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Health Plan Options |
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Commercial Bulletin: December 8, 2020
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Stay informed about safety precautions
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Geisinger.org/safety is full of the most up-to-date information about Geisinger's latest safety measures as we navigate the COVID-19 pandemic and beyond. Want the latest updates sent right to your inbox? Simply scroll down until you see the blue emails sign-up box.
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We’re bringing back our Thursday bulletins
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With an increase in COVID-19 cases, we’re bringing back our Thursday bulletins for brokers and employers now on a biweekly schedule. These special late-week bulletins will bring you information on COVID cases in northcentral Pennsylvania, masking and social distancing tips, policy changes and much more. Keep an eye out this Thursday for our new COVID-19 bulletin.
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Reporting updates for commercial groups
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As a service to our Geisinger level-funded product groups (GFA) in Pennsylvania and New Jersey, Geisinger submits the 1094-B and 1095-B. As required by the IRS, self-insured employers that are Applicable Large Employers (ALEs) must use Form 1095-C and the transmittal Form 1094-C to meet their reporting requirements. It is the group’s responsibility to determine if they meet the IRS definition of Applicable Large Employer (ALE) and submit the required 1094-C and 1095-C forms. You can learn more about from the IRS here. Are you curious about what documents are required for different group types? Check out the chart below:
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Our deadline to submit forms for Pennsylvania and New Jersey is Mar. 31, 2021; we plan to exceed this deadline for your peace of mind. Should an event arise that prevents us from meeting our March deadline, we will notify our groups and brokers.
If you have any additional questions, please contact your GHP account executive.
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CareSite Pharmacy is changing to Geisinger Pharmacy
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Our pharmacy name has changed! Your clients have counted on CareSite Pharmacy for their groups’ medication needs in the past. While its name has changed, the quality of our care service won’t change.
We’ve always been part of Geisinger, and we’re changing our name to show it. Here’s what’s changing:
- CareSite Pharmacy is changing to Geisinger Pharmacy
- CareSite Mail-Order Pharmacy is changing to Geisinger Mail-Order Pharmacy
- CareSite Specialty Rx is changing to Geisinger Specialty Pharmacy
- VITALine Pharmacy is changing to Geisinger Home Infusion Services
Learn about our pharmacy services, including mail order enrollment, curbside pickup and more here. Here’s how utilizing Geisinger’s mail-order pharmacy can make a difference for your clients:Our mail-order pharmacy saves members time and money with medications delivered right to their doorstep. Our 90-day refill prescription medicine program is cost-saving and convenient, reducing copays for members and their families with medication sent directly to their home – for free. Let’s get down to business. We’re seeing significant savings for our 2021 small group and Marketplace plans. In 2021, our ACA small group plans and Marketplace plans are seeing a copay reduction. These plans will now have a 1.5X pharmacy copay, which dropped from last year’s 2X copay for 90-day mail order supplies. Learn more about our mail-order pharmacy.
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Refresh yourself on our Marketplace plan options
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We’re in the thick of the Marketplace open enrollment period. Don’t forget about these highlights selling Geisinger Health Plan’s marketplace plans:
- Enrollments will occur through Pennie, the new state-based insurance exchange.
- The open enrollment period ends Jan. 15, 2021.
- Those who enroll before Dec. 15, 2020 will have a plan effective date of Jan. 1, 2021 – that’s just a few days away!
- Those who enroll between Dec. 16, 2021 and Jan. 15, 2021 will have a plan effective date of Feb. 1, 2021.
- We’re offering the following metallic plan types with HMO and PPO plan options:
- Gold plans: highest premiums with the lowest out-of-pocket costs
- Silver plans: moderate premiums and out-of-pocket costs
- Bronze plans: most competitive premiums overall with higher out-of-pocket costs including a Value plan for those under 30
- Choose from one of two networks
- All-Access network: this network includes all participating providers across the entire service area within a single level of cost share. With broader access and one cost share level, plans with this network may have higher premiums.
- Premier network: this network is made up of a narrowed selection of providers with proven track records of providing great care. There are significantly fewer in-network providers in the Premier network compared to the All-Access network. Costs for in-network care will typically be lower. This network is only available in select counties. *
- Additional components: Geisinger Extra
- Some of our HMO plans include a Geisinger Extra component. Those who choose this plan type have the benefit of visiting designated Geisinger Extra primary care sites.
- Members who visit Geisinger Extra sites will pay less in copays.
- Some Geisinger Extra sites are also ProvenHealth Navigator® locations, where additional care is provided because the office is staffed with a Geisinger Health Plan nurse.
- To find a Geisinger Extra site, visit GeisingerHealthPlan.com/ProviderSearch, look in our 2021 Marketplace all plans brochure or check out our Geisinger Extra flier.
- Geisinger Extra is only available in select counties. **
* The Premier network is only available in the following counties: Carbon, Centre, Columbia, Lackawanna, Luzerne, Mifflin, Monroe, Montour, Northumberland, Schuylkill, Snyder, Union and Wayne. ** Geisinger Extra is available in the following counties: Carbon, Centre, Clinton, Columbia, Cumberland, Dauphin, Juniata, Lackawanna, Lehigh, Luzerne, Lycoming, Mifflin, Monroe, Montour, Northampton, Northumberland, Perry, Schuylkill, Snyder, Susquehanna, Union, Wayne and Wyoming. Download the 2021 Marketplace all plans brochure, the Geisinger Extra flier, the participating hospital listings and more on the individual brokerHUB.
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Know your general GHP sales contacts
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Do you know who to contact when you’ve got questions? Use this handy guide for general inquiries: I have questions about: ACA/KYP small group client service team retention group specific inquiries (alternative rate requests, CSA’s and retention group specific inquiries) Contact: GHPSMBUSCLIENTSERVICE@thehealthplan.comI have questions about: Prospect quote requests (new business quote requests and prospect specific inquiries) Contact: ghpbrokerquotes@thehealthplan.com I have questions about: Commission inquiries (commercial group and individual); Broker of Record forms; Broker appointments and licensing (commercial, individual and Medicare); agency updates (additions, deletions, email updates, communications) Contact: BROKERS@thehealthplan.com I have questions about: Commercial group, Individual and Medicare inquiries such as claims, benefits, eligibility, pharmacy, ID card requests, HRA inquiries, Application status, Medicare Commissions Contact: BrokerHelp@thehealthplan.com
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Reminder: the new and improved myGeisinger app is here
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With increased functionality and a new design, the MyChart mobile app makes it easier for your groups to stay connected to their Geisinger care from anywhere. The new myGeisinger search menu makes it easier for members to find the information they need about their care. And, if employees need a COVID-19 test, there’s no need to pick up the phone. They can schedule their COVID-19 test right from the myGeisinger app and answer pre-screening questions like a phone call on the COVID-19 hotline. Find out what’s new in myChart.
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Go behind the scenes with Geisinger frontline workers
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Geisinger frontline workers battle the COVID-19 pandemic in this new documentary, “Five Days in May.” Watch here.
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New Geisinger Extra flier
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The December edition of the monthly Geisinger Extra flier is now available in English and Spanish. As a reminder, this flier is updated on a monthly basis. Download them today on the brokerHUB.
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Save the brokerHUB to your bookmarks
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We have a corrected brokerHUB link now available that takes you to the HUB without requiring you to log in! Save this link to your bookmarks or wherever you can easily access it to enter with just a click.
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- Final rules were released this week making changes to the Stark Law and Anti-Kickback Statutes, and they include some noteworthy changes to fraud and abuse regulations to promote value-based design.
- CMS released the proposed 2022 Notice of Benefit and Payment Parameters late last week. The proposed payment rule includes several major changes to state exchange pathways, SEPs, MLR requirements, risk-adjustment programs and more.
- The Trump Administration unveiled the final rule on insurance transparency last month, requiring health insurers to provide advance notice to customers about the cost of care.
The Trump Administration unveiled the final rule on insurance transparency last month, requiring health insurers to provide advance notice to customers about the cost of care.
This week’s fast facts are brought to you by the National Association of Healthcare Underwriters.
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**If you choose to share this information with others, be mindful. Please take care to avoid altering or modifying the original messaging in this bulletin, or any Geisinger communications, in any way.** |
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