WE RE IN THIS TOGETHER! HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

Transcription

1 WE RE IN THIS TOGETHER! HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

2 WELCOME TO HEALTH CHOICE GENERATIONS! We want to THANK YOU for contracting with Health Choice Generations! We look forward to helping you be successful and compliant in 2018! You are part of a special team helping Arizona beneficiaries choose a plan that best fits their needs. We value you and your partnership, and look forward to growing and innovating the landscape of healthcare with you - one member at a time! We are proud of our Arizona roots, and you will find that we truly care about our Health Choice Generations members. With an approachable and dedicated sales and marketing team, along with an amazing customer service, and innovative Buddy program YOU will see why our members and our brokers LOVE working with us! We hope you enjoy this years 2018 Health Choice Generations (HCG) Broker Guide! We are in this together thank you for your partnership! Shaun Johnson SHAUN R JOHNSON, MBA DIRECTOR OF SALES MEDICARE THIS GUIDE IS FOR AGENT & AGENCY USE ONLY All materials contained in this guide are protected by copyright laws, and may not be reproduced, republished, distributed, transmitted, displayed, broadcast, or otherwise communicated in any manner without the express written consent of Health Choice. Health Choice names and logos and all related trademarks, trade names and other intellectual property are the property of Health Choice and cannot be used without its express prior written permission. 2 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

3 ARIZONA ARIZONA WHO IS HEALTH CHOICE? OUR MISSION IS TO IMPROVE THE HEALTH AND WELLBEING OF OUR MEMBERS AND TO PROVIDE THEM WITH EXCEPTIONAL SERVICE WHEN THEY NEED IT MOST. Health Choice was founded in 1990 as a managed Medicaid health plan in Arizona. Since Health Choice was established, we have consistently grown our core managed Medicaid plan membership while building a statewide provider network. Today, through our health plans, integrated delivery systems, and managed care solutions, Health Choice coordinates healthcare for more than 660,000 distinct Medicaid, Medicare, and commercial plan members. COME VISIT US! Come and learn more by scheduling a Health Choice Tour at our corporate office! Come and see the Magic behind the Scenes! 2018 ARIZONA FOOTPRINT Coconino Mojave ARIZONA ARIZONA Navajo ARIZONA Apache Yavapai Gila La Paz ARIZONA Yuma ARIZONA Maricopa Pinal Graham Greenlee ARIZONA Pima Santa Cruz Cochise 3 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

4 WHY SELL HEALTH CHOICE GENERATIONS? THE OPPORTUNITY! THE DUAL ELIGIBLE POPULATION IS (STILL) ONE OF THE FASTEST GROWING POPULATIONS IN HEALTHCARE. Here are just a few reasons why you should consider Health Choice Generations as one of your premier D-SNP s in Arizona: Over 26 years experience serving the DSNP population in Arizona Health Choice is local headquartered in Phoenix, Arizona Top 3 Arizona D-SNP in market share (2nd highest in market share that is sellable by brokers) Extensive network of providers Long-standing history and relationship with AHCCCS Partnered with 1 of 3 Regional Behavioral Health Authorities (RHBAs) serving 225,000+ lives in Northern Arizona (Health Choice Integrated Care) Sell all year long! Customizable marketing pieces Year-round training and sales/marketing coaching Lifetime renewal commissions Locally based multi-lingual customer service and broker support staff Every member assigned a Health Care Buddy take the worry (and customer service problems) off your plate Easy access to highly engaged sales leadership and support team 4 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

5 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE GETTING STARTED CERTIFICATION REQUIREMENTS Joining Health Choice Generations is easy! We value your partnership and are always looking for talented, ambitious, compliant, and friendly partners to join the Health Choice family. CMS (Centers of Medicare & Medicaid Services) and AHCCCS (Arizona Health Care Cost Containment System) have provided us with strict guidelines on training and monitoring of our Broker partners. This is why we value our broker relationships and hold them to a high standard of performance and compliance. We encourage every new partner to contact the Health Choice sales team to discuss the opportunity to sell for Health Choice Generations, however, we may recommend you start your contracting and certification with your respective FMO to begin the process. NEW in 2018, we are excited to announce the beginning of an ongoing Medicaid Academy which will be available to all existing or potential brokers throughout the year. Be on the lookout for these invitations! STEP 1 New Brokers: Contact Health Choice Generations or your respective FMO partner to learn how you can become appointed to sell. You may be asked to fill out a form sharing your experience and possibly provide a business plan. Don t be afraid this is an opportunity for you, your FMO, and the HCG sales leadership to assist you in helping you succeed in your efforts to grow your HCG business for years to come. Returning Brokers: Welcome Back!! Check in with Health Choice Generations or your FMO partner to begin the process of recertification. STEP 2 New & Returning Brokers: Take the AHIP Exam and score a minimum of 90% to pass. You are allowed 3 attempts to pass. If you do not pass in three attempts, you will not be considered to sell for Health Choice Generations that year. You will also need to pass the following Modules: Overview of Medicare Program Basics (New Required) Medicare Health Plans (New - Required) Medicare Part D Prescription Drug Coverage (New Required) Marketing Medicare Advantage Part D Plans (New & Returning Required) Enrollment Guidance for Medicare Advantage & Part D Plans (New & Returning Required) Medicare Fraud, Waste, & Abuse 3 Modules (New & Returning Required) 5 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

6 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE STEP 3 New Brokers: You will be required to attend a face-to-face training. This will be a great opportunity for you to meet a member of the Sales Leadership team, and learn the ins and outs of Health Choice, the Medicare business, compliance, and sales techniques to get you on your way. There will also be a comprehensive exam at the end of the training that you will need to pass with an 85% score. Returning Brokers: You will be required to attend one of our Annual HCG mandatory Rollout Meetings and come on who wouldn t!! This is a great time to see your peers; your Health Choice sales support team and learn about the wonderful new benefits offered by Health Choice Generations. Come ready to learn and get PUMPED for selling Health Choice Generations in BUT WAIT you re not free and clear yet! You will receive a link via after the Rollout Meeting along with a copy of the presentation to take a 20 question exam. You must pass the HCG Recertification Exam with an 85%. You will be given three attempts. After the third attempt, if you are still unable to pass, you will not be allowed represent HCG for ALMOST THERE DO NOT START SELLING until you have received a confirmation from a Health Choice Generations Broker Support Specialist confirming you have successfully met all requirements to sell Health Choice Generations! CONGRATULATIONS YOU ARE READY TO SELL!! 6 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

7 HCG AGENT RULES OF ENGAGEMENT Good standing: All agents must be in good standing with the Arizona Department of Insurance with a valid life & health license, and must be continually certified and have met all compliance and production requirements to continue to receive renewals and compensation. Nominal Gifts: No gifts are to be used to induce enrollment or offer referrals. Gifts of any kind must not exceed a retail value of more than $15.00 and may not be readily converted into cash. SALES & MARKETING DO S & DON TS: DO NOT Solicit door to door Conduct any outbound unsolicited marketing campaigns Approach beneficiaries in common areas to solicit HCG Cross-sell any Non-health related product(s) to beneficiaries such as annuities or life insurance during an HCG presentation Conduct sales activities in health care settings, unless in a common area such as hospital cafeterias or community rooms as described in the CMS Medicare Marketing Guidelines Conduct sales activities at educational events. You are prohibited from distributing marketing materials, enrollment applications, or business reply cards at educational events. Provide a meal to prospects before, during, or after a formal sales presentation. Light snacks are allowed, but meals are strictly prohibited. DO Sell Health Choice Generations! Use HCG approved Scope of Appointment form before any face-to-face appointment. Scope of Appointment forms must be retained by the Agent for a period of ten (10) years as described by the CMS Marketing Guidelines and Health Choice Generations policies and procedures. Complete the annual HCG recertification (85%) and pass the AHIP exam (90%) to be approved to represent Health Choice Generations Follow and present the CMS approved HCG Sales Presentation and explain the HCG Summary of Benefits and Drug Formulary with each prospective enrollee. , fax, or mail all HCG Enrollments within 24 hours to: FAX MAIL TO... Health Choice Generations Attention: HCG Enrollment 410 N 44th St, Suite 510 Phoenix, AZ ** Refer to the 2018 CMS Medicare Marketing Guidelines and your HCG Agent Contract for further details ** 7 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

8 HOW TO SUBMIT AN HCG SALES EVENT ON WITH THE SHOW Health Choice Generations recognizes and encourages agents to be out in the community and to submit their formal and informal sales events. Recent changes to the Medicare Marketing Guidelines have provided health plans, like Health Choice Generations, the opportunity to stop sending event request approvals to CMS. Although this is good news, CMS still requires that we track and approve all events in a timely fashion and be prepared to present CMS, at any time, with that data. Regardless of the changes, the current policy will still apply for all event requests: FORMAL SALES EVENTS: Formal sales events MUST be approved by the respective FMO and HCG Sales Leadership. You may be asked to Try-Out to present formal sales seminars. Be prepared to present a demonstration of a full presentation to HCG Sales Leadership to become an approved presenter. Do not assume you are approved without written consent from HCG Sales Leadership. If approved, ALL Formal Sales Events MUST be submitted to the HCG Broker Service Specialist within 10 BUSINESS DAYS of the event. If not submitted within the required time frame, the event may not be approved. IN-FORMAL SALES EVENTS: In-Formal Sales events are less formal and less structured events that typically utilize a table or booth with a sales person. ALL informal Sales Events MUST be submitted to the agents respective FMO HCG Broker Service Specialist within 10 BUSINESS DAYS of the event. If not submitted within the required time frame, the event may not be approved. WAIT for approval before marketing or conducting your sales event! You will receive a confirmation from a member of the Broker Support Sales team confirming the receipt and approval of your sales event. 8 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

9 SALES EVENT CHANGES AND/OR CANCELLATIONS As described by the 2017 Medicare Marketing Guidelines, any change or cancelation to any event MUST be communicated to Health Choice Generations immediately, or no less than 48 hours prior to the scheduled date. HCG or your respective FMO will send an confirming the cancelation or change of the event: If cancelled within 48 hours of the scheduled date: Agent must create and post a sign indicating the event was cancelled and include any alternate times, dates or locations for already approved future events Agent must appear at the site for at least 15 minutes past the originally scheduled time Agent must notify both HCG and their respective FMO of the cancelation to be submitted to CMS If cancelled more than 48 hours before the scheduled date: Agent must notify the beneficiaries in the same way the event was advertised Agent must notify RSVP s by phone of the event cancelation FOR FURTHER QUESTIONS OR CONCERNS: Contact your Health Choice Generations at MedicareSales@iasishealthcare.com or the HCG Broker Support line at Option #4 9 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

10 MARKETING MATERIALS & WEBSITES All Marketing Material and websites that have not already been approved by CMS and Health Choice Generations MUST be reviewed and approved by Health Choice Generations. Please submit ALL marketing material, use of HCG on personal or agency website, and logo requests to iasishealthcare.com. You may also contact our Broker Support line at option #4. Marketing material that contains no benefit information will typically be approved without CMS approval. (Subject to Compliance Department review and approval) Marketing material that contains specific benefit information or sales event times and locations must be filed with CMS, and may require wait times from 5 to 45 days for full CMS approval. DO NOT proceed to use or market submitted materials until you have received written approval from Health Choice Generations and/or have received an approval code from CMS if applicable. All CMS approved codes must be included on Marketing Materials. At Health Choice Generations HMO, we take pride in offering you extra benefits that may not be covered by Original Medicare while providing you with excellent customer service. If you have Medicare and AHCCCS, we can help you get the extra benefits and the care you need. Want more information? OUR EXTRA BENEFITS INCLUDE: DENTAL Comprehensive/preventive dental benefit up to $1,600 per year. Includes 2 exams and 2 cleanings per year (one every 6-months), and 1 dental x-ray We make it easy for you to get the extra benefits you need. If you would like more information on how to receive these additional benefits, fill out this card and mail it back to us. (no postage necessary) Name: Address: VISION $175 allowance for eyeglasses (frames and lenses) every year PLUS one routine eye exam per year. HEARING $500 allowance every year for one hearing aid for one ear PLUS one routine hearing exam per year. OVER-THE-COUNTER ITEMS Get $240 every year ($60 per quarter) for over-the-counter items like bandages, lotion, toothpaste, vitamins and more! Order directly from catalogue. PLUS: YOUR HEALTH CARE BUDDY- Health Choice Generations understands the importance of individualized care. That is why we assign every member their very own health care buddy. Your buddy will help you with your health care needs. Your buddy is just a phone call away! All Medicare covered preventive services at zero cost share. And much more! ENROLLING IS EASY AS 1, 2, 3! You can call us to set an appointment with an enrollment specialist that will come to you to explain your benefits in person. One of our Member Services Representatives can help you enroll by phone. We can assist you with any questions you may have and send you enrollment materials. Enroll online anytime at HealthChoiceGenerations.com or Medicare.gov City, State, Zip: Phone: Best time to call me: How did you hear about us?: By providing my phone number, I give permission for an enrollment specialist to call me. Call licensed local insurance agent: <customizable field for broker name> <customizable field for broker phone number> HOW DO I ORDER MATERIALS? Ordering marketing materials is easy. We do our best to create marketing materials that are easily customizable which can be created and distributed by you or your FMO and/or agency. We also work directly with all our brokers and FMO partners on a number of marketing ideas and projects, and encourage out-of-the box approaches. We champion those ideas while remaining true and compliant to the current CMS Marketing Guidelines. If you have questions or want to begin the marketing process start by ing us at MedicareSales@Iasishealthcare.com, contact your respective FMO partner, or contact our Broker Support line at option #4 for more details. We look forward to hearing from you and helping you grow your business with Health Choice Generations. Coming Fall Materials may also be ordered through our broker ordering portal, which is a new addition for the 2018 plan year. You can find more information on this, as well as how to order, on our website under the Broker tab. 10 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

11 2017 HEALTH CHOICE GENERATIONS AGENT PRODUCTION REQUIREMENTS & COMPENSATION All broker/agent compensation is defined by CMS. Although much of the compensation regulation is the same across all carriers, there are various ways carriers may choose to pay brokers. This is why you may see differences across all carriers. Let s first take a look at this year s Commission Rates and explore the different types of enrollments as defined by CMS: 2018 HEALTH CHOICE GENERATIONS COMMISSION RATES 2018 First Year Subsequent Years ( Renewal Rate ) - Lifetimes Plan Type - MA & MAPD State $ Amount State $ Amount Initial Sale Arizona $227 + $228 prorated + Arizona $19.00 pmpm ($228 annually) Unlike Plan Type Change Arizona $455 prorated + Arizona $19.00 pmpm ($228 annually) Like Plan Type Change Arizona $228 prorated + Arizona $19.00 pmpm ($228 annually) Continuous Coverage Lifetime renewals paid pursuant to renewal rate per compensation schedule pmpm=per month per month. 1 prorated for the months that the policy is in force during the enrollment year Health Choice uses a monthly report from CMS to determine if a sale is an Initial Sale, Unlike Plan Type Change, or Like Plan Type Change. The following definitions apply to these commission payments and plan types: 1. INITIAL SALE A sale is considered an Initial Sale if the member is aging-in, is new to Medicare, moves from an employer group, or enrolls from Original Medicare. The Broker will be paid the Initial Sale Rate regardless of the enrollment effective date or month. For a beneficiary s first year of enrollment, Health Choice will pay $227 + a pro-rated amount of $228 ( Renewal Rate ) based on when the beneficiary enrolled. 2. UNLIKE PLAN TYPE CHANGE A Plan is considered an Unlike Plan Type Change if a member moves from MA or MAPD to PDP only, or moves from PDP only to MA or MAPD. The Broker is paid a prorated amount of the full Initial Sale Rate for the months that the policy is in force during the enrollment year. (For example, a change from a PDP to an MAPD effective May 1st is an unlike plan change resulting in a pro-rated initial compensation of 8/12 (May thru December) of the MAPD initial compensation rate). 3. LIKE PLAN TYPE CHANGE The sale is considered a Like Plan Type Change if the member makes any of the following changes: An MAPD to another MA or MAPD or anything else NOT considered an Unlike Plan Type Change. For example, if the member is moving from a MA or MAPD to another MA or MAPD, then the sale is considered a Like Plan Type Change and will receive a prorated commission based upon the # of months that the policy is in force during the enrollment year. 11 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

12 PRODUCTION STANDARDS & COMPENSATION LET S MAKE THIS EASY! Now let s take a look and see EXACTLY what you will get paid based on the Plan Type and the Effective date: HEALTH CHOICE GENERATIONS COMMISSION RATES BASED ON PLAN TYPE 2018 Broker Commission Rates Based on Plan Type Effective Date Months Enrolled Initial Sale Calculation Initial Year Sale Unlike Plan Type Calculation Unlike Plan Type Change Like Plan Type Change Jan of 12 $ (0 x $37.92) $ $ Feb of 12 $ (1 x $37.92) $ $ Mar.1 10 of 12 $ (2 x $37.92) $ $ April 1 9 of 12 $ (3 x $37.92) $ $ May 1 8 of 12 $ (4 x $37.92) $ $ June 1 7 of 12 $ (5 x $37.92) $ $ July 1 6 of 12 $ (6 x $37.92) $ $ Aug. 1 5 of 12 $ (7 x $37.92) $ $95.00 Sept. 1 4 of 12 $ (8 x $37.92) $ $76.00 October 1 3 of 12 $ (9 x $37.92) $ $57.00 Nov. 1 2 of 12 $ (10 x $37.92) $75.83 $38.00 Dec. 1 1 of 12 $ (11 x $37.92) $37.92 $ HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

13 PRODUCTION STANDARDS & COMPENSATION LET S MAKE THIS EASY! - Continued Also - To ease the burden and confusion on where your checks come from, Health Choice Generations pays our brokers and FMO partners direct. Subagency principal overrides are paid by their respective FMO. Looks Great Right?! Once again we love working with you and helping you grow your business. We hold our brokers to a high standard. That standard includes being 100% compliant, remaining in good standing with Health Choice Generations and the Arizona Department of Insurance (DOI). This includes using the Health Choice Generations Sales Presentation and approved marketing materials for all Sales Appointments. In order to remain in good standing with Health Choice Generations, you are required to meet the following expectations each year: PRODUCTION STANDARD & VESTED RENEWALS: Each broker must meet a minimum production standard of at least one enrollment within an 18 month rolling period. Earned renewals after the first year are vested, and will be paid to the broker until the member is no longer active with Health Choice Generations (i.e. deceased, plan change, AOR change, etc.). If an appointed broker does not meet the minimum production standard within a rolling 18 month period, the broker will be terminated for no production and considered inactive. The terminated/inactive broker would have to recontract, recertify and attend a mandatory New Agent Certification meeting in order be active to represent Health Choice Generations. All brokers seeking reappointment are subject to review and approval by the local Sales Director. As long as the broker is not terminated for cause, the broker will maintain their annual renewal payments for each consecutively enrolled active member. All active and/or non-renewing brokers may lose their renewal payments by: (1.) becoming terminated for cause, (2.) not passing the recertification exam with Health Choice Generations (3.) not certifying with or passing the AHIP examination (4.) not attending the Mandatory recertification Rollout meeting, (4.) not turning in all necessary certification paperwork (AHIP, HCG certification test) before the Nov 30th deadline. 13 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

14 PRODUCTION STANDARDS & COMPENSATION LET S MAKE THIS EASY! - Continued Here are some further details to consider while working as a Broker Partner for Health Choice Generations: Health Choice Generations Brokers will receive Lifetime Renewals on active enrollments during the next calendar year. Lifetime means the period that the member remains enrolled in the plan. Commissions are paid based on the month the application was received and not by effective date. (One exception is for commissions written during AEP AEP business will be written after the effective date) All brokers must be in good standing with CMS, the AZ Department of Insurance, Health Choice Generations, and their respective FMO with an active health & life license. Please see your HCG Contract for further details. To be in good standing with Health Choice Generations, the External Broker & FMO must meet the following requirements: 1. Must be licensed, contracted and appointed with Health Choice Generations 2. Health Choice Generations retains the sole discretion to authorize the Broker to solicit applications for HCG 3. Brokers are required to complete and pass the National AHIP exam each year they are appointed with Health Choice 4. Brokers must be in good standing with their respective State s Department of Insurance license requirements and be in good standing with the state. 5. Have current Errors & Omissions insurance ( in the amount of $250,000 per occurrence & $250,000) 6. For new Brokers: Completed the National AHIP exam and attended the required faceto-face training and passed the Health Choice certification exam with a passing score of 85% 7. For existing contracted brokers: Completed and Passed the National AHIP exam and the Annual Health Choice Recertification Exam with a passing score of 85% BEFORE November 30th, 2015 ** IMPORTANT: To remain active and appointed to sell Health Choice Generations, each Broker must: NEW: 12 Month Commission Look-Back Provision: A Broker with a commission dispute or appeal, may submit their inquiries to MedicareSales@Iasishealthcare.com or contact the Broker Support Line at Option #3. You will receive a response no later than 10 Business Days from the inquiry receipt date. However, if a Broker disputes a commission that occurred longer than 12 months from the inquiry date, Health Choice will no longer be responsible for remediation of any missed commission. No claim, demand, legal action or litigation against Health Choice may be brought by the External Broker, Agency Owner or FMO regarding a respective sale, policy or enrollment unless made within twelve (12) months from the date Broker first disputes the compensation. Agent of Record (AOR) Change: All AOR written requests must be done by an existing HCG member and submitted to HCG Sales leadership for review and approval. Old Broker commissions and renewals will discontinue when the Agent of Record (AOR) has changed. All brokers must be licensed, certified, and appointed to receive commissions and/or renewals for the member requesting an AOR change. 14 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

15 PRODUCTION STANDARDS & COMPENSATION LET S MAKE THIS EASY! - Continued Chargebacks: Rapid disenrollments and Longterm disenrollments are the most common type of chargeback that may occur. Rapid Disenrollments: This chargeback will occur when an enrollee moves from a Health Choice Generations (HCG) MAPD to another health plan within the first three months of enrollment. A full chargeback will be taken from the Broker when a Rapid disenrollment occurs. Chargebacks will be charged against future commissions and/or renewals that would otherwise be payable to the Broker. A Rapid Disenrollment DOES NOT apply in the following situation(s): When a beneficiary enrolls in a plan effective October 1st, November 1st, or December 1st and subsequently changes plans effective January 1st of the following year during the Annual Election Period (AEP) Member qualifies for other creditable coverage Moving into or out of an institution Gains or drops employer or union sponsored coverage Enrollee is disenrolled because of a CMS sanction against Health Choice Enrollee is disenrolled because of plan terminations or non-renewal in order to coordinate with Part D enrollment periods In order to coordinate with a State Pharmaceutical Assistance Program Enrollee becomes dually eligible for both Medicare and Medicaid Enrollee becomes eligible to enroll in another plan based on special needs/chronic condition Enrollee disenrolls due to auto or facilitated enrollment (as defined under Applicable Law) Enrollee dies Moves out of the service area Non-payment of premium Loses entitlement to Medicare Enrollee disenrolls due to a retroactive notice of Medicare entitlement When moving to a plan with a 5-Star rating or from a Low Performing Plan (LPI) to a higher rated plan Long term disenrollments: Members enrolled through a Broker who voluntarily or involuntarily disenroll from Health Choice before the end of the initial plan year and are not considered rapid disenrollments as described above, are considered long term disenrollments and will result in a pro-rated charge-back of previously paid commissions equal to those months the member was not enrolled on the plan (example: effective 2/1 and disenroll effective 6/30 results in 7 months charge-back). Chargebacks will be charged against future commission and/or renewal payments. The pro-rated charge-back rule applies to all years of plan membership by the member. Renewals: Renewals are paid beginning on the next calendar year of an enrollees original enrollment effective date. Renewals are paid on a per-member per-month (pmpm) basis of $19.00 pmpm. If an enrollee disenrolls during their renewal year, the renewal payment will cease the month the disenrollment occurs. No future renewal payments will occur on that member. 15 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

16 HELPFUL CONTACTS HEALTH CHOICE OFFICES CORPORATE OFFICE 410 N 44th St., Suite 900 Phoenix, AZ REGIONAL OFFICES: TUCSON 6390 E. Broadway Blvd. Ste. 240 Tucson, AZ FLAGSTAFF HCIC 1300 South Yale Street Flagstaff, AZ Additional Contact Info Commission Assistance Contracting Event Submission Marketing Materials Sales Materials MedicareSales@iasishealthcare.com, Broker Support line or your Respective FMO Partner MedicareSales@iasishealthcare.com, Broker Support line or your Respective FMO Partner MedicareSales@iasishealthcare.com, Broker Support line or your Respective FMO Partner MedicareSales@iasishealthcare.com, Broker Support line or your Respective FMO Partner MedicareSales@iasishealthcare.com, Broker Support line or your Respective FMO Partner Broker Support Line Enrollment Option #1: Member Eligibility & PCP check Option #2: Enrollment Questions Option #3: Commission Inquiries Option #4: Marketing materials & Events GenerationsEnrollment@iasishealthcare.com Fax: This is where you send your HCG Enrollments! Questions, missing pieces, etc. - we are here to help! Member Services Line Hours: 8 a.m. - 8 p.m. AHCCCS AZ Behavioral Health (RBHA) Crisis Hotline County Crisis Hot Line Phone Numbers Apache, Coconino, Gila, Mohave & Navajo Pima & Pinal Maricopa DES Hours: 8 a.m. - 8 p.m. 16 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

17 HELPFUL CONTACTS - Continued Case Management Every member of Health Choice Generations receives a call and a Health Risk Assessment within 90 days of enrolling. Our dedicated staff of Nurses and Care Coordinators reach out to every HCG member at a minimum of 1x per year regardless of their participation in a Care Management Program. A Case Manager can be reached through Member Services or through the member s Buddy The HCG Buddy Program Each HCG member is assigned a Buddy and is given the direct phone number to their assigned Buddy. Buddies contact the member a minimum of 4x a year (ie. Welcome call within 10 days of effective date, Happy Birthdays, Anniversary dates, OTC benefit reminders, surveys, to check on overall well-being of the member, etc.) A local AZ-Based Buddy may be reached directly or through the Member Services Line. Most Buddies work between 8 a.m. - 4:30 p.m. The Buddies are responsible for assisting with: PCP Assignments Case Management Transportation (HCA benefit) QM complaint forms, Fraud & Abuse, Grievance HIPAA response forms New Member/Dis-enrollment Surveys Contact Office Cell Fax How can we help? Shaun R. Johnson, Director of Sales Tanicka Deshommes, Broker Support Specialist (BSS) Team Lead Jessica Cruz, Broker Support Specialist (BSS) shaun_johnson@ iasishealthcare.com Anything we can do to help! If you have commission questions, event tdeshommes@ submissions, marketing iasishealthcare.com material questions, call us! We are anxious to help you jcruz@ succeed in growing your iasishealthcare.com business! 17 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE

18 NOTES 18 HEALTH CHOICE GENERATIONS 2018 BROKER GUIDE