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Carolina Care Plan ( a subsidiary of Medical Mutual of Ohio) just exited the South Carolina Market. No new sales effective 7/1/13. Current members to be covered thru 12/31/2013.....
Special Broker Update
Carolina Care Plan to Exit South Carolina Market in 2014, Transition Members to UnitedHealthcare Coverage
After much consideration, Medical Mutual and its Family of Companies have made the difficult decision to exit the medical health coverage market in South Carolina to focus on our core business in Ohio. We expect to exit this market effective January 1, 2014. In addition, we will no longer accept new business as of July 1, 2013.
Because we value our customers, we want to ensure they continue to have access to quality healthcare coverage. To help provide a smooth transition for our current groups and members, we are partnering with UnitedHealthcare, which will be the endorsed healthcare coverage carrier for our members in these markets. We will work with our current customers to transition them to UnitedHealthcare. For any new business received on or after July 1, regardless of the application date, we will work with the customer as well as the broker and UnitedHealthcare sales representative to place the business with UnitedHealthcare.
Carolina Care Plan medical coverage for impacted members will end at midnight on December 31, 2013. UnitedHealthcare may contact you in regard to transitioning this coverage prior to the anticipated ending of the coverage with Carolina Care Plan.
We will process claims for any services received prior to midnight on December 31, 2013, in accordance with the terms of all existing policies. For members who still have coverage with Carolina Care Plan on December 31, 2013, and who are hospitalized or have a procedure scheduled around December 31, 2013, should call our Customer Care Center at the number listed on their ID cards for more information.
We will send letters to all groups and members impacted by this change. Members with My Health Plan accounts will continue to have access to their accounts until midnight on December 31, 2014--one year after their coverage ends.
This decision was not easy to make. We thank you for your past business and wish you continued success.
For additional information, please refer to the statement and series of questions and answers from UnitedHealthcare below.
What products are impacted by this decision?
Carolina Care Plan's fully insured group medical plans and individual medical plans in South Carolina.
What is the timing of the withdrawal? What do I need to do?
It is business as usual for now and there is nothing you need to do immediately. You will be contacted by UnitedHealthcare with information about replacing your clients' Carolina Care Plan medical insurance coverage. Timing is dependent largely upon state regulatory requirements, but here's a quick overview of our estimated timeline of activity:
July 2013:
Carolina Care Plan is working with UnitedHealthcare, its designated replacement medical carrier, to start preparing to provide transition medical insurance options. This will provide you and your clients with ample time to make a replacement decision.
Late fourth quarter 2013:
We anticipate waiting periods will end in the fourth quarter 2013, at which point Carolina Care Plan's existing insurance policies in South Carolina will terminate automatically and Carolina Care Plan will not offer any fully insured medical plans in this state after that date.
We will keep you updated on timelines as more information becomes available.
We're working to make the transition as easy as possible.
To assist you and your clients, Carolina Care Plan has worked out an arrangement with UnitedHealthcare, a recognized leader in the medical insurance industry, to provide comparable medical plan options that your clients may be able to purchase when the time comes.
We will share information with you about these comprehensive, competitive medical benefits well in advance of your clients' transition dates. You can also rest assured that UnitedHealthcare will work closely with Carolina Care Plan to ensure that, once your clients' termination or non-renewal date is determined, the transition is smooth for you and your clients. In the meantime, to get more information about UnitedHealthcare, review the "Why Choose UnitedHealthcare" brochure.
UnitedHealthcare will work to enroll these customers in a comparable UnitedHealthcare plan. UnitedHealthcare will also welcome Carolina Care Plan's customers to inquire about transitioning ahead of their scheduled renewal date. UnitedHealthcare will use its technology resources and sales support to offer:
We invite you to join a call with Carolina Care Plan's and UnitedHealthcare's senior leadership onTuesday, July 2. We will discuss:
Morning Call
Date: Tuesday, July 2
Time: 10:15 a.m.
Number: (877) 269-7600; Access Code: 5307288
Afternoon Call
Date: Tuesday, July 2
Time: 3:15 p.m.
Number: (877) 269-7600; Access Code: 5307288
We will keep you informed of any updates or changes throughout this process. As always, if you have questions or would like more information, please contact your Carolina Care Plan representative.
For your reference, we've developed a Q&A to help address any initial questions you may have:
Why is Medical Mutual and its Family of Companies exiting the medical business in South Carolina?
A reconsideration of the commitment of its resources to the South Carolina market has caused Medical Mutual of Ohio, the parent company of Carolina Care Plan, to reflect on many aspects of its business. After much consideration, the Company has made the difficult decision to exit the medical insurance market in South Carolina to focus on the Company's core business in Ohio, effective January 1, 2014. In addition, Carolina Care Plan will no longer accept new business as of July 1, 2013.
Do I need to do anything now? When will my clients' coverage end?
No, you do not need to take any immediate action. You will be contacted by UnitedHealthcare with information about replacing your clients' Carolina Care Plan medical insurance coverage. As stated in the announcement, the timeline for winding down the Carolina Care Plan medical business will be largely driven by state regulatory requirements, so we cannot communicate an exact date right now as to when Carolina Care Plan will start to terminate fully insured medical groups, but we anticipate that policies issued by Carolina Care Plan in South Carolina will terminate automatically on December 31, 2013, and Carolina Care Plan will not offer any medical insurance products in this state after that date, subject to any applicable regulatory waiting period.
Well in advance of the termination or non-renewal date, Carolina Care Plan will mail plan holders and members an official notice of the termination or non-renewal of their current medical plan, which will provide the specific date when coverage is scheduled to end. Carolina Care Plan will continue to communicate specifics on its withdrawal process as they become available.
For those existing self-funded administrative services only customers, the existing contracts will continue irrespective of our decision to exit the market. We will, however, not be offering these services to new customers effective immediately.
What coverage replacement options do my clients have?
To assist you and your clients in having a convenient transition option, Carolina Care Plan is working with UnitedHealthcare to provide comparable plan options as your clients' transition dates draw near. UnitedHealthcare will also welcome Carolina Care Plan's customers to inquire about transitioning ahead of their scheduled renewal date.
Does this impact my Carolina Care Plan commission?
The Carolina Care Plan commission and bonus structure will continue as-is, and will be paid by Carolina Care Plan, unless plans transition into a UnitedHealthcare product, at which time the UnitedHealthcare standard commission and bonus structure for each applicable market will apply. The details of this additional compensation plan will be provided in the near future.
How will my clients be informed?
In the coming days, Carolina Care Plan will send each current medical plan holder an initial notification of its intent to withdraw the Carolina Care Plan medical product in South Carolina. The Company will also send an official plan termination notice to plan holders, indicating the date on which their Carolina Care Plan medical coverage is scheduled to end, along with a notice that they can share with their covered employees. Carolina Care Plan will also mail a similar advanced notification to its members.
Will medical claims continue to be paid?
Yes. It is business as usual when it comes to Carolina Care Plan's service, including claims payment and processing.
Questions relating to the UnitedHealthcare transition process
Why did you select UnitedHealthcare as the replacement carrier?
UnitedHealthcare is a leader in the medical benefits business and can offer Carolina Care Plan's customers with a flexible range of coverage options that offer affordable, high-quality benefit plans, valuable healthcare products and services and an extensive local and national network of providers. It has the largest network of medical care providers in the country, contracting directly with approximately 720,000 healthcare professionals, 5,600 hospitals and 64,000 pharmacies. We are confident that UnitedHealthcare is well-equipped to provide your clients and their employees with options to meet their medical benefit needs.
If my client switches to UnitedHealthcare, will they have to complete a new master application and/or employee enrollment forms?
UnitedHealthcare will need to receive written documentation (a signed Acceptance Form) of the group's plan choice before starting the installation process. Only new members or subscribers (those not previously on a Carolina Care Plan medical policy) will need to complete Employee Applications.
What information will Carolina Care Plan transfer to UnitedHealthcare to assist with the transition?
We anticipate that member eligibility information (for members already enrolled with Carolina Care Plan) as well as deductible and out-of-pocket maximum accumulators (if applicable) will be transferred from Carolina Care Plan to UnitedHealthcare for those groups that transfer.
Will UnitedHealthcare pay the same commission schedule as I have with Carolina Care Plan?
The payment, commission and bonus structure with Carolina Care Plan will continue unless customers transition to a UnitedHealthcare product, at which time, UnitedHealthcare's commission and bonus structure will apply.
Will UnitedHealthcare offer the same contract and/or level of benefits as my client has today?
UnitedHealthcare completed a product review and, subject to UnitedHealthcare's underwriting standards, will work closely with Carolina Care plan to identify the UnitedHealthcare plans most comparable to Carolina Care Plan products and may also provide alternative designs that give you and your clients choices.
I am not appointed with UnitedHealthcare today. What do I need to do?
Brokers not yet appointed with UnitedHealthcare have two easy options:
Special Broker Update
Carolina Care Plan to Exit South Carolina Market in 2014, Transition Members to UnitedHealthcare Coverage
After much consideration, Medical Mutual and its Family of Companies have made the difficult decision to exit the medical health coverage market in South Carolina to focus on our core business in Ohio. We expect to exit this market effective January 1, 2014. In addition, we will no longer accept new business as of July 1, 2013.
Because we value our customers, we want to ensure they continue to have access to quality healthcare coverage. To help provide a smooth transition for our current groups and members, we are partnering with UnitedHealthcare, which will be the endorsed healthcare coverage carrier for our members in these markets. We will work with our current customers to transition them to UnitedHealthcare. For any new business received on or after July 1, regardless of the application date, we will work with the customer as well as the broker and UnitedHealthcare sales representative to place the business with UnitedHealthcare.
Carolina Care Plan medical coverage for impacted members will end at midnight on December 31, 2013. UnitedHealthcare may contact you in regard to transitioning this coverage prior to the anticipated ending of the coverage with Carolina Care Plan.
We will process claims for any services received prior to midnight on December 31, 2013, in accordance with the terms of all existing policies. For members who still have coverage with Carolina Care Plan on December 31, 2013, and who are hospitalized or have a procedure scheduled around December 31, 2013, should call our Customer Care Center at the number listed on their ID cards for more information.
We will send letters to all groups and members impacted by this change. Members with My Health Plan accounts will continue to have access to their accounts until midnight on December 31, 2014--one year after their coverage ends.
This decision was not easy to make. We thank you for your past business and wish you continued success.
For additional information, please refer to the statement and series of questions and answers from UnitedHealthcare below.
What products are impacted by this decision?
Carolina Care Plan's fully insured group medical plans and individual medical plans in South Carolina.
What is the timing of the withdrawal? What do I need to do?
It is business as usual for now and there is nothing you need to do immediately. You will be contacted by UnitedHealthcare with information about replacing your clients' Carolina Care Plan medical insurance coverage. Timing is dependent largely upon state regulatory requirements, but here's a quick overview of our estimated timeline of activity:
July 2013:
Carolina Care Plan is working with UnitedHealthcare, its designated replacement medical carrier, to start preparing to provide transition medical insurance options. This will provide you and your clients with ample time to make a replacement decision.
Late fourth quarter 2013:
We anticipate waiting periods will end in the fourth quarter 2013, at which point Carolina Care Plan's existing insurance policies in South Carolina will terminate automatically and Carolina Care Plan will not offer any fully insured medical plans in this state after that date.
We will keep you updated on timelines as more information becomes available.
We're working to make the transition as easy as possible.
To assist you and your clients, Carolina Care Plan has worked out an arrangement with UnitedHealthcare, a recognized leader in the medical insurance industry, to provide comparable medical plan options that your clients may be able to purchase when the time comes.
We will share information with you about these comprehensive, competitive medical benefits well in advance of your clients' transition dates. You can also rest assured that UnitedHealthcare will work closely with Carolina Care Plan to ensure that, once your clients' termination or non-renewal date is determined, the transition is smooth for you and your clients. In the meantime, to get more information about UnitedHealthcare, review the "Why Choose UnitedHealthcare" brochure.
UnitedHealthcare will work to enroll these customers in a comparable UnitedHealthcare plan. UnitedHealthcare will also welcome Carolina Care Plan's customers to inquire about transitioning ahead of their scheduled renewal date. UnitedHealthcare will use its technology resources and sales support to offer:
- Clear, proactive communications
- Comparable plans
- A streamlined enrollment process
- Electronic transfer of member eligibility and accumulator data
- A local team to provide information, address questions and resolve any issues
- Expanded choice from UnitedHealthcare's 720,000 national healthcare providers
- Education for Carolina Care Plan's producers and consultants
- In the coming days, Carolina Care Plan will mail a notification to its members, informing them of its intent to withdraw the Carolina Care Plan medical product line.
- After options and timing are finalized, plan holders may receive an offer of medical coverage from UnitedHealthcare.
- For now, and throughout the transition process, it is business as usual in terms of service. We are committed to delivering the same level of quality service you have come to expect from Carolina Care Plan and are confident you and your clients can expect UnitedHealthcare to maintain that commitment to quality service.
We invite you to join a call with Carolina Care Plan's and UnitedHealthcare's senior leadership onTuesday, July 2. We will discuss:
- The rationale behind Carolina Care Plan's medical benefits withdrawal decision in South Carolina; and
- The transition process, as well as replacement options available through UnitedHealthcare.
Morning Call
Date: Tuesday, July 2
Time: 10:15 a.m.
Number: (877) 269-7600; Access Code: 5307288
Afternoon Call
Date: Tuesday, July 2
Time: 3:15 p.m.
Number: (877) 269-7600; Access Code: 5307288
We will keep you informed of any updates or changes throughout this process. As always, if you have questions or would like more information, please contact your Carolina Care Plan representative.
For your reference, we've developed a Q&A to help address any initial questions you may have:
Why is Medical Mutual and its Family of Companies exiting the medical business in South Carolina?
A reconsideration of the commitment of its resources to the South Carolina market has caused Medical Mutual of Ohio, the parent company of Carolina Care Plan, to reflect on many aspects of its business. After much consideration, the Company has made the difficult decision to exit the medical insurance market in South Carolina to focus on the Company's core business in Ohio, effective January 1, 2014. In addition, Carolina Care Plan will no longer accept new business as of July 1, 2013.
Do I need to do anything now? When will my clients' coverage end?
No, you do not need to take any immediate action. You will be contacted by UnitedHealthcare with information about replacing your clients' Carolina Care Plan medical insurance coverage. As stated in the announcement, the timeline for winding down the Carolina Care Plan medical business will be largely driven by state regulatory requirements, so we cannot communicate an exact date right now as to when Carolina Care Plan will start to terminate fully insured medical groups, but we anticipate that policies issued by Carolina Care Plan in South Carolina will terminate automatically on December 31, 2013, and Carolina Care Plan will not offer any medical insurance products in this state after that date, subject to any applicable regulatory waiting period.
Well in advance of the termination or non-renewal date, Carolina Care Plan will mail plan holders and members an official notice of the termination or non-renewal of their current medical plan, which will provide the specific date when coverage is scheduled to end. Carolina Care Plan will continue to communicate specifics on its withdrawal process as they become available.
For those existing self-funded administrative services only customers, the existing contracts will continue irrespective of our decision to exit the market. We will, however, not be offering these services to new customers effective immediately.
What coverage replacement options do my clients have?
To assist you and your clients in having a convenient transition option, Carolina Care Plan is working with UnitedHealthcare to provide comparable plan options as your clients' transition dates draw near. UnitedHealthcare will also welcome Carolina Care Plan's customers to inquire about transitioning ahead of their scheduled renewal date.
Does this impact my Carolina Care Plan commission?
The Carolina Care Plan commission and bonus structure will continue as-is, and will be paid by Carolina Care Plan, unless plans transition into a UnitedHealthcare product, at which time the UnitedHealthcare standard commission and bonus structure for each applicable market will apply. The details of this additional compensation plan will be provided in the near future.
How will my clients be informed?
In the coming days, Carolina Care Plan will send each current medical plan holder an initial notification of its intent to withdraw the Carolina Care Plan medical product in South Carolina. The Company will also send an official plan termination notice to plan holders, indicating the date on which their Carolina Care Plan medical coverage is scheduled to end, along with a notice that they can share with their covered employees. Carolina Care Plan will also mail a similar advanced notification to its members.
Will medical claims continue to be paid?
Yes. It is business as usual when it comes to Carolina Care Plan's service, including claims payment and processing.
Questions relating to the UnitedHealthcare transition process
Why did you select UnitedHealthcare as the replacement carrier?
UnitedHealthcare is a leader in the medical benefits business and can offer Carolina Care Plan's customers with a flexible range of coverage options that offer affordable, high-quality benefit plans, valuable healthcare products and services and an extensive local and national network of providers. It has the largest network of medical care providers in the country, contracting directly with approximately 720,000 healthcare professionals, 5,600 hospitals and 64,000 pharmacies. We are confident that UnitedHealthcare is well-equipped to provide your clients and their employees with options to meet their medical benefit needs.
If my client switches to UnitedHealthcare, will they have to complete a new master application and/or employee enrollment forms?
UnitedHealthcare will need to receive written documentation (a signed Acceptance Form) of the group's plan choice before starting the installation process. Only new members or subscribers (those not previously on a Carolina Care Plan medical policy) will need to complete Employee Applications.
What information will Carolina Care Plan transfer to UnitedHealthcare to assist with the transition?
We anticipate that member eligibility information (for members already enrolled with Carolina Care Plan) as well as deductible and out-of-pocket maximum accumulators (if applicable) will be transferred from Carolina Care Plan to UnitedHealthcare for those groups that transfer.
Will UnitedHealthcare pay the same commission schedule as I have with Carolina Care Plan?
The payment, commission and bonus structure with Carolina Care Plan will continue unless customers transition to a UnitedHealthcare product, at which time, UnitedHealthcare's commission and bonus structure will apply.
Will UnitedHealthcare offer the same contract and/or level of benefits as my client has today?
UnitedHealthcare completed a product review and, subject to UnitedHealthcare's underwriting standards, will work closely with Carolina Care plan to identify the UnitedHealthcare plans most comparable to Carolina Care Plan products and may also provide alternative designs that give you and your clients choices.
I am not appointed with UnitedHealthcare today. What do I need to do?
Brokers not yet appointed with UnitedHealthcare have two easy options:
- Visit http://broker.uhc.com and click on Tools at the top of the page. Then click onAppointment/Compensation and follow the instructions for getting appointed.
- You can also call toll free, (866) 799-1331 and speak to a specialist about the process.
