Mutual of Omaha: Submitting and Tracking Your PDP Enrollments

Posted by www.psmbrokerage.com Admin on Fri, Nov 30, 2018 @ 01:32 PM

Mutual of Omaha: Submitting and Tracking Your PDP Enrollments

Prescription Drug Plan (PDP) enrollments can be taken via e-App or paper. Below is important information on how to access, submit and track your PDP business.

ELECTRONIC ENROLLMENTS

Accessing
The PDP electronic enrollment can be found on Sales Professional Access (SPA- www.mutualofomaha.com/broker). On the left navigation bar under Sales Tools, click:
Electronic Applications – Prescription Drug Plans e-Application – Start or Continue e-App

Submitting
Electronic enrollments are submitted electronically at the completion of the application process.

Tracking
If you take an electronic enrollment (started or submitted), click the ‘View Dashboard’ button within the PDP e-app.

For CMS approved enrollments, there are two links available to access your report:

Click the link labeled ‘Prescription Drug Plan Approvals’ under the ‘Reports’ tab in Sales Professional Access (SPA), or
Click the link ‘Approved Cases’ located on the ‘Electronic Applications’ page under the button to launch the PDP e-app.

PAPER APPLICATIONS

Ordering
A PDP enrollment packet can be order through regular channels by faxing the order form or calling Sales Support @ 800-693-6083.

Submitting
Completed paper enrollment forms can be submitted to Mutual of Omaha via fax or mail. The Scope of Appointment (SOA) should be retained by the agent and a copy must be submitted to Mutual either via Fax or email.

Enrollment Form

Fax to: 855-867-6711 (Preferred method of submission); or
Mail to: Mutual of Omaha Rx, PO Box 3625, Scranton, PA, 18505-9811

Scope of Appointment

Fax to: 402-599-5822; or
Email to: scope@omahapdp.com (Preferred method of submission)

All paper enrollment forms MUST be received by Mutual of Omaha Rx’s enrollment processor within 48 hours after the signed enrollment date.

Tracking
If you submit a paper enrollment, call 877-775-1360.

For CMS approved enrollments, there are two links available to access your report:

Click the link labeled ‘Prescription Drug Plan Approvals’ under the ‘Reports’ tab in Sales Professional Access (SPA), or
Click the link ‘Approved Cases’ located on the ‘Electronic Applications’ page under the button to launch the PDP e-app.

Mutual of Omaha Rx (PDP) is a prescription drug plan with a Medicare contract. Enrollment in the Mutual of Omaha RX plan depends on the contract renewal.

Not appointed to sell Mutual of Omaha PDP plans? Request details here

Additional Updates:

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Tags: Annual Enrollment Period, Medicare Advantage, Part D, AEP, mutual of omaha

Mutual of Omaha: Submitting and Tracking Your Medicare Advantage Enrollments

Posted by www.psmbrokerage.com Admin on Fri, Nov 30, 2018 @ 01:28 PM

Mutual of Omaha: Submitting and Tracking Your Medicare Advantage Enrollments

Medicare Advantage (MA) enrollments can be taken via e-App or paper. Below is important information on how to access, submit and track your MA business.

ELECTRONIC ENROLLMENTS

Accessing
Click on the ‘Start New Application’ icon on the Medicare Advantage producer portal. The link to the MA producer portal can be accessed on the Sales Professional Access (SPA- www.mutualofomaha.com/broker) on the Medicare Advantage product page.

Submitting
Electronic enrollments are submitted electronically at the completion of the application process.

Tracking
If you take an electronic enrollment (started or submitted), click the ‘View Dashboard’ button within the Medicare Advantage e-app.

For CMS approved enrollments click on the ‘App Tracker’ icon within the Medicare Advantage producer portal.

PAPER APPLICATIONS

Ordering
Order the paper enrollment forms from the storefront found under Documents – Resources – Store Front for Supply Orders on the Medicare Advantage producer portal.

Submitting
There are two options for submitting completed paper enrollment forms.

Producer Online Quick Entry – Log in to the MA producer portal and Select the ‘Start New Application’ icon. Complete the form online and upload your paper documents.
Producer Phone Enrollment – Once the enrollment has been completed, you MUST leave the beneficiary’s house. Call Producer Support at 877-259-8657 during business hours (Monday through Friday, 8 a.m. – 5 p.m. CST) and provide details of the enrollment.

For both options, the paper documents (enrollment form, SOA and producer checklist) must be mailed to our enrollment processing center within 48 hours of enrollment sign date. A business reply envelope for submitting these forms is provided in each enrollment kit.

Tracking
For both paper enrollments you submit and CMS approved enrollments call 877-259-8657.

Mutual of Omaha CareAdvantage is an HMO plan with a Medicare contract. Enrollment in Mutual of Omaha CareAdvantage depends on contract renewal.

Not appointed to sell Mutual of Omaha MA plans? Request details here

Additional Updates:

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Tags: Annual Enrollment Period, Medicare Advantage, Part D, AEP, mutual of omaha

CVS Health and Aetna close $69 billion merger

Posted by www.psmbrokerage.com Admin on Wed, Nov 28, 2018 @ 10:32 AM

CVS Health and Aetna close $69 billion merger

(Photo: CVS/Aetna)

Nearly one year after agreeing to merge in a bid to reinvent healthcare for Americans, CVS Health and Aetna sealed the deal on Wednesday, bringing together one of the nation's largest pharmacy chains and one of the largest health insurers.

"Today marks the start of a new day in health care and a transformative moment for our company and our industry," CVS Health President and CEO Larry Merlo said in the announcement. "By delivering the combined capabilities of our two leading organizations, we will transform the consumer health experience and build healthier communities through a new innovative health care model that is local, easier to use, less expensive and puts consumers at the center of their care."

The $69 billion merger scored approval from U.S. Justice Department antitrust enforcers and insurance regulators in 28 states, despite warnings from provider groups, patient advocates, economists and antitrust experts that the combination could harm competition and patients. New York regulators were the last to sign off on the deal on Monday.

The companies say they will together offer better, cheaper, integrated healthcare. CVS walk-in clinics would become community healthcare hubs where pharmacists would manage patients' care and counsel them between primary care visits.

Source

Not appointed with Aetna? Request details here

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Tags: Medicare Advantage, aetna

How to Ask for (and Receive) Referrals

Posted by www.psmbrokerage.com Admin on Tue, Nov 27, 2018 @ 01:24 PM

How to Ask for (and Receive) Referrals

(Photo: Freepik)

Mastering customer retention is key to the health of your business, but new customer acquisition is a big piece of that puzzle, too. Your colleagues in sales are hard at work prospecting to generate new business, but you have an opportunity to do that too -- by asking for customer referrals.

According to the Wharton School of Business, a referred customer costs a lot less to acquire and has a higher potential for retention and loyalty. In fact, a referred customer has a 16% higher lifetime value than a non-referred customer. What's more, these customers are free to acquire for your business -- a win-win.

But how do you go about breaking the ice with your customers to ask them for help? How do you encourage them to mine their network to help you without being pushy or awkward? Fear not -- in this blog post, you'll learn how to identify potential referral opportunities by asking for customer feedback, and how to ask for those referrals once you've identified good candidates.

How to Use Customer Feedback to Identify Referral Opportunities

1. Identify your advocates

Identifying potential customer advocates can seem like a huge challenge, but using a simple Net Promoter Score® (NPS) survey can help make the process a little easier. Using an NPS survey can help you pinpoint potential advocates and turn this customer feedback channel into a referral growth engine.

NPS is a customer loyalty metric utilized across multiple industries to measure how happy a customer is with your product or service. NPS is determined by sending out a single-question survey to your customers that asks: How likely is it that you would recommend our company/product/service to a friend or colleague?

Respondents are asked to score their answer based on a 1-10 scale. Responses of 7 or 8 are labeled as "Passive", and scores of 0 to 6 are considered "Detractors." If a customer responds with a score of 9-10, they're labeled "Promoters" of your business. This group is most likely to provide referrals.

2. Follow up with your promoters

Just sending out an NPS survey isn't enough. You need to follow up with potential advocates and keep the positive momentum rolling along. What's the use of seeing a set of data with people who selected 9 or 10 if you're not going to use it to your advantage?

You have to mobilize your promoters by engaging with them -- and your promoters are your advocates. They are the people who took the time to select an NPS response and raise their hands, saying, "I am willing to recommend you to my friends."

Once you have identified your promoters, you should formulate a plan to follow up and make it easy for them to refer your company or product to their professional network.

If you have an employee at your company who handles new business development or customer marketing, you can have them reach out personally and see if your promoter would be interested in referring you. The key here is to make it easy for your promoters to refer your services to their professional network. Referrals and recommendations from real customers will outperform any share button or social media campaign over the long-term.

3. Use promoter feedback for referrals and testimonials

People are more likely to trust your brand early on if they have social proof of your expertise, and testimonials and case studies are one of your most powerful assets. A great way to get testimonials for your company is simply by asking for customer feedback and turning that exact same feedback that you receive into a testimonial on your website.

There are two ways you can approach this: One is by analyzing all the comments you get from the NPS survey, and then personally emailing each respondent to ask for permission to use their comment as a testimonial. The second way would be to send out a short survey soliciting feedback from promoters.

Once you've identified these happy customers and they've indicated a willingness to speak on your company's behalf, it's time to actually ask them for a customer referral.

Check out the details on the 8 Steps on How to Ask for Referrals here

Additional Updates:

4 in 10 Medicare beneficiaries expected to be on Medicare Advantage by 2028 - View
Medicare Advantage check-up. What is the health of the MA Market? - View
5 Medicare changes you should know about - View
CMS takes action to lower prescription drug costs by modernizing Medicare - View
CVS receives final approval to acquire Aetna - View
3 Ways to practice self-care - View
Increase your sales with our complimentary tools and tech - View
Express: Mutual of Omaha weekly updates - View
VALUES Quote of the Week - View
Current agent incentive trips and contests - View

Medicare Advantage / AEP Updates:

Your path to AEP success with Precision Senior Marketing - View
Enroll your MA and PDP clients online - at no cost to you - View
2019 Medicare Advantage / Part D Certifications now available - View
2019 Medicare Advantage First Looks now available - View
2019 AEP Road Map - Start your planning today - View
The DSNP Market continues to grow. Are you missing out? - View

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Tags: inbound traffic, Referrals, Leads

5 Medicare Changes for 2019 You Should Know About

Posted by www.psmbrokerage.com Admin on Tue, Nov 27, 2018 @ 09:49 AM

5 Medicare Changes for 2019
You Should Know About

Medicare provides critical health benefits for millions of seniors. Whether you're new to the program or are already enrolled, the upcoming year has a number of changes in store. Here are five you need to know about.

1. Medicare Part B premiums are going up

Though Medicare Part A, which covers hospital visits, is usually free for Medicare enrollees, Part B, which covers doctor visits and diagnostics, charges a premium for coverage. In 2018, the standard monthly premium is $134, but that figure is climbing by $1.50 a month next year to a total of $135.50. That said, if you're a higher earner, you could end up paying significantly more for Medicare Part B.

(Photo: Getty Images)

2. Medicare deductibles are also going up

When you utilize healthcare services under Medicare, you're subject to an out-of-pocket deductible that must be met before your coverage kicks in. The annual deductible for Medicare Part B will be $185 in 2019, which represents a $2 increase from 2018. Meanwhile, the Medicare Part A inpatient deductible for hospital admittance will be $1,364 in 2019. That's a $24 increase from the current year.

3. Medicare Advantage is getting a new open enrollment period

Seniors who want coverage under Medicare can choose between the original program (which includes Part A, Part B, and a Part D drug plan) or Medicare Advantage. Advantage is an alternative to traditional Medicare that allows enrollees to bundle their healthcare needs (including prescriptions) into a single plan. And since most Advantage plans offer coverage for services like dental, hearing, and vision -- items not covered under regular Medicare -- many seniors ultimately find it far more cost-effective.

Now, if you're already on Medicare Advantage, you might be familiar with its disenrollment period, which has traditionally run from Jan. 1 through Feb. 14 each year. But starting next year, Medicare Advantage will get its own open enrollment period that will begin on Jan. 1 and continue through March 31. If you're enrolled in an Advantage plan, you'll have a chance to switch to a different one, or drop your Advantage plan and sign up for original Medicare instead. Keep in mind that this Advantage open enrollment period is different from regular Medicare's open enrollment, which runs from Oct. 15 through Dec. 7 each year.

4. Medicare Advantage is expanding its scope of coverage

If you've been on the fence about Medicare Advantage, here's some news that might sway you to give it a try. Effective next year, Advantage plans will have the option to offer lifestyle support services, including home meal delivery, transportation to and from medical appointments, and home safety fixtures (like handrails and ramps). Seniors who enroll in an Advantage plan and need help with daily living activities might also find that the cost of home health aides is covered.

Finally, there's less pressure to commit to an Advantage plan. Starting next year, you'll have the option to try out an Advantage plan for up to three months and switch to another, or original Medicare, if you're not satisfied with your coverage.

5. Medicare's telemedicine program is growing

Many seniors neglect or delay medical care because they struggle with mobility issues. To address this, Medicare has been offering a telehealth program that allows patients and doctors to connect via videoconference. Beginning in 2019, telehealth services will be available to patients who have end-stage renal disease or are in the midst of stroke treatment.

The more you know about Medicare, the better it will serve your needs. Be sure to familiarize yourself with these and other changes that are coming to Medicare next year so you're prepared for what lies ahead.

Source

Additional Updates:

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Tags: Medicare Advantage, Medicare, Medicare Part D

CMS Takes Action to Lower Prescription Drug Costs by Modernizing Medicare

Posted by www.psmbrokerage.com Admin on Tue, Nov 27, 2018 @ 09:22 AM

CMS Takes Action to Lower Prescription Drug Costs by Modernizing Medicare

(Photo: Freepik)

Proposed regulation for Medicare Parts C & D would strengthen negotiations with prescription drug manufacturers to lower costs and increase transparency for patients

Today, the Centers for Medicare & Medicaid Services (CMS) proposed polices for 2020 to strengthen and modernize the Medicare Part C and D programs. The proposal would ensure that Medicare Advantage and Part D plans have more tools to negotiate lower drug prices, and the agency is also considering a policy that would require pharmacy rebates to be passed on to seniors to lower their drug costs at the pharmacy counter.

“President Trump is following through on his promise to bring tougher negotiation to Medicare and bring down drug costs for patients, without restricting patient access or choice,” said HHS Secretary Alex Azar. “By bringing the latest tools from the private sector to Medicare Part D, we can save money for taxpayers and seniors, improve access to expensive drugs many seniors need, and expand their choice of plans. The Part D proposals complement efforts to bring down costs in Medicare Advantage and in Medicare Part B through negotiation, all part of the President’s plan to put American patients first by bringing down prescription-drug prices and out-of-pocket costs.”

In the twelve years since the Part D program was launched, many of the tools outlined in today’s proposal have been developed in the commercial health insurance marketplace, and the result has been lower costs for patients. Seniors in Medicare also deserve to benefit from these approaches to reducing costs, so today CMS is proposing to modernize the Medicare Advantage and Part D programs and remove barriers that keep plans from leveraging these tools.

“In designing today’s proposal, foremost in the agency’s mind was the impact on patients, and the proposal is yet another action CMS has taken to deliver on President Trump and Secretary Azar’s commitment on drug prices,” said CMS Administrator Seema Verma. “Today’s changes will provide seniors with more plan options featuring lower costs for prescription drugs, and seniors will remain in the driver’s seat as they can choose the plan that works best for them. The result will be increasing access to the medicines that seniors depend on by lowering their out-of-pocket costs.”

Private plan options for receiving Medicare benefits are increasing in popularity, with almost 37 percent of Medicare beneficiaries expected to enroll in Medicare Advantage in 2019, and Part D enrollment increasing year-over-year as well. The programs are driven by market competition; plans compete for beneficiaries’ business, and each enrollee chooses the plan that best meets his or her needs. Consumer choice puts pressure on plans to improve quality and lower costs. Premiums in both Medicare Advantage and Part D are projected to decline next year.

Today’s proposed changes include:

Providing Part D plans with greater flexibility to negotiate discounts for drugs in “protected” therapeutic classes, so beneficiaries who need these drugs will see lower costs;
Requiring Part D plans to increase transparency and provide enrollees and their doctors with a patient’s out-of-pocket cost obligations for prescription drugs when a prescription is written;
Codifying a policy similar to the one implemented for 2019 to allow “step therapy” in Medicare Advantage for Part B drugs, encouraging access to high-value products including biosimilars; and
Implementing a statutory requirement, recently signed by President Trump, that prohibits pharmacy gag clauses in Part D.

CMS is also considering for a future plan year, which may be as early as 2020, a policy that would ensure that enrollees pay the lowest cost for the prescription drugs they pick up at a pharmacy, after taking into account back-end payments from pharmacies to plans.

Medicare Advantage and Part D will continue to protect patient access, as both programs are embedded with robust beneficiary protections. These include CMS’s review of Part D plan formularies, an expedited appeals process, and a requirement for plans to cover two drugs in every therapeutic class.

CMS looks forward to receiving comments on these proposals and other policies under consideration.

For a blog post on the proposed rule by Secretary Azar and Administrator Verma, please visit: https://www.cms.gov/blog/proposed-changes-lower-drug-prices-medicare-advantage-and-part-d.

For a fact sheet on the proposed rule, please visit: https://www.cms.gov/newsroom/fact-sheets/contract-year-cy-2020-medicare-advantage-and-part-d-drug-pricing-proposed-rule-cms-4180-p.

Additional Updates:

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Tags: Medicare Advantage, Medicare, Medicare Part D

2019 Medicare Parts A&B Premiums and Deductibles

Posted by www.psmbrokerage.com Admin on Mon, Nov 26, 2018 @ 02:19 PM

2019 Medicare Parts A&B
Premiums and Deductibles

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Tags: Medicare Part A, Medicare Part B, Medicare, deductibles, Coinsurance

Three Ways to Practice Self-Care

Posted by www.psmbrokerage.com Admin on Mon, Nov 26, 2018 @ 02:07 PM

Three Ways to Practice Self-Care

(Photo: Simon Migaj)

Self-Care Is An Act of Resistance
By Shelly Tygielski

We often push ourselves to succeed in everything we do. Whether it’s taking care of family, excelling in your career, or giving back to your community, it can be hard to cut yourself slack without feeling like you’ve failed. Giving yourself permission to ask for, or take time for, what you need in order to address what’s going on in your mind, body, and life, is a radical act of creating space for yourself. Taking care of ourselves is an important first step to taking care of others and helps us avoid burnout and fatigue.

Here are three simple ways to practice self-care:

1) Nourish your body. When you feel tired and want a break, it’s tempting to curl up on the couch—but doing so can often leave you feeling more low-energy than before. Simple movements, like stretching, can get your blood flowing and help you feel more refreshed. Try this three-minute mindful movement exercise to warm up the body and connect with the breath.

2) Set an intention to unplug: from the news, cat gifs, Facebook likes—everything. It’s difficult to stay connected and informed without getting sucked into your phone, but spending too much time staring at your screen and scrolling through social media can cause feelings of loneliness and self-loathing. Follow these four ways to cultivate a healthier relationship with your screens, so you can stay engaged while still feeling good.

3) Seek out a moment for solitude. With traffic horns blaring, kids shouting, and phones ringing, life can get pretty noisy. Taking time to pause and embrace silence restores the mind and gives your nervous system a well-deserved break. Explore this 15-minute meditation to embrace quiet moments and find peace of mind.

Here’s hoping you all find moments to enjoy being mindful this week.

Source

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Tags: mindful, mindfulness

CVS Gets Final Approval to Acquire Aetna

Posted by www.psmbrokerage.com Admin on Mon, Nov 26, 2018 @ 01:49 PM

CVS Gets Final Approval to Acquire Aetna

(Photo: Douglas Healey/AP)

Regulators in New York state today gave CVS Health Corp. the final regulatory approval the company needed to acquire Aetna Inc.

CVS — a Woonsocket, Rhode Island-based drug store chain and pharmacy benefits manager (PBM) founded in 1964 — said that it now expects to close on its acquisition of the health insurer Wednesday.

Maria Vullo, the New York State financial services superintendent, said in a ruling on the deal released today that she does not believe that CVS has provided a clear, concrete plan for making sure that the deal reduces costs or improves health outcomes for Empire State residents.

But Vullo said that she has the authority to affect only a small part of the deal in connection with her concerns, not the deal as a whole.

The New York department “has determined that obtaining commitments from CVS Health and Aetna Inc. to address these concerns better serves the people of the state of New York than would disapproval of the application,” Vullo said.

Vullo said she has tried to increase the odds that the deal will be good for New York state residents by setting a number of conditions. The conditions include commitments from CVS that:

No funds from any Aetna company or affiliate covering New Yorkers will be used to pay for the deal.
CVS cannot increase premiums or cost-sharing amounts for New Yorkers to pay for the deal.
Aetna cannot pay dividends to CVS without prior approval from New York state regulators for at least three years.
The Aetna products now available in New York state must continue to be available for at least three years.

The New York department “will use all regulatory tools, including special reports, to review the past and future conduct of CVS Health, CVS Pharmacy, and CVS Caremark, as well as Aetna Inc. and its affiliates, and take every action necessary to ensure that the representations made in the course of this approval were fully accurate and that the parties keep all commitments made,” the department said in a press release announcing Vullo’s ruling.

Aetna

The Aetna life and health business was founded in 1853.

The company survived a devastating national financial panic in 1857, and many panics, depressions and epidemics since.

Many famous people, including Robert Heinlein, the science fiction author, spent at least some time working for Aetna.

The company now provides or administers major medical for about 38 million, and it generated about $1.9 billion in net income on $61 billion in revenue in 2017.

Like other large health insurers, the company has run into challenges because of uncertainty in Washington about how the country ought to regulate and subsidize health coverage for working-age adults.

Aetna executives made optimistic forecasts when the company began offering health coverage under the Affordable Care Act framework in late 2013. Aetna executives’ views darkened over the years, as the federal government refused to make good on the payment arrangements made through the ACA risk corridors program and the ACA cost-sharing reduction subsidy program.

Source

Not appointed with Aetna? Request details here

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Tags: Medicare Advantage, aetna

4 in 10 Medicare beneficiaries expected to be on Medicare Advantage plans by 2028

Posted by www.psmbrokerage.com Admin on Tue, Nov 20, 2018 @ 10:12 AM

4 in 10 Medicare beneficiaries expected to be on Medicare Advantage plans by 2028 Medicare Advantage enrollment and spending are expected to surge over the next decade, until more than 4 in 10 beneficiaries are in the program by 2028. The MA enrollment rate is set to grow from 34% in 2018 to 42% over the next 10 years. As the share of the population on MA grows, public perception of Medicare could shift significantly, according to the New England Journal of Medicine (NEJM). "The Medicare of tomorrow could look much different than it does today—more like a marketplace of private plans, with a backup public plan, and less like a national insurance program. This may or may not be the program that people envision when they talk about Medicare for All," NEJM authors wrote in a recent report. When the Medicare Advantage program was created, just 3% of the Medicare population participated. But both Republicans and Democrats have made policy decisions that increased enrollment significantly. Beneficiaries have grown fond of MA plans due to their strong financial protections and the extra benefits they provide, like dental care and gym memberships. Yet those extra benefits are also set to take a toll on taxpayers. Spending on MA beneficiaries is expected to almost triple, from $206 billion in 2018 to $584 billion in 2028, according to projections from the Congressional Budget Office. NEJM suggested that this public spending could become a more political issue as spending spikes, even though the plans are popular. "Policymakers could face tough choices in the future as they seek to balance competing demands to reduce the growth in Medicare spending and also provide plan choice and extra benefits," the authors wrote. "To achieve savings, they could, for example, reduce plan bonus payments and rebates. … Striking the right balance in payment policy from the perspective of beneficiaries, insurers, and the federal government is likely to remain a considerable challenge." Insurers like UnitedHealthcare, Aetna and Anthem have reported huge windfalls from the government program that is administered by private plans. And new regulatory flexibilities have CEOs bullish about the future. The program is also attracting new startups like Oscar Health and Devoted Health. Over the past decade, the program has grown from 21% of Medicare beneficiaries to 34%. But inequity issues are also likely to become more acute as MA enrollment grows, as not everyone has the same access to the same plans. Among other things, MA tends to have a smaller footprint in rural areas, according to NEJM, so beneficiaries in those areas are also more likely to be on traditional Medicare. These disparities can be problematic not just because of the extra benefits MA plans provide but also because of their financial protections. Unlike traditional Medicare, MA plans are required by CMS to have an out-of-pocket limit; in 2018, the average enrollee had an annual limit of $5,215. This can make a huge difference to seniors, many of whom live on fixed incomes with high healthcare costs. "More than one-third of all beneficiaries in traditional Medicare spent at least 20% of their per capita income on out-of-pocket health-related costs in 2013," NEJM wrote. "In addition, Medicare Advantage plans offer the convenience of one-stop shopping by covering all Medicare benefits; in contrast, most beneficiaries in traditional Medicare have wraparound supplemental coverage." As a result of these changing expectations, future policymakers may either have to alter access to MA plans or change the benefits incorporated in traditional Medicare, NEJM suggested. Source
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Tags: Medicare Advantage

Medicare Advantage Penetration by State

Posted by www.psmbrokerage.com Admin on Mon, Nov 19, 2018 @ 03:40 PM

Medicare Advantage Penetration by State The share of Medicare beneficiaries in Medicare private health plans, including Medicare Advantage plans and Medicare cost plans, varies across the country. In 25 states, at least 31 percent of Medicare beneficiaries are enrolled in Medicare private health plans, with more than 41 percent of enrollees in four states (FL, HI, MN, and OR). The majority of the Medicare private health plan enrollment in Minnesota is in cost plans, rather than Medicare Advantage plans; cost plans are paid differently and subject to different rules than Medicare Advantage plans. Medicare Advantage enrollment is less than 11 percent of Medicare beneficiaries in three mostly rural states (AK, VT, and WY). Medicare Advantage by County Within states, Medicare Advantage penetration varies across counties. For example, in Florida, 66 percent of all beneficiaries living in Miami-Dade County are enrolled in Medicare Advantage plans whereas only 10 percent of beneficiaries living in Monroe County (Key West) do so. In 135 counties, more than half of all Medicare beneficiaries are enrolled in Medicare Advantage plans or cost plans. Many of these counties are centered around large, urban areas. For example, while Miami-Dade County is the urban area with the highest Medicare Advantage penetration rate, 65 percent of beneficiaries in Monroe County, NY (Rochester) and 62 percent of beneficiaries in Allegheny County, PA (Pittsburgh) are enrolled in Medicare Advantage plans. In contrast, in 688 counties (22%), no more than 10 percent of beneficiaries are enrolled in Medicare private plans; many of these low penetration counties are in rural parts of the country but some urban areas, such as the District of Columbia, also have relatively low Medicare Advantage enrollment. https://www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage/
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Tags: Medicare Advantage

Aetna Medicare: SilverSneakers fitness benefit - More reasons to rave

Posted by www.psmbrokerage.com Admin on Mon, Nov 19, 2018 @ 10:04 AM

Aetna Medicare:
SilverSneakers Fitness Benefit

Aetna Header

More reasons to rave about the SilverSneakers fitness benefit on 2019 Aetna Medicare plans

Did you know? Members of 2019 Aetna and Aetna Coventry Medicare Advantage plans (MA/MAPD) can get a FREE fitness membership at over 15,000 SilverSneakers^® participating locations nationwide.

Plus, through SilverSneakers’ partnership with CollegeSave^{1, 2}, members can save thousands (up to $4,000 the first year) on tuition at select colleges/universities for their loved ones -- simply by working out at a participating SilverSneakers location. Encourage current members to find out more at http://collegesave.org/silversneakers.

¹Please note: Due to compliance rules, the CollegeSave program cannot be promoted to prospective enrollees as an Aetna value-add program. It can only be discussed with current members.

Also, with the FREE SilverSneakers GO^TM app, members can discover new ways to move. You and your clients can download SilverSneakers Go app from your phone's app store to check it out for yourself. With this app, members can:

Find nearby locations and check amenities
Schedule a workout
Select an adjustable workout program
Set reminders and log workouts

Resources to share with your clients

Fitness benefit comparison chart

SilverSneakers fitness benefit flyer

CollegeSave flyer

(for current members only; cannot be shared with prospective enrollees)

Want to learn more?

Check out the SilverSneakers agent resources guide (agent use only). Or, contact your local Aetna Medicare Broker Manager. Happy selling!

Not appointed with Aetna? Request details here

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Tags: Medicare Advantage, aetna, AEP

Humana adds 'grandkids-on-demand' as benefit

Posted by www.psmbrokerage.com Admin on Mon, Nov 19, 2018 @ 09:10 AM

Humana Adds "Grandkids-on-Demand" as Benefit

(Photo: Freepik)

Humana Inc. has partnered with a startup called Papa Inc. to provide "grandkids-on-demand" for qualifying members of its Medicare Advantage plans.

Papa is a peer-to-peer service platform — like ride-hailing or short-term-rental services — that connects seniors to vetted college-aged young adults to help them with anything outside of medical or assisted-living needs. Think of things that young adult grandchildren might do for their grandparents, such as light housework, going on walks, running errands or just socializing.

Papa vets and hires young adults through interviews; criminal, background and driving-history checks; and a personality test to ensure the contractors, called Papa Pals, are engaging and sensitive to seniors' needs.

The deal, announced Tuesday, the is another example of Humana's holistic, value-based approach to caring for the seniors it insures. Specifically, the deal is intended to help seniors reduce loneliness and social isolation.

Humana executives said the company's better-than-projected earnings for the third quarter and the year so far were a result of its success in addressing clinical and non-clinical needs of its insurance plans.

“At Humana, we know if we truly want to impact the health of our Medicare Advantage members, we need to look at the whole person, and that includes the social determinants of health, like loneliness and social isolation,” Deb Galloway, president of Humana's Medicare program for Central and North Florida, said in a news release.

Reducing loneliness and social isolation in its members is a big deal for Humana. The Louisville-based health care and health insurance company said in a recently published report that socially isolated seniors are at a much greater risk of developing dementia and Alzheimer's disease; are four times more likely to be hospitalized with in a year of discharge; and are two to five times more likely to die prematurely than seniors with strong social ties.

Papa is headquartered in Miami, Fla., and its services to Humana Medicare Advantage members are currently limited to Tampa region, according to the release. The service is offered for free or at a nominal fee to qualifying Humana members.

In late October, Papa closed a $2.4 million seed funding round that included a lead investment from San Francisco-based Initialized Capital and an investment from Los Angeles-based Sound Ventures, a venture capital firm co-founded by actor and activist Ashton Kutcher, as the South Florida Business Journal reports.

Papa launched its services in late 2017. Seniors can access Papa's services and over 600 contractors by phone, Papa's mobile app or on the company's website.

Source

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Tags: Humana, Medicare Advantage, Part D

Aetna Medicare Producer News: Medicare Open Enrollment Period Returns

Posted by www.psmbrokerage.com Admin on Fri, Nov 16, 2018 @ 04:13 PM

Aetna Medicare Producer News:
Medicare Open Enrollment Period Returns

Medicare Producer News

Individual MA/MAPD, PDP: November 16, 2018

Medicare Open Enrollment Period returns in January: Join a "Rules of the Road" webinar

On November 29, we're hosting a free webinar to review the CMS guidelines for the Medicare Advantage (MA) Open Enrollment Period (OEP). During the call, we'll cover all the ins-and-outs of OEP so you're ready to assist your clients starting January 1.

What is OEP for Medicare?

From January 1 – March 31, members can make a one-time election to switch to another MA plan (with or without Part D coverage) or
to return to Original Medicare (with or without Part D coverage). Download an OEP overview flyer for more information.

During MA OEP, plan sponsors and producers aren’t allowed to solicit MA/MAPD enrollments. For details on what you can and can’t do, please review section 40.7 of CMS’ 2019 Medicare Communications and Marketing Guidelines. Attend our webinar on November 29, for in-depth look at CMS' guidelines.

Check out the 2019 Journey Handbooks

3-4 When your clients enroll in one of our 2019 MA/MAPD or PDP plans, they’ll get Journey Handbook as part of their welcome kit. The handbook helps new members make the most of their plan in 2019. Inside the handbook, they can find information about:

Below are links to the 2019 handbooks. Download a copy to review so you are prepared to answer your clients' questions.

Is a fitness membership important to your clients? SilverSneakers has on-the-go options

If your clients enroll in one of our 2019 MA/MAPD plans, they can get a free fitness membership at one of the 15,000+ participating SilverSneakers® locations nationwide.

PLUS, with the new and free SilverSneakers GO™ app, it’s easy for members to exercise on the go. The app lets you:

Find nearby locations and check amenities
Schedule a workout
Select an adjustable workout program
Set reminders and log workouts

Need assistance? Here’s who to call (for brokers only)

Filling out enrollment applications	Aetna Medicare Broker Services Department 1-866-714-9301 8 a.m. to 8 p.m. ET, M - F (Open Saturday, November 17, 9 a.m. to 2 p.m. ET. Closed Saturday, November 25.)
Enrollment options (fax, mail, electronic/Ascend)
Application status
Ready-to-sell status
Getting access to the Ascend app
2019 plan benefits Select prompt 2 to be directed to 2019 plan benefits
Looking up in-network providers Before calling the hotline, check our online tools: • aetnamedicare.com/findprovider • coventry-medicare.com/findprovider	Provider Lookup Hotline 1-855-242-9735 7 a.m. to 9 p.m. CT Monday - Friday (Available during AEP only, for ready-to-sell brokers)

Not appointed with Aetna? Request details here

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Tags: Medicare Advantage, aetna, AEP

Medicare Advantage Checkup

Posted by www.psmbrokerage.com Admin on Fri, Nov 16, 2018 @ 03:31 PM

Medicare Advantage Checkup (Photo: Freepik) The emerging role of Medicare Advantage, the private-plan alternative to traditional Medicare, is gradually changing the Medicare program in ways that have important implications for beneficiaries, providers, and spending. Fueled by policy changes adopted by both Democrats and Republicans, enrollment in Medicare Advantage plans has more than tripled since 2005, from approximately 6 million to 20 million beneficiaries. Between 2018 and 2028, Medicare Advantage enrollment is projected to rise from 34% to 42% of the Medicare population. At the same time, federal spending on behalf of Medicare Advantage enrollees is projected to grow from approximately $200 billion to more than $580 billion (not including additional Medicare spending associated with coverage of prescription drugs under Medicare Part D). In this article, we begin with a brief comparison of Medicare Advantage relative to traditional Medicare. We then examine the extent to which the Medicare Advantage program is achieving goals with respect to benefits and out-of-pocket costs, plan choice, federal spending, and quality. We highlight areas in which more evidence is needed to better understand the implications of the shift from traditional Medicare toward private-plan enrollment, and we identify ongoing challenges. Download the full article in PDF Here
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Get ready this AEP with the facts about in-home healthcare services with Humana

Posted by www.psmbrokerage.com Admin on Fri, Nov 16, 2018 @ 03:15 PM

Get ready this AEP with the facts about
in-home healthcare services

header-7

Humana has personalized services that can be delivered right to a beneficiary’s door. If that sounds like a big benefit, that’s because it is. And your prospects will want to know all about it.

To make it easy for you, we created a one-page PDF that’ll help you explain the Value Proposition for healthcare services at home. Download it now, so you’ll have it when you need it.

Not appointed to sell Humana Medicare Advantage plans? Request details here

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Tags: Humana, Medicare Advantage

Mutual of Omaha Living Promise Final Expense: Automated Underwriting is Here!

Posted by www.psmbrokerage.com Admin on Thu, Nov 15, 2018 @ 03:41 PM

AUTOMATED UNDERWRITING IS HERE! We just received confirmation that the installation of the Instant Decision Living Promise e-App will be the evening of Friday, November 16 and will be live on Saturday, November 17th at 9AM Central. PLEASE READ FOR IMPORTANT INFORMATION! How do you get trained? Mutual created a training video that will walk you through the new and improved application process. The entire presentation is 21 minutes long and while it can be viewed on your mobile devices, it is best viewed on a laptop. Below is the link to the training video: https://www.brainshark.com/mutualofomaha/vu?pi=zJ9zqmkqxzkVyz0 With Automated Underwriting, you can deliver instant underwriting decisions to your clients through a faster application process. What do I need to do BEFORE Saturday, November 17th The iGo eApplication will be automatically updated, so you will not need to download any new software. There are some things you will need to do by Friday, November 16th at 5PM Central Make sure any Living Promise eApplications you have started are submitted by 5PM Central on Friday, November 16th. Any eApp that is not submitted by then will be deleted during the upgrade. Make sure you have copies of a blank application with you over the weekend. While we anticipate no problems with the installation, we do not want you to be in a jam while you are in front of a client. To download the application packets, please visit our producer website at www.mutualofomaha.com/broker and visit “Forms and Materials” to download the appropriate application. Check out the on-demand training video by clicking the link below. Instant Decision for Living Promise® eApp (In Person Signature) We’ll notify you as soon as Living Promise Instant Decision is ready, so make sure you are! Need a quick refresher on Living Promise? Click here to view this on demand training video. If you have any questions or would like to get contracted with Mutual of Omaha, please contact us at 800-998-7715 or go here
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Tags: Final Expense, mutual of omaha, living promise

Why HHS wants Medicare Advantage plans to pay for home modifications, transportation for seniors

Posted by www.psmbrokerage.com Admin on Thu, Nov 15, 2018 @ 11:58 AM

Why HHS wants Medicare Advantage plans to pay for home modifications, transportation for seniors (Photo: Pexel) Starting next year, Medicare Advantage plans will be allowed to pay for a wider array of health-related benefits including transportation and home health visits, Health and Human Services Secretary Alex Azar said on Wednesday. And by 2020, HHS will extend the range of benefits even further to allow MA plans to cover benefits such as home modifications and home-delivered meals, he said. Why? "These interventions can keep seniors out of the hospital, which we are increasingly realizing is not just a cost saver but actually an important way to protect their health, too," Azar said. "If seniors do end up going to the hospital, making sure they can get out as soon as possible with the appropriate rehab services is crucial to good outcomes and low cost as well. If a senior can be accommodated at home rather than an inpatient rehab facility or a [skilled nursing facility], they should be." Azar (pictured left) was speaking in D.C. at a healthcare policy symposium focused on social determinants of health hosted by Utah-based Intermountain Healthcare and the Orrin G. Hatch Foundation's Hatch Center. He was focusing on the agency's approach to social determinants a day after it was announced that CMS would begin allowing states to cover a broader range of mental health services under Medicaid. Specifically, CMS would consider Medicaid demonstration waivers covering short-term stays for acute care provided in psychiatric hospitals or residential treatment centers in return for states expanding access to community-based mental health services. As he spoke, Azar also teased new focus areas coming from CMS' Center for Medicare and Medicaid Innovation (CMMI) for helping vulnerable populations. “What if we provided more than connections and referrals? What if we provided solutions for the whole person including addressing housing, nutrition and other social needs all together?" Azar said. "What if we gave organizations who work with us more flexibility so they can pay beneficiaries' rent if they are in unstable housing or make sure that a diabetic has access to and can afford nutritious food? If that sounds like an exciting idea, then stay tuned to what CMMI is up to.” Azar said the moves are part of a broader push under the Trump administration to better harness the flexibility of existing programs to address social determinants that drive up health costs and hurt patient outcomes. “It probably won’t surprise you to hear that this administration is thinking about how to improve healthcare and social services while preserving what is unique about our American system: its decentralized nature and the key role played by the private sector and civil society," Azar said. “But it may surprise you that we are thinking about this very specifically in the context of social determinants of health. We are deeply interested in this question, and thinking about how to improve health and human services through greater integration has been a priority throughout all of our work." Medicare Advantage (MA) plans are offered by private companies approved by Medicare and paid by Medicare to cover patients' benefits including hospital and medical insurance. While the idea has been lauded by health experts, Kaiser Health News reported few seniors will actually be able to access these changes. Medicare officials estimate about 7 percent of Advantage members — 1.5 million people — will have access, KHN reported. Companies offering MA plans both compete for patients and hold the risk for them, Azar said. "They've got incentives to offer benefits that are both appealing to their members and that will bring down healthcare costs whether those benefits are traditionally thought of as health services or not," Azar said. "The key is just that we need to give them the flexibility to do this, which we generally don't do." https://www.fiercehealthcare.com/hospitals-health-systems/azar-and-social-determinants-health
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Tags: Medicare Advantage

How to Develop Empathy with Your Prospects and Close More Sales

Posted by www.psmbrokerage.com Admin on Thu, Nov 15, 2018 @ 09:26 AM

How to Develop Empathy with Your Prospects and Close More Sales (Photo: Pexel) The robots are coming. And they're here to take your sales job. At least, that's what we're afraid of. It might be true that technology can be integrated into many steps of the sales process. But, thankfully, it can't do everything. For now, there are a number of skills computers can't learn, and one of those is our human ability to create empathetic connections with prospects and customers. This is a key ability for the modern seller. Develop empathy and you'll enjoy more effective sales conversations. More importantly, you'll build a skill set that’s in demand and hard to replace with technology. What is Empathy? Quite simply, empathy is the ability to understand the emotional state of another person and respond appropriately. It doesn't mean you have to feel the same thing (that's sympathy). Empathy is your capacity to sense what’s going on in someone's else mind and guess at the best way to engage based on your understanding of that perspective. How Empathy Drives Sales Conversations At its heart, sales has always been about the interpersonal engagement between two people. We always hear about sales professionals being "people people." That's simply another way of saying they’re empathetic. When we talk about emotional intelligence, one of the most important things we're referring to is the ability to recognize, understand, and respond to the emotional state of others in an appropriate way. Think about your sales interactions. Key steps include building trust, uncovering needs, and creating confidence. If you can't do those well you're not going to find a lot of success. All of them are driven by sales professionals' ability to create a bridge with their prospects. By picking up on the subtle and not-so-subtle clues that our conversational partners apply, salespeople with high emotional intelligence can create stronger connections and more easily influence others. This is especially important as sales processes get more complex and involve more people. It's critical to be able to understand the motivations and thoughts of everyone involved in the process. In a world where information is a commodity, you need to be more than a source of facts and figures. You need to possess the ability to engage on an emotional level and become a resource for potential customers. If you want to guide them through their buying journey, it's imperative you connect on the human level. Tips for Developing Empathy Luckily, your emotional intelligence isn't a fixed trait. Much of your empathy is developed as you mature, but it's a muscle that can be exercised and improved. There are actually pathways in our brains called mirror neurons. They have evolved to recognize and respond to the hundreds of small, usually unnoticed, signals people give off when they interact. Taking it a step further, as we grow up, we develop what neuroscientists call the Theory of Mind. It describes our ability to put ourselves in the place of someone else and see things from their perspective. It also allows us to understand others might have thoughts, feelings, and motivations causing them to do what they do. And it's why you can pick up on the unspoken signals of your friend and ask, "What's wrong?" before they even have to tell you they just had a bad day at work. Building your ability to pick up on these signals, and learning how to interpret them, can pay huge dividends. And it's not complicated. You don't have to take special classes or training seminars. In fact, your daily sales activities provide constant opportunities to build your capacity. Here are five exercises you can use to cultivate your empathetic skills. Discover the 5 ways to develop Empathy here
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Tags: closing sales, Sales Strategies

The good, the bad and the ugly of picking Medicare Advantage plans

Posted by www.psmbrokerage.com Admin on Thu, Nov 15, 2018 @ 09:05 AM

The good, the bad and the ugly of picking Medicare Advantage plans (Photo: Pexel) Nearly half of all new Medicare enrollees are signing up for Medicare Advantage plans, which now account for about 35 percent of the entire Medicare market. The other 65 percent of Medicare beneficiaries are in what’s called original Medicare, which consists of Part A (hospital, nursing home) and Part B (doctors, equipment, outpatient expenses). Those patients usually have a private Part D drug plan, and a quarter have a private Medigap supplement policy. Medicare Advantage (MA) plans must cover everything that original Medicare covers, and they can’t discriminate against people who are ill or have preexisting conditions. Anyone, regardless of their health, can get an MA plan or switch to one during open enrollment, which continues through Dec. 7. Medicare rules have also changed and will permit anyone with an MA plan to switch to another MA plan or opt for original Medicare during the first quarter of 2019; those changes will take effect the month after they have been made. As noted often in earlier Ask Phil columns, Medicare Advantage plans have lots of beneficial aspects to them, but also lots of yellow — if not red — lights for people to heed as they decide whether to enroll. First, the positive features. The “good” A single insurance plan: MA plans offer all your insurance needs through a single insurance company plan. Ask anyone who’s had to manage three sets of documents – from a government-appointed contractor for original Medicare, a private insurer for Part D, and a private Medigap insurer – and the benefit of dealing with a single entity becomes clear. You might even call it an…advantage! Additional coverage: Most MA plans go further than original Medicare and cover things that it does not, chiefly dental, hearing and vision care, along with health club memberships and an expanding list of attractive non-medical benefits such as transportation to doctors’ appointments and the delivery of nutritious meals to folks who are recuperating at home from hospital stays. These bells and whistles are likely to attract more MA converts. I’ll have more about them in a bit. Lower costs: The greatest appeal of MA plans likely is their low costs. More and more MA plans are charging zero premiums after a person has paid the government their monthly Part B premium, which will be $135.50 next year for most individuals. MA plans usually offer two or three ceilings on out-of-pocket spending – one for their Part D drug plans, one for in-network medical expenses, and often another one for out-of-network expenses. People with MA plans thus do not need Medigap plans and, in fact, it is illegal for an insurer to sell a Medigap plan for use with an MA plan. The “bad” Limited networks: The existence of medical provider networks is a big fork in the road separating MA plans from original Medicare. MA network limitations should be carefully explored by anyone thinking of an MA or considering whether to keep the one they have. Increasingly, Medicare Advantage is offering expanded geographic coverage options. People with original Medicare are covered for services from any doctor, hospital and other caregiver in the country that accepts Medicare. This includes nearly all caregivers, although it is true that it can be hard to find caregivers in some parts of the country who are accepting new Medicare patients. MA customers, by contrast, are usually restricted to getting care from doctors and organizations included in their plan’s provider network. Most MA plans are HMOs, or health maintenance organizations, that have what are called narrow networks – relatively small groups of providers located only in the plan’s home market. Plans with broader networks and larger geographic service areas are known as PPOs, or preferred provider organizations. They provide more provider choice and cost more than an MA HMO. Historically, people who travel around the country a lot and have second homes in warmer climates have avoided MA plans because of network limitations. Increasingly, however, MA insurers are offering these “snowbirds” dual market and other expanded geographic coverage options. The “ugly” Managed care: One reason MA plans can offer more benefits and often charge less is because they can save money on medical expenses through their business agreements with members of their provider networks. The bigger source of savings, however, is that MA plans are managed care plans. Original Medicare is what’s called a fee-for-service program. If you want a procedure that Medicare approves, it will be covered by original Medicare. MA plans, by contrast, would look for low-cost providers of such procedures. They usually require enrollees to get pre-authorization from their plan before approving coverage and may require less-expensive treatment alternatives. The push toward Medicare Advantage These controls are at the heart of criticisms that many advocacy groups, including the Medicare Rights Center, the Center for Medicare Advocacy, and the National Committee to Preserve Social Security & Medicare, have of MA plans. Included in their concerns is the very clear preference by federal health regulators for MA plans over original Medicare. This tilt began during the Obama Administration and was driven by the desire to limit health-care expenses and improve the health of Medicare enrollees at the same time. Managed care became the preferred pathway for these efforts, and MA plans were favored because they already had many of the management tools in place to do so. *"Under President Trump, the preference for MA plans has become even more pronounced"* Under President Trump, the preference for MA plans has become even more pronounced, in large measure because of his administration’s preference for private insurance programs in favor of government-run efforts. The Centers for Medicare & Medicaid Services (CMS), which oversees Medicare, is implementing new MA benefits that are currently not available from original Medicare. Next year, not many plans will offer these new benefits, but they should be widely available in 2020. According to Forbes, one insurer — Anthem — will be testing in several states new services that include home-delivered meals, transportation to doctor appointments, limited in-home support from a health aide and up to $500 for home safety devices. Brent Sanders, who oversees Cigna MA marketing, said transportation benefits and home delivery of meals are “the two big ones” in terms of his firm’s non-traditional MA benefits next year. Some benefits will cost extra while others will not. Where available, such features will be offered as a package within Cigna plans but not available for purchase as individual benefits. Christopher Ciano, head of Aetna Medicare, said Aetna is providing several new benefits and is expanding its MA offerings into hundreds of new markets. “Picking an MA plan should be a holistic experience for a customer,” he said in a phone interview. “You should look at all the critical benefits that are important to you. You can’t use just a premium or an out-of-pocket maximum” to make your choice. Navigating the choices Medicare’s online Plan Finder can help people compare things likes premiums and projected plan expenses. But it is not designed to make useful comparisons with non-monetary aspects of MA plans. Even when I knew a specific plan was offering new non-medical benefits, they often weren’t included in Plan Finder or not clearly explained. Realistically, the only way to get a detailed understanding of MA benefits is to call individual insurers, and this is what insurers prefer anyway, so they can directly impress you with the virtues of their plans. Aetna and other insurers are beefing up their consumer communication programs. “We don’t want beneficiaries to get into a plan and not understand it and not be satisfied,” Ciano said. Consumers can get non-biased Medicare advice from the State Health Insurance Assistance Program (SHIP). SHIP counselors traditionally have been more equipped to help people with questions about original Medicare than private MA and Part D drug plans. But the growth of new MA benefits and the growing popularity of MA plans will require SHIP counselors to broaden their insurance skills. In most respects, the new MA benefits available in 2019 will be a test run for the more significant expansion of MA offerings for 2020. Plan Finder, in particular, will need to do a much better job to help people find and compare plans with these new benefits. Source
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Tags: Medicare Advantage

Mutual of Omaha Dental Insurance Highlights

Posted by www.psmbrokerage.com Admin on Wed, Nov 14, 2018 @ 02:35 PM

Dental Insurance for Your Medicare Clients (Photo: Freepik) Mutual of Omaha now offers dental insurance for your Medicare eligible clients. Mutual Dental Preferred and Mutual Dental Protection insurance policies also have an optional vision care rider underwritten by Mutual of Omaha Insurance Company. The dental product is available in all states except: Maryland, North Carolina, New Mexico, New York, Virginia and Washington. Mutual Dental Protection not available in Alaska Senior-age customers said they wanted a simpler dental insurance choice, one where they didn’t have to guess what’s covered. And we listened, designing two transparent, straightforward dental insurance policies that deliver the coverage they want with the confidence from knowing what their out-of-pocket costs will be. It’s dental care with no surprises. Dental insurance through Mutual of Omaha is:* Simple \| Guaranteed issue, two questions on the Med supp application, e-app available Transparent \| Customers know what’s covered and what’s not Flexible \| Two plans to choose from, both include optional vision rider Extensive \| Backed by a network of 375,000 dental provider locations Affordable \| Both policies are competitively priced See complete details. Straightforward design, guaranteed issue and coverage your clients want… all reasons for you and your clients to smile! Request details here or call us today at 800-998-7715.
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Mutual of Omaha Offers Competitive Prescription Drug Plans for your Medicare clients

Posted by www.psmbrokerage.com Admin on Wed, Nov 14, 2018 @ 02:20 PM

Mutual of Omaha Offers Competitive Prescription Drug Plans for your Medicare clients

This AEP you have two new Prescription Drug Plans to offer your Medicare clients. These new plans – Mutual of Omaha Rx Value and Mutual of Omaha Rx Plus – are available nationwide except New York.

Check out the plan details here

Looking for a reason to sell Mutual of Omaha Rx plans?

Did you know…

Their PDP Value plan shows up on Plan Finder at Medicare.gov ranked at #2 when using CMS’s average prescription cost*, and
85% of Medicare supplement customers also purchase a Part D prescription drug plan and 73% buy their Med supp and PDP from the same carrier**. Take the opportunity to offer your client a Mutual Med supp with a Mutual of Omaha Rx PDP plan from a trusted carrier.

Mutual of Omaha has plans for your Medicare-aged clients who are looking for an affordable, reliable prescription drug plan that can help make their savings last and offers broad prescription coverage.

In fact, here are three things we think they’ll love about Mutual of Omaha Rx Value and Mutual of Omaha Rx Plus:

Deliver coverage with low premiums and deductibles
Broad Coverage. Build plans around the medications that matter most to our members
Extensive Preferred Network. Give members access to a national network of more than 67,000 pharmacies, retailers, grocery stores and neighborhood pharmacies

Not appointed to sell Mutual of Omaha Part D plans? Request details here

*Estimated Annual Drug Cost: This is an estimate of the average amount an individual might pay each year for their prescription drug coverage. This estimate includes – monthly premiums, annual deductibles, drug copayments/coinsurance and drug cost not covered by prescription drug insurance.

** Source: Oliver Wyman, “The Part D Dilemma” February 2015,

Insurance products and services are offered by Mutual of Omaha Insurance Company or one of its affiliates. Mutual of Omaha Rx (PDP) is a prescription drug plan with a Medicare contract. Enrollment in the Mutual of Omaha Rx plan depends on contract renewal.

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Tags: Annual Enrollment Period, Medicare Part D, AEP, mutual of omaha

A Dozen Facts About Medicare Advantage

Posted by www.psmbrokerage.com Admin on Wed, Nov 14, 2018 @ 11:27 AM

A Dozen Facts About Medicare Advantage

(Photo: Pexel)

Medicare Advantage plans have played an increasingly larger role in the Medicare program over the past decade. More than 20 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans in 2018. This collection provides updated information about Medicare Advantage enrollment trends, premiums, and out-of-pocket limits. It also includes new analyses of Medicare Advantage plans’ extra benefits, use of prior authorization, and bonus payments paid by Medicare.

1. Enrollment in Medicare Advantage has nearly doubled over the past decade

In 2018, one in three (34%) Medicare beneficiaries – 20.4 million people – is enrolled in a Medicare Advantage plan. Between 2017 and 2018, total Medicare Advantage enrollment grew by about 1.5 million beneficiaries, or 8 percent – a nearly identical rate of growth compared to the prior year. The Congressional Budget Office (CBO) projects that Medicare Advantage enrollment will to continue to grow over the next decade, with plans including about 42 percent of beneficiaries by 2028.

2. One in five Medicare Advantage enrollees are in employer or union-sponsored group plans in 2018

One in five Medicare Advantage enrollees (4.1 million) are in group plans offered by employers and unions for their retirees in 2018. Under these arrangements, employers or unions contract with an insurer and Medicare pays the insurer a fixed amount per enrollee to provide benefits covered by Medicare. The employer or union (and sometimes the retiree) may also pay a premium for additional benefits or lower cost-sharing. The growth in enrollment in Medicare Advantage group plans reflects a larger trend by large employers (including state governments) and unions to adopt strategies to limit their liability for retirees’ health costs. Group enrollees comprise a disproportionately large share of Medicare Advantage enrollees in nine states: Alaska (100%), West Virginia (53%), Michigan (51%), Illinois (42%), Kentucky (39%), Delaware (37%), Maryland (35%), New Jersey (34%), and Wyoming (30%).

3. The share of Medicare beneficiaries in Medicare Advantage plans ranges across states from 1% to over 40%

The share of Medicare beneficiaries in Medicare private health plans, including Medicare Advantage plans and Medicare cost plans, varies across the country. In 25 states, at least 31 percent of Medicare beneficiaries are enrolled in Medicare private health plans, with more than 41 percent of enrollees in four states (FL, HI, MN, and OR). The majority of the Medicare private health plan enrollment in Minnesota is in cost plans, rather than Medicare Advantage plans; cost plans are paid differently and subject to different rules than Medicare Advantage plans. Medicare Advantage enrollment is less than 11 percent of Medicare beneficiaries in three mostly rural states (AK, VT, and WY).

4. The share of Medicare beneficiaries in Medicare Advantage plans varies across counties from less than 1% to more than 60%

Within states, Medicare Advantage penetration varies across counties. For example, in Florida, 66 percent of all beneficiaries living in Miami-Dade County are enrolled in Medicare Advantage plans whereas only 10 percent of beneficiaries living in Monroe County (Key West) do so. In 135 counties, more than half of all Medicare beneficiaries are enrolled in Medicare Advantage plans or cost plans. Many of these counties are centered around large, urban areas. For example, while Miami-Dade County is the urban area with the highest Medicare Advantage penetration rate, 65 percent of beneficiaries in Monroe County, NY (Rochester) and 62 percent of beneficiaries in Allegheny County, PA (Pittsburgh) are enrolled in Medicare Advantage plans. In contrast, in 688 counties (22%), no more than 10 percent of beneficiaries are enrolled in Medicare private plans; many of these low penetration counties are in rural parts of the country but some urban areas, such as the District of Columbia, also have relatively low Medicare Advantage enrollment.

5. Half of Medicare Advantage Prescription Drug Plan enrollees pay no premium (other than the Part B premium)

Most Medicare Advantage enrollees (88%) are in plans that include prescription drug coverage (MA-PDs), and about half of these beneficiaries pay no premium for their plan, other than the Medicare Part B premium. However, one-quarter of beneficiaries in MA-PDs pay at least $50 per month, including 10 percent who pay $100 or more per month, in addition to the Part B premium. Among MA-PD enrollees who pay a premium for their plan, the average premium is $70 per month. On average, beneficiaries in MA-PDs pay $34 per month in 2018.

6. Premiums paid by Medicare Advantage Prescription Drug Plan enrollees have been relatively constant since 2012

Overall, average premiums at the national level have been relatively steady for MA-PD enrollees since 2012, although premiums for regional PPOs have steadily increased while premiums for other types of plans have declined. Average MA-PD premiums range from $26 per month for HMO enrollees to $48 per month for local PPO enrollees and $45 per month for regional PPO enrollees.

7. Medicare Advantage enrollees’ out-of-pocket costs for Part A and B services are capped at $5,187, on average, in 2018

In 2018, the average out-of-pocket limit for in-network services covered under Medicare Part A and B services for Medicare Advantage enrollees is $5,187, similar to 2017 and 2016 levels, but substantially higher than $4,288 in 2011. As in prior years, HMO enrollees generally have lower out-of-pocket limits ($4,908 on average) than enrollees in local PPOs ($5,908 on average) or regional PPOs ($6,519 on average). Since 2011, Medicare Advantage plans have been required to limit enrollees’ out-of-pocket expenditures for services covered under Parts A and B – in contrast with traditional Medicare – and are required to have limits for in-network services that are no more than $6,700 annually. Limits were required for regional PPOs since they were first authorized in 2006.

8. Four out of five Medicare Advantage enrollees are in plans that require prior authorization for some services

Medicare Advantage plans can require enrollees to receive prior authorization before a service will be covered, and most Medicare Advantage enrollees (80%) are in plans that require prior authorization for some services in 2018. Prior authorization is most often required for expensive services, including skilled nursing facility stays, inpatient hospital stays, and Part B drugs, and is infrequently required for preventive services. In contrast to Medicare Advantage plans, traditional Medicare does not generally require prior authorization for services.

9. Most Medicare Advantage enrollees have access to some benefits not covered by traditional Medicare in 2018

Medicare Advantage plans may provide extra benefits that are not offered in traditional Medicare. Medicare Advantage plans can use rebate dollars (including bonus payments) to help cover the cost of extra benefits. Plans can also charge additional premiums for such benefits. Most enrollees are in plans that provide some dental care (62%), a fitness benefit (69%), and/or eye exams or glasses (77%). Since 2010, the share of enrollees in plans that provide fitness benefits or some dental care has increased (from 52% and 48% of enrollees, respectively) while the share with a vision benefit has been relatively steady (77% in 2010).

10.Total bonuses paid by Medicare to Medicare Advantage plans more than doubled over 4 years

Since 2012, Medicare Advantage plans have been receiving bonus payments, as a result of changes made by the Affordable Care Act of 2010 and a CMS demonstration that terminated after 2014. Medicare Advantage plans with quality ratings of 4 or more stars, and plans without ratings are eligible for bonus payments. Between 2015 and 2018, the total annual bonuses to Medicare Advantage plans have more than doubled, from $3.0 billion to $6.3 billion. The rise in bonus payments is due to both an increase in the number of plans receiving bonuses, and an increase in the number of enrollees in these plans.

11. Extra benefits are funded by bonuses and other rebate dollars paid by Medicare

Extra benefits offered by Medicare Advantage plans are funded wholly or in part by bonuses and other rebate dollars. In 2018, Medicare Advantage plans will receive an estimated $6.3 billion in bonuses, averaging $321 per enrollee. Medicare requires plans to use bonus payments to reduce cost-sharing or premiums, or provide extra benefits, while retaining some portion of the bonus payments for administrative expenses. Bonus payments are much higher, on average, for people enrolled in Medicare Advantage plans sponsored by employers or unions ($585 per enrollee) than for people in Medicare Advantage plans open to all beneficiaries ($260 per enrollee). Employer-sponsored group plans account for 20 percent of Medicare Advantage enrollment but 37 percent of bonus payments. Special Needs Plans, which are mostly comprised of people dually eligible for Medicare and Medicaid, account for 13 percent of enrollment but only 9 percent of bonus payments in 2018.

12. Most (74%) enrollees are in Medicare Advantage plans that receive bonuses in 2018 (4 or more stars or not rated)

In 2018, 74 percent of Medicare Advantage enrollees are in plans with quality ratings of 4 or more stars and eligible for bonus payments, an increase from 67 percent in 2017. An additional 1 percent of enrollees are in plans that were not rated because they were part of contracts that had too few enrollees or were too new to receive ratings.

For many years, CMS has posted quality ratings of Medicare Advantage plans to provide beneficiaries with additional information about plans offered in their area. All plans are rated on a 1 to 5-star scale, with 1 star representing poor performance, 3 stars representing average performance, and 5 stars representing excellent performance. CMS assigns quality ratings at the contract level, rather than for each individual plan, meaning that each plan covered under the same contract receives the same quality rating (and most contracts cover multiple plans).

https://www.kff.org/medicare/issue-brief/a-dozen-facts-about-medicare-advantage/

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Mutual of Omaha Living Promise Final Expense: Automated Underwriting - It's Almost Here

Posted by www.psmbrokerage.com Admin on Wed, Nov 14, 2018 @ 10:04 AM

AUTOMATED UNDERWRITING IT'S ALMOST HERE!!! Mutual of Omaha is getting even closer to releasing Automated Underwriting for Living Promise (Final Expense) e-Applications and we want you ready to go when we do. With Automated Underwriting, you can deliver instant underwriting decisions to your clients and a faster application process. Check out the on-demand training video by clicking the link below. Instant Decision for Living Promise® eApp (In Person Signature) We’ll notify you as soon as Living Promise Instant Decision is ready, so make sure you are! Need a quick refresher on Living Promise? Click here to view this on demand training video. If you have any questions or would like to get contracted with Mutual of Omaha, please contact us at 800-998-7715 or go here
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19 of the Most Motivational Videos to Inspire Your Sales Team in 2019

Posted by www.psmbrokerage.com Admin on Mon, Nov 12, 2018 @ 01:22 PM

19 of the Most Motivational Videos to Inspire Your Sales Team in 2019 Benjamin Franklin once said, "Experience keeps a dear school, but fools will learn in no other." In other words, you can rely solely on first-hand experiences to gain sales knowledge -- but it might be painful. 1. "Boiler Room": To get you hungry for success A young Ben Affleck nails it with this classic "Boiler Room" speech. Fifteen years later and this interview scene still racks up thousands of hits on YouTube. Why? He's not joking. Inspiring Line: "You will make a million dollars within three years of your first day of employment at J.T. Marlin. There is no question as to whether or not you'll become a millionaire working here. The only question is how many times over." 2. Amy Cuddy: To remind you nonverbal cues are crucial to your success Bow down to the queen of keynotes. Amy Cuddy brought in an impressive seven million views for this TED Talk, placing it among the top 20 TED Talks of all time -- and for good reason. This video is full of interesting tidbits about the nonverbal cues you're giving every minute, every day. Her advice on "power posing" is invaluable when it comes to sales meetings. Remember: Your prospects are not only evaluating your pitch, but your confidence and how you carry yourself. Inspiring Line: "If you feel like you shouldn't be somewhere: Fake it. Do it not until you make it, but until you become it." 3. "Hidden Figures": To highlight the importance of being first "Hidden Figures" is the true story of Katherine Johnson (Taraji P. Henson), Dorothy Vaughan (Octavia Spencer), and Mary Jackson (Janelle Monáe), three African-American women who serve at NASA as part of astronaut John Glenn's historic launch into orbit. This clip highlights Jackson's fight to be allowed to attend classes that would further her work as a NASA engineer. Never underestimate the value of a well-worded, thoughtful speech in winning someone over. Inspiring Line: "Out of all the cases you're going to hear today, which one is going to matter a hundred years from now? Which one is going to make you the first?" 4. Steve Jobs: To encourage you to love what you do Steve Jobs. Arguably the best salesperson of our generation explains what really makes us salespeople tick: The love of what we do. Remind yourself of this and you will succeed every time. Inspiring Line: "If you look at the ones that ended up being successful in the eyes of society, oftentimes it's the ones that loved what they did, so they could persevere when it got really tough." 5. "Friday Night Lights": To motivate you to work as a team It has been said that sales is the ultimate contact sport. Football or sales, every day you go out there and hustle your way to the top. Whether you're in the locker room or sitting at your desk, this one pulls on the heartstrings. Inspiring Line: "Being perfect is not about that scoreboard out there. It's not about winning. It's about you and your relationship to yourself and your family and your friends. Being perfect is about being able to look your friends in the eye and know that you didn't let them down." 6. Motivational Montage: To give you a quick hit of all the motivational greats A quick search for "motivational speech" will bring you 2,150,000 YouTube results, but when it comes to quality, Mateusz M is the king of catalyst. Mateusz has created an art of his own. "Dream" is a personal favorite. A montage made from the very best of "Into The Wild," "Rocky 4," "Seven Pounds," "Pursuit of Happyness," and "A Beautiful Mind," completes this piece of gold. Inspiring Line: "Greatness is not this wonderful, esoteric, elusive, god-like feature that only the special among us will ever taste. It's something that truly exists -- in all of us." 7. "Wolf of Wall Street": To get you fired up This entire movie is full of outrageous monologues, but if you don't have hours to spare, here's a three-minute refresher. A quick recap of this blockbuster: Jordan Belfort (the real-life "Wolf of Wall Street") gets out of jail, writes a New York Times bestselling memoir, and sells the film rights to Red Granite Productions. The biopic grosses $392 million worldwide and Leo lands a Golden Globe for Best Actor. Everybody's happy! The (Only SFW) Inspiring Line: "So you listen to me and you listen well. Are you behind on your credit card bills? Good -- pick up the phone and start dialing!" 8. The Young Guru: To make you cry a little The youngest motivator to grace this list, this six-year-old superstar's words of wisdom are so moving they have been made into dozens of autotune remixes. A T-Pain in the making. Inspiring Line: "Thumbs up everybody -- for rock and roll!" 9. Shonda Rhimes: To remind you to push past your comfort zone For one year, Shonda Rhimes said "yes" to everything that scared her and got her out of her comfort zone. She's the powerful mind behind the hit shows Grey's Anatomy, Scandal, and How to Get Away With Murder. Rhimes is passionate about her work and when she's in the zone, and deep in her work, she calls it a "hum." In her Ted Talk, she tells her story of how she lost her "hum" and what she did to get it back. Inspiring Line: "And a crazy thing happened: the very act of doing the thing that scared me undid the fear, made it not scary. My fear of public speaking, my social anxiety, poof, gone. It's amazing, the power of one word. "Yes" changed my life." 10. "Erin Brockovich": To highlight why you should play the long game Erin Brockovich is a legal clerk and environmental activist who was instrumental in building a case against the Pacific Gas and Electric Company of California in 1993 despite her lack of formal education. Julia Roberts famously brought Brockovich to life in the eponymous film, showing just what planning, hard work, and grit can do to turn a meeting or a deal your way. Inspiring Line: "By the way, we had that water brought in special for you folks." 11. "Glengarry Glen Ross": To make you feel like a closer I'm just going to say it: This is the most iconic sales monologue of all time. Alec Baldwin completely demolishes this scene from 1992's "Glengarry Glen Ross." In terms of practical advice, you might be better off with Amy Cuddy but Alec instills a bit of good old-fashioned grit. Who's a closer? You're a closer! Inspiring Line: "A-B-C. A: always, B: be, C: closing. Always be closing!" 12. Amy Purdy: To challenge you to look at obstacles as opportunities How do you respond to challenges? Amy Purdy, now a professional snowboarder, lost both her legs below the knee when she was 19 years old. She tells her inspiring story of recovery and how she drew inspiration despite facing a tremendous obstacle. Inspiring Line: "So the thought that I would like to challenge you with today is that maybe instead of looking at our challenges and our limitations as something negative or bad, we can begin to look at them as blessings, magnificent gifts that can be used to ignite our imaginations and help us go further than we ever knew we could go. It's not about breaking down borders. It's about pushing off of them and seeing what amazing places they might bring us." 13. "Braveheart": To inspire your courage Alright, so Mel isn't really talking about sales here but it's too epic to not make the list. Channel your inner William Wallace while you work through those cold calls. Inspiring Line: "They may take our lives but they will never take our freedom!" 14. "Joy": To put a smile on your face "Joy" is the true story of entrepreneur and QVC star Joy Mangano. During a tour of the QVC sound stage, executive Neil Walker (played by Bradley Cooper) explains what makes stars Joan Rivers and her co-host Cindy so great at selling. He highlights their timing and the warmth they bring to their sales segments. It's more than just who they are and what they're pitching, it's that they're masters of knowing their audience and closing deals. Inspiring Line: "The stars, they always make the mistake -- they think it's about the face but it's not. It's really about the hands and the eyes." 15. Eric Thomas: To remind you, you've got to want it How bad do you want it? Perhaps one of the most underrated speeches on this list comes from Eric Thomas, a motivational speaker, and youth activist. While you're at it, download this as an MP3 and put it on your gym playlist. Get your elliptical on. Inspiring Line: "Listen to me -- you will never be successful until I don't have to give you a dime to do what you do." Bonus Inspiring Line (too great to leave out): "When you want to succeed as bad as you want to breathe, then you'll be successful." 16. Angela Lee Duckworth: To help you build your grit It takes grit to succeed in sales. In her TED Talk, Angela Lee Duckworth speaks about the power of passion and perseverance. She also emphasizes the need for a growth mindset to build grit. The growth mindset is the idea that "the ability to learn is not fixed, that it can change with your effort" and it was introduced by psychologist Dr. Carol Dweck. Bonus material: Here's Dweck's Ted Talk that provides more detail about the growth mindset. Inspiring Line: "Grit is passion and perseverance for very long-term goals. Grit is having stamina. Grit is sticking with your future, day in, day out, not just for the week, not just for the month, but for years, and working really hard to make that future a reality. Grit is living life like it's a marathon, not a sprint." 17. "Any Given Sunday": To stress no gain is too small In this classic clip from "Any Given Sunday", Al Pacino's Coach Tony D'Amato fires up his players before a big game by explaining that life is a game of inches. We fight for what we want, inch by inch, to reach our goals. That's how we become successful. That's how we win. Inspiring Line: "Life's this game of inches. In life or football, the margin for error is so small ... the inches we need are everywhere around us ... on this team, we fight for that inch ... That's what living is -- that six inches in front of your face." 18. "The Pursuit of Happyness": To remind you no one can tell you what you can or can't do In the Pursuit of Happyness, Will Smith's character is a father on the brink of homelessness trying to make a better life for his son. In this scene, he encourages his son to fight for his dreams -- even in the face of being told he "can't" do something. Inspiring Line: "Don't ever let someone tell you can't do something. Not even me, alright? You got a dream? You got to protect it." 19. "The Office": To show you the power of passion in creating a compelling message If you're a fan of the office, you're likely familiar with this inspiring clip. Dwight's prank-prone coworker Jim, coaches a nervous Dwight before a big speech he must give to other paper salespeople at a Northwest conference. What Dwight doesn't know is that Jim has coached him with speech notes from infamous dictators. Dwight delivers the speech and puts so much heart into it, the room is inspired -- a reminder that when you're passionate about something, it's infectious (even if it's a little ridiculous). Inspiring Line: "Some people will tell you salesman is a bad word. They'll conjure up images of used-car dealers and door-to-door charlatans. This is our duty to change their perception. I say salesmen and women of the world unite. We must never acquiesce, for it is together, together that we will prevail." Source
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Tags: sales advice, mentor, sales books

New Medicare Advantage Benefits Are Supposed To Help Seniors Stay Out Of The Hospital

Posted by www.psmbrokerage.com Admin on Mon, Nov 12, 2018 @ 12:58 PM

New Medicare Advantage Benefits Are Supposed To Help Seniors Stay Out Of The Hospital For some older adults, private Medicare Advantage plans next year will include a host of new benefits, such as transportation to medical appointments, home-delivered meals, wheelchair ramps, bathroom grab bars, or air conditioners for asthma sufferers. But the new benefits will not be widely available, and they won't be easy to find, during this fall's enrollment period. Of the 3,700 plans across the country next year, only 273 in 21 states will offer at least one. About 7 percent of Advantage members — 1.5 million people — will have access, Medicare officials estimate. That means even for the savviest shoppers it will be a challenge to figure out which plans offer the new benefits and who qualifies for them. Medicare officials have touted the expansion as historic and an innovative way to keep seniors healthy and independent. Despite that enthusiasm, a full listing of the new services are not available on Medicare's web-based "plan finder," the government tool used by beneficiaries, counselors and insurance agents to sort through dozens of plan options. Medicare officials see the added benefits as a key to helping Advantage members prevent costly hospitalizations. Federal approval of new supplemental benefits is "one of the most significant changes made to the Medicare program," said Seema Verma, the head of the Centers for Medicare & Medicaid Services, at an insurers' meeting last month. She added that she expects plans to expand the number of services in coming years. Medicare Advantage plans, which are an alternative to traditional Medicare, serve 21 million beneficiaries and limit their out-of-pocket expenses. But they also restrict members to a network of doctors, hospitals and other medical providers. They often offer benefits not available in traditional Medicare, such as dental and vision care, hearing aids and gym memberships. The federal government pays the plans to help cover the cost of each member. Enrollment is underway now for choosing a Medicare Advantage plan, as well as for people in traditional Medicare who want to buy a policy for drug coverage. The deadline for both plans is Dec. 7. Among the new benefits that some Medicare Advantage plans said they will offer are: Trips to the pharmacy or fitness center in addition to doctor's appointments for plan members, depending on where they live or their health conditions. A monthly or quarterly allowance for over-the-counter pharmacy products such as cold and allergy medications, eye drops, vitamins, supplements and compression stockings. Doctors or other health care providers who make housecalls, under certain conditions. A home health care aide for a limited number of hours to help with dressing, eating and other daily activities, sometimes including household chores and light housekeeping. Read the full article here
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Tags: Medicare Advantage

Medicare Supplement 3rd Quarter Results

Posted by www.psmbrokerage.com Admin on Mon, Nov 12, 2018 @ 12:49 PM

Medicare Supplement 3rd Quarter Results Last month CSG Actuarial reported the 3rd quarter 2018 Medicare Supplement enrollment results for UnitedHealthcare. They now have updates from other market leaders Aetna, Humana, CNO Financial, and Torchmark, summarized below. Aetna Reports Results for 3rd Quarter 2018 For 3rd quarter 2018, Aetna reported Medicare Supplement member in-force counts of 775,000, up 18,000 from 2nd quarter 2018 and 42,000 over the past 12 months. The 18,000 increase in membership during 3rd quarter 2018 was double the membership growth in 3rd quarter 2017. The table below shows Aetna’s Medicare Supplement enrollment counts by quarter since 4th quarter 2011 and annual increase in Medicare Supplement enrollment counts by quarter since 4th quarter 2012. CSG Actuarial projects Aetna’s overall Medicare Supplement sales at 4th in the overall market over the past 12 months. Humana Reports Medicare Supplement Results for 3rd Quarter 2018 Humana reported 3rd quarter 2018 Medicare Supplement lives of 246,600, a 2.1% increase over 2nd quarter 2018 and a 5% increase over 3rd quarter 2017. The 5,100 increase in membership during 3rd quarter 2018 was 132% higher than the membership growth in 3rd quarter 2017. The table below shows Humana’s Medicare Supplement enrollment counts by quarter since 1st quarter 2011. Humana also reported 2nd quarter 2018 Medicare Supplement premiums of $129 million, up 7% from 3rd quarter 2017. Based on estimates from CSG Actuarial, Humana’s sales ranked 7th in the market over the past 12 months. CNO Financial Group Reports Medicare Supplement Sales in 3rd Quarter 2018 CNO Financial Group (parent company of Bankers Life & Casualty, Washington National, and Colonial Penn) reported 3rd quarter 2018 Medicare Supplement sales of $13.9 million, down 3% from 2nd quarter 2018. For the past 12 months CNO Financial Group reported Medicare Supplement sales of $61.1 million, ranking in the top 10 in the Medicare Supplement market. CNO Financial Group also reported 3rd quarter 2018 Medicare Supplement earned premiums of $204 million, equal to results from 2nd quarter 2018. Torchmark Reports Medicare Supplement Sales in 3rd Quarter 2018 Torchmark reported 3rd quarter 2018 Medicare Supplement annualized new sales of $13.4 million, up 32% from 3rd quarter 2017. For the past 12 months, Torchmark reported Medicare Supplement annualized new sales of $72.7 million, ranking in the top 10 in the market. Source
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The 22 Most Highly-Rated Sales Books of All Time

Posted by www.psmbrokerage.com Admin on Mon, Nov 12, 2018 @ 12:23 PM

The 22 Most Highly-Rated Sales Books of All Time (Hubspot) Benjamin Franklin once said, "Experience keeps a dear school, but fools will learn in no other." In other words, you can rely solely on first-hand experiences to gain sales knowledge -- but it might be painful. To dramatically cut down on your learning curve, pick up some sales books. A read penned by a selling expert will offer you all the benefits of personal experience without negatively affecting your quota or efficacy. Picking a book can be tough, as there are thousands to choose from. Enter: This reading list. Hubspot has curated the top-ranked books from Amazon's sales best-sellers. Whether you want to ask better questions, prospect more effectively, lead your sales team, or become an all-around better salesperson, there's a pick here for you. Here is the list: 1. "The Challenger Sale: Taking Control of the Customer Conversation" Matthew Dixon and Brent Adamson According to a study of thousands of sales reps across multiple industries and geographies, the most successful put their energy toward delivering valuable insights -- not becoming their prospect's friend. Join the ranks of the top performers with Adamson and Dixon's signature Teach, Tailor, and Take Control methodology. Review excerpt: "This is an excellent book, with provocative insights and useful information for salespeople looking for ways to break out of the pack." 2. "The Challenger Customer: Selling to the Hidden Influencer Who Can Multiply Your Results" Brent Adamson, Matthew Dixon, Pat Spenner, and Nick Toman CEB's latest research reveals even Challenger salespeople struggle to close without the help of a very specific type of customer stakeholder: The Mobilizer. In this book, you'll learn how to identify Mobilizers, engage them, and work with them to get deals over the finish line. Review excerpt: "What a great follow-up to the Challenger Sale. (It) provided me with additional insight on how to approach selling to a group of stakeholders. It has real data, real studies and real tactical strategies. If you're in the B2B space, this book is a must!" 3. "New Sales. Simplified.: The Essential Handbook for Prospecting and New Business Development" Mike Weinberg Looking for a one-stop guide to bringing on new business? Look no further. In this book, Weinberg lays out a proven formula for finding prospects, developing the relationship, and reaching a mutually beneficial agreement. Review excerpt: "I loved the stories, the irreverent tone, and the honesty of this book. But what I appreciated most was that it delivered on its title -- this book really does simplify what you have to do successfully acquire new customers." 4. "The Psychology of Selling: Increase Your Sales Faster and Easier Than You Ever Thought Possible" Brian Tracy Learn how to harness psychological principles in the sales process while simultaneously getting a dose of personal motivation. Review excerpt: "‘The Psychology of Selling' is a superb, practical, easy-to-read return to the fundamentals of professional salesmanship for novices, journeymen, and seasoned, top-performing salespeople. More than common sense placed into form, it serves as an instructional blueprint -- or as a road map -- to establish, build, grow, and maintain a successful sales career." 5. "The Science of Selling: Proven Strategies to Make Your Pitch, Influence Decisions, and Close the Deal" David Hoffeld Hoffeld's advice is based on the latest research in behavioral economics, social psychology, and neuroscience. You'll learn a science-based approach to asking questions, securing incremental commitments, resolving objections, reducing your competition's influence, and more. Review excerpt: "‘The Science of Selling' is the ultimate collection of evidence-based practices for sales ever collected in one volume. Until now, most of the studies in ‘The Science of Selling' have been scattered and tucked away in academic journals, (making them) virtually inaccessible to sales leaders. Most readers will find the material new, and I expect, quite surprising." 6. "The Sales Acceleration Formula: Using Data, Technology, and Inbound Selling to go from $0 to $100 Million" Mark Roberge Sales leaders aiming to scale their sales team and build a multi-million dollar business should definitely pick up this book, written by former HubSpot CRO Mark Roberge. Review excerpt: "Every company -- regardless of its business and sales strategy -- will absolutely benefit from reading this book. The stories (Roberge) tells, the way his selling initiatives fit together, the combination of selling and technology he describes … even the use cases he lists make the approach he describes applicable to any sales organization -- however well-entrenched." 7. "Influence: Science and Practice" Robert B. Cialdini Cialdini reveals the six psychological principles that cause people to comply. Once you've incorporated these powerful concepts into your messaging, leading your prospects to say "yes" will be less challenging. Review excerpt: "Whether you are on the selling or buying end of any transaction, knowing what Mr Cialdini discovered through years of research and testing will be to your financial advantage. (But) 'Influence' is not just about money. It is a guide to getting what you want or need in a fair and ethical manner." 8. "To Sell Is Human: The Surprising Truth About Moving Others" Daniel H. Pink If you're currently working in sales, you're probably well-aware the old playbook doesn't work. Pink offers fresh yet practical insights to modern selling, including how to move others, make your message clearer and more persuasive, and gain referrals. Review excerpt: "No, this is not 'another' book about selling. I've read a lot of them, written a few of them, and I can tell you: This book stands alone in a special category." 9. "Secrets of Closing the Sale" Zig Ziglar This book includes more than 100 different ways to close depending on the situation and 700 thought-provoking questions to use with prospects. You'll also find suggestions from a hundred of America's most successful salespeople. Review excerpt: "Ziglar teaches you, from the beginning, that there's no room for success in a salesman's career if he's taking the fast route, making the quick sale, and then locking the door behind him." 10. "The Only Sales Guide You'll Ever Need" Anthony Iannarino Iannarino shares his biggest lessons from 25 years of selling, including how to increase your self-discipline, get over your fear of the competition, be more resourceful, discover the buyer's true needs, and more. Review excerpt: "Anthony Iannarino is my new sales guru. His book shows you exactly how to understand your offer and relate to your customer." 11. "The New Strategic Selling: The Unique Sales System Proven Successful by the World's Best Companies" Robert B. Miller, Stephen E. Heiman, and Tad Tuleja Every salesperson will benefit from learning how to reach "win-win" agreements, prevent sabotage by internal blockers, identify the four types of decision makers, engage senior executives, and more. Review excerpt: "This book, in my opinion, found a perfect balance between theoretical framework and hands-on, immediately applicable knowledge." 12. "Cracking the Sales Management Code: The Secrets to Measuring and Managing Sales Performance" Jason Jordan and Michelle Vazzana Jordan dives into the critical activities and metrics sales managers and executives should implement and track to lead their teams to success. Review excerpt: "I liked the focus on real-world quantitative management via metrics (and) would recommend this book to any sales manager who wants to achieve and measure results." 13. "Words That Sell: More than 6000 Entries to Help You Promote Your Products, Services, and Ideas" Richard Bayan Keep this informative manual at your desk so you can quickly find the perfect terms and phrases to grab your prospect's attention, create desire for your product, and ultimately, win their business. Review excerpt: "After a brief primer on writing in which the author lays down basic writing principles, readers are free to comb through the book to find the words they need to make a big difference in the way they communicate with others." 14. "Book Yourself Solid: The Fastest, Easiest, and Most Reliable System for Getting More Clients Than You Can Handle Even if You Hate Marketing and Selling" Michael Port Port's book covers a range of strategies for earning more business, from building a powerful social media presence to developing a personal brand to perfecting your pricing strategy. Review excerpt: "An excellent and enjoyable read. Michael Port lays out a fresh and honest approach to marketing yourself and your business. 'Be true to yourself' and the people you serve. This takes the pressure off of trying to contrive an image of someone (or something) that is really not you, and makes self-promotion almost natural!" 15. "7L: The Seven Levels of Communication: Go From Relationships to Referrals" Michael J. Maher If you're not generating warm introductions to potential customers, you're losing out on a valuable source of business. Discover the concrete steps that will win you referrals. Although "7L" is geared toward real estate professionals, its takeaways are applicable to any sales role. Review excerpt: "Michael provides an easy-to-follow step-by-step system to create long-lasting relationships with clients and vendors that will result in an endless supply of referrals. This book has completely changed how I do business … I went out and bought 30 [copies to give] to my associates." 16. "Fanatical Prospecting" Jeb Blount Successful prospecting incorporates multiple touches across multiple channels. Pick up this book to learn how to text, email, call, and socially engage buyers. Review excerpt: "Jeb teaches you how to prioritize your prospects and leverage social selling in your overall prospecting efforts. If you are thinking about a career in sales or you want to jump start what you are doing in your present job, then this is the book for you." "Predictably Irrational, Revised and Expanded Edition: The Hidden Forces That Shape Our Decisions" Dan Ariely Have you ever been flummoxed by a prospect's irrational decision? Once you read this book, you'll have a new understanding for the assumptions and emotions behind the actions we take. Guiding buyers to the right choices will become far easier. Review excerpt: "This is a fascinating look into how our brains process information. The author sets up experiments to test his hypotheses about how people respond under a variety of situations." 18. "Go-Giver, Expanded Edition: A Little Story About a Powerful Business Idea" Bob Burg and John David Mann This quick read reveals the importance of giving to business success. Not only will you walk away convinced that giving leads to receiving, you'll also know how to give to achieve your desired results. Review excerpt: "Clear, entertaining, and immediately practical, this book has evolved my approach to business -- and life. When you go through your day focusing on how you can give and being open to receiving, you build stronger relationships and prosper on multiple levels." 19. "DISCOVER Questions Get You Connected" Deb Calvert and Renee Calvert Learn how to structure your calls, ask thoughtful, intelligent questions, and help prospects come to their own conclusions about your product's value. Review excerpt: "'Discover Questions' was excellent -- giving experienced and novice salespeople guidance on how to ask questions, drive the sales conversation, and show you care!" 20. "Little Red Book of Selling: 12.5 Principles of Sales Greatness" Jeffrey Gitomer This book is short, sweet, and to the point. Readers will learn to focus on why people buy and why it matters to the sales process. With entertaining illustrations and soundbites in every chapter, this book is easy to return to for specific helpful tips when you need them most. Review excerpt: "Excellent book that focuses on selling the right way. Highly recommend this for anyone who is involved in sales and wants to expand their techniques so they close more." 21. "Think and Grow Rich" Napoleon Hill This book is beloved by many career salespeople. The result of nearly 20 years of research, Hill's book outlines 13 steps to success, including developing a definite purpose, building a positive mental attitude, and channeling the power of the subconscious mind. Review excerpt: "This book is one that everyone must read. From the very beginning, it began changing my mindset and how I view life. Some books are filled with information on how you should be thinking, but this one shows how to create lasting change." 22. "Spin Selling" Neil Rackham "Spin Selling" shares the results of Rackham's 12-year, million-dollar research project examining effective sales performances. In his book, Rackham outlines his findings and shares the principles of SPIN (Situation, Problem, Implication, Need-payoff). Review excerpt: "If you love sales, read this book and discover how to improve your technique. The research behind this book is exhaustive, and the technique is so organic you may discover you're already using it. In that case, you'll be able to improve your skills." Source
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Tags: sales advice, mentor, sales books

MA/PDP Star Ratings: Proposed Technical Changes for 2020

Posted by www.psmbrokerage.com Admin on Fri, Nov 09, 2018 @ 04:40 PM

Medicare Advantage and PDP Star Ratings: Proposed Technical Changes for 2020 In the most recent technical changes made to Part C and Part D plans for 2019, CMS codified the star ratings methodology in regulations. Now, CMS is proposing changes to these regulations, such as new definitions to clarify the meaning of terminology used in describing the star ratings methodology. In addition, CMS is proposing several changes to improve program quality and accessibility of the Medicare Advantage (MA) and Part D Prescription Drug Program (PDP) Plan Quality Rating for measures other than Consumer Assessment of Healthcare Providers and Systems (CAHPS). Cut Point Predictability and Stability CMS proposes two enhancements to the current hierarchical clustering methodology that is used to set “cut points” for non-CAHPS measures. Cut points are used to separate a distribution of measure scores into distinct groups or star categories, such that each grouping accurately reflects true performance. These two enhancements would increase year-over-year stability and predictability for a plan’s cut points, but may also slow the programs’ ability to keep pace with changes in performance across the industry. First, CMS proposes to modify §§ 422.166(a)(2)(i) and 423.186(a)(2)(i) to add mean resampling to the current clustering algorithm. Mean resampling would reduce the sensitivity of the clustering algorithm to outliers. In short, it would reduce the random variation that contributes to fluctuations in cut points and, therefore, improve the stability of the cut points over time. The second proposed enhancement is a 5% “guardrail” for all measures that have been in the Part C and D Star Ratings program for more than 3 years, whether scored on a 0 to 100 scale or an alternative scale. The guardrail would be a cap that imposes a 5% maximum allowable movement from the previous year’s cut points for each measure threshold. Thus, it would allow a degree of predictability. Measure Updates and Other Adjustments CMS also proposes changes to measures in the Star Ratings program for performance periods beginning in 2020 and 2021, including: MA plans controlling high blood pressure, to apply new hypertension treatment guidelines from the American College of Cardiology and American Heart Association by moving the blood pressure target to <140/90 mmHg; Medicare plan finder (MPF) pricing accuracy for PDP plans, to better measure the reliability of sponsors’ prices advertised on MPF; MA plan all-case readmissions, to assess the percentage of hospital discharges resulting in unplanned readmissions within 30 days of discharge; and MA and PDP plan improvement measures, to exclude any measure that has a reduction due to data integrity concerns. Among other things, CMS proposed to add a provision that would assign a 1-star rating to the applicable appeals measure(s) if an MA organization or PDP plan sponsor failed to submit Timeliness Monitoring Project (TMP) data for CMS’s review to ensure the completeness of their independent review entity (IRE) data. CMS is also adopting detailed modifications for the Star Ratings measures for MA and PDP plans in areas that have “experienced extreme and uncontrollable circumstances” like natural disasters. These modifications would apply at the contract level to mitigate certain negative Star Ratings effects on any contract within an “emergency area” during an “emergency period” as defined by federal law. In sum, CMS recognizes the public’s “overall support for the use of the hierarchical clustering algorithm,” and now seeks to further refine the Star Ratings program to ensure that the methodology is stable, predictable, and free from undue influence of outliers. This rulemaking presents a significant opportunity for stakeholders to shape the rating methodology for quality and performance of MA and Part D programs. Comments on the proposed rule are due to CMS no later than December 31, 2018. https://www.cmhealthlaw.com/2018/11/ma-pdp-star-ratings-proposed-technical-changes-for-2020/
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Tags: Medicare Advantage, Medicare, Medicare Part D

Guidance for Advocates to Help People Move from Expansion Medicaid to Medicare

Posted by www.psmbrokerage.com Admin on Fri, Nov 09, 2018 @ 04:25 PM

Guidance for Advocates to Help People Move from Expansion Medicaid to Medicare Last week, the Medicare Rights Center and the National Council on Aging (NCOA) released a new resource on the expansion Medicaid-to-Medicare transition process. Our Expansion Medicaid Transitions Guide is designed, in part, to help advocates learn about their state’s transition process and better assist clients when they need to switch from expansion Medicaid to Medicare. The guide includes terminology, an overview of select state processes, and some troubleshooting steps advocates can consider when encountering problems. Source
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Tags: Medicare Advantage, Medicare

What the Midterm Elections Mean for Medicare, Medicaid, and the ACA

Posted by www.psmbrokerage.com Admin on Fri, Nov 09, 2018 @ 04:22 PM

What the Midterm Elections Mean for Medicare, Medicaid, and the ACA The 2018 midterm elections mean big changes are coming to Washington. When the 116th Congress convenes in January, it will be a divided one: Republicans will continue to control the Senate, but Democrats will have a majority in the House of Representatives for the first time in eight years. With split-party control, any legislation will require bipartisan support in order to pass. The need for such consensus greatly decreases the likelihood that radical, disruptive bills will reach the President’s desk in the coming years, and effectively eliminates the acute threats to Medicare, Medicaid, and the Affordable Care Act (ACA) that have dominated congressional conversations since 2017. With efforts to repeal the ACA, overhaul Medicare, and restructure Medicaid temporarily off the table—what does the future hold for these programs? Read our top takeaways from the midterms and our predictions for the 116^th Congress. Source
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Tags: Medicare Advantage

Product Spotlight: United of Omaha Living Promise Final Expense

Posted by www.psmbrokerage.com Admin on Fri, Nov 09, 2018 @ 10:27 AM

United of Omaha Living Promise Final Expense

United of Omaha’s’ Living Promise® Final Expense is designed to help provide affordable protection that pays benefits directly to the person you choose to take care of your outstanding medical bills, unexpected expenses or debt that you may leave behind.

Living Promise® premiums are guaranteed to never increase, and the benefits are guaranteed to never decrease. Your clients will feel secure with the knowledge that they are locking in the price and coverage that work for them.

United of Omaha Living Promise Final Expense Options:

Level Benefit Plan Features:

For ages 45-85
Face amounts from $2,000 to $40,000 (in WA, $5,000 to $40,000)
Accelerated Death Benefit for Terminal Illness or Nursing Home Confinement
Optional: Accidental Death Benefit Rider

Graded Benefit Plan Features:

For ages 45-80 (in NY, 50-75)
Face amounts from $2,000 to $20,000 (in WA, $5000 – $20,000)
This policy contains a graded benefit meaning that for death due to natural causes (any cause other than accidental) during the first two years, the beneficiary will receive all premiums plus 10 percent. After the two years, the full benefit is paid for death due to all causes. Full death benefits will be paid, in all years, if death results from an accidental bodily injury

Plus:

Offers competitive premiums that fit many budgets
Top of the line Agent Portal Tools - for running illustrations, tracking applications, and submitting business.
Top of the line E-Application – seamless technology to complete enrollments over the phone.
Top of the line Administration - quick turnaround, email notifications, etc.
Top of the line Agent Support – quick and reliable answers, short waiting times.
Simplified underwriting. No medical exam – coverage is based on your answers to a few simple health questions.
A great product with a strong brand and from a stable and secure company that you know *Not available in AR, MT, NC.

Automatic Underwriting:

Mutual of Omaha will soon offer Automated Underwriting on e-Applications for their Living Promise® Final Expense product. Automated Underwriting delivers instant underwriting decisions for clients when using the iGO e-App platform.

Simply complete the e-App for Living Promise and the new automated underwriting feature will work in the background.

Key points about Automated Underwriting:

Provides an instant underwriting decision — Possible outcomes include: Approved (with level benefit), Approved (with graded benefit), Referred to Underwriting (you or your client will be contacted for more information), or Declined.

Mobile friendly - It's available on mobile devices so it goes where you go

Mutual of Omaha quoting application - Click to download in the iTunes App Store

Mutual of Omaha quoting application - Click to download in Google Play

Mutual of Omaha has additional information in this Flyer

Mutual of Omaha Automatic Underwriting

Policy Exclusion:

The death benefit will not be paid if the insured commits suicide, while sane or insane, within two years from the contestability date (in ND, within one year). Instead, we return all premiums paid, minus any loan. (May not be available in all states.)

Call now to talk to one of our stellar marketing staff for details on how you can start selling these plans today.

Not appointed with United of Omaha? We encourage you to learn more and put this in-demand product in your portfolio, request details here

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Tags: Final Expense, product spotlight

Prior Authorization in Medicare Advantage Plans: How Often Is It Used?

Posted by www.psmbrokerage.com Admin on Thu, Nov 08, 2018 @ 10:26 AM

Prior Authorization in MA Plans: How Often is it Used? This year, during the annual Medicare Open Enrollment period, more than 60 million people on Medicare have the opportunity to choose between traditional Medicare and Medicare Advantage plans. In making this decision, they are encouraged to take into account a number of factors, including premiums, cost-sharing, extra benefits, drug coverage, quality of care, and provider networks. A potentially overlooked consideration is access to covered services; specifically, how prior authorization may affect beneficiaries’ access to covered services. Medicare Advantage plans can require enrollees to get approval from the plan prior to receiving a service, and if approval is not granted, then the plan generally does not cover the cost of the service. Medicare Advantage enrollees can appeal the plan’s decision, but relatively few do so. Traditional Medicare, in contrast, does not require prior authorization for the vast majority of services, except under limited circumstances, although some think expanding use of prior authorization could help traditional Medicare reduce inappropriate service use and related costs. Optimally, prior authorization deters patients from getting care that is not truly medically necessary, reducing costs for both insurers and enrollees. Prior authorization requirements can also create hurdles and hassles for beneficiaries (and their physicians) and may limit access to both necessary and unnecessary care. In this data note, we examine the share of Medicare Advantage enrollees in plans that impose prior authorization requirements for Medicare-covered services. Findings 80 percent of Medicare Advantage enrollees are in plans that require prior authorization for at least one Medicare-covered service (Figure 1). At least 70 percent of enrollees are in plans that require prior authorization for durable medical equipment, Part B drugs, skilled nursing facility stays, and inpatient hospital stays. 60 percent of enrollees are in plans that require prior authorization for ambulance, home health, procedures, and laboratory tests. More than half of enrollees are in plans that require prior authorization for mental health services. In general, Medicare Advantage plans typically use prior authorization for relatively high cost services used by enrollees with significant medical needs, such as inpatient care and drugs covered under Medicare Part B. Prior authorization is also being used to limit access to services for which there has been evidence of fraud, such as durable medical equipment, and for services, such as home health, that have experienced disproportionately rapid growth in Medicare spending, at least in certain parts of the country. Beginning in 2019, Medicare Advantage plans will also be allowed to use prior authorization in conjunction with step therapy for Part B (physician-administered) drugs, which could result in some enrollees being required to try a less expensive drug before a more expensive one is covered. Whether prior authorization serves as an appropriate tool for limiting use of unnecessary care or a worrisome barrier to medically necessary care is an important question for both lawmakers and beneficiaries. Recently, more than 100 Members of Congress sent a letter to the Centers for Medicare and Medicaid Services (CMS) Administrator, Seema Verma, expressing concern about Medicare Advantage plans’ use of prior authorization, and asked CMS to collect data on the scope of prior authorization practices to enable better oversight. The HHS Office of the Inspector General (OIG) recently found that Medicare Advantage plans deny care – inappropriately – at relatively high rates. To the extent that the OIG findings are more the norm than the exception, they raise concerns for enrollees and questions as to whether prior authorization rules contribute to the relatively high rates of disenrollment among sicker Medicare Advantage enrollees. Currently, CMS does not collect or disseminate plan-specific denial rates, as it is required to do for plans offered in the ACA marketplaces, nor assess the extent to which prior authorization rules affect enrollees’ access to various types of services. Greater transparency with respect to prior authorization could help explain how Medicare Advantage plans are managing care and costs, help beneficiaries choose among the many Medicare coverage options offered in their area, and help CMS carry out its important oversight responsibilities on behalf of the rapidly growing Medicare Advantage population. Source
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Tags: Medicare Advantage

Offer Your Med Supp Clients Cancer/ Heart Attack and Stoke During Open Enrollment

Posted by www.psmbrokerage.com Admin on Wed, Nov 07, 2018 @ 02:51 PM

Sales Ideas: Tips on how to sell Cancer, Heart Attack and Stroke Policies to your Med Supp Clients Your clients have worked hard their entire lives. And they’re ready to enjoy retirement. But, as people reach the age of 65 their risk for cancer and heart disease increases. Additionally, the costs associated with addressing these conditions can drain retirement or savings quickly. THE NEED Nearly everyone knows someone who has been affected by cancer or heart disease. Unfortunately, many believe that their existing coverage is adequate to cover all the expenses associated with these conditions. As costs and deductibles rise, seniors are feeling the pinch more and more. TODAY’S REALITY Among seniors 65 and older, just 37 percent claim to have $1,000 available in savings The average healthy 65-year-old couple retiring in 2016 should expect to spend $377,000 on health care expenses over the course of their retirement The average annual cost of treatment for cancer patients rose 19 percent to $58,097 in 2014 SOLUTION Discuss options for covering out-of-pocket expenses: savings, assets or insurance coverage. Mutual of Omaha’s Cancer & Heart Attack/Stroke policies offer policies up to $100,000 with limited underwriting Living comes with a price tag. With advances in medical treatment, people are surviving cancer and heart disease more frequently Cancer & Heart Attack/Stroke policies fit in well with other products and protect income for a variety of expenses, from deductibles to prescription drug to travel or time off from work expenses With a variety of price points and options, there are numerous ways to provide clients the coverage they need Make sure you are providing your Medicare clients insurance for all their health care needs. Request details here.
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Mutual of Omaha: Dental Insurance for Your Medicare Clients

Posted by www.psmbrokerage.com Admin on Wed, Nov 07, 2018 @ 01:25 PM

Dental Insurance for Your Medicare Clients This Spring 2018, Mutual of Omaha began offering Mutual Dental Preferred and Mutual Dental Protection insurance policies with an optional vision care rider underwritten by Mutual of Omaha Insurance Company. The dental product is available in all states except: Maryland, North Carolina, New Mexico, New York, Virginia and Washington. Mutual Dental Protection not available in Alaska While this product is positioned for individuals who are Medicare eligible the issue age is 19 – 99 for these policies. For more information and to see rates view the Dental Insurance Product and Rate Guide. Medicare supplement and Dental Insurance – Better Together* You have a built-in target market. If you are selling Medicare supplement, there are a number of reasons you should be offering your Medicare clients a dental policy. First, good dental care is important to overall health. But do you know Medicare doesn’t cover dental services? That means dental bills have the potential to take a bite out of people’s savings. Second, there is a need among individuals age 65 and old for dental insurance. 87% of this group still have their natural teeth Due to cost, 1 in 5 of them has untreated tooth decay and fewer than half see a dentist even once a year Only 12% have dental insurance Third, it is an easy sale. If you are taking a Med supp e-App the dental plans are quoted up front and with a few simple questions at the end of the app you can complete a dental sale. Also, all Med supp paper apps have the dental application included in the application book. And with Mutual's mobile quote app you can provide your clients a quote on the spot. Get Started - Make sure you are providing your Medicare clients insurance for all their health care needs.
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Tags: mutual of omaha, dental plans

Transform Your Fears Mindfully

Posted by www.psmbrokerage.com Admin on Tue, Nov 06, 2018 @ 03:16 PM

Transform Your Fears Mindfully The only way through your fears is to get comfortable being uncomfortable As the Stranger in The Big Lebowski says, “Sometimes you eat the bear and sometimes, well, he eats you.” You don’t always win, in other words, but you learn as much from the mistakes as from the triumphs. And fear will always give you more chances on the path of life. 3 Steps to Transform Your Fears To help get cozier with the uncomfortable, and even the downright fear-inducing parts of life, try this: Approach your fears with a bit of tough love. The tough part is that you don’t give up on yourself or the task at hand at the first sign of difficulty. Unless you have hit a life-threatening precipice, you can press on a little—even if it’s a tiny little step forward. Like the children’s story of The Little Engine that Could, tell yourself: I think I can, I think I can. Then take another step and see how it goes. Appreciate that you have shown up. The love part of tough love is that you have won by just showing up. So be kind to yourself. You may not conquer your fear, but you make some inroads forward. Celebrate that, and next time press on a little further. Meditate and observe your fears. Mindfulness meditation provides a safe space in which your fears can arise. See them come and go, breathe them out, breathe them in. The more familiar they become, the less power they have to control you. At some point you may even be able to sit with your fears and smile at them. Source
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Tags: mindful

CMS Finalizes Changes to Advance Innovation, Restore Focus on Patients

Posted by www.psmbrokerage.com Admin on Mon, Nov 05, 2018 @ 12:05 PM

CMS Finalizes Changes to Advance Innovation, Restore Focus on Patients Changes to the Medicare Physician Fee Schedule and Quality Payment Program will shift clinicians’ time from completing unnecessary paperwork to providing innovative, high-quality patient care Today, the Centers for Medicare & Medicaid Services (CMS) finalized bold proposals that address provider burnout and provide clinicians immediate relief from excessive paperwork tied to outdated billing practices. The final 2019 Physician Fee Schedule (PFS) and the Quality Payment Program (QPP) rule released today also modernizes Medicare payment policies to promote access to virtual care, saving Medicare beneficiaries time and money while improving their access to high-quality services, no matter where they live. It makes changes to ease health information exchange through improved interoperability and updates QPP measures to focus on those that are most meaningful to positive outcomes. Today’s rule also updates some policies under Medicare’s accountable care organization (ACO) program that streamline quality measures to reduce burden and encourage better health outcomes, although broader reforms to Medicare’s ACO program were proposed in a separate rule. This rule is projected to save clinicians $87 million in reduced administrative costs in 2019 and $843 million over the next decade. “The historic reforms CMS finalized today move us closer to a healthcare system that delivers better care for Americans at lower cost,” said Health and Human Services (HHS) Secretary Alex Azar. “Among other advances, improving how CMS pays for drugs and for physician visits will help deliver on two HHS priorities: bringing down the cost of prescription drugs and creating a value-based healthcare system that empowers patients and providers.” “Today’s rule finalizes dramatic improvements for clinicians and patients and reflects extensive input from the medical community,” said CMS Administrator Seema Verma. “Addressing clinician burnout is critical to keeping doctors in the workforce to meet the growing needs of America’s seniors. Today’s rule offers immediate relief from onerous requirements that contribute to burnout in the medical profession and detract from patient care. It also delays even more significant changes to give clinicians the time they need for implementation and provides time for us to continue to work with the medical community on this effort.” Coding requirements for physician services known as “evaluation and management” (E&M) visits have not been updated in 20 years. This final rule addresses longstanding issues and also responds to concerns raised by commenters on the proposed rule. CMS is finalizing several burden-reduction proposals immediately (effective January 1, 2019), where commenters provided overwhelming support. In response to concerns raised on the proposal, the final rule includes revisions that preserve access to care for complex patients, equalize certain payments for primary and specialty care, and allow for continued stakeholder engagement by delaying implementation of E&M coding reforms until 2021. For the first time this rule will also provide access to “virtual” care. Medicare will pay providers for new communication technology-based services, such as brief check-ins between patients and practitioners, and pay separately for evaluation of remote pre-recorded images and/or video. CMS is also expanding the list of Medicare-covered telehealth services. This will give seniors more choice and improved access to care. In addition, the rule continues CMS’s work to deliver on President Trump’s commitment to lowering prescription drug costs. Effective January 1, 2019, payment amounts for new drugs under Part B will be reduced, decreasing the amount seniors have to pay out-of-pocket, especially for drugs with high launch prices. CMS is also finalizing an overhaul of electronic health record (EHR) requirements in order to focus on promoting interoperability. Today’s rule finalized changes to help make EHR tools that actually support efficient care instead of hindering care. Final policies for Year 3 of the Quality Payment Program, part of the agency’s implementation of MACRA, will advance CMS’s Meaningful Measures initiative while reducing clinician burden, ensuring a focus on outcomes, and promoting interoperability. CMS also introduced an opt-in policy so that certain clinicians who see a low volume of Medicare patients can still participate in the Merit-based Incentive Payment System (MIPS) program if they choose to do so. In addition, CMS is providing the option for clinicians who are based at a healthcare facility to use facility-based scoring to reduce the burden of having to report separately from their facility. To view the CY 2019 Physician Fee Schedule and Quality Payment Program final rule, please visit: https://www.federalregister.gov/public-inspection/ For a fact sheet on the CY 2019 Physician Fee Schedule final rule, please visit: https://www.cms.gov/newsroom/fact-sheets/final-policy-payment-and-quality-provisions-changes-medicare-physician-fee-schedule-calendar-year For a fact sheet on the CY 2019 Quality Payment Program final rule, please visit: https://www.cms.gov/Medicare/Quality-Payment-Program/Quality-Payment-Program.html For a chart on E&M payment amounts, please visit: https://www.cms.gov/sites/drupal/files/2018-11/11-1-2018%20EM%20Payment%20Chart-Updated.pdf
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Tags: medicare updates

Trump Administration Drug-Pricing Proposal Includes Big Changes to Medicare Part B

Posted by www.psmbrokerage.com Admin on Mon, Nov 05, 2018 @ 12:00 PM

Trump Administration Drug-Pricing Proposal Includes Big Changes to Medicare Part B Last week, the Department of Health & Human Services (HHS), the department of the federal government that oversees the Medicare program, previewed some changes it will be proposing for Medicare Part B prescription drug coverage. The administration claims these changes will lower the cost of Part B medications. Most prescription drugs are covered under Medicare Part D, but a select number of drugs–usually ones that are administered by providers–are covered under Part B. These drugs tend to be very expensive and are generally used to treat serious conditions such as cancer, End-Stage Renal Disease, autoimmune disorders, or in the event of an organ transplant. Read More
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Tags: Medicare Part D, medicare updates

Withdrawal of PlanRight Voice Signature Telesales

Posted by www.psmbrokerage.com Admin on Mon, Nov 05, 2018 @ 08:23 AM

Withdrawal of PlanRight Voice Signature Telesales Over the past number of years Foresters has worked to ensure that PlanRight remains a sustainable product for the final expense market. Unfortunately PlanRight sold through the Voice Signature process (VSOP) has continued to see high levels of non-disclosure and higher than expected claims, causing a negative impact on PlanRight as a whole. Foresters recognizes that for many of you, VSOP is a key part of your portfolio. And while we remain committed to PlanRight as a product, we have made the difficult decision to withdraw the VSOP telesales option from sale effective November 30th, 2018. You can continue to sell PlanRight through VSOP up until November 30th. All VSOP personal health interviews (PHIs) must also be completed by November 30th. As of December 1st, the “PlanRight Voice Auth Final Expense” product will no longer be a product option on Apptical’s LiveApp website. Any incomplete or pending applications will also be deleted from LiveApp. PlanRight can continue to be sold through the traditional face-to-face sales process. Foresters Financial™ is committed to the final expense market; we’re excited to be making updates to PlanRight in 2019, and continuing our partnership with you. Questions? If you have questions regarding PlanRight Voice Signature please contact the Sales Desk at 1‑866‑466‑7166 option 1. If you have questions about the status of a submitted application, please contact the Service Center at 1‑866‑466‑7166 option 2
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Tags: Final Expense, Whole Life, Foresters

12 of the Funniest Insurance Memes [Infographic]

Posted by www.psmbrokerage.com Admin on Fri, Nov 02, 2018 @ 01:25 PM

Our Pick of the Funniest Insurance Memes

Everyone loves funny insurance memes. But if you're like me, you've probably seen the same 20 Insurance Memes over and over again in different blogs or floating around social media.

For this list, we tried to dig a little deeper and find some of the funniest Insurance memes that you may not have seen a million times yet.

Also, don't miss the interesting Info-graphic about the history of memes at the end.

Here's to having a good laugh...

Holy AEP Batman! I think we can all identify with this one.

Funny, and a few years ago, it may have been accurate. Today we have excellent Dental Options that people will actually use.

Truth!

Thanks to Mozy for creating this great Infographic on the history of the meme.

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Tags: Insurance Memes

Mutual of Omaha: It’s Showtime! Prescription Drug Plans

Posted by www.psmbrokerage.com Admin on Thu, Nov 01, 2018 @ 01:25 PM

We'd Like to Call Your Attention to a New Attraction - Prescription Drug Plans

There's a new act in town...Mutual of Omaha Rx. Two prescription drug plans are designed to help your Medicare supplement clients manage their out-of-pocket prescription drug costs. With Mutual of Omaha Rx, they get:

Low co-payments
Competitive premiums
Nationwide pharmacy providers

Get ready for the applause! Your clients are going to love the convenience of having all their coverage with one company. In fact, 83 percent of existing Mutual of Omaha Medicare supplement policyholders said they would likely purchase a prescription drug plan from Mutual of Omaha, if offered.* So, take advantage of this captive audience.

Learn more about our new prescription drug plans on mutualofomaha.com/sales-professionals. You'll also find links to the training and certification you need to sell Mutual of Omaha Rx

Not appointed to sell Mutual of Omaha Part D plans? Request details here

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Tags: Annual Enrollment Period, Medicare Part D, AEP, mutual of omaha

Gerber Life: Help Save Families the Burden of Final Expenses

Posted by www.psmbrokerage.com Admin on Thu, Nov 01, 2018 @ 01:17 PM

At Gerber Life, their Guaranteed Life insurance policy makes providing peace of mind to families simple. It enables your clients to obtain up to $25,000¹ in coverage to pay their final expenses — and it comes with an added advantage. Acceptance is guaranteed, regardless of health. WHY YOUR CLIENTS SHOULD CONSIDER COVERING FINAL EXPENSES WITH GERBER LIFE As a reminder, Gerber Life’s Guaranteed Life was created for clients between 50 and 80 years old who are looking for insurance to cover their final expenses, whether as a late entry to life insurance, or to help offset coverage they already have. Every policy gives your clients these important benefits: They can’t be turned down and no medical exams are required Beneficiary proceeds are generally not taxable Their premiums never increase for the life of the policy and coverage cannot be cancelled as long as premiums are paid Coverage amounts range from $5,000 to $25,000¹ HOW SELLING GUARANTEED LIFE IS NOW EVEN EASIER Gerber's Guaranteed Life product is simple and easy to understand — so we’ve updated our marketing materials to reflect that. Their streamlined materials, which focus more on benefits, will help your clients quickly and easily understand what makes Gerber Life’s Guaranteed Life unique, and why it may be right for them. All marketing materials are accessible through Gerber Life's Agent Portal. You can also download the improved agent reference guide and the consumer brochure below. Agent Reference Guide, click here. Consumer Brochure, click here. Put the power of Gerber Life to work for you and your clients today. Questions? Contact us today at 800-998-7715. Request details here
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Tags: Whole Life, gerber life

All Posts

Medicare Blog | Medicare News | Medicare Information

How to Use Customer Feedback to Identify Referral Opportunities

1. Identify your advocates

2. Follow up with your promoters

3. Use promoter feedback for referrals and testimonials

1. Medicare Part B premiums are going up

2. Medicare deductibles are also going up

3. Medicare Advantage is getting a new open enrollment period

4. Medicare Advantage is expanding its scope of coverage

5. Medicare's telemedicine program is growing

Aetna

Resources to share with your clients

Medicare Producer News

Individual MA/MAPD, PDP: November 16, 2018

Medicare Open Enrollment Period returns in January: Join a "Rules of the Road" webinar

What is OEP for Medicare?

Check out the 2019 Journey Handbooks

Is a fitness membership important to your clients? SilverSneakers has on-the-go options

Need assistance? Here’s who to call (for brokers only)

What is Empathy?

How Empathy Drives Sales Conversations

Tips for Developing Empathy

1. "Boiler Room": To get you hungry for success

Inspiring Line:

2. Amy Cuddy: To remind you nonverbal cues are crucial to your success

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3. "Hidden Figures": To highlight the importance of being first

Inspiring Line:

4. Steve Jobs: To encourage you to love what you do

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5. "Friday Night Lights": To motivate you to work as a team

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6. Motivational Montage: To give you a quick hit of all the motivational greats

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7. "Wolf of Wall Street": To get you fired up

The (Only SFW) Inspiring Line:

8. The Young Guru: To make you cry a little

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9. Shonda Rhimes: To remind you to push past your comfort zone

Inspiring Line:

10. "Erin Brockovich": To highlight why you should play the long game

Inspiring Line:

11. "Glengarry Glen Ross": To make you feel like a closer

Inspiring Line:

12. Amy Purdy: To challenge you to look at obstacles as opportunities

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13. "Braveheart": To inspire your courage

Inspiring Line:

14. "Joy": To put a smile on your face

Inspiring Line:

15. Eric Thomas: To remind you, you've got to want it

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Bonus Inspiring Line (too great to leave out):

16. Angela Lee Duckworth: To help you build your grit

Inspiring Line:

17. "Any Given Sunday": To stress no gain is too small

Inspiring Line:

18. "The Pursuit of Happyness": To remind you no one can tell you what you can or can't do

Inspiring Line:

19. "The Office": To show you the power of passion in creating a compelling message

Inspiring Line:

1. "The Challenger Sale: Taking Control of the Customer Conversation"

Matthew Dixon and Brent Adamson

2. "The Challenger Customer: Selling to the Hidden Influencer Who Can Multiply Your Results"

Brent Adamson, Matthew Dixon, Pat Spenner, and Nick Toman

3. "New Sales. Simplified.: The Essential Handbook for Prospecting and New Business Development"

Mike Weinberg

4. "The Psychology of Selling: Increase Your Sales Faster and Easier Than You Ever Thought Possible"

Brian Tracy

5. "The Science of Selling: Proven Strategies to Make Your Pitch, Influence Decisions, and Close the Deal"

David Hoffeld

6. "The Sales Acceleration Formula: Using Data, Technology, and Inbound Selling to go from $0 to $100 Million"

Mark Roberge

7. "Influence: Science and Practice"

Robert B. Cialdini

8. "To Sell Is Human: The Surprising Truth About Moving Others"

Daniel H. Pink

9. "Secrets of Closing the Sale"

Zig Ziglar

10. "The Only Sales Guide You'll Ever Need"