Presented by: Aetna Small Group · TITLE OF PRESENTATION 8 Billing Bills run the 3rd Saturday of every month for 1 st of the month business • New Business-most 1st bill packages

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Presented by:Rachel Stevens, Manager

Bob Moore, Renewal Specialist

David Berky, Renewal Specialist

Imran Khan, Broker LiaisonJanuary 2012

How to Get Things Done with Aetna Small Group

TITLE OF PRESENTATION

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Dedicated Broker Support Overview• 1. New business quoting• 2. Billing & Enrollment• 3. Renewal & Rating• 4. License & Appointment• 5. Commissions• 6. Claims

Online Tools via ProducerWorld• 1. Download Frequently Used Documents • 2. Order Marketing Materials• 3. Access renewals and quote additional

alternates• 4. Broker Portal for enrollment and billingadministration

AGENDA


3©2012 Aetna

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The Regional Service Centers are dedicated to delivering best-in-class service to our brokers and plan sponsors through accurate, timely and professional support service.

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Aetna Service Centers ― Mission Statement

Broker & General Agent Phone Support


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Menu Options

2. Billing & Enrollment

5. Commissions3. Renewal &Rating

Answers commissions questions/issues

Answers billing, enrollment, & eligibility questions/ issues

Answers questions on collections

Answers licensing and appointment questions/issues

Broker or General Agent

Call

MenuOption

SupportContact

ServiceActivities

Plan SponsorServices

CoreCompensationSales Support Team

6. Claims4. Licensing & Appointment

Claims

• Answer renewal & alternate plan questions

• Answer renewal procedural questions

• Cross Sales

Sales Support Team

Answer questions on products, policies, and procedures

Support on broker self-serve tools such as fulfillment & quoting

Resolve general questions/issues

Forward/ escalate issues to appropriate departmental supervisors

1-866-71-AETNAHours of operation: 8 a.m. – 5 p.m. ET

Monday through Friday

Licensing &Appointment

Answers member & claim questions/issues

When calling, please have the following information:

a) Member Name

b) Member ID or Social Security Number

c) Member Date of Birth for each member for whom the requestor is inquiring information about.

1. New Business


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New Business Quoting

Utilize self-service quoting tools Quote early--first in/first outWatch your out-of-state

membership Tips for efficient prescreens L&A up to date

Contact Information: Email: [email protected]

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New Business Installation

Reference and complete underwriting checklist• Copy of the initial premium check or ACH form not provided• Incomplete sections of the master and employee applications• Missing Prior Carrier bill• The number of applications received is less than the number of eligibles listed on

the master application

Submit 15 days prior to the effective date

Electronic submission• No more than 8 mb. per transmission• No acknowledgement means no receipt


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BillingBills run the 3rd Saturday of every month for 1st of the month business

• New Business-most 1st bill packages are received 60 days after the effective date• Existing Business with plan changes ― 1st bill will have ‘old’ rates, 2nd bill will reflect

the plan change

Review billing packages monthly, retroactivity not allowed over 60 days• Contact our billing team with any questions• Contact Sales Support to escalate issue

Paperless payment• eBilling via our Plan Sponsor Portal for customers with original effective dates of

11/01/11 or later• Call the billing and enrollment department to pay via phone


©2012 Aetna

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Eligibility/Enrollment

Use our Broker PortalSM (eEnrollment) for Small Group eligibility maintenance Use Paper submissions only when

necessary• Complete form in its entirety• Plan selections noted on enrollment form for all

products• Legible• Signed by EE/ER• SSN/DOB

Be aware of ‘service area’ requirements

Contact Information: Online: Producer World/Broker Portal Email: [email protected] Fax: 866-847-4039

©2012 Aetna

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Renewals Use Producer World®/Quoting Renewal

System (QRS) to obtain early renewals with plan alternates.

Contact your Renewal Specialist• Strategize for plan alternates• Remote open enrollment support (as appropriate)• Cross-sell support

Required Paperwork for Renewal Process• Pre-Renewal--Return EVF (Employer Verification Form)

to address on form • By Renewal Date--Plan Sponsor Signature Page• By Renewal Date--Cross-sell paperwork


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Commissions

Sign up for electronic funds transfer (EFT)Make sure you are licensed and appointed in each state in

which you write business• Manage your appointments online via Producer World,

Self-Service Center, Your Licenses and Appointments Review commission statements monthly, retroactivity not

allowed over 60 days


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Claims Members have access to submit questions on claims via Aetna

Navigator®

– If unable to resolve issue, member is the only person who may initiate an appeal– Appeals process is time sensitive and highly regulated

If you do call into the claims area team on behalf of a member’s claim:– Must have a HIPAA release signed by the member– Have all member information; name, DOB, member ID; date of service, type of

service, etc. Be mindful of your group’s TEFRA status to determine primary payor

Sales Support does not have access to claims data and does not have authority to make any exceptions

Contact Information: Email:

– [email protected]– [email protected]

©2012 Aetna

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Online Broker Tools via Producer World


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Producer World Access Tips

• Agency principle must register and delegate authority

• Different access levels are available, ie: quoting/commissions/billing & enrollment

• For Technical Assistance contact the Producer World HelpDesk: – 1-800-225-3375– eBusiness Technical Assistance – 866-910-9895

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Frequently Used Documents

• Log in to Producer World

• Select “Small Group”• Select appropriate link

ie: forms/plan designs/underwriting rules

• Select state from the dropdown menu

• Download and Save your document

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Marketing Materials

• Log in to Producer World• Select “Small Group”• Select “Order Enrollment

Materials”• You will be linked to a

separate fulfillment website to place your order

• Orders are filled within 24-48 hours

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Quoting and Renewal Access

• Log in to Producer World• Select “Small Group”• Under Quoting,

Underwriting & Enrollment select “Quoting & Renewal Center”

• You will be linked to a separate quoting & renewal site to add new groups and pull renewals

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Broker Portal—Billing & Enrollment

• Log in to Producer World• Select “Small Group”• Under Quoting,

Underwriting & Enrollment select “eBusiness”

• You will be linked to our Broker Portal for Billing and Enrollment functionality

©2012 Aetna

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© 2010 | Benefitfocus.com, Inc. 19

xx


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View Plan Sponsor Invoice

© 2010 | Benefitfocus.com, Inc. 21Billing – View Invoices


Sample Navigation Back to Portal

© 2010 | Benefitfocus.com, Inc. 23Billing – back to home page banner

Add/Edit Subscribers & Dependents

© 2010 | Benefitfocus.com, Inc. 24Enrollment – HR Role Option 2


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Thank you for joining us today! We appreciate your participation

and your business with Aetna Small Group!

Contact us at:1-866-71-AETNA

Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company and its affiliates (Aetna).

This material is for illustrative purposes, is intended for brokers only, and may not be distributed to plan sponsors or members. This material is not an offer or invitation to contract. Rates and benefits vary by location. Information is believed to be accurate as of production date; however, it is subject to change.

©2012 Aetna

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