Insurance Agent Forum

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Got this email

Dear Wellpoint Affiliated Health Plans Medicare Advantage and Part D Certified Broker:

As a result of recent CMS audit findings, as well as issues stemming from member ability to access pharmacy benefits in January, WellPoint affiliated health plans must temporarily suspend marketing and selling all Medicare Advantage and Part D products.

We have fully disclosed all known issues to CMS, as well as plans for correcting these issues. To date, we have made significant progress in addressing these issues. We take member access to benefits and member safety very seriously and have put processes in place to help ensure that our members receive their medications and are being billed correctly.

[COLOR=black][COLOR=black]Our plan is to continue working with CMS to make the necessary business improvements in our operations and processes as quickly as possible so that we can re-enter the market in a position to better serve our current and future Medicare members.[/COLOR][/COLOR]

During this time out of the market, we will focus additional resources on the critical task of improving our processes and delivering excellent service to our current members. In the long run, it is our belief that we will all benefit from this temporary suspension.

If you are currently marketing our Medicare Advantage or Part D Plans, please cease all activity until we notify you that we have approval to begin selling these plans again.

Our current members will not be impacted by this suspension. However, we will not add new members until these issues have been fully resolved. Those plans specifically affected by this suspension include all individual and group Medicare Advantage (MA), Medicare Advantage with Part D (MAPD), and Prescription Drug Plans (PDP). We will accept Group Retiree members who age in to Medicare eligibility for Groups where we are the sole carrier of a given Medicare product.

Any[COLOR=black][COLOR=black] Medicare Advantage or Part D enrollment forms that were received in the home office on or before 01/12/09 will be processed. For any received in the home office after that time, they will be date stamped and held until we receive final direction from CMS. We hope to have additional direction from CMS by January 14th on this matter.[/COLOR][/COLOR]

[COLOR=black][COLOR=black]It is important you know that the 2.5 million MA, MAPD, Part D and Medicare Supplement members we currently serve can continue to count on us to provide their health benefits. We will continue to sell our Medicare Supplement products, and we will be repositioning those products for continued growth in 2009, while working to retain our existing Medicare Supplement members.[/COLOR][/COLOR]

You can continue to sell our Medicare Supplemental plans in 27 states in which they are offered. Currently, we (through our affiliated companies) are the second largest provider of Medicare Supplemental plans in the country.

Please be assured that you will be paid commissions on your current book of business, plus any new sales made through January 12, 2009.

We know that this will be a difficult period for you as you work hard to service and support all of our members. We want to thank you for all that you do to support our members. We look forward to working with you as we prepare to re enter the market in the near future.

If you have questions, please contact your Broker Sales Director or Agent Support