Company Information

Aetna Medicare Broker Services Department:

Phone: 1-866-714-9301

Email: brokersupport@aetna.com

Hours: Monday through Friday from 8:30 a.m. to 5 p.m. EST

Aetna’s Medicare Resource Center:

In order to gain access to Aetna’s Medicare Resource Center, agents must call Aetna at 1-800-255-3375 and choose option 4. Agents will then be registered for access, and upon completion of the request, agents will receive a notification call or email from Aetna that they may now register.

How to Check Enrollment Status:

To check the status of an application, please call the BSU at 1-866-714-9301. Do not call Medicare directly.

Aetna’s Provider Search Tool:

To search for doctors, dentists, hospitals, and other Aetna health care professions that accept your plan, please click here.

Certification

2018 Certification

Products:

  • Medicare Advantage (MA)
  • Medicare Advantage Prescription Drug (MAPD)
  • Prescription Drug Plans (PDPs)

Certification Start Date:

Live

What’s Required to Sell 2018 MA/MAPD and PDP Plans?

Agents must successfully complete the Aetna Individual Medicare annual certification process and meet all contracting requirements prior to marketing or selling Aetna or Coventry Individual Medicare products (MA/MAPD and PDP) during the Annual Election Period for January 1 effective dates and throughout the year.

Uplines and principals must be fully licensed, appointed and certified in all states and markets where their downline agents or employees intend to sell.

What’s Required to Receive Renewal Commission?

Agents must complete Aetna’s annual certification process by December 31 to receive renewal commission next January for business sold in prior years. They must also be licensed and appointed with Aetna.

Is AHIP Required for Certification?

Yes. You may transfer your existing AHIP certification to Aetna using their certification portal as long as you score 90% or higher on the final exam within three attempts.

What is the Cost of AHIP?

It is $175 if an agent registers on the AHIP site directly. However, if an agent completes AHIP through Aetna’s certification site, the cost is only $125 ($50 less than directly through AHIP).

2016 Aetna Medicare Front Runners can complete AHIP through Aetna’s certification sitefor FREE. Agents qualify for Aetna’s Front Runners program if they sold 18 or more apps with a January 1 effective date during AEP.

Can AHIP Be Used for Compliance Credit?

Yes

Does Carrier Reimburse for AHIP?

If you are a 2016 Aetna Medicare Front Runner, your certification is free. If you are not a Front Runner but complete AHIP through Aetna’s certification site, your cost is only $125 ($50 less than directly through AHIP).

MA/MAPD/PDP Certification Components:

This year, there will be one standardized learning plan. This will be for all agents including uplines. Aetna will not have access codes this year, which should alleviate confusion on which learning plan to choose. Agents certifying for Medicare Advantage will not have the separate Individual Market trainings this year, just the MAPD Overview. This overview will cover all markets.

  • AHIP Medicare Training and Exam: This course has five modules. The final exam requires a passing score of 90% or better within three attempts and includes Fraud, Waste and Abuse (FWA) training and a test.
  • Core Training and Exam: Provides a high-level view of Aetna’s Code of Conduct and Medicare Compliance Program to satisfy annual CMS certification requirements.
  • MA/MAPD Overview: Training and Exam: Offers a high-level look at Aetna and Coventry Individual MA/MAPD and Medicare Supplement products to satisfy annual CMS certification requirements.
  • Part D Training and Exam: Offers a high-level look at Aetna and Coventry Part D products.

PDP-Only Certification Components:

  • AHIP Medicare Training and Exam: This course has five modules. The final exam requires a passing score of 90% or better within three attempts and includes Fraud, Waste and Abuse (FWA) training and a test.
  • Core Training and Exam: Provides a high-level view of Aetna’s Code of Conduct and Medicare Compliance Program to satisfy annual CMS certification requirements.
  • Part D Training and Exam: Offers a high-level look at Aetna and Coventry Part D products.

Is Face-to-Face Training Required?

Face-to-face trainings are encouraged, but they are not required.

Will Certifying for 2017 Allow Me to Sell 2016 Products?

Yes, 2017 certification will count for the remainder of the 2016 selling season.

Are Additional Steps Required for Those Certifying for the First Time Versus Those Who Are Recertifying?

Agents certifying for the first time must complete AHIP training modules 1–5. Those who are recertifying and completed last year’s AHIP training requirements must only complete modules 4–5 and the Fraud, Waste, and Abuse training/exam.

Note: Since the final exam covers all five modules, agents who are recertifying should still reacquaint themselves with modules 1–3.

How Do I Retrieve My Username and Password?

You can click on the “Forgot your username?” or “Forgot your Password?” links. If you need further assistance, you can contact Aetna’s Broker Service Department at 1-866-714-9301.

Who Do I Contact at Carrier to Confirm Certification?

Agents can contact Aetna’s Broker Services Department at 866-714-9301 and select option 4.

Certification Web Link:

https://aetna.cmpsystem.com/ext/ahip/login.php

2018 Certification

Certification Instructions for the Following Products:

  • Medicare Advantage (MA)
  • Medicare Advantage Prescription Drug (MAPD)
  • Part D

Certification Start Date:

Live (July 10, 2015)

Is AHIP Required?

Yes. You may transfer your existing AHIP certification to Aetna using their certification portal.

Note: If you transfer your existing AHIP certification to Aetna, please be aware that you must still complete other Aetna-specific requirements to satisfy the Aetna Individual Medicare annual certification requirements.

What is the Cost of AHIP?

The cost of AHIP is $125.

Can AHIP Be Used for Compliance Credit?

Yes

Does Carrier Reimburse for AHIP?

If you are a 2018 Aetna Medicare Front Runner, your certification is free.

Certification Product Modules:

  • Core Training and Exam – 28 questions
  • Part D Training and Exam – 16 questions
  • Individual Medicare Market MA/MAPD Training
  • MA/MAPD Overview Training and Exam

Certification Compliance Modules:

AHIP Medicare Training and Exam (Fraud, Waste and Abuse included) – 50 questions

Is Face-to-Face Training Required?

No. New for 2018, you can now complete the certification process entirely online.

Will Certifying for 2018 Allow Me to Sell 2017 Products?

No. Completion of the 2016 AHIP courses and exam will satisfy the requirement for both 2015 and 2016 certification; however, you must complete all of the other 2015 certification components to sell 2015 products.

Are Additional Steps Required for Those Certifying for the First Time Versus Those Who Are Recertifying?

Agents certifying for the first time must complete AHIP training modules 1–5. Those who are recertifying and completed last year’s AHIP training requirements must only complete modules 4–5 and the Fraud, Waste, and Abuse training/exam.

Note: Since the final exam covers all five modules, agents who are recertifying should still reacquaint themselves with modules 1–3.

How Do I Retrieve My Username and Password?

You can contact your Aetna Medicare representative or you can contact the Broker Service Department at 1-866-714-9301 or brokersupport@aetna.com.

Who Do I Contact at Carrier to Confirm Certification?

You can contact Broker Support at 888-247-1050 option 3.

Certification Web Link:

https://aetna.cmpsystem.com/ext/ahip/login.php

Navigation to Certification Portal and Training Courses:

1) Go to https://aetna.cmpsystem.com/ext/ahip/login.php.

  • New Agents: Click “Create a New Account” in the “Register” box.
  • Returning Agents: Enter your username (NPN or email) and password. Then, click “Login.”

2) Let the system know whether you are an Aetna employee, Front Runner, or telesales agent.

  • Aetna employees: enter your Aetna ID number in the first text box
    and click “Submit”
  • 2015 Individual Medicare Front Runners: enter your NPN in the second text box and click “Submit”
  • Individual Medicare call center agents: enter your employer’s Aetna telesales access code into the second text box and click “submit”
  • All other users: leave the text boxes empty and click “Continue Producer Registration”

4) Fill out the “Confidential Information” section of the registration form and click “Submit”

  • Last name
  • Date of birth
  • Last 4 digits of Social Security Number

5) Complete the remaining personal information fields, and click “Register” button.

6) Create a password. Make note of your password and username, and click “Continue to Home” button.

7) Select your certification

a. Select Medicare plan year

b. Select line of business that you want to sell

c. Check to make sure certification is checked

d. Click “Place me in the selected learning” button

8) Once at the main training page, look at the “My Certifications” section. Click on the title of a training section to get started. Your training course or mastery test will begin.

Note: You have three attempts to pass the mastery test. You must obtain a score of 90% or better on the test. If you abandon the test before you complete it, your answers will not be saved and you will have to restart the test. If you must abandon the test before completing it, you will not be charged an attempt.

9) Complete the certification steps one at a time.

10) Fill out a short survey (optional) about your certification experience.

Submitting Business

Please remember that Aetna/Coventry must receive signed medicare enrollment applications within two calendar days after you receive them. Also, keep in mind that you must document a Scope of Appointment (SOA) if you meet with a client for a one-on-one appointment (in person or by phone) to discuss Medicare Advantage (MA), Medicare Advantage Prescription Drug (MAPD), or Prescription Drug Products (PDP) products.

IMPORTANT: You must maintain SOA forms for at least 10 years, and you must be able to produce them upon request.

Before Submitting Enrollment Applications:

  • Verify that all producer information (e.g., all producer names and NPN numbers) appears correctly in the Broker section of the application. If this information is not provided, commission will not be paid, and applications cannot be changed or corrected once submitted.
  • Make sure the following items are included on all applications:
    • Beneficiary’s name, as shown on their Medicare card
    • Beneficiary’s date of birth
    • Beneficiary’s permanent residence address/physical street address (P.O. Box is not acceptable)
    • Beneficiary’s contact phone number
    • Medicare Health Information Claim Number (HICN) – This is the number on the beneficiary’s Medicare card
    • Proof of Medicare Part A and/or B entitlement
    • Requested effective date
    • Plan selection
    • Method of payment
    • Signature(s) and date
    • Aetna applications: your National Producer Number (except in Florida where your NPN and AWN are required)
    • Coventry applications: your Coventry Agent Writing Number (except in Florida where your NPN and AWN are required)

After Submitting Enrollment Applications:

  • Make sure to inform your clients about what will happen next.
  • New MA/MAPD and PDP members, as well as some members who make a plan change (for example, those who change from an MA plan to a PDP plan or from a PDP plan to an MA plan) will receive an enrollment verification letter within 10 business days after we receive their application.
  • All MA/MAPD and PDP members will receive their member ID card and welcome kit.
  • Some members will receive a welcome call from an Aetna or Coventry customer service representative. On the call,
    we’ll help ensure members understand how to start using their plan benefits.
  • Members may also be contacted by phone later in the year about free services that are part of their plan, such as an in-home
    health assessment.

How to Submit Aetna MA/MAPD/PDP Enrollment Applications:

All Aenta MA/MAPD/PDP enrollment applications must be submitted directly to Aetna. There are several ways that agents can submit business with Aetna:

  • Online through Aetna’s Ascend Virtual Sales Office app
    • After you’re ready to sell with Aetna, you can request access to this app on the Broker Portal.
    • App works for any iPad-based devise (requires iPad 2 or later model running iOS7 or later) or Windows-based devise (requires Windows7 or later and x86 processor).
  • Email: MedicareEnrollmentTransactions@aetna.com
    • Scan and save the paper application, and other required paperwork, as a single document in one of the following file formats: .doc, .dox, .jpg, .pdf or .tif. Attach the file to an email message and send securely with encryption.
    • One applicant and one attachment per email is recommended; however, up to five applicants/attachments per email are permitted.
    • Attachments cannot exceed seven pages and the email body cannot contain embedded images, graphics, or logos.
    • You will receive an automatic reply confirming the status of your submission.
  • Fax:
    • All States, except Florida: 1-866-441-2341 or 1-888-665-6296
    • Central Florida: 1-866-669-5604
    • South/North Florida: 1-877-573-0074
  • Mail:
    • All States, except Florida:
      • Aetna Medicare Broker Enrollment Team
        P.O. Box 14088
        Lexington, KY 40512-4088
    • Central Florida:
      • Aetna & Coventry Health Care
        630 Woodland Corporate Blvd., 3rd Floor
        Tampa, FL 33614
    • South/North Florida:
      • Aetna & Coventry Health Care
        1340 Concord Terrace
        Sunrise, FL 33323

How to Check the Status of an Enrollment Application for Aetna:

  1. Go to the “Individual Medicare” page of Aetna’s Producer World
  2. Click the “Reporting” drop-down menu
  3. The status of applications that are being processed or were denied will be shown on the application pipeline status report. After an application is approved, it will appear on the enrollment roster report.

Commissions

Announcements:

Commission Statements for Medicare Supplement will no longer be sent to you by mail.

General Information:

  • Commission is a percentage of the monthly paid premium per policy at the time of initial sale. It is paid on a monthly or quarterly basis.
  • Commission reduction is not available for under 65 or over 80.
  • There are no advancing options.
  • Custom Benefit Plans will pay Aetna commissions on or around the 10th of the month via direct deposit. Agent’s commission statements for Aetna Medicare Advantage (MA) and Prescription Drug Plans (PDP) are available to view on the Custom Benefit Plans website.

How to Access Aetna Commission Statements Online:

  1. Log in to Aetna’s Producer World.
  2. Click on the “Compensation & Book of Business” link in the toolbar on the left side of your screen.
  3. Click on the “Compensation Statements” link.

How to Receive Commissions via Direct Deposit:

If you are set up for EFT, your commission will be deposited directly into your bank account. However, if you are not set up for EFT and you would like to receive your commissions via EFT, please complete the following steps:

  1. Log in to Aetna’s Producer World.
  2. Click on the “Compensation & Book of Business” link in the toolbar on the left side of your screen.
  3. Click on the “Compensation Statements” link.
  4. Click on the blue “Direct Deposit…click here” link located on the right side of the screen in the pale yellow box.

Supplies

How to Order Supplies for Aetna:

Agents must be “ready to sell” – meaning licensed, certified, and contracted to order 2016 supplies.

To order 2016 kits, complete the following steps:

  1. Go to Aetna’s Producer World and log in.
  2. Click the “Order Enrollment Kits” link in the toolbar on the left side of the screen.
  3. Under “Individual Medicare” tab, click on the “Order 2016 Aetna and Coventry MA/MAPD and PDP enrollment kits” link to access the corresponding product-specific kit-ordering site and place your order.
  4. Select the Order Wizard to choose the plans. It should show you what you are ready to sell. Click “continue.”
  5. Select items and add to your cart. Items are available by area (010-PACENTRAL) and description (2015 Medicare HMO/PPO Lehigh Valley & Central Pennsylvania Counties (PA)).
  6. Click “Proceed to Checkout” to select the quantity.
  7. Enter your shipping address and confirm the order.
  8. Place the order to get your confirmation number.

 

Important Changes & New Processes for 2015 Aetna Business

Important Changes & New Processes for 2015

Here’s What You Need to Know

Since Aetna acquired Coventry Health Care in May 2013, they’ve been working diligently to integrate their Aetna and Coventry Medicare operations.

They’re very excited to offer Aetna and Coventry Medicare products for the 2018 Annual Enrollment Period through a single process! Here are some key facts about upcoming changes.

2015 Individual Medicare Contracting for Existing and New Agents

• You MUST enter into a new contract for 2018.

  • There will be one contract for Aetna and Coventry Medicare products (MA, MAPD, and PDP) beginning with a 1/1/18 effective date.
  • You’ll need to use the Nomoreforms system to contract with them. You’ll be able to access that system through Aetna’s Producer World website and the Coventry Broker Portal. They provided complete instructions, assistance, and education for Aetna and Coventry agents/agencies in late June.
  • There will be two types of agreements for 2015 Aetna and Coventry business within Nomoreforms: one for uplines and one for producers.

Follow existing contracting and certification processes to sell 2014 Aetna or Coventry Individual Medicare products.

Your existing contract, with respect to Individual Medicare sales only, will be terminated at the end of 2017. All existing Aetna and Coventry Medicare contracts will remain in effect through the end of the year. You should have received a formal notice about this in July.

• Existing Transfer/Release guidelines remain in place.

2015 Individual Medicare Certification and Training

• They’re consolidating their 2015 Individual Medicare certification programs (includes AHIP and “core training”) into a streamlined process that all Medicare writing agents must fulfill.

• Our Individual Medicare certification program became available in mid-July.

• Agents marketing MA/MAPD products will be required to complete local market product training for the markets in which they intend to sell, and complete a final overview exam for Aetna MAPD products. There are separate online training and testing requirements for agents marketing PDP products.

2018 “Ready-to-Sell” Requirements

• To sell their 2018 Individual Medicare products (MA, MAPD, and PDP), agents must be licensed and appointed in the states in which they intend to sell, and certified through the 2018 Aetna Individual Medicare producer certification program (includes AHIP, “core training,” local market product training, and tests for each component).

New – Principals now need to be licensed, appointed, and certified (i.e., must complete all Aetna Individual Medicare producer certification program requirements). In past years, they were only required to complete certification. (This is new for Coventry principals. It’s an existing policy at Aetna.)

New – Payees now need to be licensed, appointed, and certified (i.e., must complete all Aetna Individual Medicare producer certification program requirements). (This is new for Coventry payees. It’s an existing policy at Aetna.)

Questions?

Aetna and Coventry are committed to ensuring that you have everything you need to be ready for 2015. If you have any questions at this time, please contact the Aetna Medicare Broker Support Unit (BSU) or the Coventry Broker Services Department (BSD).

Aetna Medicare BSU Contact Information:

888-247-1050

BrokerService-MedicareTeam@aetna.com

Monday–Friday, 8:30 a.m.–5 p.m., all time zones

Coventry BSD Contact Information

1-866-714-9301

brokersupport@cvty.com

Monday–Friday, 8 a.m.–6 p.m. EST