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Medicare Advantage plans that don't embrace telehealth 'will get left behind'

Posted by www.psmbrokerage.com Admin on Wed, Oct 28, 2020 @ 01:53 PM

Healthcare Technology

Deloitte: Medicare Advantage plans that don't embrace telehealth 'will get left behind'

COVID-19 has dramatically accelerated the adoption of digital health, and a new analysis from Deloitte finds that trend extends similarly to Medicare Advantage (MA) beneficiaries.

Deloitte researchers surveyed executives at MA plans, as well as digital health companies, and found that through April 2020 more MA members used telehealth than did so in all of 2019.

telehealth in medicare advantage

Through April, 26% of beneficiaries said they used telehealth or had a virtual visit for any reason, compared to 13% saying the same across all of 2019.

As open enrollment for Medicare continues, insurers that are embracing digital are getting a leg up on the competition, the analysis found.

“COVID has been a game changer. None of this was table stakes six months ago," the Medicare sales lead at one MA plan said. "As we go into the next open enrollment, if you don’t have telemedicine, you’re going to hurt.”

"There's a significant and growing portion of people who are beginning to expect to get enrolled virtually," she said.

The researchers also found that providers, who are critical partners in growing the use of these benefits, are also "surprised" by how effective these tools are.

Deloitte analysts surveyed physicians prior to the pandemic and found that these tools were making their work more efficient and a bit easier. They're also finding it an effective way to deliver care in many circumstances, Thomas said.

“We have a primary care provider-centric view of technology. That’s our tech strategy," the chief technology officer at one plan told Deloitte. "We arm our PCPs with as much tech as possible. The best product or tool to engage the seniors are the PCPs."

The pandemic's impact on digital health has included insurers' supplemental benefits that target MA members' social determinants of health.

Insurers pointed to several key areas where they've focused amid the pandemic: transportation, home drug delivery, food and nutrition and social isolation. All of these get at one of the main challenges under COVID-19: the push for people, especially populations at high risk like seniors, to stay home to avoid exposure.

MA plans are offering transportation benefits to assist members in getting to their doctor's office or to buy groceries and are also partnering with local food banks and other services to provide food delivery.

In addition, they're offering programs to provide companionship and help members secure medications from their homes, according to the report.

"The direction and the emphasis on digital—there is no turning back," Thomas said. "Health plans that are sort of waiting on the sidelines and hoping to be a fad follower will get left behind."

See the latest report from Deloitte


Nassau Medicare Supplement Producer Bonus Program

Posted by www.psmbrokerage.com Admin on Tue, Oct 27, 2020 @ 09:05 AM

Tags: Medicare Supplement, Nassau

Med Adv Market Competition: 2021

Posted by www.psmbrokerage.com Admin on Mon, Oct 26, 2020 @ 08:53 AM

Med Adv Market Competition: 2021

Medicare Advantage market penetration is strong in 2020,and there’s ample opportunity for growth in this segment with about 40% of the nearly 63 million people eligible for Medicare enrolled in M/A plans.

M/A commands a sizable share of the health care industry, providing coverage to over 25 million beneficiaries. 

In the last three years, these plans collectively increased enrollment by approximately 5.2 million members. 

2021Landscape 2


Many M/A plans and stand-alone PDPs continue to broaden supplemental offerings and coverage area for 2021. 

According to CMS reports, Humana is marketing more M/A plans than any other insurer, with 571 distinct plans.

The insurer has expanded its M/A HMO plans into 125 new counties and has PPO plans in 98 new counties, serving about 3 million more M/A beneficiaries in 2021.

2021 Landscape Pic 1

Read the Full Article Here


Medicare Advantage Enrollment Up 125% Among Dual-Eligible Beneficiaries

Posted by www.psmbrokerage.com Admin on Thu, Oct 22, 2020 @ 08:47 AM

growth chart header

Medicare Advantage Enrollment Up 125% Among Dual-Eligible Beneficiaries

We know that Medicare beneficiaries have the opportunity to enroll in Medicare Advantage (MA) every year during annual open enrollment.

We also know that the number of beneficiaries choosing MA each year has been steadily increasing.

Among the beneficiaries choosing MA in increasing numbers is the cohort of Dual Eligible beneficiaries, those that qualify for both Medicare and Medicaid. 

According to a new report from actuarial consulting firm Milliman,
2019 MA enrollment was 60% more than in 2013, but fee-for-service Medicare (FFS) increased by only 5%.

In 2013 there were 9.6 million full or partial dual beneficiaries, with 2.4 million (25%) enrolled in Medicare Advantage.

By 2019 the total number of partial or dual eligibles had increased to 12.3 million, with 5.4 million (42%), enrolled in Medicare Advantage.

This represents an overall increase in dual eligibles from 2013 to 2019 of 28%, while MA enrollment grew by 125% and FFS dropped by 5.6%

medicare among full and partial dual elegible


Medicare Advantage Growth

From 2013 to 2019, the number of Medicare beneficiaries enrolled in MA plans increased faster than overall Medicare enrollment.

The FFS population grew by 5% in that time period, while the MA population grew by 60%.

2013-2019 change in enrollment


In 2019 MA made up about 37% of total beneficiaries.

The Congressional Budget Office (CBO) projects that Medicare Advantage enrollment will grow to nearly 50% by 2029.

It’s pretty clear at this point that Medicare Advantage is poised for even more growth for the foreseeable future, and the Dual Eligible population is choosing MA in increasing numbers.

We hope you can utilize this information to better serve the Dual Eligible population, as they have been largely underrepresented in the Medicare landscape.

Check out the full report by Milliman and the Better Medicare Alliance.


Additional Updates:

    • An Agent Guide to Dual Eligible Special Needs Plans - View
    • Learn How to Sell Medicare Advantage Plans - View
    • What is AHIP Certification and How do I Get It? - View
    • 7 Ways to Grow Your Insurance Business - View


An Early Look at 2021 Medicare Advantage Benefits

Posted by www.psmbrokerage.com Admin on Wed, Oct 21, 2020 @ 10:58 AM


An Early Look at 2021 Medicare Advantage Benefits

Now that marketing for Plan Year 2021 is underway, this is an excellent time to check on 2021 MA supplemental benefits and compare them to supplemental benefits in 2018, 2019 and 2020.

As shown in Table 1 below, the most popular supplemental benefits continue to be benefits with a long history in the MA program — including optical, audio and dental benefits, and relatively low-cost benefits that plug holes in original Medicare’s idiosyncratic benefit structure.

While readers familiar with MA benefits will not be surprised by the benefits on this list, they might be surprised by how many plans continue not to offer them.

Table 1 - Eight Most Popular Supplemental Benefits for 2021

Figure 1 below shows that, across the board, the number of plans that offer the most popular supplemental benefits has increased every year since 2018.


Figure 2 below analyzes the annual change in the percentage of MA plans offering the top eight supplemental benefits compared to total plans offered.

We saw a decrease in outpatient blood services, a benefit that is difficult to market, as plans increase more marketable supplemental benefits. All other popular benefits are increasing in frequency.

The percentage of total plans offering hearing aids, for example, as a supplemental benefit was the largest increase.


Over the last two years, we have consulted a number of MA organizations, associations and vendors about the new supplemental benefit flexibilities.

In these touch points, certain benefits are consistently discussed for their potential to provide a positive return on investment (because the costs avoided as a result of the benefit exceed the cost of the benefit) or marketing sizzle.

Figure 3 below shows the rising popularity of these most discussed benefits.

Readers will note that some of the benefits (Comprehensive Dental and Over-the-Counter Drugs, in particular) are now common MA plan offerings. Transportation and meal benefits are also gaining in popularity.

Other much-talked-about benefits, such as in-home support, remain uncommon but are growing.


Still, other benefits have been the subject of much discussion for their potential to treat chronic conditions in new ways.

These range from covering new provider types — such as acupuncturists, therapeutic massage and chiropractors (beyond existing Medicare-covered chiropractic services) — to creative benefits that increase member safety, such as bathroom/home safety devices.

Figure 4 below demonstrates a considerable rise in the number of MA plans covering new provider types, particularly with regard to acupuncture and chiropractic services.



See the full report


Tags: Medicare Advantage, 2021

Leave These Things Behind to Get Ahead

Posted by www.psmbrokerage.com Admin on Wed, Oct 21, 2020 @ 09:04 AM

Agent Compliance Guide - Checklist

Posted by www.psmbrokerage.com Admin on Mon, Oct 19, 2020 @ 12:52 PM


Agent Compliance Guide - Checklist


We all need help remembering tasks that need to be completed throughout the week.

Especially when it comes to the amount of documentation and compliance issues an insurance agent needs to deal with.

So we’ve put together a detailed 10 page checklist with interactive check boxes to help remind you of all the things that are required to remain compliant before, during, and after a sale.

Use the PDF digitally or print it out as a reminder of all the things you need to be aware of.

The check list includes reminders for things such as :

  • Completing a Scope of Appointment
  • Licensing
  • Meeting with a client
  • Making a compliant presentation
  • Communicating with a client after the sale
  • Avoiding and dealing with canceled applications
  • Avoiding and dealing with Rapid Disenrollment’s
  • Dealing with complaints
  • And much, much more..


Below you can see an example of the 10 page checklist.


agent compliance 1


Download the complete 10 page interactive PDF checklist


Tags: Medicare Advantage, Medicare Part D, Compliance

Part D Overview for AEP 2021

Posted by www.psmbrokerage.com Admin on Fri, Oct 16, 2020 @ 03:41 PM

Medicare Advantage, Part D members shifting to higher-rated plans

Part D Overview for AEP 2021

In 2021, 996 Prescription Drug Plans will be offered across the 34 PDP regions nationwide (excluding the territories).

This represents an increase of 48 PDPs from 2020 (a 5% increase) and an increase of 250 plans (a 34% increase) since 2017.
This fact sheet provides an overview of the Medicare Part D program, plan availability, enrollment, spending and financing.

Part D Benefit Parameters Increasing in 2021

Part d parameters 2021

The Part D standard benefit has several phases, including a deductible, an initial coverage phase, a coverage gap phase and catastrophic coverage.

Between 2020 and 2021, the parameters of the standard benefit are rising, which means Part D beneficiaries will face higher out-of-pocket costs for the deductible and in the initial coverage phase, as they have in prior years, and will have to pay more out-of-pocket before qualifying for catastrophic coverage (see graph above).

  • The standard deductible increases from $435 in 2020 to $445 in 2021;
  • The initial coverage limit increases from $4,020 to $4,130, and;
  • The out-of-pocket spending threshold increases from $6,350 to $6,550 (equivalent to $10,048 in total drug spending in 2021, up from $9,719 in 2020).

Part D Standalone Enrollment has Declined, But Increased in Medicare Advantage Plans

Part D Enrollment

In 2020, 46.5 million Medicare beneficiaries are enrolled in Medicare Part D plans, including employer-only group plans; of the total, just over half (53%) are enrolled in stand-alone PDPs and nearly half (47%) are enrolled in Medicare Advantage drug plans.

Full article with many interactive graphs

Tags: Medicare Part D

Trump Admin Drives Telehealth Services in Medicare and Medicaid

Posted by www.psmbrokerage.com Admin on Fri, Oct 16, 2020 @ 10:00 AM

White House

Trump Admin Drives Telehealth Services in Medicare and Medicaid

Today, the Centers for Medicare & Medicaid Services (CMS) expanded the list of telehealth services that Medicare Fee-For-Service will pay for during the coronavirus disease 2019 (COVID-19) Public Health Emergency (PHE).

CMS is also providing additional support to state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their efforts to expand access to telehealth.

The actions reinforce President Trump’s Executive Order on Improving Rural Health and Telehealth Access to improve the health of all Americans by increasing access to better care.

Expanding Medicare Telehealth Services

For the first time using a new expedited process, CMS is adding 11 new services to the Medicare telehealth services list since the publication of the May 1, 2020, COVID-19 Interim Final Rule with comment period (IFC).

Medicare will begin paying eligible practitioners who furnish these newly added telehealth services effective immediately, and for the duration of the PHE.

These new telehealth services include certain neurostimulator analysis and programming services, and cardiac and pulmonary rehabilitation services.

The list of these newly added services is available at: https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes.

Preliminary Medicaid and CHIP Data Snapshot on Telehealth Utilization and Medicaid & CHIP Telehealth Toolkit Supplement

In an effort to provide greater transparency on telehealth access in Medicaid and CHIP, CMS is releasing, for the first time, a preliminary Medicaid and CHIP data snapshot on telehealth utilization during the PHE.

This snapshot shows, among other things, that there have been more than 34.5 million services delivered via telehealth to Medicaid and CHIP beneficiaries between March and June of this year.

Full Article

To further drive telehealth, CMS is releasing a new supplement to its State Medicaid & CHIP Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth, COVID-19 Version that provides numerous new examples and insights into lessons learned from states that have implemented telehealth changes.

To view the Medicaid and CHIP data snapshot on telehealth utilization during the PHE, please visit: https://www.medicaid.gov/resources-for-states/downloads/medicaid-chip-beneficiaries-COVID-19-snapshot-data-through-20200630.pdf.


5 Tips To Make Your AEP Successful

Posted by www.psmbrokerage.com Admin on Tue, Oct 13, 2020 @ 09:32 AM


Photo by Gerd Altmann from Pexels

5 Tips To Make Your AEP Successful

About 23 million of the 62 million people eligible for Medicare have Medicare Advantage coverage, and about 14 million have Medigap coverage.

Some of the other Medicare enrollees have other types of Medicare plans. Companies in the Medicare market are so enthusiastic that, last spring, as the first C-19 wave was peaking, distributors put out press releases announcing they were hiring a total of thousands of call center agents.

Here are five things to know about the Medicare plan market heading toward Thursday:

 ► The market looks competitive: UnitedHealthcare has put out rate sheets showing that, in states like Alabama and Maine, its typical standard rates will be going up about 6% to 7% in 2021.

CMS has spreadsheets showing what’s happening to Medicare Advantage and Part D prices. There, the average monthly premium is on track to decrease 11% in 2021, to $21;

► 31% of people aging into Medicare plan to get enrollment help from live humans: GoHealth, a broker, came up with that statistic in an online survey of 2,106 people 62 and older and not enrolled in Medicare; or 65 and older and enrolled in Medicare;

► Agents and marketers in the field are feeling the effects of the increased level of competition: Jesse Slome of the American Association for Medicare Supplement Insurance (AAMSI) said the “pace of change has been greatly accelerated compared to a year ago.

There is accelerated consolidation and acquisition of companies
that will give larger national distributors significant competitive advantages.”;

► COVID-19 itself might not have that much effect on experienced retail agents: Lindsay Engle, a Medicare market tracker who works for

MedicareFAQ.com, said the image of local agents meeting with clients at a kitchen table is off the mark. “Social distancing won’t have much of an impact, since most sell over the phone.”;

► At least some in the private Medicare plan sector are excited about the idea of the possibility of a change in Medicare age eligibility: Looking ahead, the growth potential for the industry is enormous if the eligibility age is dropped to 60.

If the federal government cuts the regular Medicare eligibility to age 60, “That will result in an immediate growth of the market by 20.5 million,” said Jesse Slome of the AAMSI.

Read The Full Article


Tags: Medicare Advantage, Medicare Part D, 2021 aep

Star Ratings Released for Medicare Advantage, Part D

Posted by www.psmbrokerage.com Admin on Fri, Oct 09, 2020 @ 01:41 PM

Star ratings

Star Ratings Released for Med Adv, Part D

The CMS released Star Ratings for Medicare Advantage and Part D plans Thursday, and the quality ratings of M/A and prescription drug plans remain strong.

Most Medicare beneficiaries – about 77% – who enroll in M/A plans with drug coverage will be in plans with 4-or-more stars in 2021, compared to 69% of beneficiaries enrolled in such plans in 2017.

The 21 health plans earning 5 stars include:

  • KelseyCare Advantage
  • Kaiser Permanente
  • UnitedHealthcare
  • CarePlus by Humana
  • Tufts Health Plan
  • Health Partners
  • Capital District Physicians' Health Plan
  • Quartz Medicare Advantage of Wisconsin
  • Cigna
  • Health Sun - Anthem
  • BCBS - Health Now New York and Martins Point
  • and more

MA star ratings 2020

Almost half – about 49% – of M/A plans offering prescription drug coverage will have an overall rating of four stars or higher, up from about 45% in 2017.

The average Star Rating for all M/A plans with prescription drug coverage improved to 4.06 out of 5 stars in 2021, up from 4.02 in 2017.

2021 Star Rating Fact Sheet

Full Article


Tags: Medicare Advantage, Medicare Part D, star ratings

Enrollment 2020: A Different Challenge

Posted by www.psmbrokerage.com Admin on Thu, Oct 08, 2020 @ 12:04 PM

uncertainty in health coveragephoto created by creativeart

Enrollment 2020: A Different Challenge

The unpredictable impacts of the coronavirus pandemic on Medicare open enrollment will require both broker and member engagement to be technology-enabled, transparent, and streamlined.

Britta Orr, chief Medicare officer at Allina Health l Aetna, told HealthPayerIntelligence that she could see the pandemic having two disparate effects on member decision-making during this open enrollment season.

“There's been sort of a shift in the market and the mindset around insurance,” said Orr. “We see a lot of employers in small and large group plans really choosing to stay put right now with what they're offering their employees.”

These employers and members may be more hesitant to switch out of their current plan given the unpredictable economy and uncertain healthcare environment.

Instead of shifting to an untested plan, those in this category prefer to stay in a plan where they already have an idea of what their costs will be. This could improve retention in the health payer industry, Orr noted.

Meanwhile, other employers and members may be more eager to switch plans and may be more interested in educating themselves about their options than in previous years, given the possibility that they may catch COVID-19.


Whereas last year the changes to Medigap Plan F stirred up a lot of confusion among members, brokers, and navigators alike, this year there have been no major regulatory shifts to trigger uncertainty.

Medicare covers COVID-19 lab testing, antibody tests, medically necessary hospitalizations and hospital quarantines—though some copays may apply—, and the potential COVID-19 vaccine.

Medicare Advantage plans cover many of these same services and may provide coverage for additional benefits, such as telehealth and meal delivery.

However, some of these benefits are not permanent. For example, according to a Peterson-Kaiser Family Foundation brief published in August, coronavirus waivers for a little over 31 percent of payers on the individual and fully-insured markets will end in December 2020.

This extends to some Medicare Advantage plans as well.


This is a time for payers to streamline and focus their messaging, Orr emphasized.

The coronavirus pandemic creates a lot of noise for members. In order to support careful, informed decision-making during open enrollment, payers need to pare down their messaging for both members and brokers to the most relevant content.

For the first half of the year as the country struggled to manage the pandemic, preventive and direct, clinical care fell lower on the priority list for payers and members alike. Humana recently reported a sharp decline in preventive care when COVID-19 struck.

Now, however, preventive care and primary care services are more important than ever.

The payer has resumed its emphasis on these services by participating in Aetna’s Time for Care campaign.

The campaign informs members about how to get wellness checks and safely meet with their providers.

Agents Need to be on top of all the information coming out about plans and Medicare COVID-19 related coverage, as there are a lot of questions around the subject.

The better you are able to explain the situation and put your clients at ease, the better chance you have of finding the right plan for the right person.

Full Article

Centene Expands Medicare Advantage Offerings for 2021

Posted by www.psmbrokerage.com Admin on Wed, Oct 07, 2020 @ 02:42 PM

centene corp building

Centene Corporation Expands Medicare Advantage Offerings for 2021

Centene Corporation announced today it plans to expand its Medicare Advantage offerings for 2021.

The company's Medicare plans – branded WellCare, Allwell, Fidelis, and Health Net – will operate in 1,249 counties across 33 states in 2021 – a 30% increase since 2020.

"At a time when many seniors are grappling with the effects of COVID-19, we are committed to expanding choice and access to high-quality, affordable Medicare plans that support our members' health and well-being during the pandemic and beyond," said Michael F. Neidorff, Chairman, President and CEO for Centene.

Today, Centene serves nearly 1 million Medicare members across the country, and in 2021, the company will continue to expand its presence. Among the highlights, Centene is offering:

  • 122 new plan designs across 30 states;
  • Medicare Advantage plans in Vermont (10 counties) and Rhode Island (statewide); and,
  • Preferred Provider Organization (PPO) plans in 10 additional states including Alabama, Arizona, Illinois, Kansas, Kentucky, Louisiana, Mississippi, New Jersey, Rhode Island, and Vermont.

"Selecting a Medicare plan is one of the most critical decisions seniors and their families make each year," said Michael Polen, Centene's Senior Vice President and Chief Executive Officer, Medicare Solutions.

"As we approach the Annual Enrollment Period, we want our members to know we are expanding our presence and continue to offer a number of new benefits and solutions to help our members live better, healthier lives."

Official News Release



Cigna Expands Medicare Advantage Offerings to 23 States

Posted by www.psmbrokerage.com Admin on Wed, Oct 07, 2020 @ 09:27 AM


Cigna Expands Medicare Advantage With Offerings Now Across 23 States

Cigna Corporation is rapidly expanding its Medicare Advantage (MA) plans to make it easier for more customers to access affordable, predictable and simple health care.

During the 2021 Medicare Annual Election Period (AEP), beginning October 15, customers will be offered comprehensive, highly-rated, affordable MA plans – including a $0 premium plan in every market.

Telehealth services offered to all customers, including behavioral health and physical therapy

To help seniors access care from the safety and comfort of their homes, Cigna is offering telehealth services to all MA customers, including no-cost access to behavioral health providers via audio and video.

For the first time, Cigna also is adding virtual physical therapy services to its MA plans. This new feature is an addition to 2021 plans to help customers gain strength and/or recover from less complex procedures at home.

"Since the COVID-19 pandemic, we've seen a significant change in how people want to receive care and these patterns vary based on regions of the country and individual preferences.

We're offering our customers more options than ever before, so they can seek affordable, high-quality care in a way that meets their lifestyle – whether that's in-person, over the phone or virtually," said Brian Evanko, president of Cigna's government business. 

"No matter the setting, our Medicare Advantage plans ensure our valued customers get the proper preventive care, chronic condition management and emotional support they need during these challenging times."

Medicare Advantage provides additional benefits beyond what Medicare traditionally offers. In most of its MA plans for 2021, Cigna includes vision, dental, fitness, and discharge meal benefits along with an allowance on common over-the-counter products, like aspirin, adhesive bandages, and dental care products.

Cigna is also offering benefits associated with social determinants of our customers' health, addressing key factors like transportation and nutrition.

In select markets in 2021, the company is adding Healthy Benefits Plus, a new program making it easier for customers to purchase fresh fruits and vegetables through a produce card with a monthly allowance of up to $30.

Reaching more communities

In 2021, Cigna will offer plans in 369 counties spanning 23 states, representing a 22 percent increase in our county footprint.

Cigna is expanding to 67 new counties for 2021, including a broad portfolio of HMO and/or PPO plans. In addition to the new county expansion, Cigna is expanding PPO offerings in 154 counties in our existing footprint.

PPOs typically offer an out-of-network benefit, while HMO plans generally do not.

Cigna will enter markets in five new states in 2021 with MA plans:

  • Ohio (Cleveland area)
  • Virginia (Tri-Cities area in the southwest part of the state)
  • Oklahoma (Oklahoma City area)
  • Utah (Salt Lake City area)
  • New Mexico (Albuquerque area)

This expansion builds upon Cigna's 2020 footprint, which currently serves more than 500,000 MA customers across 18 states and the District of Columbia.

The 2020 footprint includes: Alabama, Arkansas, Arizona, Colorado, Delaware, Florida, Georgia, Illinois, Kansas, Missouri, Maryland, Mississippi, New Jersey, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas and the District of Columbia.

Driving better health care outcomes

To accommodate the expansion, Cigna has significantly increased its network, adding more than 25,000 physicians throughout its service territory.

Physician collaboration is an important part of the Cigna MA model, with more than 85 percent of its customers cared for by doctors who are in a value-based arrangement.

Value-based care increases coordination, emphasizes preventive care and generally results in better health outcomes and greater patient satisfaction.

Additionally, Cigna continues to offer a Dual Special Needs Plan in many geographies that coordinates care for people who qualify for both Medicare and Medicaid.

Increased consumer choice

The company offers six standalone Prescription Drug Plans (PDPs) for 2021 in all states, including three branded Cigna and three branded Express Scripts, providing cost savings and benefit options for all customer needs.

The Cigna Secure Rx and Express Scripts Medicare – Value plans are collectively qualified for CMS low-income subsidy auto-enrollment in 33 regions in 2021.

The Secure and Value plans offer $0 copays (Tier 6) and $1 copays (Tier 1) for medications purchased at preferred pharmacies, and will offer $0 copays (Tier 6) for select insulins at preferred pharmacies.

All six plans have $0 copay options for select medications purchased through preferred mail order.

Additionally, the Cigna Secure-Extra Rx plan and Express Scripts Medicare – Saver and Express Scripts Medicare – Choice plans will participate in the CMS Part D Senior Savings Model, helping Medicare customers manage diabetes with affordable and predictable insulin copays of $35 or less.

Cigna also offers Medicare Supplement plans in 48 states and the District of Columbia. Medicare Supplement insurance helps pay for what Original Medicare doesn't cover, including copayments, coinsurance and deductibles.

Medicare's AEP begins October 15 and continues through December 7. Plans selected during AEP are effective January 1, 2021.

News Release



Life Insurance Sales: August 2020

Posted by www.psmbrokerage.com Admin on Tue, Oct 06, 2020 @ 11:05 AM


Life Insurance Sales: August 2020

LIMRA tracks monthly sales in order to provide continuing insight into the COVID-19 pandemic’s impact on individual life sales and applications.

Sales in August (the most recent month for which information has been compiled) continued the positive trend from July with a 4% increase in premium and 8% increase in policy sales.

Policy growth was driven primarily by large, direct-to-consumer carriers.

Monthly Sales Growth

monthly life sales growth


Sales Growth by Product

life sales growth by product


Premium growth was driven by indexed universal life, which lead on both a growth rate and overall dollar increase basis.

IUL premiums were driven by a one-time occurrence for one carrier and a new product introduction.

Two participants dropped their IUL product this year. Overall, just under half of IUL companies had a premium increase in August.

IUL policy gains were more widespread. VUL and whole life premiums also increased in August.

On a policy basis, term and whole life also increased.

August Premium Growth Range by Product

august life premium growth by product


August Policy Growth Range by Product

life policy growth rate by product


August applications were up 6%, however less than half of participants reported an increase over August 2019.

Applications increased for all products except fixed universal life and variable universal life.

For companies able to respond, face-to-face application submissions dropped off in August after increasing in July while online/mobile applications continue to do better.

Face-to-face channels fared slightly better than in previous months, with a slightly higher percentage experiencing an increase.

Download the Full Report


Mid-Year Health Care Trends & Performance

Posted by www.psmbrokerage.com Admin on Mon, Oct 05, 2020 @ 01:43 PM



Mid-Year Health Care Trends & Performance


About 274 million people received medical coverage from U.S. health insurers as of June 30, 2020, up from 268.2 million – about 5.8 million – from a year ago.

Mid-year enrollment trends indicated membership gains for Individual,
Medicare Advantage and Employer-Group ASO (administrative services only for self-funded plans) business, while the Employer-Group risk segment experienced a year-over-year decline.

This brief is an assessment of the latest year-over-year enrollment trends, comparing Q2 2019 with Q2 2020 segment membership.

Enrollment by Segment: Q2 2020



The individual market has weathered the storm during the early years of ACA and stabilized into a health segment for insurers.

COVID-19 hasn’t presented major challenges for the segment so far. In June 2020, insurers reported total individual, non-group coverage for over 15.3 million people, a 2.8% increase, or 420,000 members, from 14.9 million in June 2019 and the first year-over-year increase since 2015.

Medicare Advantage continues to experience enrollment gains as M/A plans, with extra benefits and services remain appealing to seniors. 

Although M/A market penetration is strong, there is still ample opportunity for growth with just 36% of the nearly 70 million people eligible for Medicare enrolled in M/A plans.


Enrollment by Segment: Q2 2020

Segment Percent 

Health Enrollment Shifts Segment

Segment Shifts

Read the Full Brief


Relaxed Medicare Repayment Terms Ease the Burden on Healthcare Providers

Posted by www.psmbrokerage.com Admin on Thu, Oct 01, 2020 @ 02:32 PM

us capitol

Relaxed Medicare Repayment Terms Ease the Burden on Healthcare Providers

President Donald Trump on Sept. 30 signed a short-term spending bill that funds the government through Dec. 11 and relaxes the repayment terms for Medicare loans hospitals received earlier this year. 

Below are the details on six key healthcare provisions in the CR for providers:

Revises the Medicare Accelerated and Advance Payment (AAP) Program.
The CR allows providers (a) to extend repayment for a full year before recoupment of the AAP payment begins, and (b) to limit claim offsets to 25 percent of the full Medicare payment for 11 months followed by six months with claim offsets limited to 50 percent of the full amount.

This change effectively provides a full 29 months to repay the AAP amount in full.

Delays Medicaid Disproportionate Share Hospital (DSH) Reductions.
The CR delays until Dec. 11, 2020, scheduled Medicaid payment reductions for DSH hospitals.

Extends Health Center and Workforce Funding.
The CR extends funding for Community Health Centers, National Health Service Corps and the Teaching Health Center Graduate Medical Education Program through Dec. 11, 2020.

Clarifies Medicaid Drug Rebate Program for Medication-Assisted Treatment.
The CR clarifies that any drugs and biologicals used for medication-assisted treatment will continue to be eligible for rebates under the Medicaid program.

Maintains Medicare Reimbursement for Rural Providers.
Medicare reimbursement for physicians and other providers includes three geographic adjustments. The CR extends a “floor” for such adjustment at 1.0 until Dec. 12, 2020.

Provides for Additional Medicaid Extensions.
he CR also extends three CARES Act provisions changing the Medicaid program.

Specifically the CR further extends two Medicaid demonstration programs — the Medicaid Money Follows the Person demonstration project and the Medicaid Community Mental Health Services demonstration — as well as the Medicaid spousal impoverishment protections program.


The CR gives healthcare providers participating in federal programs some flexibility in repayment timelines for amounts received from CMS as part of the AAP program, including both a delayed start for repayments and a longer period to repay the full sum.

This reflects the ongoing and long-term nature of the COVID-19 pandemic, which may impact future funding bills.

Similarly, the CR extends certain Medicare and Medicaid provisions until December.

Congress will return after the election to determine how lawmakers will address funding the government beyond Dec. 11, 2020.

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