AEP Calendar
What is Sept 15 – 30, 2022
· ANOC/LIS Rider Mailings
· Plan can review mailing and discuss 2023 changes to member’s current plan ONLY
· Do not discuss any other 2023 plans with members
What are the ways to enroll
Complete a Paper Application Or Online
· Available by October 5th, advocates may request a 2023 Medicare Advantage Plan Enrollment Package (Kit) through Service Cloud
· 2023 Enrollment Packages are available in:
English & Spanish OR preferred language
Complete an Online Application
· Available on connecticare.com/medicare
What are ANOCs?
What is NOA?
Medicare Annual Notice of Change (ANOC) - letters notify members of their 2023 plan and benefit changes.< Mailing Sept 16-Sept 30th>
The Notice of Availability (NOA) - Included in ANOCs explains that members can view their plan documents on our website – the member portal on or after October 15, 2022.
What is the Rewards program?
Members may earn more than $225 in rewards for getting services and completing activities that promote good health and wellness.
What is the NEW process recently added to our call opening?
Once HIPAA is verified
"May I have a good callback number in case I need to call you back?"
What is Oct 1 – 14, 2022
· Plan may begin discussing other 2023 plan options.
· Members may not enroll until October 15th.
What is Extra Help – Low Income Subsidy
Members who have questions or disagree with their 2023 Low Income Subsidy (LIS) Level may contact Centauri Health Solutions to confirm Extra Help Level or reapply for Low Income Subsidy.
Centauri contact information:
Phone: number: 877-236-4471
Business Hours: Monday to Friday, 8:30AM – 7:30 PM
Website: https://www.centaurihs.com
How do you categorize a call received about ANOC?
Service Cloud Documentation
Category: Benefits
Sub-Category: Overview
Reason: ANOC Letter 2022
(we are re-using the existing ANOC letter reason)
What is the activity for:
A New or Existing Member can earn up to $50 on Day 1 of eligibility
· Member Portal Registration
· Paperless Sign-Up
· Reward Portal Registration
What are the core elements of our Call Opening?
6 Elements
1. Branding: Thank you for calling LOB (ConnectiCare’s Medicare Connect Concierge, ConnectiCare…)
2. Rep Name: My name is REP NAME, and who do I have the pleasure of speaking with?
3. Member’s Name: Thanks for calling us, MEMBER NAME.
4. Verification: May I please have your Member ID Number? - HIPAA Verify according to Verification of Identity.
5. Call Back Number: May I have a good callback number in case I need to call you back?
6. Assistance: How may I help you today?
What is Oct 15 – Dec 7, 2022
· During the Annual Enrollment Period (AEP) Medicare beneficiaries may make health care and prescription drug coverage changes for the next year
· 2023 Sales Season starts
· Plan can review all options and warm connect members to TeleSales to change plans for 2023
· Warm Transfer prospective members (new to ConnectiCare) to TeleSales to schedule an appointment with a licensed Sales agent
· Warm Transfer existing members to TeleSales to complete a Plan Change form
· Duals (D-SNP) can only change once in the last quarter of the year. Effective date of change is 1/1/23
· Reminder: Members who wish to remain in their current plan do not take any action
What is Part D: Late Enrollment Penalty (LEP)
The Late Enrollment Penalty is an amount added to the member’s Medicare Part D monthly premium.
A member may be charged a late enrollment penalty if the member is without Part D drug coverage for any continuous period of 63 days or more after their Initial Enrollment Period.
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When can we discuss 2023 plans with Members?
What is the Activities for:
A New Member can earn additional rewards (as applicable)
$25 for completion of their HRA in the first 90-days
$25 for completion of an office visit with their PCP
$75 for members with diabetes
$50 for NEW to MEDICARE members for complete Initial Medicare Annual Well visit in the first 90-days
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What is Dec 8 – Dec 31, 2022
· Annual Enrollment Period ends
· Only members with a qualifying Special Enrollment Period may change plans for 2023
· Plan may accept January 1st, 2023, plan cancellations from members over the phone before effective date
· Members who cancel their plan prior to effective date will remain in current plan
What is included in a welcome Kit?
· Making the Most of Your plan – member handbook
· Getting information in your language
· How to access plan documents
· Notice of Availability of EOC, Directories, formulary
· Cost Sharing Guide
· PHI Release Form
· Privacy Statement
· Mail order prescription drug form
· Rewards information
· OTC Mail Order form (for OTC Mail Order plans)
What are a few ANOC Reminders?
- Should only review the ANOC mailings and the member’s current plan changes for 2023. (current members vs prospective members)
- Should NOT warm transfer members to TeleSales
Activities for An Existing Member to earn additional rewards (as applicable)
75 for preventative care
$75 for members with diabetes
$50 for female members
$25 for D-SNP members
What is the TCPA Disclaimer and what is it used for?
The TCPA disclaimer must be read:
Please confirm you understand that the phone number(s) you have provided on this call may be used by ConnectiCare or any of its contracted parties to contact you about your account, your health benefit plan or related programs or services provided to you.
USED: If the member wishes to have their account updated with a new telephone number
What is Jan 1 – Feb 28, 2023
What is Jan 1 – Mar 31, 2023
· Additional Enrollment period for members currently enrolled in a non-renewal plan (ConnectiCare Part B Saver)
· Medicare Advantage Open Enrollment Period (MAOEP) - Members may add or drop Medicare Part D
What/How can members request a Plan cancellation
Advocates can accept plan cancellations from members over the phone before the 1/1/2023 plan effective date.
Members who cancel their plan prior to the effective date will remain in their current plan. Plan cancellations can be made over the phone.
Summarize the current process on:
Materials Requests
Available 2023 plan documents that we offer:
EOCs
Drug Formularies
Provider/ Pharmacy Directories
Now through Oct. 4:
Program Overview
Members will start earning rewards January 1, 2023
Access to Rewards Portal and reward distribution goes live on 3/1
Each member has their own rewards profile so not every reward is available for every member
To earn a reward a member MUST register in the Rewards Portal and complete eligible services or activities before December 31, 2023
Members will be sent (via the mail) a reloadable rewards card upon completion of their first eligible service or activity
What is the disconnect process?
In the event the call disconnects, a callback to the Caller must be completed immediately regardless of Service Level. This includes:
· Call Disconnects while transferring an escalated call to a SR Rep, if this happens the SR Rep returns the call immediately.
· Call Disconnects while receiving assistance from a mentor. CSR to return call immediately
- Place yourself in project and email SUP for adjustment on adherence