AmeriHealth New Jersey is an insurance company in New Jersey entirely owned by Independence Blue Cross. It was originally created to provide insurance for Pennsylvania employees living in southern New Jersey, but has since expanded to cover the citizens of the entire state. AmeriHealth New Jersey currently offers Medicare coverage in 14 New Jersey counties with their AmeriHealth 65 Preferred HMO plan and their AmeriHealth Medigap plan.
Any questions regarding AHNJ can be directed to Joe DiNardo at Jdinardo@custombenefitplans.com or 866-422-9188 ext. 205. AmeriHealth New Jersey also has a broker services team that can be contacted at firstname.lastname@example.org.
2016 Product Availability:
AmeriHealth 65 HMO—A competitively priced HMO throughout the state with a strong network of doctors. Very strong in Southern New Jersey, but a little less competitive in Northern New Jersey. The benefits are uniform throughout the state, but the premium is split into three regions. Available with or without drug coverage.
AmeriHealth Medigap—AmeriHealth offers Plans A, C, F, and N. Their rates are extremely competitive, particularly for T65 Males (lowest in the state). They have a flat commission structure, but an excellent bonus program that is retroactive to the first application.
New Broker Care Specialist Department will be able to assist agents with the following:
- Provide benefit information on Medicare
- Provide benefit information on Independence’s/AmeriHealth’s individual Medicare Advantage w/ Rx plans
- Assist the agent with completing the enrollment application
- Verify the status of providers in a network
- Provide enrollment status of submitted applications
- Assist the agent with the certification/appointment process
- Forward claim inquiries presented by agents to member services and assure resolution and follow up by member services to the agent’s client.
- Troubleshoot enrollment issues
- Provide compliance information to agents
- Provide information to agents regarding enrollment periods, Medicare rules and regulations
- Request supplies
Certification Instructions for the Following Products:
Medicare Advantage (MA) HMO and PPO plans
Certification Start Date:
Note: Prior to being certified, an agent must complete a contract (can be found on our contracting site). Once the contract has been returned to Ritter, the agent’s certification link will be turned on at Independence.
Is AHIP Required?
What is the Cost of AHIP?
It costs $175 and must be completed through the carrier’s website.
Can AHIP Be Used for Compliance Credit?
Does Carrier Reimburse for AHIP?
Certification Product Modules:
Information is currently unavailable.
Certification Compliance Modules:
Information is Currently Unavailable.
Is Face-to-Face Training Required?
Will Certifying for 2016 Allow Me to Sell 2015 Products?
Does First Time Certification Differ from Recertification?
First time will include information on the 2015 plan year, recertification will not include this information.
How Do I Retrieve My Username and Password?
Your username is generally your Social Security Number. You can click on the “Forgot Your Password?” link to retrieve your password.
Who Do I Contact at Carrier to Confirm Certification?
Agents can contact the Broker Medicare Resource Center at 888-234-3314.
Certification Web Link:
Agents Who Certified Last Year:
MediGap Only Agents:
Parts of a Compliant Application Submission:
- New Business Cover Sheet
- Scope of Appointment (SOA)—if not necessary, please indicate that on the cover sheet
- Completed Application
- Completed “Office Use Only” section
- Name of agent/broker
- NPN of agent/broker
- Agent/broker signature—If the application was taken in a face-to-face meeting, this date will be the same date as the enrollee’s signature. If the application was mailed, this date will be the date you received the application.
- FMO Number—will always be 1001
How to Submit Applications with AmeriHealth New Jersey:
- AmeriHealth New Jersey uses the DRx enrollment system to enroll beneficiaries online. The agent needs to be set up to use this program by AmeriHealth New Jersey, and will need to complete additional training. Please contact Ritter for additional information.
- Please use this cover sheet for online applications.
Tracking Submitted Business:
- Agents can track their submitted business via myBiz.
- Applications should appear on the submitted tab within 24 hours of application submission.
- Applications should appear as enrolled on the enrollment tab within 10 days of application submission.
- If applications are not meeting those timelines, please contact us so we can make sure applications are being successfully submitted and enrolled.
For More Information:
Please view the AmeriHealth Quick Guide located in the “Downloads” section.