Commercial group: Total Cost of Care webinar next week
Please join us for our first producer webinar of 2025 on Wednesday, February 26 at 10:00 AM. Our chief medical officer, Jeremy Wigginton, will join us to talk about total cost of care.
Refer to your invitation for details and registration information.
Commercial group sales team
Our sales team members are available to collaborate with you and your employer group customers and prospects.
Unlock success with Medicare-focused training from Capital Blue Cross
At Capital Blue Cross, we understand the vital role you play in helping clients navigate their Medicare options. To support your continued success, we’re offering a series of exclusive training sessions designed specifically for our Medicare-certified agents. Here’s what you can look forward to when you reserve your spot:
These sessions are tailored to highlight Capital Blue Cross tools, resources, and strategies that empower you to provide top-tier service and grow your business. Whether it’s leveraging all the resources available on our producer portal, a demo on how to accurately complete a Medicare Supplement application, or showcasing innovative member benefits, these trainings are designed to set you apart.
Don’t miss your chance to gain these valuable insights! Thank you for choosing Capital Blue Cross as your trusted partner. Together, we’re making a difference for Medicare beneficiaries in our communities.
Medicare: Dual eligible/low-income subsidy special enrollment period
As we move into 2025, we want to remind you of an important change to the dual eligible/low-income subsidy (LIS) special enrollment period (SEP) and provide guidance on the Medicare open enrollment period (OEP).
Dual/LIS SEP Update — Effective January 1, 2025 The Dual/LIS SEP has reverted to a monthly enrollment opportunity but now applies only to stand-alone prescription drug plans (PDPs).
Who is impacted? Individuals who currently have Dual/LIS status without a change in benefit status.
What’s changing? Eligible individuals can now switch PDPs once per month but cannot use this SEP to enroll in or switch between Medicare Advantage (MA-only or MA-PD) plans.
What remains the same? SEPs for individuals who gain, lose, or experience a change in Dual/LIS eligibility are not affected by this change.
Additional Considerations:
Only PDP enrollments are permitted — no MA or MA-PD enrollments.
Individuals identified as "at-risk beneficiaries" or "potential at-risk beneficiaries" may not be eligible for this SEP.
Effective dates remain the first of the following month after enrollment.
Medicare OEP (January 1-March 31) Dos & Don’ts
As we are in the Medicare open enrollment period (OEP), it’s important to follow CMS marketing guidelines regarding what is and isn’t allowed:
DO:
Assist beneficiaries who proactively reach out to you with questions about plan options.
Provide factual, unbiased information when discussing plan changes or benefits.
Educate beneficiaries on their OEP rights, including the ability to make a one-time plan change if they are enrolled in a Medicare Advantage (MA) plan as of January 1.
Ensure all marketing and outreach efforts comply with CMS regulations.
DON’T:
Proactively market OEP as an opportunity to switch plans — CMS prohibits unsolicited outreach during this period.
Engage in outbound calls or advertisements specifically promoting plan changes during OEP.
Encourage beneficiaries to switch plans unless they ask about their options first.
Mislead beneficiaries about their eligibility to make changes.
For additional details on Medicare OEP compliance, please refer to CMS marketing guidelines or reach out to your broker support team.
We appreciate your continued partnership and commitment to compliance! If you have any questions, feel free to reach out to our broker support team.
Individual accounts: Check out the new application tracking feature in the producer portal
We’re excited to introduce a new enhancement to our Individual products producer portal. Brokers with Individual accounts now have access to view applications they have submitted, along with real-time status updates.
With this new feature, brokers can:
Search for applications they’ve submitted.
View a PDF copy of the application.
Check key details and status updates, including SEP approval and enrollment progress.
Use the status legend to better understand application milestones.
Export a copy for their records.
We hope this enhancement makes tracking applications easier and more transparent for our producers. If you have any questions, please reach out to our broker support team.
SOGI language will be removed from enrollment applications
We want to inform you of an important update regarding CMS guidance on Sexual Orientation and Gender Identity (SOGI) language in Medicare Advantage enrollment applications.
What you need to know:
Online enrollment forms: We are removing SOGI-related language from all online applications. Our vendor, Connecture, will begin this process by February 20, and we are instructing other vendors to do the same.
Paper enrollment forms & agent guidance: You may continue using the existing paper applications until CMS provides further guidance and a new form is issued. However, agents should NOT ask any SOGI-related questions during the enrollment process.
We will keep you informed of any further updates. If you have questions, please reach out to your broker support team.
CONTACT
Your producer relations team
Capital Blue Cross has adopted a team approach to support you, as we collaborate to enhance business relationships, foster your growth through education and incentives, and actively support the communities we serve. The Producer Relations team thanks you for your commitment and hard work. Reach out whenever you need them.
Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Communications issued by Capital Blue Cross in its capacity as administrator of programs.
