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Your Guide to the Open Enrollment Period and Changes to
DSNP SEP for 2019
2019 is almost here, and the Centers for Medicare and
Medicaid Services (CMS) has announced important changes - Open
Enrollment Period (OEP) will be reinstated for 2019 and changes have
been made to the Dual Special Needs Plan (DSNP) Special Election Period
(SEP). UnitedHealthcare is here to help you understand the
opportunities and best practices for 2019!
WHAT YOU NEED TO KNOW
OEP
AGENTS MAY
Support members who are not happy with their Medicare
Advantage (MA) or Dual Special Needs Plan (DSNP) by helping them find a
UnitedHealthcare plan that works for them and educating them about
election period options. This could be if you are approached by a
consumer at an event that you marketed to 65+ or DSNP consumers; at a
retail location; with a consumer who contacts you via phone or email;
or if a consumer you have permission to contact expresses
dissatisfaction in their current plan during a conversation.
- Educate consumers about the OEP if you are
enrolling them into a plan, or they have reached out to you about
their dissatisfaction with their current plans.
- For example, when enrolling someone, you may
say, "If you enroll in this plan and decide it's not the
right fit, you may have the opportunity to make a change to a plan
that better meets your needs. Call me and I can help determine
whether you are eligible." If a consumer reaches out to you
and says they are unhappy with his or her current plan, you can
talk about the OEP and ask if that person has already used the
election period.
AGENTS MUST
Determine if the consumer
has a valid election period and which election period is best for the
consumer's circumstances.
AGENTS MUST NOT
- Market the OEP to individuals enrolled in or
enrolling in a Medicare Advantage plan
- Knowingly target individuals to get them to
change plans so you become the agent of record.
- Promote OEP to further sales. You must not say,
"If you try out a plan in January and find it isn't working
for you, you have an Open Enrollment Period from January 1 through
March 31 to enroll in a different Medicare Advantage (MA) plan. If
that happens, give me a call, and I'll get you in a better
plan."
- Call or otherwise contact former members who
have selected a new plan during AEP
DSNP SEP
Support your members as you always do! Here is the quick
overview of the changes:
- Dual-eligible consumers can change plans once
per calendar quarter for the first nine months of the year.
- Note: Dual-eligible
consumers have the opportunity to change more frequently if their
Low Income Subsidy (LIS) or Dual status changes.
- Dual-eligible consumers can make an election
during the Annual Enrollment Period (AEP) during the fourth
quarter or use another election period if eligible.
- In line with the Comprehensive Addiction and
Recovery Act (CARA), dual-eligible consumers, who may be at risk
for misusing or abusing frequently abused drugs, are not allowed
to use the DSNP SEP. Find more information in the Enrollment Handbook on Jarvis.
CONTACT US WITH QUESTIONS
- Contact UnitedHealthcare Compliance with any
questions about how OEP or the Dual SEP works at compliance_questions@uhc.com.
- Contact the Producer Help Desk for the
following:
- At risk
- Used the SEP or not
TRAINING OPPORTUNITIES
Get the information you need to confidently sell in 2019
with the Election Period Training. Find it on the National Training
Calendar on Jarvis or register for one of December sessions below:
RESOURCES
Learn more about these changes on Jarvis or
click on the materials below.
Thank you for your
business! We strive to provide unmatched
value and a distinctive
experience for both agents and members.
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