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Posts Tagged: Evidence of Coverage

PERSPECTIVES: How to Improve Communications with Health Plan Members

October 2nd, 2018 | by Stephen Billias

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Imagine a Medicare Advantage member thumbing through the Evidence of Coverage (EOC) document from his insurance company, struggling to find the information he’s looking for in this 200-page document. Now imagine this member works on building EOCs and other communications for health plans every day, and he still can’t find what he’s looking for.

That MA member/insurance document expert is me.

If someone who looks at these materials day in and day out can’t find the information that’s relevant to him, what hope does the average American have?

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Posts Tagged: Evidence of Coverage

4 ways to reduce – or eliminate – errors in your ANOCs and EOCs

September 20th, 2018 | by Stephen Billias

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The accuracy of Annual Notice of Changes (ANOC) and Evidence of Coverage (EOC) documents is an important requirement for all health plans. The Centers for Medicare and Medicaid Services (CMS) takes errors in these documents very seriously and penalties are given to health plans that distribute documents with errors.

CMS recently announced changes to the distribution of these documents. ANOCs and EOCs have been uncoupled, and electronic sharing of EOCs is now allowed. CMS has also reiterated the importance of distributing these documents on time and in compliance. Read more »


Posts Tagged: Evidence of Coverage

Are you Outsourcing your ANOC and EOC Creation to the Best People for the Job?

March 19th, 2018 | by Brad Boyer

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Preparing materials for the Annual Enrollment Period (AEP) – namely Annual Notice of Changes (ANOC), Evidence of Coverage (EOC), and Summary of Benefits (SB) documents – can be a time-consuming, labor-intensive process wrought with compliance risk. As a result, many health plans opt to outsource the creation of these documents to a third-party vendor.

There are several benefits to outsourcing the creation of ANOC, EOC and SB documents. But not all vendors are created equally. Below are three things to look for when hiring a third-party vendor to create your ANOC and EOC documents. Read more »


Posts Tagged: Evidence of Coverage

Errors in ANOCs and EOCs could cost up to $55 per affected enrollee

August 14th, 2017 | by Kevin A. LeBlanc

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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: Evidence of Coverage

Document Accuracy Assessment helps identify errors before CMS

July 18th, 2017 | by site admin

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The creation of your Annual Notice of Changes (ANOC) and Evidence of Coverage (EOC) document is a very challenging process and can be a strain on already over-taxed resources.  Ensuring the accuracy of these documents is extremely important, as CMS has taken an increasingly tough stance on plans that distribute documents with unclear and/or inaccurate benefit information.

If you’re like most health plans, you could use a few extra set of eyes to review your final materials to ensure accuracy.

Backed by our team of model document experts, our Document Accuracy Assessment services can identify inconsistencies and errors in your plan documents that could negatively impact members and cause CMS to take action against your plan. Cody’s Document Accuracy Assessment service allows you time to self-report these errors before CMS’ Oct. 31 deadline for self-reporting. Read more »


Posts Tagged: Evidence of Coverage

How Accurate ANOCs and EOCs can Help Health Plans Retain Members

October 14th, 2016 | by Kevin A. LeBlanc

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The Henry J. Kaiser Family Foundation recently published an Issue Brief on its website titled “Medicare Advantage Plan Switching: Exception or Norm?” The brief shared that 11 percent of Medicare Advantage plan enrollees in 2013 voluntarily switched to another plan in 2014. It also addressed various factors that impacted switches to other plans, such as the members’ age, rate increases and coverage changes.

In addition, research showed Medicare Advantage enrollees who voluntarily switched plans were disproportionately in plans with lower quality ratings. Between 2013 and 2014, 14 percent of enrollees in plans with 2 or 2.5 star quality ratings switched plans, while only 3 percent of enrollees in 5 star plans switched. The article states, “These findings suggest that factors related to the star ratings may cause some beneficiaries to switch plans.”

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Posts Tagged: Evidence of Coverage

Putting Together Your AEP Team

May 27th, 2015 | by site admin

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For Medicare plans, the 2016 Annual Enrollment Period (AEP) is quickly approaching. This means that preparations should be well underway to ensure that member marketing materials will be accurate, on schedule and in compliance. This includes all pre- and post-enrollment materials and the annual notification of change (ANOC) and evidence of coverage (EOC).

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Posts Tagged: Evidence of Coverage

CodySoft Ensures Client Success with ANOC and EOC Materials Creation Process

January 6th, 2015 | by site admin

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For Medicare Advantage (MA) and Prescription Drug Plans (PDPs), the creation process for 2015 Annual Notification of Changes (ANOC) and Evidence of Coverage (EOC) materials is now over.

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Posts Tagged: Evidence of Coverage

Lessons Learned from the 2015 AEP Materials Creation Season – And how to best prepare for next year

October 31st, 2014 | by site admin

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At the end of September, Medicare Advantage (MA) and Prescription Drug Plans (PDPs) should have successfully delivered to members their Annual Notification of Changes (ANOC) and Evidence of Coverage (EOC) materials. This should come as a relief to health plans, as creating these materials – which must be distributed before the Annual Enrollment Period (AEP) – can be a time-consuming, labor-intensive process wrought with compliance risk.

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Posts Tagged: Evidence of Coverage

Surviving the 2015 AEP Materials Creation Process – Part 2 of 2

July 28th, 2014 | by Deb Mabari

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Medicare plans are mid-way through the process of creating Annual Election Period (AEP) materials – namely, Annual Notification of Change (ANOC) and Evidence of Coverage (EOC) documents – that are due to members by the end of September.

At this stage of the game, tension is running high. By now, many health plans have likely discovered the way they were planning on creating the documents won’t work, have encountered issues with vendors, or any other number of challenges that put tasks and timelines into a tailspin.

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