UPMC Health Plan Medicare Program

Quick Links

Online Provider Directory & Formulary-  Make sure you choose the correct plan- There are different networks for different plans and the SNP plan also has its own network.

https://www.upmchealthplan.com/find/#provider

 

Access to Summary of Benefits & Evidence of Coverage- Again make sure you pick the correct plan year and plan.

https://www.upmchealthplan.com/medicare/documents-and-forms/

 

Silver Sneakers- Location lookup for 2019 plans

https://www.silversneakers.com/

Company Information

Administrative Office Mailing Address:

UPMC for Life
ATTN: Linda Pittner, 9th Floor
600 Grant Street
Pittsburgh, PA 15219

Overnight Mailing Address:

UPMC for Life
ATTN: Linda Pittner, 9th Floor
600 Grant Street
Pittsburgh, PA 15219

Broker Support:

Broker Resource Center- 855-289-3197

Agents should contact the Broker Manager for their area if they have any questions:

Sr. Broker Manager          Amy Gralewski    412-454-2964     gralaj@upmc.edu

Sr. Broker Manager          Bill Reichert         814-746-1566     reichertwg@upmc.edu

Sr. Broker Manager          Roger Williams   814-262-1061     williamsr2@upmc.ed

Broker Manager                Mike Kirkwood   412-454-8549     kirkwoodme@upmc.edu

Broker Manager                Caty Pasqualini   412-454-6111     pasqualinic@upmc.edu

Broker Manager                Tessa Rado          412-402-3601     radot@upmc.edu

New Business:

Crystal Kominskic, Broker Manager 
Phone: 570-550-4828
Email: kominskic@upmc.edu
Fax: 412-454-2110

Member Services:

Phone: 1-877-539-3080
Email: memberservices@upmc.edu 
Fax: 412-454-752

Certification Details

Stay tuned for UPMC 2020 certification information.

Instructions for the Following Products:
  • Medicare Advantage
Certification Status:

Certification Start Date:

Live

Note: Agents have until September 22, 2018, to complete the training.

Certification Links:

Certification Instructions

QUIA Reminders and Resources from UPMC for Life:

  • To ensure your success, please complete each module. The training module DOES NOT require a log in. When you are ready to take the required quiz, you will need to login to Quia.
  • Watch for a separate e-mail from Quia.com – this is not a phishing email.
    • This email will contain your username and password.
    • You will need this information to complete the quiz.
    • If you do not receive the email and if not found in your spam folder, then contact your broker manager.
  • You can change your password by going to the change password form. (You will be prompted to log in if you have not already done so.)
  • There are three (3) attempts to complete the quiz.
    • Your logon counts the attempt.
    • A passing score is 85%.
  • You have the ability to skip a question and backtrack to complete it.
  • You are encouraged to complete the quiz in one sitting. If you cannot do so: you can save your progress, log out, and continue at a later time.
  • Do not leave the quiz without saving your progress.
Is AHIP Required for Certification?

UPMC accepts AHIP. If you do not see the option to transmit your results to UPMC for Life in the AHIP website, then please make sure to log in through this link so that UPMC can receive them. Once you login, or transmit your results, UPMC will receive them. 

Will Certifying for 2020 Allow Me to Sell 2019 Products?

No, completing 2020 certification will not count for the remainder of the 2019 selling season.

How Do I Retrieve My Username and Password?

You will receive an email directly from Quia with your username and password.  You will need this login information to complete the training quiz.  If you do not receive the email and cannot find it in your spam folder, please contact your broker manager.

Who Do I Contact to Confirm Certification?

Agents can contact Amy Gralewski, UPMC Health Plan Senior Broker Manager, at 412-454-2964 or gralewskiaj@upmc.edu. 

Submitting Business

Important Information
  • Must be able to access Cavulus frequently to retrieve leads and update leads within 72 hours
  • Must place your broker code at the top of applications

Note: Agents must complete face-to-face training to utilize Cavulus. If you’re interested in attending a Cavulus training session, please contact ,Crystal Kominskic UPMC Health Plan Broker Manager, at  570-550-4828 or kominskic@upmc.edu for more information. 

How to Submit Business with UPMC:

Agents must submit UPMC business directly to Care Value using the Secure Application Manager (SAM) in AllRep  or utilize the online enrollment tool called Cavulus through UPMC. Due to new CMS cybersecurity guidelines, we can no longer accept faxed or emailed applications.

How to Upload Applications to the Secure Application Manager.
  • Log in to CareValue.com
  • Log in to CareValue.com/allrep
  • Click the “Dashboard” button
  • Click “SAM” in the toolbar that pops up on the left side of the page
  • Click the blue “check Opportunities” button
  • Fill out the required fields
  • Attach the completed application in PDF form
  • Click “Submit”
  • Upload all incomplete applications to SAM as soon as possible.

Compliance

General Information:

Brokers MUST be certified and product-trained annually to receive commissions on new sales AND renewals.  All commissions for UPMC Health Plan are paid to agents by Care Value™.

Contact for Commission-Related Inquiries:

If you have questions regarding your commissions, please call Care Value ’s Commissions team at 855-888-8326 ext. 3008.

Ordering Supplies

How to Order Supplies for UPMC Health Plan:

To order supplies, Agents should contact Crystal Kominskic, UPMC Health Plan Broker Manager, at 570-550-4828  or  kominskic@upmc.edu