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Broker News FlashCoventry Health Care
www.southernhealth.com
April 22, 2011
BenefitExpress Multi-Option Adjustment
In early 2010, Coventry Health Care began applying a multi-option adjustment to groups offering benefit packages wherein the lowest premium plan and the highest premium plan had a cost differential greater than 10.9%. Due to systems limitations with BenefitExpress, you were required to evaluate the rate differences and apply the multi-option adjustment yourselves based on a sliding scale. In the last year, Coventry Health Care has received feedback that this requirement placed an undue burden on our broker partners. As such, starting with new and renewing groups effective May 1, 2011, Coventry Health Care will no longer require the multi-option adjustment for groups rated in BenefitExpress. In addition to the multi-option adjustment, Coventry Health Care also had a maximum premium differential of 30%. This maximum differential has been adjusted to a 50% maximum in order to allow for additional pairing of traditional benefit designs with consumer driven benefit designs.
Virginia Medical History Form
Broker Toolkit
It has come to our attention that the version of the Virginia Medical History Form previously released by the Bureau of Insurance lacked the necessary functionality for you to save or print the completed forms. In cooperation with the Bureau of Insurance, Coventry Health Care has posted a version of the Virginia Medical History Form in the Broker Tool Kit on southernhealth.com that will allow you to print completed forms. Please visit our website and take advantage of this updated form.
Broker Commissions - Groups with 100 or More Employees

The Affordable Care and Patient Protection Act limits carriers' non-medical expenses, including Consultant fees. Beginning July 1, 2011, Coventry Health Care will be implementing a new process for collecting Consultant fees for groups with 100 or more enrolled employees in Virginia and West Virginia. The improved process grants brokers a new level of control over their own income and offers maximum flexibility for you to set the appropriate fee to be charged to the employer, accounting for unique services offered by your agency. Coventry Health Care will be administering this process at the group level.


To offer you a simple and straightforward experience, Coventry Health Care will:

  1. Provide a template Billing Services Agreement which, when signed by your client, makes it easy to implement the Consultant fee process.
  2. Act as a third-party administrator managing various Consultant fees you establish with your clients in Billing Services Agreements.
  3. Deliver a seamless employer experience by offering a single invoice that includes both premiums and Consultant fees.
  4. Remit the portion of fees received from the employer to you as premiums are paid.

If you currently have a client with 100 or more enrolled employees, Coventry Health Care will be sending you an amendment to the Agency Compensation Agreement reflecting the improved Consultant fee process. Because we will no longer be including commissions as part of the premium, we need to ensure that Coventry Heath Care is legally authorized to bill and collect your Consultant fee effective July 1, 2011. Please ensure that you have returned an executed Billing Services Agreement to us by June 1, 2011.


If you are interested in taking advantage of this pass-through process for your clients with between 51 and 99 enrolled employees, Coventry Health Care will offer you the option of doing so. This option is available to you for new sales or renewals effective July 1, 2011.


Coventry Health Care values your contributions to our membership. We will continue to make every effort to deliver efficient and flexible operations so you can be most productive. Please contact your Coventry Health Care representative with questions.

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Coventry Health Care and Southern Health are registered trade names of Southern Health Services, Inc., a Virginia HMO. PPO products are underwritten by Coventry Health and Life Insurance Company and administered by Southern Health Services, Inc. in Virginia.
In This Issue
BenefitExpress Multi-Option Adjustment

Virginia Medical History Form

Broker Commissions - Groups with 100 or More Employees

Contact Us
 Charlottesville Office:
434.951.2500

Richmond Office:
804.747.3700

 
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