Posts Tagged: ANOCs3 Ways your Health Plan is Overspending – And How to Stop
Health plans today are feeling more pressure than ever before to do more with less. With increased scrutiny from The Centers for Medicare and Medicaid Services (CMS) and decreased budgets, leadership is constantly looking for ways to save money. Doing so might be easier than you think.
Below are three ways that health plans are overspending, and how they can stop: Read more »
Posts Tagged: ANOCsErrors in ANOCs and EOCs could cost up to $55 per affected enrollee
Over the last several years, The Centers for Medicare and Medicaid Services (CMS) has taken an increasingly tough stance on health plans that distribute Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) documents with unclear and/or inaccurate benefit information.
CMS is no longer sending health plans warnings for these errors; they are imposing civil money penalties (CMPs) for thousands of dollars that health plans must pay. For instance, CMS recently imposed a CMP in the amount of $132,000 to a health plan for failing to provide accurate benefit information to 2,400 enrollees in its Contract Year (CY) 2017 ANOC and EOC documents. For larger health plans, fines can quickly add up to millions of dollars.
CMS’s reasoning behind these fines is that if members receive inaccurate information related to premiums, deductibles and co-pays, they may enroll in a plan under false expectations. Read more »
Posts Tagged: ANOCsBest Practices for Language beyond the CMS Model Language
The Centers for Medicare and Medicaid Services (CMS) templates for the Annual Notice of Changes (ANOC) and Evidence of Coverage (EOC) contain extensive model language that is required and must be used by every insurer. However, there are also numerous places in these documents where health plans have latitude and flexibility to use their own language to describe benefits, cost-sharing, coverage limits and so forth. These areas provide significant opportunities for health plans to better communicate with their members, and thereby positively impact the member’s experience.
Posts Tagged: ANOCsMA and Part D Plans: Jumpstart Your CY2016 ANOC and EOC Documents Creation
In late January, CMS released the “CY 2016 PBP/SB Software List of Changes and Known Issues,” which includes a summary of the changes to the Plan Benefit Package (PBP) software that Medicare Advantage and Part D plans will use to upload their 2016 AEP materials bid submissions to CMS later this year.