Healthcare.gov
What dates are Open Enrollment?
Nov 1st - Dec 15th
Name our 3 primary market competitors.
Network Health, Molina, and Common Ground
In order to qualify for a subsidy, a member's income needs to be under what percent of FPL?
400%
What is the annual PT/OT/ST maximum benefit limit?
20 for each
What year did the Together product launch?
2017
What does FFM stand for?
Federally Facilitated Marketplace
Name our two newest competitors in the SE Wisconsin area?
Anthem and WPS/Arise
What will the federal MOOP limit in 2021?
$8,550
What revenue code is used for ER/emergencies?
450
What is the name of our specaility pharmacy partner?
Accredo or Froedtert Specialty
Name the tax form that the FFM sends out to on-exchange members annually?
1095B
Which of our competitors include Children's Wisconsin in their network?
They all do.
In 2021, how many of our plans will have a copay for Urgent Care?
0
What is the telehealth POS code?
02
Name one of the insulin medications that is moving to Tier 6 in 2021.
Basaglar, Humalog, Humulin, Lantus, Solilqua, Toujeo, Xultophy, Lyumjev
What is the FFM's CS phone number?
800-318-2596
Which of our competitors currently has the largest market share in our service area?
Network Health
How many total plan designs will we have in 2021? This includes all standard plans and CSR plans.
29
DME over what dollar threshold requires a PA?
$500
How many millions of dollars did Together rebate to our members through this years MLR process?
$36M
In what city/state is the CMS/FFM headquartered?
Baltimore, MD
Which Minneapolis based health insurance company was purportedly going to enter our service area in 2021 (but did not)?
Bright Health
What is the generic drug copay for our Gold plan?
$10
Name one non-EHB that we currently cover on our plan.
Allergy testing or nutritional counseling
What is our Summit Place suite number?
2270