Every year, prior to AEP, important information goes out to both Medicare agents and Medicare members about the upcoming year. Agents receive First Looks from major Medicare Advantage and Medicare Part D carriers, which give them an early glimpse at changes for the upcoming year. Members with these plans will receive the Annual Notice of Change (ANOC) from their insurance plans notifying them of any changes to their plan coverage for next year.
Here’s what you need to know about First Looks and ANOCs, and how the timing of these notifications aligns with each other.
First Looks – What You Should Review
It’s important to take the time to thoroughly review carrier First Looks. This information is key to planning your marketing efforts for AEP and helping prospective and existing clients make informed decisions.
You should review all First Looks, even for carriers you are not contracted with. This is a good time to review your contracts and certifications to make sure you are prepared to offer the plans that are most competitive in your area. Here’s information you should be looking for.
- Expansion Areas
Look for growth opportunities into areas you have not serviced before. Also look to see if there a reduction in an area that could impact any of the clients you currently service.
- Preliminary Benefit Information and Plan Enhancements
This information will help you to know what plans are most competitive in your area. Look at supplemental benefits such as vision, dental, hearing, gym memberships which are very appealing to prospective clients. You should also check to see if any benefits have been reduced or eliminated as this could affect your current clients.
- Agent Tools and Resources
You will find information about any market support offered by carrier, features offered in their agent portal, such as how to submit and track electronic applications, new processes, sales incentives and more.
Reviewing First Looks will put you in a better position to grow your business. You will know where there are new expansion opportunities, what the most competitive plans are to offer prospective clients, as well as knowing if existing clients would benefit from a plan change.
As a reminder, the information in First Looks is confidential and cannot be shared with clients until AEP officially begins. First Looks are released after the carriers have filed their plans with CMS for the following year, but they have not yet been approved. So be aware, that while it does not happen frequently, there could be changes once approval is official.
Annual Notices of Change – What You Should Know
While you are busy reviewing First Looks, members are receiving their Annual Notice of Change (ANOC). Every September Medicare Advantage and Medicare Part D members will receive the ANOC letter in the mail. This notifies them of how their current plan will change for the following year.
Some of the changes they might be notified of include:
- The plan may no longer be offered
- Changes to premiums, deductibles, copays
- Benefit changes
- Network changes
- Referral or preauthorization changes
- Drug formulary changes- dropping or adding drugs, changing tiers which may change copays, changing the restrictions on some drugs (prior authorizations, quantity limits, or step therapy) by lifting them from some meds and imposing them on others
Members should receive the ANOC no later than September 30, so they have plenty of time to compare costs and benefit details with other plans. They can choose to make a plan change during AEP if their current plan no longer meets their needs.
The Timing of These Notifications Is Ideal for You
Because you have familiarized yourself with the information in carrier First Looks, you will be prepared to assist any clients who have received the ANOC and have decided their plan is no longer suitable for them. You can be proactive in reaching out to them once AEP begins to discuss any changes and help them find the right plan. Your clients will value your knowledge and see you as a trusted advisor.
Do you need additional support? Call us today. We are here to help.
