terms. Training for producers can be found on the Producer Portal under the Resources section listed as Find a Doctor Producer Training.  

Additionally, the Find a Doctor Member Flyer is available on under the Resources section - share this with customers to help them better understand the tool.  

If you have any questions, please contact your Highmark Client Manager or Sales Executive. 

MINIMUM ESSENTIAL COVERAGE REPORTING UPDATES

The due date for providing 1095-b forms to members for the 2016 tax year is March 2, 2017. Highmark will mail 1095-b forms to members in late February.

In December of 2016, Highmark mailed approximately 22,000 "Invalid TIN Letters" to members. There are separate group and individual versions of these letters that were sent to contract holders if a 1095-b form that Highmark filed with the IRS for that contract holder for the 2015 tax year was flagged by the IRS as having a Name/TIN mismatch. A Name/TIN mismatch occurs when a name associated with a TIN on the form filed by Highmark is different from the name associated with that TIN in the pre-existing IRS records. For example, a SSN on our file belongs to a member named Mary Smith and the same SSN in the IRS files belongs to a taxpayer named Ann Jones.

Click here to learn how a member can update their IRS/Social Security records. 

INDIVIDUAL MARKET UPDATE: HIGHMARK 2017 FFM CERTIFICATION REQUIREMENT REMINDER

In order to receive renewals for an agent's book of business in 2017, all agents should have completed their 2017 Marketplace Training Certification by December 31, 2016, as explained in the September 8, 2016, Health Care Reform Update, and in the Sales Process Training released in the October 20, 2016, Individual Market Update. If an agent has not completed Highmark's 2017 Marketplace Training, renewals will not be paid for their current book of business in 2017. 

If training has been completed, and you are not showing as "certified" in Sentinel Elite, please complete the Sentinel Elite certification by Wednesday, January 25, 2017. Failure to report certification will result in no commissions being paid.

How Does an Existing Agent Access Sentinel Elite?

Follow the instructions in the User Guide. Make sure to register in Step 3 using code HMKEX17. We would greatly appreciate your assistance distributing this important information to all your agents.

If you have any questions, please contact your Highmark Individual Sales Channel Consultant.

INDIVIDUAL MARKET UPDATE: PROPOSED SHORT TERM BLUE PRODUCT DISCONTINUATION

Highmark has filed withdrawal plans with the Pennsylvania Insurance Department (PID) to discontinue the sale of its individual market Short Term Blue PPO plans sold in the western and central regions of Pennsylvania. Pending PID approval, this product may be discontinued as early as February 1, 2017 with no new policies providing for new Short Term Blue coverage periods issued after this date.

Federal regulatory guidance issued October 28, 2016 imposing new conditions under which short-term, limited-duration insurance coverage can be offered prompted many issuers, including Highmark, to review their current products.  This guidance requires that short-term coverage must be for a period less than 90 days.  Current Highmark Short Term Blue offerings do not meet this new guidance so Highmark has decided to discontinue the product all together.  

Members who are currently enrolled in these policies will be permitted to remain on their current coverage without interruption through the end of the coverage period that they selected when they applied for their policy.  Existing policyholders will be reminded of that fact via letter that will be sent once our withdrawal plans are approved by the PID.

If you have any questions, please contact your Highmark Individual Sales Channel Consultant.