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Medicare updates

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Here is a list of election periods still available to sell Select Health Medicare products!

Five Star Special Election Period (SEP): This enrollment period is redetermined every year by Medicare. In 2024, the Select Health Medicare HMO product was awarded five stars, permitting one additional enrollment period. The enrollment period will end November 30 unless the plan is awarded five stars for 2025. 

The Initial Coverage Election Period (ICEP): This enrollment period is for your clients who are aging into Medicare. Enrollment opens three months prior to your client’s birthday month and continues up to three months after their birthday month.

Permanent Address Change (SEP): Your clients have an SEP if they move out of a Medicare Advantage plan's service area and take permanent residence in a new service area that offers Medicare Advantage products.

Select Health Medicare D-SNP (Utah and Colorado): This is a Special Enrollment Period (SEP) specifically for clients enrolled in Medicare and Medicaid. Members are offered three additional enrollment periods, once a quarter, as their enrollment to Medicaid is re-evaluated. 

Select Health Medicare + Kroger Benefits postcards

Need an approved Select Health branded postcard to add to your marketing efforts? We’ve got you covered. You can download these postcards and other approved Select Health Medicare agent marketing materials in Link.

Compliance Corner: Marketing and Agent complaints.

Select Health Medicare is a Medicare Advantage plan with a Medicare contract. Part of this contract stipulates oversight and investigation of every complaint received from members on the plan. 
Occasionally, Select Health Medicare receives complaints regarding sales agents or marketing practices. A complaint or grievance may be received by phone, written correspondence, direct contact from Medicare or the Department of Insurance, or even other sales agents.

Select Health Sales leadership partners with the Select Health Compliance and Appeals & Grievances team members to conduct a thorough investigation of every sales/marketing complaint received. Outcome notifications are provided to members. These are documented and reviewed for potential opportunities to provide any necessary coaching or additional training to sales agents and identify trends.

Select Health Medicare will contact the agent and/or Field Marketing Organization (FMO) in question during its investigation to solicit a response regarding any sales allegations or grievances made toward an agent. The agent and/or FMO must respond to Select Health Medicare, preferably within five business days.
We ask that the agent, and/or FMO involved not contact the complainant during the investigation period.

In most investigations, the outcome is determined to be a misunderstanding or confusion, however, if determined to be substantiated, Select Health Medicare sales will contact the agent and/or FMO for further action.

For compliance questions or concerns, email shcompliance@selecthealth.org or call 1-844-442-5844.

Medicaid: Unwinding SEP extensions.

Starting March 28, 2024, CMS extended a temporary special enrollment period (SEP) to help people who are no longer eligible for Medicaid or CHIP transition to Marketplace coverage in states using HealthCare.gov. This “Unwinding SEP” will be extended from July 31, 2024, to November 30, 2024, which will help more people leaving Medicaid or CHIP secure affordable, comprehensive coverage through the start of the next open enrollment period. States with state-based Marketplaces can adopt similar extensions. Please note: The Medicaid unwind period has ended for Idaho.

Select Health has several plans that fit the needs of those who are transitioning from Medicaid to an ACA plan. Please encourage your clients to seek your guidance as they determine what type of plans best meet their needs if they no longer qualify for Medicaid.

Links

CMS also released new guidance and other resources to help protect coverage. These include:

New resources for partners to help families navigate their state Medicaid fair-hearing process, such as if someone was determined no longer eligible for Medicaid.