CMS
MARKET
ADVANTAGE MD
MEMBER
PROVIDER
100
What RO do we report to and what is the last name of our CMS representative?
Philadelphia & Wristbridge
100
What is the largest Medicare Advantage County in MD?
Prince George's County
100
How many and who are our Equity Partners?
6 and Anne Arundel, Mercy, Lifebridge, Peninsula Regional, Frederick, Adventist
100
What does HICN stand for and what Government agency assigns the HICN?
Health Insurance Claim Number and Social Security Administration
100
Who was hired recently to act as a liaison between PR and the Equity Partners?
Karen Rider
200
What is the original CMS name?
Healthcare Financing Administration
200
Who is our biggest competitor in MD and is a 5 STAR plan?
Kaiser
200
What does PBP stand for?
Planned benefit & bid package
200
What is the percentage of our PPO members who have not selected a PCP?
31% of our members
200
What is the name of the letter in which providers received recently announcing our HMO product?
Deeming Letter
300
How many unique quality measures are plans measured on for STARS?
41 measures
300
Who are the two other provider sponsored plans that entered the Maryland MA market in the last 5 years?
University of Maryland and Medstar
300
What is the name of the software tool we are using this year to ensure consistency with the content of our 2018 plan documents?
CodySoft
300
What is the percentage of our members in our HMO product do we expect will select a PCP?
100%
300
What is the percentages of our PPO members that are attributed to a JHCP provider?
24%
400
What is another name for the coverage Gap in Part D?
Donut Hole
400
What is the MA penetration rate in MD and Nationally?
11% and 32%
400
What is the number of in home assessments that CENSEO is attempting to complete this year?
1,200
400
What is our most recent enrollment number from CMS?
7,926
400
DAILY DOUBLE: With our HMO product... is a referral required if a Mercy PCP refers a member to a Hopkins specialist?
YES
500
What are the 3 basic requirements members must have to join a MA Plan?
1-Live in the service area where the plan operates 2-Must Have Medicare Part A and B 3-Must not have been diagnosed with End Stage Renal Disease
500
What is the MA plan in Maryland that was just removed from sanctions by CMS?
Cigna Healthspring
500
What are the 2018 premiums for our basic and plus products?
$78 and $49
500
What is the average risk score of our PPO members?
.890
500
What is the most recent score we received from CMS on our Provider directory accuracy?
54%
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