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Health Plan Options |
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Commercial Bulletin: February 9, 2021
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You’re invited to attend our town hall
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We’re dishing about the COVID-19 vaccine for our upcoming virtual town hall! Employer and brokers are invited to join us on Thursday, February 18 at 1:00 p.m. for a dynamic conversation with Allison Hess, Geisinger Vice President of Health and Wellness and Dr. Stanley Martin, Geisinger Director of Infectious Diseases. We’ve got a full agenda for you all about vaccines, COVID-19 and staying safe – you don’t want to miss this! Click here to register.
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NEW: A COVID-19 Special Enrollment Period for Pennsylvania’s Marketplace customers
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We have been informed that Pennie, Pennsylvania’s insurance Marketplace, will be opening a newly approved Special Enrollment Period (SEP) due to the exceptional circumstances of the COVID-19 pandemic. Here’s what we know:
- The COVID-19 SEP will occur Feb. 15 – May 15, 2021.
- The SEP will be available to everyone. This means new and current enrollees are eligible to purchase coverage or switch plans.
- The date that consumers apply on with Pennie will be the “qualifying event” for this SEP.
- Coverage for this SEP will be prospective. The effective date will be the first day of the following month, even if the consumer applies on the last day of the prior month.
- While there will be a 60-day window from the qualifying event for the consumer to select a plan, the consumer must make their plan selection no later than Jun. 15, 2021.
We’ll share more information as it becomes available. But in the meantime, remember these appointment guidelines to make sure you can earn commission: Appointment processing for broker appointmentsIf you are already appointed to sell individual Marketplace plans on behalf of Geisinger Health Plan (GHP), or are seeking a new appointment for individual sales, remember that those sales are not commissionable unless we have received your FFE certification for remaining 2020 business and Pennie training certification for 2021. We will not be requiring any additional GHP product training for individual commercial business. Send your certifications to brokers@thehealthplan.com to make sure you’re ready to sell. Enrolling a new member? We’re paying commission.That’s right! For this SEP, we will be paying commissions to our brokers who enroll new members at a rate of $20 per member, per month (PMPM). But remember – you must be appointed with us to sell our Marketplace products and have completed your Pennie training to receive commission.
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1095 forms are on their way
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Subscribers are beginning to receive their 1095 forms! There may be cases in which a subscriber will receive more than one 1095 form. Here are a few examples of how this would happen:
- The member has two ID numbers.
- Example: An ACA/fully insured member had a 1/1/2019 effective date but termed on 3/31/19; they then moved to a GFA plan from 4/1/19 - 12/31/19. The member will receive two 1095 forms showing the two different spans.
- The member had termed but was then reinstated.
- Example: A member had a 1/1/2019 effective date but termed 3/31/19. They were then reinstated on 4/1/19 through 12/31/19. The member will receive two 1095 forms showing the two different spans.
- The member had any lapse of coverage.
In any of the cases listed above, the subscriber will receive a 1095 form for each enrollment span.
Our broker care team can help
There also may be situations which a subscriber will need assistance regarding their 1095 form. We encourage you to reach out to our broker care team if:
- A member’s spouse or dependent is missing on their 1095-B form.
- A member received their 1095-B form but lost it and they are requesting another copy.
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Geisinger and Children’s Hospital of Philadelphia announce affiliation agreement
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Geisinger and Children’s Hospital of Philadelphia (CHOP) announced an affiliation agreement that will increase access to and further advance the delivery of pediatric healthcare to families in central and northeast Pennsylvania. The affiliation seeks to leverage the combined expertise and infrastructure of the two organizations, ensuring that children in the region receive the right care, at the right time, in the right place, delivered by the best clinical team to meet their medical needs.
Initially focused on increasing access to excellence in quaternary, or the most advanced, specialized levels of pediatric care, the affiliation will expand to include several distinct agreements aimed at improving pediatric healthcare for children across the vast spectrum of pediatric disorders. Clinicians from CHOP and Geisinger have already begun to collaborate across numerous clinical areas including Cardiology/Cardiac Surgery, Radiology, and Laboratory Services, utilizing enhanced technology powered by virtual connections and electronic medical record (EMR) capabilities. The alliance will provide access to CHOP’s expertise in rare and complex diseases, while harnessing Geisinger’s well-established outpatient general and specialty pediatric programs and inpatient services at Janet Weis Children’s Hospital.
The affiliation also supports the healthcare, education and research missions of both organizations.
“This is an important step forward for pediatric care in Pennsylvania. When two great institutions work together to improve pediatric care delivery, our children and families win,” said Frank Maffei, MD, chair of the Department of Pediatrics at Geisinger. “This affiliation means that when children will benefit most by staying close to home, our organizations will collaborate to deliver the highest quality care. And when a child will benefit most from being at one hospital or the other, we’ll make sure this happens safely and efficiently so families can be together during these trying times, which we know is directly tied to improved outcomes.”
“CHOP and Geisinger share a dedication to improving children’s health,” said Steve Docimo, MD, senior vice president and chief operating officer of the Care Network at Children’s Hospital of Philadelphia. “We look forward to an alliance that will provide families access to the best of both of our organizations. Together, we will keep children’s well-being at the center of all we do to advance patient care.”
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Don’t forget: AdaptHealth is saying goodbye
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AdaptHealth, a company that provides home medical equipment, will stop participating with Geisinger Health Plan effective March 21, 2021. AdaptHealth is the corporate parent company that operates under the following business names: Young’s Medical, Royal HomeStar and McKesson Patient Care Solutions.
Please know that Geisinger Health Plan is committed to making this transition as smooth as possible for members. We’re working with Tomorrow Health to ensure an efficient transition with no gap in service. Existing orders and rentals will continue without interruption and Tomorrow Health will contact members to coordinate new orders.
We want to make this an easy and stress-free process and ensure members get the most out of their healthcare benefits. If you have any questions or concerns, please contact your service representative.
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Participating urgent care/convenient care clinic list now available
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The February 2021 edition of the participating urgent care flier is now available in English and Spanish. Visit the brokerHUB to download them today.
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Stay informed about COVID-19
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Geisinger.org/coronavirus is full of the most up-to-date information about the latest on COVID-19 including vaccine FAQs, our safety checklist, community resources and much more. Want the latest updates sent right to your inbox? Simply scroll down until you see the blue email sign-up box.
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Save the brokerHUB to your bookmarks
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Can’t keep all our brokerHUBs straight? Save these links to your bookmarks or wherever you can easily access it to enter with just a click:
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- Lawmakers have been negotiating on provisions of the most recent $1.9 trillion COVID-19 relief bill, which would be one of the largest spending bills ever passed by Congress.
- NAHU’s coalition, the Partnership for America’s Health Care Future, released a study this week emphasizing how catastrophic public option could be in the middle of an economic crisis like we have seen during the pandemic.
- Are you registered for Capitol Conference? It will be held virtually February 22-24. This will be one of the most important conferences ever, so please register and be ready for an experience you won’t forget.
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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