Notice to Customers Not Eligible for a Rebate
| As you know, one requirement of the Affordable Care Act relates to provisions regarding potential rebates from insurers and health maintenance organizations (HMOs) to employers and individuals if certain minimum standards regarding medical claims payment, also known as Medical Loss Ratio (MLR), are met. The MLR is defined as the percentage of premiums insurers/HMOs spend on medical care, less federal and state taxes and licensing and regulatory fees. In most states, the MLR for individual and small group markets is 80%; large group is 85%.
The MLR is used to determine if a refund is due in any of the market segments in which Coventry Health Care of Virginia, Inc. operates. Individual, small-group and large-group health plans are examples of market segments. At Coventry Health Care of Virginia, Inc., our goal is to provide the most competitive pricing possible. We have begun to send letters to groups and subscribers that are not eligible for any rebate. This includes small and large groups covered under our PPO products in 2011, as well as HMO/POS groups 51+.
Attached is a sample of the letter being mailed. It contains content required by HHS.
If you have any questions, please contact your account representative.
|
Prompt Care Now Urgent Care Facility
| Recently, we were notified that Prompt Care, Inc., located at 1149 Seminole Trail in Charlottesville, was acquired by MedExpress Urgent Care.
Effective September 1, 2012, the facility at this address will no longer operate as a Primary Care Physician (PCP) group. Members may continue to utilize MedExpress for urgent care needs. As of this date, members who are seen by doctors at this MedExpress facility will be required to pay an Urgent Care copay, which is typically higher than a PCP copay. Members who were seen by a Prompt Care doctor within the last six months were sent a letter notifying them of this change.
If a member received PCP services from a Prompt Care physician, they may select another PCP through My Online Services or by calling Customer Service at 800-627-4872 from 8:30 a.m. - 5:30 p.m., Monday through Friday.
|
Enrollment Applications
|
Please note that the email address shsbrokerapps@cvty.com
has changed to chcvabrokerapps@cvty.com
to reflect our rebranding to Coventry Health Care of Virginia, Inc. The shsbrokerapps@cvty.com email will continue to work but we ask you to begin sending your information to the new address.
This process is strictly for brokers and only applies to enrollment applications for groups currently with us. For new quotes, please submit your forms to CHCVA_SalesAdministration@cvty.com. As stated, we ask you give us time to process the documents before inquiring. If there is an urgent situation, please contact the CARE Team at 866.667.3062, Monday-Friday from 8:00 a.m. to 6:00 p.m. (ET).
|
Safe Senders
| If you are not receiving emails notifying you that a new commission statement is available, please check to make sure that the email address coventrycommissions@cvty.com is in your "safe senders" list. Do not send an email to this address. Instead, call 800.438.4029 for any questions regarding commissions.
|
| | PPO products are underwritten by Coventry Health and Life Insurance Company and administered by Coventry Health Care of Virginia, Inc. |
|
 |
Charlottesville Office:
434.951.2500
Richmond Office:
804.747.3700
|
|
