How to Get Things Done with Aetna Small Group - Insurance ...
How to Get Things Done with Aetna Small Group - Insurance ...
How to Get Things Done with Aetna Small Group - Insurance ...
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<strong>How</strong> <strong>to</strong> <strong>Get</strong> <strong>Things</strong> <strong>Done</strong> <strong>with</strong><br />
<strong>Aetna</strong> <strong>Small</strong> <strong>Group</strong><br />
January 2012<br />
Presented by:<br />
Rachel Stevens, Manager<br />
Bob Moore, Renewal Specialist<br />
David Berky, Renewal Specialist<br />
Imran Khan, Broker Liaison<br />
14.25.031.1 (1/12)
TITLE OF PRESENTATION<br />
AGENDA<br />
• Dedicated Broker Support Overview<br />
• 1. New business quoting<br />
• 2. Billing & Enrollment<br />
• 3. Renewal & Rating<br />
• 4. License & Appointment<br />
• 5. Commissions<br />
• 6. Claims<br />
• Online Tools via ProducerWorld<br />
• 1. Download Frequently Used Documents<br />
• 2. Order Marketing Materials<br />
• 3. Access renewals and quote additional<br />
alternates<br />
• 4. Broker Portal for enrollment and billing<br />
administration<br />
2
<strong>Aetna</strong> TITLE OF PRESENTATION Service Centers ― Mission<br />
Statement<br />
• The Regional Service Centers<br />
are dedicated <strong>to</strong> delivering bestin-class<br />
service <strong>to</strong> our brokers<br />
and plan sponsors through<br />
accurate, timely and<br />
professional support service.<br />
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©2012 <strong>Aetna</strong><br />
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Broker & General Agent Phone Support
TITLE OF PRESENTATION<br />
1-866-71-AETNA<br />
Hours of operation: 8 a.m. – 5 p.m. ET<br />
Monday through Friday<br />
Broker or<br />
General Agent<br />
Call<br />
Menu Options<br />
Menu<br />
Option<br />
1. New Business<br />
2. Billing &<br />
Enrollment<br />
3. Renewal &<br />
Rating<br />
4. Licensing &<br />
Appointment<br />
5. Commissions<br />
6. Claims<br />
Support<br />
Contact<br />
Sales Support Team<br />
Plan Sponsor<br />
Services<br />
Sales Support Team<br />
Licensing &<br />
Appointment<br />
Core<br />
Compensation<br />
Claims<br />
Service<br />
Activities<br />
5<br />
• Answer questions on<br />
products, policies,<br />
and procedures<br />
• Support on broker<br />
self-serve <strong>to</strong>ols such<br />
as fulfillment &<br />
quoting<br />
• Resolve general<br />
questions/issues<br />
• Forward/ escalate<br />
issues <strong>to</strong> appropriate<br />
departmental<br />
supervisors<br />
• Answers billing,<br />
enrollment, &<br />
eligibility questions/<br />
issues<br />
• Answers questions<br />
on collections<br />
• Answer renewal<br />
& alternate plan<br />
questions<br />
• Answer renewal<br />
procedural<br />
questions<br />
• Cross Sales<br />
• Answers<br />
licensing and<br />
appointment<br />
questions/issues<br />
• Answers<br />
commissions<br />
questions/issues<br />
• Answers member &<br />
claim questions/issues<br />
• When calling, please<br />
have the following<br />
information:<br />
a) Member Name<br />
b) Member ID or Social<br />
Security Number<br />
5<br />
c) Member Date of Birth<br />
for each member for<br />
whom the reques<strong>to</strong>r is<br />
inquiring information<br />
about.
TITLE OF PRESENTATION<br />
New Business Quoting<br />
• Utilize self-service quoting<br />
<strong>to</strong>ols<br />
• Quote early--first in/first out<br />
• Watch your out-of-state<br />
membership<br />
• Tips for efficient prescreens<br />
• L&A up <strong>to</strong> date<br />
6<br />
Contact Information:<br />
• Email: SESG@aetna.com<br />
©2012 <strong>Aetna</strong><br />
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TITLE OF PRESENTATION<br />
New Business Installation<br />
• Reference and complete underwriting checklist<br />
• Copy of the initial premium check or ACH form not provided<br />
• Incomplete sections of the master and employee applications<br />
• Missing Prior Carrier bill<br />
• The number of applications received is less than the number of eligibles listed on<br />
the master application<br />
• Submit 15 days prior <strong>to</strong> the effective date<br />
• Electronic submission<br />
• No more than 8 mb. per transmission<br />
• No acknowledgement means no receipt<br />
Contact Information:<br />
• Email: SENBUnderwriting@aetna.com<br />
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©2012 <strong>Aetna</strong><br />
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TITLE OF PRESENTATION<br />
Billing<br />
Bills run the 3 rd Saturday of every month for 1 st of the month business<br />
• New Business-most 1 st bill packages are received 60 days after the effective date<br />
• Existing Business <strong>with</strong> plan changes ― 1 st bill will have ‘old’ rates, 2 nd bill will reflect<br />
the plan change<br />
Review billing packages monthly, retroactivity not allowed over 60 days<br />
• Contact our billing team <strong>with</strong> any questions<br />
• Contact Sales Support <strong>to</strong> escalate issue<br />
Paperless payment<br />
• eBilling via our Plan Sponsor Portal for cus<strong>to</strong>mers <strong>with</strong> original effective dates of<br />
11/01/11 or later<br />
• Call the billing and enrollment department <strong>to</strong> pay via phone<br />
Contact Information:<br />
• Email: EastSGPlanSponsorInquiries@aetna.com<br />
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©2012 <strong>Aetna</strong>
TITLE OF PRESENTATION<br />
Eligibility/Enrollment<br />
• Use our Broker Portal SM (eEnrollment)<br />
for <strong>Small</strong> <strong>Group</strong> eligibility maintenance<br />
• Use Paper submissions only when<br />
necessary<br />
• Complete form in its entirety<br />
• Plan selections noted on enrollment form for all<br />
products<br />
• Legible<br />
• Signed by EE/ER<br />
• SSN/DOB<br />
• Be aware of ‘service area’ requirements<br />
• Contact Information:<br />
• Online: Producer World/Broker Portal<br />
• Email: SoutheastEnrollment@aetna.com<br />
• Fax: 866-847-4039<br />
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©2012 <strong>Aetna</strong><br />
9
TITLE OF PRESENTATION<br />
Renewals<br />
• Use Producer World ® /Quoting Renewal<br />
System (QRS) <strong>to</strong> obtain early renewals <strong>with</strong> plan<br />
alternates.<br />
• Contact your Renewal Specialist<br />
• Strategize for plan alternates<br />
• Remote open enrollment support (as appropriate)<br />
• Cross-sell support<br />
• Required Paperwork for Renewal Process<br />
• Pre-Renewal--Return EVF (Employer Verification Form)<br />
<strong>to</strong> address on form<br />
• By Renewal Date--Plan Sponsor Signature Page<br />
• By Renewal Date--Cross-sell paperwork<br />
Contact Information:<br />
• Email: Capi<strong>to</strong>lRenewalSpecialists@aetna.com<br />
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©2012 <strong>Aetna</strong><br />
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TITLE OF PRESENTATION<br />
Commissions<br />
• Sign up for electronic funds transfer (EFT)<br />
• Make sure you are licensed and appointed in each state in<br />
which you write business<br />
• Manage your appointments online via Producer World,<br />
Self-Service Center, Your Licenses and Appointments<br />
• Review commission statements monthly, retroactivity not<br />
allowed over 60 days<br />
Contact Information:<br />
• Email: BrokerComm@aetna.com<br />
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©2012 <strong>Aetna</strong>
TITLE OF PRESENTATION<br />
Claims<br />
• Members have access <strong>to</strong> submit questions on claims via <strong>Aetna</strong><br />
Naviga<strong>to</strong>r ®<br />
– If unable <strong>to</strong> resolve issue, member is the only person who may initiate an appeal<br />
– Appeals process is time sensitive and highly regulated<br />
• If you do call in<strong>to</strong> the claims area team on behalf of a member’s claim:<br />
– Must have a HIPAA release signed by the member<br />
– Have all member information; name, DOB, member ID; date of service, type of<br />
service, etc.<br />
• Be mindful of your group’s TEFRA status <strong>to</strong> determine primary payor<br />
Sales Support does not have access <strong>to</strong> claims data and does not<br />
have authority <strong>to</strong> make any exceptions<br />
Contact Information:<br />
• Email:<br />
– HMORBCOSUPPORT@aetna.com<br />
– TRADRBCOSUPPORT@aetna.com<br />
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12<br />
©2012 <strong>Aetna</strong>
Online Broker Tools via Producer World
TITLE OF PRESENTATION<br />
Producer World Access Tips<br />
• Agency principle must register and delegate authority<br />
• Different access levels are available, ie:<br />
quoting/commissions/billing & enrollment<br />
• For Technical Assistance contact the Producer World<br />
HelpDesk:<br />
– 1-800-225-3375<br />
– eBusiness Technical Assistance<br />
– 866-910-9895<br />
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©2012 <strong>Aetna</strong>
TITLE OF PRESENTATION<br />
Frequently Used Documents<br />
• Log in <strong>to</strong> Producer<br />
World<br />
• Select “<strong>Small</strong> <strong>Group</strong>”<br />
• Select appropriate link<br />
ie: forms/plan<br />
designs/underwriting<br />
rules<br />
• Select state from the<br />
dropdown menu<br />
• Download and Save<br />
your document<br />
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©2012 <strong>Aetna</strong><br />
15
TITLE OF PRESENTATION<br />
Marketing Materials<br />
• Log in <strong>to</strong> Producer World<br />
• Select “<strong>Small</strong> <strong>Group</strong>”<br />
• Select “Order Enrollment<br />
Materials”<br />
• You will be linked <strong>to</strong> a<br />
separate fulfillment website<br />
<strong>to</strong> place your order<br />
• Orders are filled <strong>with</strong>in 24-<br />
48 hours<br />
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©2012 <strong>Aetna</strong><br />
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Quoting and Renewal<br />
TITLE OF PRESENTATION<br />
Access<br />
• Log in <strong>to</strong> Producer World<br />
• Select “<strong>Small</strong> <strong>Group</strong>”<br />
• Under Quoting,<br />
Underwriting &<br />
Enrollment select<br />
“Quoting & Renewal<br />
Center”<br />
• You will be linked <strong>to</strong> a<br />
separate quoting &<br />
renewal site <strong>to</strong> add new<br />
groups and pull renewals<br />
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©2012 <strong>Aetna</strong><br />
17
Broker Portal—<br />
TITLE OF PRESENTATION<br />
Billing & Enrollment<br />
• Log in <strong>to</strong> Producer World<br />
• Select “<strong>Small</strong> <strong>Group</strong>”<br />
• Under Quoting,<br />
Underwriting &<br />
Enrollment select<br />
“eBusiness”<br />
• You will be linked <strong>to</strong> our<br />
Broker Portal for Billing<br />
and Enrollment<br />
functionality<br />
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©2012 <strong>Aetna</strong><br />
18
x<br />
© 2010 | Benefitfocus.com, Inc. 19
x<br />
© 2010 | Benefitfocus.com, Inc. 20
View Plan Sponsor Invoice<br />
© 2010 | Benefitfocus.com, Inc. Billing – View Invoices 21
© 2010 | Benefitfocus.com, Inc. 22
Sample Navigation Back <strong>to</strong> Portal<br />
© 2010 | Benefitfocus.com, Inc. Billing –back <strong>to</strong> home page banner 23
Add/Edit Subscribers & Dependents<br />
© 2010 | Benefitfocus.com, Inc. Enrollment –HR Role Option 2 24
TITLE OF PRESENTATION<br />
Thank you for joining us <strong>to</strong>day!<br />
We appreciate your participation<br />
and your business <strong>with</strong> <strong>Aetna</strong> <strong>Small</strong> <strong>Group</strong>!<br />
Contact us at:<br />
1-866-71-AETNA<br />
25<br />
• <strong>Aetna</strong> is the brand name used for products and services provided by one or more of the <strong>Aetna</strong> group of subsidiary<br />
companies, including <strong>Aetna</strong> Life <strong>Insurance</strong> Company and its affiliates (<strong>Aetna</strong>).<br />
• This material is for illustrative purposes, is intended for brokers only, and may not be distributed <strong>to</strong> plan sponsors or members. This<br />
material is not an offer or invitation <strong>to</strong> contract. Rates and benefits vary by location. Information is believed <strong>to</strong> be accurate as of production date;<br />
however, it is subject <strong>to</strong> change.<br />
14.25.031.1 (1/12)<br />
©2012 <strong>Aetna</strong><br />
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