Group-to-Medicare Services Guide

Transcription

1 Group-to-Medicare Services Guide The purpose of this guide is to help you assist employees and retirees with Medicare plan selection in the workplace. This document contains the resources you need to promote your capabilities and to explain individual Medicare products to employer groups. Y0114_15_23159_I_001 05/27/ WPBENMUB_001

2 Contents Group-to-Medicare Services Guide...Pages 2-10 Overview...Page 4 Getting Started: Five Easy Steps...Page 5 Building Business: Three Program Components...Page 6 On-site Medicare Resource Page 7 HR Support Materials...Page 9 Group Transition Support...Page 10 Program Follow-Up...Page 10 Resource Library...Pages Preparation Guide and Checklist...Page 12 Letter of Introduction...Pages 13 On-site Flier...Page 14 Group-to-Medicare Services Brochure...Page 15 Healthy Choices Booklet...Page 16 Six Reasons Flier...Page 17 Frequently Asked Questions (FAQs)...Page 18 1

3 Group-to-Medicare Services Guide 2

4 Dear <Valued Agent>, Group-to-Medicare Services is a unique program that helps you engage with employers about individual Medicare products for their employees and retirees. With it, you offer a set of consultative services to employers and become their preferred Medicare resource. By providing Medicare information in the workplace, you provide a valuable service to employers who don t offer retiree benefits to their employees and retirees. With rising health care costs, health care reform and huge growth in the Medicare population (Baby Boomers), fewer employers offer group Medicare benefits. That means more people are buying their own individual coverage when they become Medicare-eligible. But it gets complicated. There are many options and carriers, and a lot to consider. Employees and retirees need information, so they often turn to their company Human Resources (HR) staff with questions. They want to assist employees and retirees, but may not have the time or expertise to provide Medicare guidance. You re the solution. With Group-to-Medicare Services, you can: n Offer a set of services to employers who don t provide retiree benefits and become their preferred Medicare resource. n Engage employees and retirees who need help understanding their Medicare options and who are in the market for the Medicare products and services you provide. The Group-to-Medicare Services program is an easy, powerful business-building tool. So get ready to generate new and ongoing leads and enrollments, now and throughout the year, and year after year. Best regards, Medicare Programs Team 3

5 Group-to-Medicare Services Group-to-Medicare Services assists employees and retirees with their individual Medicare plan selection while building ongoing business for you. Value to Employers n Saves time and trouble by relieving HR staff of the responsibility of explaining Medicare n Saves money as older employees and retirees move off the group plan to an appropriate individual plan n Provides a value-added service at no extra cost Value to Employees and Retirees n Provides confidence through a licensed and certified Medicare health plan agent who helps navigate the Medicare enrollment process and options n Provides convenience by offering work-site access to information and support, as well as support for spouses and other family members n Provides ongoing support via annual plan consultation for those who enroll Value to Your Business n Generates income by providing an ongoing pipeline for leads and sales n Builds business by providing a great client development opportunity n It s versatile and easy! 4

6 Getting Started: Five Easy Steps Step 1: Identify Your Prospect Your customer is any employer (within or outside of your current client base) that: n Does not offer retiree coverage. n Wants to assist employees and retirees in their transition from the group plan to an individual plan as they become Medicare-eligible. Identifying employers that don t offer retiree benefits is easy just ask! You ll find prospects in the everyday course of doing business: Chambers of Commerce, local business directories, local business associates, etc. All of these are good sources for leads. To help qualify and prioritize your leads, you ll want to know: n Number of employees. n Current plan designs for retirees, Medicare-eligibles and under-65 (U-65) employees. n Goals for retiree coverage. Step 2: Introduce the Program Once you ve identified your prospects, promote your services with a letter of introduction (see Resource Library). You can send the letter to the CEO, CFO, business owner or Human Resources Specialist. Contact information is often available on the employer s website. Or simply call the business and ask who makes the benefits decisions. Step 3: Secure a Meeting Follow up with your employer prospect by phone a week after you mail your letter of introduction. The goal of the call is to secure a face-to-face meeting to go through the Group-to-Medicare Services brochure (see Resource Library) and identify the best options for the prospect. The meeting should take less than an hour. Step 4: Present the Program Now that you ve generated the employer s interest, present the program in more depth at a face-to-face meeting. Use the Group-to-Medicare Services brochure (see Resource Library) as your guide. It can be printed out or presented electronically. Step 5: Choose and Confirm Employer Options Group-to-Medicare Services provides you with options to offer employers. At the end of your presentation, discuss these options with your prospect, answer any questions and determine which services best meet the needs of the employer and employees. It s that easy! 5

7 Building Business: Three Program Components Group-to-Medicare Services opens the door to dialogue, sales and ongoing customer loyalty. The program has three distinct components that can be used individually or in combination. Program Components 1. On-site Medicare Resource 2. Human Resources (HR) Support Materials 3. Group Transition Support These components are described in more detail on the following pages. How to make the program work for you Group-to-Medicare Services provides the tools and guidance to help you sell. And it s flexible so you can make it work for you. How you use the program components will be determined by two factors: you and the employers you work with. You n Group presentation: Group information sessions may work for you. n One-to-one meetings: Consider quarterly lunch-and-learns for information Q&A sessions with employees. n You can periodically update the employer about how many employees call you. Employer n Find out how many employees or retirees are eligible for Medicare at any one time: Business size will help determine the most appropriate approach. n Look for a facility and time available for a group presentation or discussion: Is a conference room or lunchroom available? Are employees able to leave their desks or jobs at specific times? 6

8 On-site Medicare Resource You can be available on site at an employer s workplace periodically to discuss Medicare coverage options with employees and retirees. Recommended On-site Formats Informal Q&A In this format, you arrange with the HR contact to be at the work site on a certain date, for a certain period of time, to answer employee or retiree Medicare-related questions and discuss plans. Perhaps you sit in a lunchroom or conference room, and folks come and talk with you on a one-to-one basis. Ask your HR contact to send an or post a flier to announce the time you will be on site, as well as your location, the week before or early in the week of your visit. See the Resource Library for the On-site flier template. Scheduled Presentation In this format, you arrange with the HR contact to be at the work site on a certain date, at a certain time, to give a scheduled Medicare presentation to a group of employees or retirees who have previously signed up to attend. It s very important that your HR contact announce your on-site presentation one to two weeks in advance of the event and ask people to sign up, so you know how many attendees to plan for. This is the best way to generate leads and develop a book of group clients. You ll be present in the workplace, increasing your visibility and access to the decision-maker, and building your reputation as a trusted Medicare expert. 7

9 Tips for Successful On-site Events n Arrange with your HR contact a mutually agreeable date and time to schedule your on-site presentation. Allow enough lead time for your presentation to be publicized and retirees to be contacted. n Emphasize to your HR contact the importance of notifying employees and retirees in advance of your on-site visit. (See the On-site flier template in the Resource Library.) n Ask your HR contact about possible security issues when entering the building. Be sure you know where and how to enter the building. n On the day of your visit, arrive early to allow time for unforeseen issues. Also, give yourself an extra half hour to set up. n For a scheduled presentation or an informal Q&A session, determine with your HR contact how to best manage the event. n For a scheduled presentation, determine with your HR contact any technology needs, such as projector, screen, etc. Determine if the employer will provide these items or if you need to bring them with you. If the employer will provide the technical equipment, confirm the day before that it s available and functioning properly. n Use only the presentation materials provided. They ve been approved for compliance with CMS regulations. n Remember to send a follow-up /letter to your HR contact after your meeting. n If you conduct a subsequent in-home visit, please complete a Scope of Appointment (SOA) in our AHIP certification site and keep for your records. This includes selling all individual Medicare Advantage and Part D plans. Important! Familiarize yourself with CMS regulations and guideline for Sales and Marketing events (Medicare Marketing Guidelines. 70.9), and manage your on-site event accordingly. Per current guidance interpretation, on-site events in the closed-employer group setting will not require CMS filing. 8

10 HR Support Materials Is this employer too small for on-site events? No problem! Simply provide your HR contact with informational materials to hand out to employees and retirees as questions arise. It s a convenient value-added service for the employer. And since the handouts carry your contact information, it s an easy way to grow your business. Interested employees and retirees can contact you directly. Steps to a Successful HR Support Program 1. Determine with your HR contact which materials they d like, and how many (see Resource Library). 2. Deliver the materials in person to your customer. Be sure to call ahead and ask the best time to stop by. 3. When you deliver the materials, do not stay long unless invited to this is not a meeting. HR staffers are very busy. 4. Check in every few months to see if they d like to re-order. This is a great way to take the burden off the HR staff to answer questions they may not be equipped to answer. Employees and retirees are directed to an experienced expert you. 9

11 Group Transition Support You may identify a situation in which a number of employees or retirees will be losing group coverage entirely. For example, an employer may be eliminating retiree coverage from their benefits offerings. When you identify an opportunity for group transition support, contact us for help assessing the opportunity and develop a strategic proposal. Program Follow-Up No matter which Group-to-Medicare Services options you and the employer choose, it s essential to follow up in a timely and service-oriented manner. As you know, this is crucial to building an ongoing collaborative relationship, developing trust and ensuring repeat business. You should follow up immediately after any: n On-site presentation or Q&A. n Delivery of HR support materials. n Group transition support (although you will interface with the employer on a regular basis as you develop a strategy and execute the transition process). 10

12 Resource Library 1. Preparation Guide and Checklist 2. Letter of Introduction 3. On-site Flier 4. Group-to-Medicare Services Brochure 5. Healthy Choices Booklet 6. Six Reasons Flier 7. Frequently Asked Questions (FAQs) 11

13 Preparation Guide and Checklist Follow these steps to achieve a successful Group-to-Medicare Services program. Identify your prospect. This can be any employer within or outside your current client base. Send a letter of introduction. Once you ve identified your prospect, promote your services with a letter of introduction. This programmable document is in the Resource Library. Schedule a face-to-face meeting. Follow up with your client by phone a week after mailing your introduction letter and secure a face-to-face meeting to identify their best health care options. Choose and confirm employer options. The program offers several service options. At the end of your face-to-face meeting, discuss these options with your prospect, answer any questions and determine which services best meet the needs of the employer and employees. Schedule an on-site presentation. Arrange with your client (HR contact) for an on-site presentation or informal Q&A session to answer employee or retiree Medicare-related questions and plans. Determine with your HR contact the best way to manage the event (registration, location, etc.). Publicize your on-site presentation. Use the programmable On-site flier. Work with your HR contact to make sure the event is planned well in advance and that the fliers are posted in popular areas or ed to the appropriate audience. It s also important to order handout materials such as the Healthy Choices booklet and Six Reasons flier for those in attendance. It s best to deliver these additional items in person. Do this on the day of your presentation. Confirm any technical equipment needs with your HR contact. Arrive early, be aware of possible security issues and know where to enter the site. Use only the presentation materials provided to you. They ve been approved for compliance with CMS regulations. Follow up. After your on-site presentation, follow up immediately with your client to thank them and to secure future communication. This is crucial to building an ongoing collaborative relationship, developing trust and assuring repeat business. 12

14 Letter of Introduction Available for ordering from CustomPoint site. < LOGO > <Date> <Customer Contact Name> <Customer Company Name> <Street Address> <City, State, ZIP> Want help transitioning your group health plan members to Medicare? Our Medicare specialists take the burden of explaining group-to-medicare planning off you. You want to continue assisting your employees and retirees as they reach Medicare eligibility. But chances are your HR staff doesn t have the time or expertise to provide answers to Medicare questions. That s where we come in. Our agents are Medicare-licensed and certified. With our program, you ll be able to: Help your Medicare-eligible employees/retirees understand Medicare and find the right coverage for their individual health and financial needs. Relieve your HR staff of the responsibility of advising them. Offer a valuable service to employees/retirees at no cost to them or your business. Our services are free and efficient. We offer several options you can tailor to your needs: A Medicare overview presentation or informal Q&A session in your workplace Organized support if a group of Medicare-eligible employees move off of a group plan Let s talk soon at <Agent Phone Number>. Sincerely, <Agent Name> <Agency Address> <Agent Phone Number> <Agent Address> Authorized licensed independent agent for <Brand name> in <State> License Number: <XXXXXX> 13

15 On-site Flier Available for ordering from CustomPoint site. What happens to your health plan when you turn 65 or retire? Find out from a Medicare specialist <Logo> You have important decisions to make about Medicare. And we want to help you make choices that are right for you. That s why we ve arranged a presentation for you with a licensed, certified Medicare specialist. Learn more about Medicare and your health plan options, get answers to your questions and gather information you can share with your loved ones at this free, no-obligation meeting. Topics include: <Medicare Advantage HMO, PPO Plans, Part D Prescription Drug Plans> <Agent Name> <Company Name> Day: <XXXX> Date: <Month XX, 20XX> Time: <Beginning at X:XX> Location: <Employer Name> <Specific on-site location> <XXXXX> What does Medicare cover? What s not covered? How can I protect myself from high medical costs? What are my health plan options? How do I know what s right for me? How much does it cost? What do I do next? Authorized licensed and certified independent agent for <Anthem Blue Cross> of <State> <License number XXXX> Call or me to sign up now. Contact: <Employer HR contact> Phone: <1-XXX-XXX-XXXX> TTY: <1-XXX-XXX-XXXX> < address> 14

16 Group-to-Medicare Services Brochure Available for ordering from CustomPoint site. <logo> Group-to-Medicare Services A no-cost, value-added service for <Insert Client Name> Presented by: <Medicare-Certified Agent and/or Agency Name> <Date of Presentation> Y0071_15_23755_I <mm/dd/yyyy> WPBENMUB ENT Smooth Transitions Broch WPBENMUB 15

17 Healthy Choices Booklet < > PRSRT STD U.S. POSTAGE PAID San Diego, CA Permit #1 Available for ordering from CustomPoint site. [<Form # XXXX>] Make the best Medicare choice. Use this guide to learn about coverage, costs and choices and what they mean to you. THIS IS AN ADVERTISEMENT. <12345 Street Name, City, XX 99999> < Logo > Start learning about Medicare health plans today... so you'll be making the best choices later! [<Event ID>] [<John Q. Sample>] [<1234 Street Name>] [<Extra Address Line>] [<City, ST >] [ ] Inside... The parts of Medicare Plan choices and payment options What you need to do and when you need to do it < Logo > Compliments of your local <Company name> agent. Y0071_15_19946_U CMS Accepted 11/04/2014 <45772MUMENMUB> MUMENMUB 2015 Broker Co-op HlthyChoices BR

18 Six Reasons Flier Available for ordering from CustomPoint site. <logo> Questions about Medicare? I ve got answers. < > No stress. And no cost to you. If you re 65 or will be soon, I can help you find a Medicare plan that may provide better coverage and savings even if you plan to continue working. That s because an individual Medicare plan may cover more of your health care needs than the group plan you re accustomed to without hurting your budget. As a local Medicare sales representative, I ll help you find the best plan for your needs. And you ll never pay a penny extra for my services, so let s talk! <Broker NameXXXXXXXXXX> <1-XXX-XXX-XXXX> (TTY/TDD: 711) Authorized independent licensed agent for <Company Name> in <State>. You may also call <Company Name> Customer Service at < , TTY/TDD 711, 8 a.m. to 8 p.m., seven days a week (except Thanksgiving and Christmas)> from <October 1 through February 14,> and Monday to Friday (except holidays) from <February 15 through September 30.> THIS IS AN ADVERTISEMENT. Y0071_15_21815_U CMS Accepted 10/30/2014 <49124MUMENMUB> 17

19 Frequently Asked Questions (FAQs) Q. If a private follow-up meeting with a group retiree occurs after a presentation at the closed-employer group, do I need to complete a Scope of Appointment (SOA)? A. Yes. If you conduct a subsequent in-home visit, please complete a SOA in our AHIP certification site and keep for your records. This includes selling all individual Medicare Advantage and Part D plans. Q. What happens when someone is 65, still works and has health care coverage through their employer? A. Employees who continue to work past age 65 may be able to keep their employer s plan. But group health plans with fewer than 20 employees can choose to drop or reduce coverage for Medicare-eligible employees. In these cases, the employer may offer wrap-around or supplemental coverage, and the employee must enroll in Medicare for primary coverage. Be sure to understand what this employer currently offers. Q. What if a spouse works and has employer-provided health care coverage? A. Employees might be able to move to their spouse s health care plan if it provides them with equal or better coverage than Medicare. Again, they should determine how the plan would coordinate with Medicare (for example, as primary or secondary payer). Q. What if someone is retired and has retiree health benefits through their former employer? A. If employees have coverage as good as or better than Medicare under their retiree benefits, they might be able to defer Medicare Part B if their retiree health care plan allows them to do so. However, some retiree plans stipulate that Medicare is the primary payer and the retiree plan is the secondary payer. Therefore, they need to understand how much coverage is provided under their retiree health plan to determine if they need additional Medicare coverage. We re here to help your business grow. 18

20 Anthem Blue Cross is a Medicare Advantage Organization with a Medicare contract. Enrollment in Anthem Blue Cross depends on contract renewal. Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensee of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association. 19