Aries insurance services, a division of URL.
Medicare Offerings
 
Applies to: Medicare
 
In this issue:
    

Getting Ready for AEP: Don't be Left Behind

Ordering Marketing Material

The 2024 Annual Enrollment Period is just around the corner, so it's a great time to make sure that you're ready.

Do you have the access you need to order enrollment kits?
All marketing material ready for ordering is available on our online storefront. Your user ID is your email address. If you do not remember your password, please click on "forgot the password," and you will get an email with a temporary password.

Need an account? Please email Laud_Anderson@HorizonBlue.com or  Nemesio_Kinsora@HorizonBlue.com to receive your login information.

Certification Begins in August

To be certified to sell Braven Health Medicare Advantage (MAPD), Horizon NJ TotalCare (HMO D-SNP) and Horizon Medicare Prescription Drug Plans (PDP), you must complete and pass the Certification Program for the current year. You must also be a licensed producer in New Jersey. Our MA, MAPD, D-SNP and PDP Certification Program closes each year at 11:59 pm on September 30, Eastern Time. Agents representing Braven Health’s MA Plans, Horizon PDP, DSNP, and Medicare Supplement plans MUST be certified or recertified by the deadline to sell for the upcoming Annual Election Period.

In order to assist your clients with 2024 plan benefits and to collect renewal commissions for the prior year’s business, you will need to be recertified in 2023.

Please Note: This also applies to 2024 Medicare Supplement Certification in order for renewals to be paid. Certification requirements do not apply to Braven MA/PDP Employer Group business.
 
Stay tuned for more information coming soon….
    

2023 FIDE SNP MIPPA Contract Changes

Brokers who sell our Horizon NJ Total Care (HMO-DSNP) should be aware of updated marketing guidelines in our New Jersey state contract.  The changes are highlighted below in red:
MARKETING REQUIREMENTS In accordance with 42 CFR 422.2268(j) and (k), the Contractor may not conduct sales activities in healthcare settings except in common areas. The Contractor’s marketing representatives, brokers, and/or agents Plan sponsors  are prohibited from conducting sales presentations, distributing and accepting enrollment applications, and soliciting beneficiaries in areas where patients primarily intend to receive health care services or are waiting to receive health care services. The Contractor shall act in accordance with the requirements and restrictions regarding active face-to-face marketing set forth in Article 5.16.1.A of the Contract as applicable to individuals eligible to enroll in FIDE SNP.
STANDARDS FOR MARKETING REPRESENTATIVES  - NEWLY ADDED - STANDARDS FOR MARKETING REPRESENTATIVES Marketing in or around a PACE (Program of All-inclusive Care for the Elderly) center shall not be permitted. “In or around a PACE center” is defined as being in an area where a marketing representative, broker, or agent can be seen from the PACE center and/or where the PACE center can be seen. The fact that an obstructed view prohibits the marketing activities from being seen shall not mitigate this prohibition.
STANDARDS FOR MARKETING REPRESENTATIVES  Marketing representatives, brokers, or agents shall not otherwise approach individuals they have reason to suspect are enrolled in PACE.
    
Going on Now:
Braven Health's Virtual Wellness Series

Our Virtual Wellness Series is happening now, and all members are invited. We will cover a new topic every month, giving them helpful insights and activities designed to improve their health and quality of life.
 
 
New topics every month!
July Fall Prevention
August Heart Health
September Stress Management
Seminars occur on the first and third Wednesday of each month.
Find a session
Members can also reserve a spot by phone.

1-888-444-0393 (TTY 711)

Monday-Friday from 9 am to 5 pm.
 
    
Routine vs. Comprehensive Dental Benefits.
 

What Is a Routine Dental Exam?

Generally, this is when a member goes to the dentist for a checkup, cleaning, and possibly X-rays. They are not seeing the dentist to treat any problems with their mouth.
Braven Health Medicare Advantage plan members pay $0 for routine dental services when they see an in-network dentist.

Routine services that are covered:

  • Three oral health exams and three cleanings per year
  • One fluoride treatment every six months
  • One full-mouth X-ray every three years
  • Bitewing X-rays every six months
    • This is an X-ray of a specific area of the mouth.
    • Bitewing is the name of the sensor used to take the image.
While this does not fall under "routine dental services," Braven Health members also have coverage for up to 50% (up to a $1,000 annual limit) for services like:
  • simple tooth extractions
  • amalgam (silver) and composite fillings
  • treatment for a disease that affects your gums and the bones supporting the teeth
Members should ask their doctor to submit an estimate to Braven Health before treatment. This is also known as pre-determination. The member will then get a document that shows if there are any costs you would need to pay.

Please note: A member's costs may be higher at an out-of-network dentist. An out-of-network dentist has not agreed to Braven Health's maximum allowed amount for each service. They may hold patients responsible for any costs above that amount.

Download the Braven Health Dental Benefits flier for a complete summary of what is and is not covered.
 
    
The Medicare Broker Portal

Your success is a big part of our success. We want you to have the necessary tools – in one centralized hub. With our Broker Portal, you have easy access to:
  • Information and resources for both Braven Health and Horizon
  • Online enrollment and tracking
  • Book of business reporting
  • Check the application status of your newly submitted enrollments
  • And more!
To gain access, please email MedicarePortal@HorizonBlue.com
For Technical Support, please call Medicare Portal Support.: 1-888-777-5075 option 5, Monday – Friday, 7 am to 6 pm, ET.
 
    
A Money-Saving Member ExtraThe Medicare Broker Portal


Blue365® is a discount program available to all Braven Health, Horizon Medicare Advantage plan, and Horizon NJ TotalCare (HMO D-SNP) members.

Once a member signs up at Blue365Deals.com, they will receive great deals and discounts from top national and local retailers. Deals either come with an instant coupon code or send the member to the vendor's website to make a discounted purchase or enroll in a discount program. 

Members can find deals in the following categories:
  • Fitness
  • Healthy Eating
  • Lifestyle
  • Personal Care
  • Financial Health
Register a Member Now
    
Lowering Rx Costs for Horizon Medicare Prescription Drug Plan and Braven Health Members
 
Several pharmaceutical assistance programs are available to help members with the cost of their medications:
  1. Pharmaceutical Assistance to the Aged and Disabled (PAAD)
  2. Senior Gold (SG)
  3. Low-Income Subsidy (LIS)
PAAD and Senior Gold

PAAD and Senior Gold are state-funded prescription programs that help eligible New Jersey residents with the cost of prescribed medication (including insulin, insulin needles, and needles for injectable medicines used for treating Multiple Sclerosis).

To receive PAAD and Senior Gold benefits, beneficiaries must enroll in a Prescription Drug Plan (PDP) or Medicare Advantage Prescription Drug (MAPD) Plan. The MAPD premiums are reduced for PAAD members; Senior Gold members pay the total premium.

Copay amounts are as follows:
  1. PAAD generic copay: $5.00, brand name drugs: $7.00.
  2. Senior Gold copay: $15.00 plus 50% of the remaining cost of each Senior Gold-covered prescription.
Members can call the PAAD/Senior Gold Hotline at 1-800-792-9745 on weekdays, 8 am to 5 pm, if they have any questions.

Low-Income Subsidy (LIS)

Low-Income Subsidy/Extra Help is a Federal Medicare program to help people with limited income and resources pay Medicare prescription drug program costs, such as premiums, deductibles, and coinsurance.

Beneficiaries may receive an application or information about Extra Help in the mail. To apply:
  1. Call Social Security Administration at 1-800-772-1213, weekdays, 7 am to 7 pm.
  2. Call the State Medicaid Agency.
  3. Enroll online at www.ssa.gov.
    
Important Reminders
  • Before submitting your online or paper application, please check you have indicated your NPN to prevent any delays with reporting and commissions.
  • If you are submitting a paper application, please also make sure your client’s Medicare number is clear and legible.
  • Please keep your information up to date so we can continue sharing updates with you. Log in to your account at Miramar-agent.com and review your profile information to ensure accuracy.
  • Make sure you are using the 2023 Permission to Contact Form. Download the form now.
  • If you have any questions about commissions, contact your GA directly.
Important Phone Numbers

Please have your GA/NPN# available when you call.
  • Star Broker Unit – Call 1-888-400-8533, Monday – Friday, 8 a.m. to 6 p.m. Get answers to your product and benefits questions.
  • Horizon NJ TotalCare (HMO D-SNP) Eligibility – Call 1-888-863-3675 to verify your client can enroll.

Contact Us

Individual Medicare Plans

Laud Anderson
Horizon BCBSNJ
Medicare Broker Sales Account Manager, Government Programs
Email: Laud_Anderson@HorizonBlue.com
Mobile: 1-973-901-4683

Nemesio J. Kinsora
Horizon BCBSNJ
Medicare Broker Sales Account Manager, Government Programs
Email: Nemesio_Kinsora@HorizonBlue.com
Mobile: 1-973-558-1866

Group Medicare Plans

Heide Rivera
Horizon BCBSNJ
Medicare Advantage Group Sales/Account Manager
Email: Heide_Rivera@HorizonBlue.com
Mobile: 1-908-801-3237

Dana Gatto
Horizon BCBSNJ
Medicare Advantage Group Sales/Account Manager
Email: Dana_Gatto@HorizonBlue.com
Mobile: 1-973-498-4347
*Blue365® offers access to savings on items that members may purchase directly from independent vendors, which are different from items that are covered under your policies with your local Blue company, its contracts with Medicare or any other applicable federal health care program. These independent vendors do not provide Blue Cross and/or Blue Shield products or services and are solely responsible for the services provided. To find out what is covered under your policies, call Horizon Blue Cross Blue Shield of New Jersey. The products and services described herein are neither offered nor guaranteed under your local Blue company’s contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to Horizon Blue Cross Blue Shield of New Jersey’s grievance process. Blue Cross and Blue Shield Association (BCBSA) and local Blue companies may receive payments from Blue365 vendors. Neither Horizon Blue Cross Blue Shield of New Jersey nor BCBSA recommends, endorses, warrants or guarantees any specific Blue365 vendor or item.

Products are provided by HIC, Horizon NJ Health, and/or Braven Health. Communications are issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. All are independent licensees of the Blue Cross Blue Shield Association. The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross Blue Shield Association. The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey. The Braven HealthSM name and symbols are service marks of Braven Health. © 2023 Horizon Blue Cross Blue Shield of New Jersey and Braven Health. Three Penn Plaza East, Newark, New Jersey 07105.
 
Horizon Blue Cross Blue Shield of New Jersey will never send you an email asking you to click on a link to validate User ID(s), password(s) or PIN(s), Social Security number(s), card or account number(s), cardholder verification value(s) (CVV2), or user-defined challenge information (e.g., mother’s maiden name, place of birth, etc.). If such a message is received, please immediately forward it to Abuse@HorizonBlue.com.

Read about Horizon BCBSNJ’s nondiscrimination policy.

This email was sent from an unmonitored mailbox. If you have questions, please contact your Horizon BCBSNJ sales executive or account manager.