Welcome open enrollment
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1 Welcome 2016 open enrollment
2 A powerful force Integrity. Excellence. Caring. Inspiration. Integrity Do the right thing for the right reason Excellence We strive to deliver the highest quality and value possible through simple, easy and relevant solution Caring We listen to and respect our customers and each other so we can act with insight, understanding and compassion Inspiration We inspire each other to explore ideas that can make the world a better place 2
3 Our reach 2016 National footprint On and off exchange: Arkansas Arizona Delaware Florida Georgia Illinois Iowa Kansas Kentucky Louisiana Maine Missouri Nebraska North Carolina Ohio Pennsylvania South Carolina Texas Utah Virginia Aetna-branded plans Aetna and Coventry-branded plans Off-exchange only: Connecticut Michigan Nevada Coventry-branded plans Public on-exchange participation (Aetna, Coventry or both) 3
4 Our reach 4
5 The 2016 Portfolio 5
6 The 2016 Portfolio 6
7 Public exchanges By 2025, it s estimated that 22 million people will use public exchanges to shop for their health insurance. That s a business opportunity for you Aetna is the #1 national carrier on the FFM
8 Public exchanges Who can you sell to on the public exchange? To be eligible for individual public exchange plans, your clients must be: A U.S. citizen, U.S. national or lawfully present immigrant A state resident where the exchange is based Not incarcerated Available assistance Access to premium tax credits and cost-sharing subsidies: Tax credit subsidies for those between 133% and 400% of the federal poverty level (FPL); assumes state has elected to expand Medicaid eligibility Cost-sharing subsidies for those at or below 250% of the FPL Available if not offered affordable, comprehensive coverage through an employer Only available via a public individual exchange 8
9 Public exchanges Help your clients maintain their subsidy Members must keep their income and household information up to date at These updates may change the coverage or savings they are eligible for in the Marketplace Each year members must file their federal taxes with Form 8962 to reconcile their Advanced Premium Tax Credit (APTC). If your clients have questions, they can contact the IRS directly at or or speak with their tax advisor 9
10 Public exchanges Understand Medicare and the Marketplace Individuals already enrolled in Medicare may not purchase a Marketplace plan, but a Marketplace member who later enrolls in Medicare is allowed to keep the Marketplace coverage, or to cancel it without penalty Members who enroll in Medicare while receiving tax subsidies for a Marketplace plan are no longer eligible for those subsidies once their Medicare Part A coverage begins If individuals obtain Medicare coverage while continuing to receive subsidies for a Marketplace plan, federal rules may require them to repay the subsidies when they file their next tax return 10
11 Important information for members
12 Helping members 2016 renewals: important dates November 1, 2015: Open Enrollment begins - This is the first day your clients can log on to to shop and enroll in a 2016 health insurance plan December 15, 2015: Last day to renew or choose a plan to avoid a coverage gap (December 31, 2015, if they qualify for a Special Enrollment Period) - Most Aetna and Coventry members will be auto-enrolled into a 2016 plan. If they decide to select a different plan, this is the last day to do so to make sure coverage will start on January 1, This is the last day to renew or choose a plan to make sure coverage will start on January 1, 2016 January 1, 2016: First date health insurance coverage can begin - This is the plan effective date if your clients renew or choose a plan by December 15, 2015 January 31, 2016: 2016 Open Enrollment ends - This is the last day clients can make changes or enroll in a new 2016 health insurance plan, without potential penalty for being uninsured 12
13 Helping members 2016 renewals: stay informed and be prepared for open enrollment Let your clients know they should be on the lookout for more information in the mail, prior to the start of Open Enrollment We ll send them a letter with detailed information about what they need to do to make sure they continue to have health coverage in
14 Helping members Helping Coventry members Let your clients know all they can find on the web for quicker access to valuable information My Online Services: To register, under Coverage Tools - Go to My Online Services - Click the Get Started - Click on the Register Now link View your claims, explanations of benefits (EOBs) and benefit usage details Access valuable health and wellness tools Research cost of care data, if available for your plan Request, display or print your member ID card Search for doctors, hospitals and other providers within your network 14
15 Helping members Tools for members Account management tools Member Payment Estimator lets members compare service costs Aetna Mobile allows members to search for providers, view benefits, view ID card, check prices Health management tools Health Connections Disease Management helps members stay on track with ongoing care itriage provides mobile access to check symptoms, compare nearby care options 15
16 Helping members Payments made easy: Coventry plans EFT is the only option for recurring payments; credit cards can be used for binder payments only Members can set up the recurring EFT in My Online Service (online member portal) for both on and off-exchange plans post issue Members can also set up EFT by phone On-exchange members can select recurring EFT when applying thru the federal marketplace if they pay their binder at time of application and select the recurring draft option See more details in our new Producer Guide on Producer World 16
17 Contacts Coventry billing and enrollment: on-exchange phone: off-exchange phone:
18 Thank You This information is intended for brokers only. Aetna individual health insurance plans are underwritten by Aetna Life Insurance Company and/or by Aetna Health Inc. (Aetna). CoventryOne health insurance plans are underwritten by the following affiliates of Aetna Life Insurance Company: Coventry Health and Life Insurance Company, Coventry Health Care of Kansas, Inc., Coventry Health Care of Georgia, Inc., Coventry Health Care of the Carolinas, Inc., Coventry Health Care of Louisiana, Inc., Aetna Health Inc. d/b/a Coventry Health Care of Iowa, Inc., Coventry Health Care of Nebraska, Inc., Coventry Health Care of Illinois, Inc., Coventry Health Plan of Florida, Inc., Coventry Health Care of Missouri, Inc., Coventry Health Care of Nevada, Inc., Coventry Health Care of Texas, Inc., Coventry Health Care of Virginia, Inc., Coventry Health Care of West Virginia, Inc., HealthAmerica Pennsylvania, Inc., Coventry Health Care of Delaware, Inc., or Altius Health Plans Inc. Certain plans are underwritten by Arches Mutual Insurance Company, administered by Coventry Health Care of Utah, Inc. or Montana Health CO-OP, administered by Altius Health Plans Inc Aetna Inc /15
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