Action Required to Sell 2014 CoventryOne Exchange Products

In order to sell CoventryOne Qualified Health Plans on the Federally Facilitated Marketplace (FFM), you must get certified by completing the Individual Marketplace Curriculum. Agent training and certification is available online at: http://marketplace.medicarelearningnetworklms.com.

To register for this certification, you will need your National Producer Number (NPN) to create a user account. Your NPN can be found at: https://pdb.nipr.com/html/PacNpnSearch.html.

Once certification is complete, please send confirmation to Michelle Roach at mmroach@cvty.com. You must complete registration with CMS and submit verification of your certification prior to submitting your first client enrollment application. 

Click for the most recent product grids and rate grids.

I am pleased to welcome Ashleigh Martin back to Coventry. Ashleigh has over ten years of experience in the industry in carrier and broker roles. She will be focusing her attention on sales and service related to the CHC VA exchange offerings in central and southern Virginia. Ashleigh's contact information is below.

Ashleigh Martin
akmartin@cvty.com
Work: (804) 727-2716
Cell: (804) 715-2735 

Many of you stressed in our broker meetings that you need as much time as possible to work with your clients as you evaluate their benefit options in 2014. We heard you, and we have escalated the timeline for releasing February and March small group renewals in BenefitExpress.

February Renewals: Releasing Friday, November 1
March Renewals: Releasing early in the week of November 11

Our Small Group Rate Grids will be released early next week. These are to supplement your BenefitExpress new business and renewal quotes. This will answer the question of what adding on a new employee at open enrollment will cost.

At our recent broker meetings, we presented the separate and distinct product portfolios that we will offer to small and large employers in 2014. As such, it is more important than ever to understand whether our mutual clients are small or large. Effective January 1, 2014, the state definition of small and large employers has been updated to mirror the definition used in the ACA in the MLR requirements:

"Small employer" means in connection with a group health plan or health insurance coverage with respect to a calendar year and a plan year, an employer who employed an average of at least one but not more than 50 employees on business days during the preceding calendar year and who employs at least one employee on the first day of the plan year. (§ 38.2-3431.)

Notice that this definition does not include the calculation for full time equivalent employees that is used in the Employer Shared Responsibility section of the ACA. This makes it easy to determine if your client is large or small - simply take the number of employees who were paid in each month of the previous calendar year (full-time, part-time, and seasonal), add them together, and divide by twelve. This number is what you should enter into BenefitExpress when it asks for the number of MLR employees. If it is higher than 50, your client will be rated as a large group in 2014. Click here for an MLR size tool.

Please also note that effective January 1, 2014, two-person groups consisting of only husband and wife owners will not be considered a group.

As promised, the Stable Funding product (small group ASO) we previewed in our broker meetings is now live for employers with between 10 and 100 enrolled employees with effective dates on or after January 1, 2014. Because of the potential volume and required training, this is a phased roll-out to selected producers. This product will be underwritten with individual medical applications for new business. Renewals will be generated using existing data. Another great reason to sell Coventry small group for December 2013 - you will have the option to renew into Stable Funding in December 2014.

Again, we are rolling the Stable Funding product and training out to select agencies first and anticipate that we will have all agencies trained and selling within the next six months. Click here for the product brochure.

There is a lot of information in this newsletter. If you have questions, please reach out to your Account Executive, Account Manager, or someone on the management team. Contact information is listed below.

Dental and Vision
Enrollment
Marketing Materials
New Business Forms
Plan Grids
Provider Network
Quality
Quoting

Schedules of Benefits
WellBeing