Commercial Plan Updates
Reconcile Your Book of Business
At the close of 2022 Open Enrollment, please take time to reconcile your Individual book of business to ensure you are listed as the Agent of Record (AOR) for all your clients. As a protection to you, AOR changes initiated through the Federally Facilitated Marketplace are not validated until a signed AOR letter is uploaded to our Link system.
To run a book of business report in Select Health Link, hover over Individual on the main landing page. Choose Member Search/Maintenance. To look up one individual, use the search box. To pull a complete book of business report, choose the Search button or Download Book to export this information into an Excel spreadsheet.
If any clients are missing from your commission statement or book of business, please submit an AOR letter via the upload tool in Link. Under Agent Tools on the home page, you’ll see the link: Individual Agent of Record Request.
This tool determines which AORs are valid before allowing you to upload a completed and signed AOR letter. It will check for:
- Subscriber eligibility. If the subscriber is ineligible or not enrolled, the AOR will not be accepted.
- Current AOR. If you are already assigned as AOR, an alert will indicate the submission is unnecessary.
At the end of the upload process, a submission receipt page will allow you to save as a PDF or print for your records. AOR changes for Your Health Idaho (YHI) enrollments are to be submitted directly through the YHI portal.
AOR changes for Nevada Health Link enrollments are submitted directly through the Nevada Health Link portal. For a January 1, 2022 effective date, please upload AOR letters by January 31, 2022. For questions, please contact Kenzie Gray at 801-442-9334 or email@example.com.
Update for Disclosure Requirements
Limited guidance was just released for broker and consultant compensation disclosure. The Consolidated Appropriations Act of 2021 (CAA) imposed new obligations for reporting direct and indirect compensation received in connection with services performed for group health plans. The Department of Labor (DOL) issued a news release and a more detailed bulletin addressing some disclosure questions. Here are a few highlights:
- Applying a Temporary Enforcement Policy: The DOL will not treat a broker/consultant as having failed to meet requirements if the person made disclosures using a good faith, reasonable interpretation.
- Attempting to Comply with the New Requirements: Brokers/Consultants could look to prior DOL guidance developed for similar pension plan disclosures.
- Compensation disclosure is required for services to both insured and self-insured group health plans regardless of size.
- The new disclosure requirements apply to service contracts entered into, extended, or renewed on or after December 27, 2021. For “Broker of Record” agreements, the contract date is generally considered to be the earlier of the date the agreement is submitted to the insurance carrier, or the date on which a group application for coverage is signed leading up to the plan year.
The DOL also mentioned not intending to release comprehensive regulations for the new requirements, though less formal guidance (such as FAQs) may be issued going forward.
What is Select Health doing to assist you?
- All Large Employer proposals include the negotiated commission/service fee arrangement agreed upon by you and your client.
- We are working to include the commission rate on all Small Employer quotes generated in Link and will let you know when this feature is functional.
Finally, we recommend you review the basic requirements of providing disclosure documentation to group clients, as applicable.
As an annual reminder, form 1095 is no longer required to process a Federal Tax Return. This form is available electronically through the member portal after February 5, 2022, or members can request a copy by contacting us at 844-442-4106.
Group plan members who need to correct information on their 1095 form should contact their employer. Employers can submit these changes to Select Health. Members enrolled directly with Select Health should contact Member Services with questions at 800-538-5038.
For questions regarding IRS forms and filing requirements for companies, please go to the AIR website for the IRS at https://www.irs.gov/affordable-care-act/questions-and-answers-about-health-care-information-forms-for-individuals
No Surprises Act
Information about consumer protections in the No Surprises Act can be located at selecthealth.org/no-surprises-act . For additional questions related to this information, please contact your sales account manager.
UnitedHealthcare® Options PPO Network
Select Health utilizes the UnitedHealthcare Options PPO network to provide easy in-network access outside of Utah, Idaho, and Nevada. This network includes access to 83% of all hospitals and two out of every three healthcare professionals in the U.S. We ensure you and your employees will be provided with the same great Select Health customer service and benefits anywhere in the U.S.
It is important to note, the UnitedHealthcare Options PPO Network will only apply to in-network benefits if accessed outside our service area of Utah, Idaho, and Nevada. The following provides details of which networks can be utilized within our service areas:
|Select Health Med®
|Select Health Network, which includes BrightPath and St. Luke's Health Partners
|Select Health Med, Beech Street Network (outside Clark and Nye Counties)
|All Other States
|UnitedHealthcare Options PPO Network
The Small Employer Sales Guides provide additional information about in-state networks, UnitedHealthcare Options PPO network, participating facilities and more. They can be accessed here:
If you have questions regarding coverage or would like to request providers be considered for contracting, please contact your account manager.