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May
06
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2024

Excellus BCBS Medicare Broker News Vol. 6 No. 5

May 6, 2024
Excellus BlueCross BlueShield

Multiplan Marketing Material Guidance

Last year, CMS updated their definition of Marketing to include all materials or activities that mention any benefits (i.e., dental, vision, eyewear allowances). This ruling directly impacted our broker partners and the materials you use to market yourselves. While Excellus' recommendation for obtaining CMS Marketing approval is to refer to your FMO upline for guidance, they wanted to remind you of the role health plans have in the process.

  • You must have consultant access to HPMS to submit a Multiplan Marketing material to CMS. It is the Excellus policy that they only grant consultant access to organizations they have a direct contract with. For many agents, the direct contract is your FMO. Please defer to your FMO upline for additional guidance on marketing material submissions.
  • If you have a direct contract with Excellus and need consultant access, the process is outlined in section §§ 422.2261(a)(3), 423.2261(a)(3) of the MCMG.
  • The multi-plan submission process is not the vehicle for plan review of third-party submitted materials. To use the Excellus BlueCross BlueShield name or logo in your Multiplan Marketing material, you must submit the material to their health plan for review prior to submitting it to CMS. They require at least 2 weeks for material review. Please build this into your timeline.
  • Please email any Multiplan Marketing Materials to your Broker Account Executive for health plan review. They will notify you once the material has approval.
  • If you include the Excellus contract number in your Multiplan Marketing submission without prior health plan review and approval, they will not opt in.

If you have questions about this process or whether your material is considered Marketing under the updated CMS definition, please reach out to your Broker Account Executive or Account Service Consultant. Use the link below to view the most recent MCMG.

(MCMG) Medicare Communications And Marketing Guidelines (PDF)

Special Enrollment Period Reminder

To keep broker partners more informed about enrollment opportunities, Excellus BCBS is going to make Special Enrollment Period updates a regular part of their monthly newsletter. Please keep the following rules in mind when it comes to using SEPs:

  • SEPs can be declared by CMS or a government entity, such as NYS or a county executive.
  • SEPs are valid for two full calendar months after declaration but can be extended by the original issuing agency.
  • Individuals are eligible to use a disaster or emergency declaration SEP for enrollment as long as they:
    • Reside in the affected area or rely on someone for healthcare decisions who resides in the affected area.
    • Were eligible for another election period at the time of the SEP.
    • Did not make an election during the above election period due to the emergency or disaster that occurred.

Please reach out to your Broker Account Executive with any questions about Special Enrollment Periods.

Spring Medicare Member Insider

The spring edition of the Medicare Member Insider magazine is now available. All Excellus BCBS direct pay Medicare members will receive a copy of this in the mail in addition to an email version in their inbox.

Excellus BCBS encourages you to read and share with your clients, as they include important plan information and tips on how to use supplemental benefits.

The Spring edition covers topics such as:

  • Understanding the Medicare Drug Formulary
  • New Benefit: Vori Health Virtual Physical Therapy
  • Our Care Management Team in action
  • Spring Cleaning Injuries

Spring Medicare Member Insider (PDF)

Medicare Member Insider Archive

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