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BGA _ Medicare


									                                                                                                               July 2011

                                                             BGA & Medicare
                                  Agents have been partnering with Black, Gould & Associates for their Medicare
                                  product needs since 1980 – and our services are about to get even better.

                                  In addition to the advantages you already receive working with BGA; we’re ex-
                                  panding the suite of tools available to our agents for the coming Medicare sea-
                                  son. As with all of BGA’s services, we are providing these tools to you at no
                                  cost. As always, you own all the business you submit through BGA as an agent.

                                  By writing your senior market business through BGA, you’ll have access to:
                                    ♦   Our proprietary Medicare quoting engine, giving you the ability to compare and
July 2011                               contrast MAPD and Medicare supplement products in Arizona.
Black, Gould & Associates, Inc.     ♦   Our library of compliant Medicare marketing resources.
                                    ♦   Marketing resources and personal assistance for educational and sales events.
                                    ♦   Medicare Advantage, Part D, and Medicare Supplement plans from top carriers in
                                        the Arizona marketplace.
                                    ♦   A full lineup of ancillary products to complement your existing senior market port-
                                        folio, including dental, vision, and final expense products.
                                    ♦   True “one-stop” service for all your senior products – no more batch sheets,
                                        bounced faxes, or time wasted trying to request status or audit commissions from
Business Hours:                         different insurance carriers.
Mon-Thurs 8am-5pm
Fri       8am-3pm                 The resources available to you through Black, Gould & Associates are unparal-
                                  leled in the Arizona marketplace; and provide you with the tools necessary to com-
                                  pete in the rapidly-expanding Medicare insurance field.
Phoenix office
3800 N. Central Ave.              Our list of Medicare carrier partners include:
9th Floor                           Aetna
Phoenix, AZ 85012                   Caremore
Phone (602)277-2144                 CIGNA
Toll Free (800)407-0376             Health Net
Fax (602)241-9711                   HUMANA
                                    Mutual of Omaha
Tucson office
4516 E. Camp Lowell Dr.             and, possibly more to come.
Tucson, AZ 85712
Phone (520)290-8822               According to the Social Security Administration, there are more than 10,000
AZ Toll Free (800)423-5582        newly-eligible seniors every day in America. Let BGA help you take advantage of
Fax (520)296-0899                 this tremendous business opportunity with the tools you need to succeed in the
                                  senior market.
                                                                               What this means
From the Group Department                                                      You may now begin marketing Aetna Medicare Advantage
DELTA DENTAL                                                                   plans (MA, MAPD, PDP). You may enroll eligible beneficiar-
Small Employer Plans More Affordable                                           ies who are in their Initial Enrollment Period for Part D or
Effective September 1, 2011 Delta Dental will be lowering rates on eligible for a CMS defined Special Election Period with effective dates
their small employer group dental insurance products by as much as beginning
5%. Rate reductions are effective on contract renewals dated       July 1, 2011.
September 1, 2011 and forward.                                     Before you begin, please make sure you read and understand the impor-
Contact your BGA Group Account Executive for more information. tant marketing, enrollment and compliance policies.
                                                                       Producers must be certified. All producers are required to complete
                                                                       Aetna’s 2011 Producer Certification Program and be licensed and ap-
                                                                       pointed before selling or marketing Aetna Medicare Individual plans. If
                                                                       you still need to complete 2011 certification, contact your BGA Individ-
HUMANA                                                                 ual/Medicare Account Executive for information.
Enhanced Small Group Plans
                                                                       Aetna has a “Pay as Presented” policy. Aetna only pays commissions
Humana has refreshed their product offerings to make them sim-
                                                                       to producers, GAs and FMOs who have completed the 2011 certification
pler. Some of the features of the plans include:
                                                                       program and are licensed and appointed prior to engaging in the sale or
♦ New deductible and copayment options
                                                                       marketing of any Aetna Medicare products. Commissions are paid based
♦ Convenient Care Clinics covered at PCP copay level
                                                                       on the information provided in the Broker and GA sections of the appli-
♦ New Rx3 and Rx4 plans, as well as Rx4 with deductible options
                                                                  Submit completed enrollment applications. As part of Aetna’s “Pay as
                                                                  Presented” policy, all information required to properly pay commissions
                                                                  (e.g., all producer names and TIN numbers) must appear correctly in the
UNITED HEALTHCARE                                                 Broker and GA sections of the application. If the information is not pro-
Rate Reduction on 2-50 Segment                                    vided, commissions will not be paid. The enrollment application can-
UHC has approved a new business rate reduction up to 6% effective not be changed or corrected once submitted.
August 1, 2011.                                                   Follow all Aetna and CMS marketing guidelines. For example, you
Just give your BGA Group Account Executive a call for more infor- may only use Aetna-branded, CMS-approved marketing materials and
mation.                                                           sales presentations.
                                                                       Accurately document permission to contact leads, and record the
                                                                       scope of all appointments.
AZ Schedule of Benefits Change Notification
In accordance with the requirement of laws of the State of Arizona,    Submit enrollment applications within 48 hours. All Aetna Medicare
the UnitedHealthcare Insurance Company Schedule of Benefits has        Individual enrollment applications must be received by Aetna within 48
been updated to remove the in-network only limitation on covered       hours of receipt by the producer. This policy applies to all Aetna produc-
preventive care and vision services.                                   ers, GAs, FMOs and Affinity Partners. If producers work with an FMO,
                                                                       GA or Affinity Partner, the FMO, GA or Affinity Partner must submit
A project is also underway to reprocess out-of-network preventive      enrollment applications so they are received by Aetna within 48 hours.
or vision service claims beginning with dates of service February 1,
2011 and forward that may have been impacted.                          As an Aetna Medicare producer, it is imperative you adhere to these
                                                                       policies so that Aetna can provide a consistently high-level of service to
UHC is in the process of providing written notice to affected Em-      beneficiaries and satisfy CMS compliance rules.
ployer Groups of this change. The Enrolling Group is responsible
for giving notice to Covered Persons on a timely basis.                Producers who do not comply will be notified by Aetna. Continued non-
                                                                       compliance may result in required retraining, loss of compensation or
For more information, please contact your BGA Group Account            termination.
                                                                       If you have further questions, please contact your BGA Individual/
                                                                       Medicare Account Executive.

                                                                       HEALTH NET
From the Medicare Department                                           Current 2011 Medicare Sales Kits
AETNA                                                             Due to out-dated information in the 2011 Health Net sales kits, Health
CMS Lifts Sanction of Aetna Medicare Plans                        Net is asking that you discard all 2011 Health Net sales kits in your
The Centers for Medicare & Medicaid Services (CMS) has lifted its possession. Once the CMS sanction is lifted Health Net will re-distribute
marketing and enrollment sanctions against Aetna Medicare. With   updated 2011 Health Net sales kits.
this news, Aetna will immediately resume marketing their Aetna    If you have any questions, please contact your BGA Individual/Medicare
Medicare Advantage and Prescription Drug Plan products and may Account Executive.
begin enrolling beneficiaries with effective dates beginning
July 1, 2011.
The improvements Aetna has made will further support beneficiary
access, patient safety, and compliance with CMS guidelines.
From the Individual                                                                         Calendar of Events
Department                                                                                  UPCOMING MEDICARE MEETINGS
HEALTH NET                                                                       AETNA
Domestic Partnership                                                             Aetna 2011 Medicare Supplement & PDP plan Certification Review
Effective July 1, 2011, Health Net now accepts Domestic Partners                 PHOENIX ~~ Tuesday, July 26, 2011 ~~ 9:00-10:00am (check-in 8:30a)
                                                                                   Location: Phoenix Country Club , 7th Street & Thomas Rd., Phoenix, AZ
on Individual plans. Applications will not change, just enter the
domestic partner on the spouse line.                                                         RSVP to
                                                                                 TUCSON ~~ Thursday, July 28, 2011 ~~ 9:00-10:00am
                                                                                 Location: Venue has moved to the BGA Tucson office
New Materials for Individual & Family Plan                                                            4516 E. Camp Lowell, Tucson, AZ
New materials for the Health Net Individual & Family Plan became
available June 1, 2011. If you have not obtained any new packets
                                                                                               RSVP to
and are in need of some, contact the BGA Individual Supply Line at
(602) 776-1312 to place your order.                                              CAREMORE
                                                                                 2012 Medicare Product Rollout ** SAVE THE DATE
                                                                                 PHOENIX ~~     Tuesday, September 6, 2011
                                                                                                  time & location to be determined soon

                                                                                 HEALTH NET
This ‘N That                                                                     2012 Medicare Product Rollout ** SAVE THE DATE
                                                                                 PHOENIX ~~     Tuesday, September 13, 2011
BGA WEBSITE                                                                                       time & location to be determined soon

Compliance Tools Available
When you’re working with your clients don’t forget to utilize all of the tools   AETNA
available via These may be found either under the            2012 Medicare Product Rollout ** SAVE THE DATE
Tools & Resources tab; or if related to Reform under the HealthCare Re-          PHOENIX ~~     Thursday, September 22, 2011
form tab. Some of the resources include information on GINA, Medicare                               9:00 am—11:00 am
Part D Creditable Coverage, Mental Health Parity, COBRA, as well as a                              Phoenix Country Club
variety of information on healthcare reform plus model notices.
For more information contact your BGA Account Executive.                         CIGNA
                                                                                 2012 Medicare Product Rollout ** SAVE THE DATE
                                                                                 PHOENIX ~~     Tuesday, September 27, 2011
                                                                                                    9:00 am—11:00 am
                                                                                                location to be determined soon

                                                                                      OTHER UPCOMING INDUSTRY MEETINGS
                                                                                 Group Product Training
                                                                                 TUCSON ~~ Thursday, July 28, 2011 ~~ Tucson Country Club
                                                                                                       2950 N. Camino Principal
                                                                                                 1:00 pm - 2:30pm (check-in 12:30p)
                                                                                               RSVP to

                                                                                 BGA INDIVIDUAL & SMALL GROUP
                                                                                 NEW BROKER TRAINING
                                                                                 Phoenix BGA Office Tucson BGA Office
                                                                                 August 18, 2011               August 16, 2011
                                                                                 September 15, 2011            September 20, 2011
                                                                                 The sessions are held every month at 10:00am until approximately 12:30pm.
                                                                                 Please RSVP to: for the Phoenix meetings, or
                                                                        for Tucson.

                                                                                 Monthly Luncheon
                                                                                                      There will be no August meeting

                                                                                 Monthly Speakers Meeting
                                                                                                      There will be no August meeting
                                                                                                   The summer sales incentive program offers an opportunity to
Contests & Bonuses                                                                                 earn up to $15,000 by surpassing your 2nd quarter sales. That's
AETNA—Individual                                                                                   $15,000 on top of your regular commission, and in addition to
                                                                                                   any extra money earned through Aetna’s other sales incentive
2011 Out Front with Aetna Sales Incentive Program                                   programs. All together, Aetna’s 2011 sales incentive programs offer a chance
Sell the individual Aetna Advantage Plans during each quarter in 2011 and           to earn up to $25,000. Get on the fast track and get out front with Aetna
you’ll earn additional cash—possibly more than $10,000 per quarter!—                Advantage Plans.
above your regular commission when you reach the tier targets below of              Summer Sales Incentive Details
6, 12, 25, and 50 enrolled applications.                                            You can earn additional cash, up to $15,000! By selling 5, 10, 20, 30, 40, 50
Tier     Apps Per Quarter         Payout         Cumulative Payout                  or 60 more applications in the 3rd quarter (July 1 - September 15, 2011 effec-
 1         6 (minimum)            $ 250              $ 250                          tive dates) than in the 2nd quarter (April 1 - June 15, 2011 effective dates), and
 2             12                 $ 1,125            $ 1,375                        must be in force for 90 days. This is in addition to your regular commission.
 3             25                 $ 3,000            $ 4,375                        Sell this many new apps in Quarter 3        Payout
Begin earning cash by selling a minimum of 6 applications. You’ll receive your      Quarter 2 apps +5 more                      $ 2,000
Tier 1 payout of $250 once these applications remain in force for 60 days.          Quarter 2 apps +10 more                     $ 4,000
You’ll receive payment 2 weeks after the close of the quarter for the previous      Quarter 2 apps +20 more                     $ 6,000
quarter’s business.                                                                 Quarter 2 apps +30 more                     $ 8,000
♦ Only 2011 effective dates qualify:                                                Quarter 2 apps +40 more                     $10,000
                                                                                    Quarter 2 apps +50 more                     $12,000
    °   1st quarter January 1 thru March 15, 2011
                                                                                    Quarter 2 apps +60 more                     $15,000
    °   2nd quarter April 1 thru June 15, 2011                                      ♦ The amounts listed are not cumulative. The incentive payout is based on the
    °   3rd quarter July 1 thru September 15, 2011                                    number of applications you increase over your 2nd quarter sales. Sales
                                                                                      incentive program payments will be issued in late November, 2011.
    °4th quarter October 1 thru December 15, 2011
  Enrolled applications are counted separately for each quarter. Applications       ♦ The broker must generate a minimum of 5 enrollments in the 3rd quarter to
  are not cumulative across quarters for this bonus.                                  be eligible for this program and must have enrolled at least 1 app between
                                                                                      January 1, 2011 and June 1, 2011.
♦ You’ll receive monthly emails on your program status with enrolled apps to
  date, and emails advising you of payouts as they occur.                           ♦ Eligibility for payments under this program is conditioned on broker’s ad-
                                                                                      vance disclosure of the nature of compensation programs to customers.
♦ Email opt-in required. See Aetna Producer World under bonuses for full
  details, or talk to your BGA Individual Account Executive.                        Contact your BGA Individual Account Executive for more information.

2011 Front Runner Rewards Sales Incentive Program                                   AETNA—Group
For the Aetna Advantage Plans for Individuals, Families & the Self-Employed.        Small Group Incentive Destination
Earn a one-time cash bonus each time you progress to the next commission tier.      You voted, Aetna listened. With more than 200 votes counted, the 2011 Aetna
In addition to earning a higher commission rate, Aetna will reward you for          Small Group Incentive destination (with 54% of the vote) is Costa Rica.
achieving the next level of sales.
                                                                                    Aetna will roll out trip dates, resort location and detailed contest criteria very
Tier Advancement                                       Payout                       soon. In the meantime, remember the qualifying period begins July 1, 2011
Gold to Platinum (50 apps in prior 12 months)          $5,000                       and goes to January 1, 2012.
Silver to Gold (25 apps in prior 12 months)            $3,000
Bronze to Silver (12 apps in prior 12 months)          $1,000                       The top 10 producers in Arizona/Nevada will earn a trip to Costa Rica in the
♦ This program applies to enrolled and approved applications during a rolling       1st or 2nd Quarter 2012. Winning producers must sell at least 100 medical
    12-month period.                                                                apps within the contest period to qualify.
♦ You are evaluated based on your starting 1/1/2011 commission tier.
♦ You can receive each tier payment only once. If your tier drops, you will
    not receive the payout for the second time you advance to the higher tier.
♦ Sales incentive program payments will be issued monthly.
For Platinum and Gold Front Runners
 Earn more cash when you reach the Platinum tier – up to $20,000 per year!
                                                                                    Group Disability & Life Contest
Gold tier brokers can earn more, too. If you’re already a Platinum or Gold Front    Win an iPad 2®
Runner as of 1/1/2011 (50 applications for Platinum or 25 for Gold in prior 12      ♦ Sell $100,000 total new premium of group Disability and/or Life coverage
months), you’ll receive additional cash per application for growing and main-       ♦ Sell $50,000 total new premium of group Disability and/or Life coverage,
taining your active book of business each quarter in 2011.                            with a total of 7 points combining any of the following:

Not yet at the Platinum or Gold level? Achieve a new Front Runner level, and
                                                                                      °   Add group Life or Disability to an existing customer             3 points
you’ll start earning more cash in the following quarter.                              °   Sell bundled group Life & Disability to a new customer           3 points
Platinum Front Runner                                 Payout                          °   Sell single-line group Life or Disability to a new customer      1 point
Increase your book of business by 10% or more         addtl $10 per application
Maintain or increase your book of bus. up to 10% addtl $7.50 per application        Contest Details and Case Eligibility:
Gold Front Runner                                     Payout                        Contest for group Disability and Life product sales to groups with 2+ covered
Increase your book of bus. by 10% or more             addtl $7.50 per application   lives for plan effective dates of August 1, 2011 thru December 1, 2011. Win-
Maintain or increase your book of bus. up to 10% addtl $5 per application           ners will be awarded a $499 Apple gift card (iPad 2 retail value), based on
                                                                                    each individual broker’s sales. Limit of 1 prize per person (e.g. selling
                                                                                    $200,000 will not win you two gift cards). Sales must be issued no later than
Beat the Summer Heat Bonus Program                                                  December 31, 2011 to qualify for contest prize. Contest subject to state regula-
                                                                                    tory filing and approval. All prizes (cash and noncash) are considered taxable
Earn up to $15,000 with Aetna’s new summer sales incentive program. Now
                                                                                    income to you. If you received prizes totaling $600 or more during the year, a
sell more and earn more in the Summer of 2011. Aetna’s new sales incentive
                                                                                    1099-MISC will be issued, reporting your prize amounts to the IRS.
program will pay you more for increasing your sales of the Aetna Advantage
                                                                                    iPad 2 is a trademark of Apple, Inc.
Plans for Individuals, Families and the Self-Employed in the 3rd quarter. This
                                                                                    Excluded from contest: The following do not count as coverage: Basic
incentive program is for sales of the Aetna Advantage Plans in AK, AZ, CT,
                                                                                    AD&D, Guardian Universal Life (GUL), Universal AD&D, and aggregate
DC, DE, FL, GA, IL, KS, MD, MI, MO, NC, NV, OK, PA, TN, TX and VA.
                                                                                    coverages (DTA, STA, VIA). Voluntary AD&D only counts as a coverage
                                                                                    when the plan does not include any other Voluntary Life coverages.

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