Excellus BCBS Medicare Broker News Vol. 6 No. 10

AEP Operational Reminders & Best Practices

As we approach the halfway mark this AEP, the Excellus BCBS team wanted to provide some helpful reminders and tips to keep in mind:

• Flex Card Usage: Members with a flex card benefit should use their 2024 balance by the end of the year. Members will have 180 days to send in a claim submission to use any remaining funds, but the service date of the claim must be in 2024.
  • Any additional reward funds earned will continue to be available on the card through 12/31/2025.  Those funds can continue to be used on 2025 expenses.  
• Event Supplies: As a reminder, if you plan to host an event, please make sure you file the event with the Excellus BCBS team and request any needed supplies at least 21 days in advance. This is especially important for customizable items, like banners.
• Emailing PHI: Please remember to send any personal health information (PHI) securely when emailing about clients. Any member information should be encrypted and never used in email subject lines.
• Electronic App Submission: Please do not fax a paper application in addition to submitting your applications electronically. This creates duplicates and can slow down the enrollment process.
• Sales Hub: Excellus has experienced an uptick in new Sales Hub users, but a few broker partners have experienced issues accessing the site. Here are a few troubleshooting tips:
  • Make sure you register for the Medicare Sales Hub, using this link. There is a Sales Hub for commercial brokers, but you will not be able to access the Medicare resources from that site.
  • The letters in your username (if any) will always be lowercase.
  • If you’ve made multiple login attempts, you may receive an error. Try deleting your recent search history or cookies before trying again, especially if we’ve reset your password.
  • When in doubt, refer to this Quick Start User Guide or reach out to your Broker Account Service Consultant.
• Formularies & Directories: Formularies and provider directories are updated for 2025. You can find PDFs on the website using the links below. Excellus recommends using the Plan-Specific Drug List to search for your clients’ drugs by name.
  • 2025 Medicare Formularies
  • Search Plan-Specific Drug List
  • Provider Directories

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Answering Your Medicare Prescription Payment Plan Questions

As the pharmacy team continues to receive inquiries on the Medicare Prescription Payment Plan, Excellus BCBS wanted to make sure you have the resources you need to help members navigate this important program. Below you will find a PDF with answers to your frequently asked questions, the participation request form, and the CMS fact sheet on the Medicare Prescription Payment Plan. You can find these resources, as well as the Part D resources we shared in October by logging into the Medicare Sales Hub.

Thank you for your collaboration and patience as we learn more about the implementation and impact of this program. The Excellus BCBS team is working hard to make sure they provide you with the best information available.

• Medicare Prescription Payment Plan FAQs (PDF)
• Medicare Prescription Payment Plan Participation Request Form (PDF)
• CMS Medicare Prescription Payment Plan Fact Sheet

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Order Your FitOn Materials

Need materials to help explain our new fitness benefit? FitOn member and broker flyers are available for print ordering. Please email your Broker Account Service Consultant to place an order. You can download the flyers using the links below.

• FitOn Member Flyer (PDF)
• FitOn Broker Flyer (PDF)

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Notice of Nondiscrimination Member Mailing

Excellus BCBS wanted to make broker partners aware of updates to the Notice of Nondiscrimination Addendum per the 2024 Section 1557 Final Rule. Starting November 1, 2024, members will only be required to receive the Notice of Nondiscrimination Policy and Notice of Availability once per calendar year. To meet this requirement, Excellus BCBS will be mailing out these notices to all members in November.

You will notice this language start to disappear from many of the materials moving forward. There is no action required on your part and you can continue using current materials. If you have any questions, please reach out to your Broker Account Service Consultant.

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LIS/Dual SEP Changes for 2025

There will be significant changes to the quarterly SEP for Dual-eligible or LIS-eligible individuals in 2025. Currently, individuals with LIS can switch into a different MA plan once per quarter (during the first 9 months of the year). Starting January 1, 2025, the SEP no longer applies to MA plans and is now a Part D SEP. Beneficiaries with LIS will only have the option to enroll in any standalone prescription drug plan using the SEP.

• MA and Part D Enrollment and Disenrollment Guidance
• LIS / EPIC Premium Chat (PDF)

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