1. 2016 Individual Medicare Broker Training
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2016 Individual Medicare Broker Training
Heartland Market
For Agent Use Only. Not to be shared with Medicare beneficiaries. Aetna Inc. Proprietary and Confidential. 1
XX.XX.XXX.X (XX/15)

2. Service Area Heartland Market Service Area:
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Service Area
Heartland Market
Service Area:
AR: Benton, Carroll, Crawford, Franklin, Garland, Logan, Madison, Montgomery, Pulaski, Scott, Sebastian, Washington
KS: Allen, Anderson, Atchison, Bourbon, Butler, Cherokee, Douglas, Franklin, Harvey, Jackson, Jefferson, Johnson, Labette, Leavenworth, Linn, Miami, Montgomery, Osage, Pottawatomie, Sedgwick, Shawnee, Wabaunsee, Wyandotte
MO: Barry, Barton, Bates, Benton, Caldwell, Carroll, Cass, Cedar, Christian, Clay, Clinton, Dade, Dallas, Douglas, Greene, Henry, Hickory, Jackson, Jasper, Johnson, Laclede, Lafayette, Lawrence, Livingston, McDonald, Newton, Ozark, Pettis, Phelps, Platte, Polk, Pulaski, Ray, St. Clair, Saline, Stone, Taney, Vernon, Webster, Wright
OK: Canadian, Cleveland, Grady, Kingfisher, Lincoln, Logan, Muskogee, Oklahoma, Pottawatomie, Tulsa
Plan designs and service areas described in this document are pending government approval and are therefore subject to change. For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited and may be grounds for termination of your agreement with Aetna. 14

3. How to be “ready to sell” for 2016
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How to be “ready to sell” for 2016
To become “ready to sell” our 2016 Aetna and Coventry Individual MA/MAPD and PDP products and receive commissions, you’ll need to complete several requirements prior to marketing or selling:
CERTIFICATION: You’ll need to successfully complete the 2016 Aetna Individual Medicare annual certification process.
Access our certification site via Producer World, the Broker Portal, or directly:
CONTRACTING:
New agents: Agents who haven’t contracted to sell our Individual Medicare products before must complete and submit a 2016 contract package online through our nomoreforms contracting site.
Existing agents: Agents who are currently contracted and ready-to-sell for 2015 do not need to re- contract unless they are changing hierarchy or contract level. If you need to change hierarchy or contract level, you’ll need to request those changes in nomoreforms.
Access nomoreforms via Producer World, the Broker Portal or
Plan designs and service areas described in this document are pending government approval and are therefore subject to change. For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited and may be grounds for termination of your agreement with Aetna.

4. How to be “ready to sell” for 2016 (continued)
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How to be “ready to sell” for 2016 (continued) 3.
LICENSING AND APPOINTMENT: You’ll need to be properly licensed in states where you sell. You’ll also need to be properly appointed by Aetna for all products you intend to sell. New agents will also need to pass a background check. 4.
RECEIVE A READY-TO-SELL NOTICE: You’ll receive a ready-to-sell notice confirming your ready-to-sell status. It will list out the specific states and products that you’re ready to sell and for which you can receive commissions. You’ll receive separate ready-to-sell notices for Aetna and Coventry Medicare products.
Note: Uplines and principals must be fully certified, licensed and properly appointed in ALL states and markets where their downlines agents or employees intend to sell.
Plan designs and service areas described in this document are pending government approval and are therefore subject to change. For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited and may be grounds for termination of your agreement with Aetna.

5. How to submit enrollment applications – Coventry
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How to submit enrollment applications – Coventry
Mail/Fax
Each Coventry Medicare plan has a unique fax number and mailing address. Be sure to submit enrollment applications and Scope of Appointment forms to the right place. The plan fax number and mailing address are shown on the enrollment form. Use the Coventry (or First Health Part D) fax coversheet available on the Broker Portal when faxing enrollment forms. Fax one enrollment form at a time (DO NOT BATCH FAX).
Online through our Ascend Virtual Sales Office app
Available for use on any device—including your laptop or tablet—that runs with an iPad platform (iPad 2 or later model running iOS7 or later version) or a Windows platform (Windows 7 or later and x86 processor). Contact the Broker Services Department to request access. Or, starting in mid-August, you can request access through the Broker Portal.
Plan designs and service areas described in this document are pending government approval and are therefore subject to change. For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited and may be grounds for termination of your agreement with Aetna.

6. The Ascend Virtual Sales Office app
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The Ascend Virtual Sales Office app
Now available on the iPad, laptops and other Windows 7 devices!
Capture client information.
Conduct PAPERLESS sales presentations.
Easily utilize the Aetna and Coventry sales presentation videos.
Take and submit enrollment applications in REAL TIME (eliminate turnaround-time issues).
Decrease application pending issues.
Contact the Broker Services Department to request access. Or, starting in mid-August, you can request access through the Broker Portal.
Plan designs and service areas described in this document are pending government approval and are therefore subject to change. For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited and may be grounds for termination of your agreement with Aetna. 49

7. Enrollment application turnaround time
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Enrollment application turnaround time
We must receive completed enrollment applications within 2 calendar days!
A signed Medicare enrollment application must reach us within two calendar days of when you receive it from the beneficiary (this is usually two calendar days from the signature date).
The two-calendar-day requirement ensures we have enough time to review applications and send them to CMS for processing within the CMS-required timeframe.
Our Agent Oversight team monitors timely receipt of all Medicare enrollment applications. If you miss the two-calendar-day turnaround time three times within a CMS contract year, you won’t be able to sell our Medicare products for the remainder of the year.
Plan designs and service areas described in this document are pending government approval and are therefore subject to change. For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited and may be grounds for termination of your agreement with Aetna.

8. Welcome calls to new members and members with a plan change
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Welcome calls to new members and members with a plan change
The member experience begins with members having the information they need to successfully use their benefits.
During the welcome call, we want to help members understand their plan benefits and get answers to any questions they have. Some of the topics might cover include:
Doctor – who’s your doctor? Based on your plan, let’s see where he/she is in our network.
Pharmacy – do you use a local pharmacy or mail order? Let’s review the preferred pharmacy list if you prefer and see how we may be able to help you save money here.
Medications – are you familiar with the formulary list of medications? Brand or generic, tiers, specialty or limited use, look at the formulary and match what medications you take right now and review with your doctor or pharmacist if you have a question.
Premium or copays or coinsurance – what questions do you have? Here’s what you should expect with your (HMO/POS/PPO).
Beyond your annual wellness visit and your plan benefits, there are some additional services, including (fitness, hearing, vision etc.).
Plan designs and service areas described in this document are pending government approval and are therefore subject to change. For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited and may be grounds for termination of your agreement with Aetna.

9. Coventry Medicare member tools
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Coventry Medicare member tools
Coventry members can register for My Online ServicesSM to get easy online access to great information and resources about their health plan. They can access:
In-network physicians
Preferred pharmacies
Covered drugs
Claims and explanation of benefits
ID cards
Forms and documents
Secure messaging
Health and wellness tools
Articles
To register, members can go to Members can also get to My Online Services by clicking the My Online Services link at the top of every page on medicare.coventryhealthcare.com.
Plan designs and service areas described in this document are pending government approval and are therefore subject to change. For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited and may be grounds for termination of your agreement with Aetna.

10. Your agent websites Aetna Producer World Coventry Broker Portal
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Your agent websites
Aetna Producer World
Your go-to site for information, tools and reports on Aetna Medicare (MA/MAPD, PDP) products.
Product information
Producer Guide
Reports (i.e., application status)
Compensation information
Sales presentations
Scope of Appointment form
Permission-to-Contact form
Sign-in sheet
Link to order kits
Log in or register at:
Once logged in, click "Individual Medicare" at the top to access all your Individual Medicare information.
Coventry Broker Portal
Your go-to site for information, tools and reports on Coventry Medicare (MA/MAPD, PDP) products.
Product information
Producer Guide
Reports via App Tracker (i.e., application status)
Compensation information
Sales presentations
Scope of Appointment form
Permission-to-Contact form
Sign-in sheet
Link to order kits
Register or log in at: Contact Broker Services at for help. 66

11. How to order 2016 enrollment kits
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How to order 2016 enrollment kits
Starting in mid-August, you can order enrollment kits for 2016 Aetna and Coventry products in one place!
The link will be located on Producer World and the Broker Portal.
To access the kit ordering site via Producer World, login, go to the Individual Medicare page, click the Enrollment dropdown menu, and select the link to order 2016 kits.
To access the kit ordering site via the Broker Portal, login and follow prompts to order 2016 kits.
Kit ordering limits
We set limits on how many kits you can order. If you need more, you can submit a request for more through the kit ordering site.
Plan designs and service areas described in this document are pending government approval and are therefore subject to change. For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited and may be grounds for termination of your agreement with Aetna.

12. Consumer websites www.coventry-medicare.com
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Consumer websites
Use this site to locate Coventry Medicare product information and plan documents such as:
Provider Search
Summary of Benefits
Star Ratings sheets
Plan Guides
Formularies
Note: You can’t use these sites for online enrollments. Use the Ascend Virtual Sales Office app instead.
Plan designs and service areas described in this document are pending government approval and are therefore subject to change. For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited and may be grounds for termination of your agreement with Aetna.

13. Broker Services Department
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Broker Services Department
For assistance with Aetna or Coventry Individual Medicare products (MA/MAPD, PDP), just contact the Broker Services Department. They can help answer your questions about contracting, certification, commissions and more.
The Aetna Medicare Broker Services Department Phone:
Hours: Monday through Friday, 8 a.m. to 6 p.m. ET
Plan designs and service areas described in this document are pending government approval and are therefore subject to change. For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited and may be grounds for termination of your agreement with Aetna.

14. Return to Topics
Local Resources
Springfield Office: S. National Ave Springfield, MO 65810
David Riddle, , (OK/SW MO/AR)
Plan designs and service areas described in this document are pending government approval and are therefore subject to change. For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited and may be grounds for termination of your agreement with Aetna.

15. Return to Topics
Next steps
If you haven't already done so, complete your "ready-to-sell" requirements
AHIP
PDP
All products exam
Order supplies
Broker portal
Download sales presentations (starting in September)
ANOC/Retention
Make your members aware of changes and assist them with issues
Referrals
Be sure to let your members know you are always available to help any of their friend or acquaintences
Marketing
New tools in “Ad Builder” or now called “Print Portal
Plan designs and service areas described in this document are pending government approval and are therefore subject to change. For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited and may be grounds for termination of your agreement with Aetna. 76

16. 2016 Benefits Return to Topics 77
Plan designs and service areas described in this document are pending government approval and are therefore subject to change. For producer use only. Distribution to consumers, other insurers, or any other person or company is strictly prohibited and may be grounds for termination of your agreement with Aetna. 77