News
Dickerson brings you the latest weekly industry, legislative and carrier updates.
Aetna Standalone Dental Quotes, Blue Shield Stanford Health Contract, California Choice Rate Changes, Employee Navigator System Training, Updates, News & More
Thursday, July 18 2024
Carrier Updates
Aetna Small Group Dental Small Group standalone dental quotes now available Great news! Aetna now offers two options to get a Small Group dental quote for groupsof 2-100 eligible employees. Please note, a vision quote is automatically included in allstandalone dental requests. Vision rate sheets are available in Producer World under the “ Aetna Vision Preferred ” tab. If you need an immediate quote, follow the steps below for the self-service option: Step 1: Select “ Quoting and Renewal ” from the left menu Step 2: Select the “ Small Group ” tab Step 3:Select self-service illustrative quoting Step 4: Select 'proceed' to navigate SMART. If you are looking for a more customized experience, use our full-service option to send your quote and census information to our standalone dental email box: DentalStandAlone@AETNA.com (a 72-hour turnaround time is standard). For More Information or Help Quoting Aetna, Please Contact Your Dickerson Sales Rep Today.
Carrier Updates
The Stanford Health Care hospitals and facilities contract with Blue Shield ended on June 28, 2024. Despite many months of good faith negotiations with Stanford Health, Blue Shield has not been able to reach a reasonable agreement on reimbursement rates and contractual terms that are beneficial for both parties and keep care sustainably affordable for our members. They are notifying impacted members, as is required, regarding this network change: Impacted HMO and PPO Individual and Family Plan, Small Business, and Large Group members - those who have received care in the last 12 months and/or PPO members within a 15-mile radius of an Stanford Health facility - will be notified five days post contract termination (July 3, 2024). Sample member letters. Please see list of the nearest alternate facilities (These all have pediatric and/or NICU services, unless otherwise noted): El Camino Health Good Samaritan Hospital Mills-Pen Medical Center O’Connor Hospital Regional Medical Center of San Jose (NO pediatric and/or NICU services) Santa Clara Valley Medical Center UCSF Medical Center and UCSF Benioff Children's Hospital – Oakland (37 miles from Lucille Packard Children’s Hospital) Blue Shield has taken steps to ensure members will continue to have uninterrupted access to quality medical care in their area. Blue Shield has an extensive hospital network that is available to serve members who previously received care through the Stanford Health Care hospitals and facilities. For More Information or Help Quoting Blue Shield, Please Contact Your Dickerson Sales Rep Today.
Carrier Updates
California Choice has announced when 10/1 quoting is available, medical rates are changing for the following carriers. MEDICAL RATES Changes - Anthem Blue Cross, Cigna + Oscar, Health Net, Sharp Health Plan, Sutter Health Plus and UnitedHealthcare; see attached 10.2024 Rate Guide (PDF and Excel) No changes - Kaiser Permanente and Western Health Advantage MEDICAL ZIP CODE No changes When October quoting is available, updated materials and forms will be available at www.calchoice.com; please log in and click Forms and Documents. For More Information or Help Quoting California Choice, Please contact Your Dickerson Sales Rep Today.
Industry News
(By Emma Beavins) July 11 - The Centers for Medicare & Medicaid Services' (CMS') proposed calendar year 2025 physician fee schedule rule, out Wednesday, proposed an assortment of new payments and coverage for digital health services, including digital therapeutics, telehealth and audio-only telehealth services. It did not, however, address the bulk of Medicare telehealth waivers expiring at the end of the year, which need to be extended by Congress. The draft rule contains significant proposals for rural health clinics and federally qualified health centers to continue receiving payment for audio-only telehealth, waive the in-person visit requirement for telemental health services and report remote monitoring codes outside of catch-all code G0511. CMS' proposal also gives opioid treatment programs more flexibility in their use of telehealth and audio-only telehealth services, which the agency says will improve health equity While some of the changes were obvious wins for the digital health community, policy experts are still digging into the implications of other proposals. To Read More Click Here
Industry News
This 2-day webinar series is intended to help train the newest of users. The sessions showcase system tools and features used to set up a company including plans & employees, conduct an open enrollment, effectively & easily manage enrollments with carriers and so much more. To prepare for this event, we ask that you: 1. Ensure you have completed your Employee Navigator account registration* 2. Watch a few self-paced training videos** 3. Download and review the training Q&A document to familiarize yourself with questions asked by attendees in prior sessions** *System access is proven to be beneficial for attendees, please only register once you have system access **Links to the materials are included in the registration questions Employee Navigator license holders without access: Contact your licensee admin to request they provide you with a login For Ease license holders without Employee Navigator access: Review the email you have received from ben@ease.com --Step 1 includes the form that MUST be completed and submitted to provide your agency with an amendment to your Ease contract via DocuSign --The amendment once submitted takes 3-4 days to process on our end after which you will receive a registration email --Employee Navigator access cannot be provided until the amendment has been executed, returned, and processed by Ease & Employee Navigator; don't delay To Register Click Here