Purpose. This webinar is NOT a replacement for the 2016 HCSC/HISC Producer Training & Certification requirements.

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2 Purpose The purpose of this webinar is to help producers prepare for the 2016 HCSC/HISC Producer Training & Certification Program by reviewing milestone dates, changes and requirements. This webinar is NOT a replacement for the 2016 HCSC/HISC Producer Training & Certification requirements. 2

3 Agenda Milestone Dates 2016 Changes Accessing Training Courses, Exams and Forms To Do List Communications Continuing Education Credits 3

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5 Milestone Dates 2016 MAPD/PDP Certification Launch 2015 Certification Closes 8/31/ Business Renewal Deadline/Close 2016 Certification Reopens 5

6 Milestone Dates Launch Targeted for early July News for the Blues Newsletter Producer launch Resource page 6

7 2016 Business Renewal Deadline December 23, 2015 at 11:59 p.m. (Sub-Agent) December 30, 2015 at 11:59 p.m. (All Agents/Agencies) In accordance with the guidelines established by the Centers for Medicare & Medicaid Services (CMS), all producers must be trained and certified annually in order to market, sell and/or service and receive renewal commissions on MAPD and PDP products. 7

8 2016 Business Renewal Deadline CMS guidance for all policies sold after the 2008 plan year states that producers must be certified annually in order to receive renewal compensation Failure to complete 2016 HCSC/HISC Producer Training & Certification requirements by the established deadlines will result in: Blue Cross MedicareRx and Blue Cross Medicare Advantage (where applicable) Book of Business for CYs 2009 and forward being moved to an HISC House Account Blue Cross MedicareRx and Blue Cross Medicare Advantage (where applicable) Book of Business is NOT returned if certification occurs after December 30, 2015 deadline or in a subsequent year 8

9 More Milestone Dates 2015 Certification Closes August 31, 2015 (all 2015 courses removed from to-do list) 2016 Certification Closes (Renewal Deadline) December 30, 2015 at 11:59 pm Access is disabled 2016 Certification Reopens January 4, 2016 Applicable for February 2016 effective dates and beyond Do not regain lost Blue Cross MedicareRx / Blue Cross Medicare Advantage Book of Business 9

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11 AHIP Operating System Compatibility Internet Explorer 8, 9 & 10 Mozilla Firefox current version + previous 2 versions Safari 5 or higher Chrome Adobe Acrobat Reader 10 Shockwave 11 Flash 10 11

12 ComplianceWire Operating System Compatibility Internet Explorer 7, 8, 9, & 10 Mozilla Firefox current version + previous 2 versions Safari 5 or higher Chrome Adobe Acrobat Reader 10 Shockwave 11 Flash 10 Call the HCSC Help Desk at if you do not have any of the software or have problems accessing the training. 12

13 Technical Support AHIP Technical Support ComplianceWire Technical Support (passwords, browser issues) HCSC Commission Certification Information

14 Training Platforms AHIP Platform Access Link If you have never used the AHIP platform, create a new account User ID: National Producer Number (10-digit NPN#) Example: NPN # is , place zeros in front to equal 10 digits: Password: User generates at profile set-up 14

15 Training Platforms ComplianceWire Access Link Login Information Prior Users: User ID: 10-digit NPN# Password: Previously Created Password New Users: User ID & Password: 10-digit NPN# Company Code HCSCProducers (not case sensitive) 15

16 Login Access for AHIP and CW Access Certification Links Via: Certification Launch MAPD/PDP Producer Certification Resource Page ource_page.html Blue Access for Producers (BAP) Click on the Certify to Sell 2016 MAPD/PDP Products link Available July 1 16

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18 Objectives Set expectations Deadlines Certification launch and closure Requirements Courses and Exams to be completed Communications s, newsletters and notifications Requirements 2016 CMS Producer / Broker Training Guidelines are met in all courses, exams and forms 18

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20 AHIP Courses / Exam Courses Medicare Basics Medicare Marketing Rules and Regulations Fraud, Waste and Abuse Exam 2016 Final Exam and 2016 FWA exam Must pass with a 90% proficiency score 20

21 AHIP Fee Information HCSC has partnered with AHIP to provide a seamless training environment for completing three parts of the annual Medicare training required by CMS; use of the AHIP platform requires a fee. Producers who log in to AHIP via a designated HCSC/AHIP link will pay $125, a discount from the standard $175 rate. Producers may begin AHIP training as early as Monday, June 22, 2015 Once the AHIP portion of the training is complete, producers must transmit all AHIP completions via the designated HCSC/AHIP link to HCSC to receive credit for the applicable courses/exams and to complete the remaining tasks of the certification process. Detailed transmittal steps have been provided in prior communications and will be available on Blue Access for Producers (BAP). 21

22 ComplianceWire Course / Exam / Forms Sales Agent Requirements Course MAPD/PDP Product Course and Exam Producer or Agency Certification Form Producer or Agency Amendment (Does not apply to Sub Producers) 22

23 Sales Agent Requirements Course Sample Topics* Reinforce CMS training requirements Introduce and explain deadlines Review communications *Topics not all inclusive 23

24 MAPD / PDP Product Course Sample Topics* MAPD and PDP Product specific Plan designs, formulary and pharmacy network Marketing processes Enrollment Operational processes (e.g., Appeals / Grievances) Available collateral and ordering process Enrollment and billing options Monitoring Program *Topics not all inclusive 24

25 MAPD / PDP Product Exam Quizzes and Challenges and Exams oh my! Quiz Challenge Exam Location After each course module At the end of each course After the Challenge Passing Score 85% 85% 85% # of attempts to achieve 85% As many as needed As many as needed 3 Random questions pulled from pool No No Yes 25

26 AHIP and CW Exams Passing score is 85% for CW on all exams, per CMS guidelines Passing score is 90% for AHIP on exam, per CMS guidelines Three attempts per exam No lockout period Can re-take exam immediately after a failed attempt Please note: Exam questions are randomly selected; not all questions are the same for each attempt 26

27 Exams: AHIP and CW Answer all exam questions The exam cannot be submitted unless all questions are answered and the SUBMIT button has been selected If a user stops in the middle of an exam and exits the program or is locked out due to inactivity (20 minutes), the exam will not count as long as the SUBMIT button was not selected Unlike the courses, the exam will start from the beginning 27

28 AHIP Certificate 28

29 ComplianceWire Certificate 29

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31 Certification Form After courses and exams Completes certification portion of the 2016 HCSC/HISC Producer Training & Certification requirements Attest to various questions Some responses may initiate a call from Producer Monitoring Enter Producer/Agency first and last name 10-digit producer/agency NPN # 31

32 Amendment If Applicable Not applicable to all users Individual and Agency Principal users only After courses, exams and Certification Form Confirms the contract between HISC and producer or agency Includes Compensation Enter Producer/Agency first and last name 10-digit NPN# 32

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34 2016 To Do List Will not allow the user to complete a task out of order [Detail] Go here to view completed course content Task name (course, exam or form) *Please disregard automated ComplianceWire task deadline. HCSC required deadline is Dec. 23, 2015 for sub producers and Dec. 30, 2015 for individual producers and agencies. 34

35 2016 Individual Producer 2016 AHIP Course Sales Agent Requirements MAPD/PDP Product course MAPD/PDP Product exam Certification Form Medicare Amendment 35

36 2016 Sub Agent 2016 AHIP Course Sales Agent Requirements MAPD/PDP Product course MAPD/PDP Product exam Certification Form Note: Sub Agents are not deemed certified until the Agency Principal completes the agency certification requirements 36

37 Agency Curriculum: Non-Selling Principal (AHIP & CW Platforms) Subagent Curriculum 2016 AHIP Course (Individual NPN) Sales Agent Requirements (CW, Individual NPN) MAPD/PDP Product course (CW, Individual NPN) MAPD/PDP Product exam (CW, Individual NPN) Certification Form (CW, Individual NPN) Note: Agency curriculum will be available on the ComplianceWire launch date Agency Curriculum Certification Form Medicare Amendment 37

38 Agency Curriculum: Selling Principal (AHIP & CW Platforms) Subagent Curriculum 2016 AHIP Course (Individual NPN) Sales Agent Requirements (CW, Individual NPN) MAPD/PDP Product course (CW, Individual NPN) MAPD/PDP Product exam (CW, Individual NPN) Certification Form (CW, Individual NPN) Note: Agency curriculum will be available on the ComplianceWire launch date Agency Curriculum Certification Form Medicare Amendment 38

39 2016 Commissions for Individual Producers MAPD Initial YR: $429 Renewal YR: $215 PDP Initial YR: $63 Renewal YR: $32 39

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41 Certification Resource Page For your convenience, we ve created an online resource page that will serve as your single source and guide to certification training throughout the remainder of the certification calendar year. Here you can find: The most up-to-date certification news Information about your login instructions Transferring your AHIP credits to HCSC Useful links 41

42 Notification of AHIP Completion NEW! Message Confirms completion of all 2016 AHIP Producer Training & Certification Requirements How Via When ed approximately 1-3 business days after certification completion Who Individual Producers Sub Agents Agency Principal (only after completing their requirements) 42

43 Notification of Certification Completion Message Confirms completion of all 2016 HCSC/HISC Producer Training & Certification Requirements Includes link to supply portal How Via When ed approximately 1-3 business days after certification completion Who Individual Producers Sub Agents Agency Principal (only after completing their requirements) Keep copy for records 43

44 Notice of Certification Incompletion Message States there are outstanding items for 2016 HCSC/HISC Producer Training & Certification Requirements One task on the to-do list must be completed to alert a notice of certification incompletion How Via When Approximately 7 days after user begins 2016 HCSC/HISC Producer Training & Certification Program Who Individual Producers Sub Agents Agencies 44

45 Notification of Exam Failure Message Informs producer they failed one of the exams after three attempts thus failing the certification Cannot market, sell or service 2016 Blue Cross MedicareRx and Blue Cross Medicare Advantage plans Blue Cross MedicareRx and Blue Cross Medicare Advantage book of business (CYs ) is being moved to HISC house account How Via certified letter When Mailed approximately one week after exam failure Who Individual Producers Sub Agents Agency Principal 45

46 Book of Business Move Notification Message Due to failure to complete certification requirements your book of business has been moved to the HISC House Account How Via and letter When Mailed in January Who Individual Producers Agency Principal 46

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48 Continuing Education Credits Great News! During AHIP course registration, producers will have the option to request the filing of applicable state CE credits for completing the AHIP portion of the certification process. Should you opt to receive CE credits for completing the AHIP portion of the training, the applicable fees must be paid at the individual producer level by credit card. IL Approved 6 $23.00 MT Pending - $26.00 NM Approved 6 $20.00 OK Approved 5 $26.00 TX Pending $

49 Additional Information SM Service Mark of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans Registered Service Marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans Blue Cross MedicareRx is a prescription drug plan provided by HCSC Insurance Services Company (HISC), an independent licensee of the Blue Cross and Blue Shield Association. A Medicare-approved Part D sponsor. Blue Cross Medicare Advantage HMO and HMO POS plans in Illinois and New Mexico and PPO plans in Montana, New Mexico and Oklahoma are provided by Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC). Blue Cross Medicare Advantage Dual Care is an HMO Special Needs Plan provided by HCSC. Blue Cross Medicare Advantage PPO plans in Texas are provided by HCSC Insurance Services Company (HISC). Blue Cross Medicare Advantage HMO and HMO POS plans in Oklahoma are provided by GHS Health Maintenance Organization, Inc. d/b/a BlueLincs HMO (BlueLincs). HCSC, HISC, and BlueLincs are independent licensees of the Blue Cross and Blue Shield Association. HISC and BlueLincs are Medicare Advantage organizations with a Medicare contract. HCSC is a Medicare Advantage organization with a Medicare contract and a contract with the New Mexico Medicaid program. 49

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