Arkansas Works Updates (updated November 21)
Arkansas Works Update #1
Agents enrolling members through the new Arkansas Works portal may have noticed these enrollments have not yet displayed on their status reports. Arkansas Blue Cross and Blue Shield (and all other carriers) has yet to receive an enrollment file from the state since mid October. Typically, we receive files and you see activity on your reports on a regular basis.
- You will begin seeing activity on your Arkansas Works business.
- The initial file will only include catch-up activity for 2017. The bulk will be enrollments and terminations for November 1 and December 1.
- We don't know when the state will begin sending January 1, 2018, plan selections for new and existing Arkansas Works members, but hope and expect this will quickly follow the processing of the referenced catch-up file.
- Because we have not received any enrollments for Arkansas Works, please do not send us agent of record (AOR) requests for these. As instructed, these new AOR forms should be used for Arkansas Works enrollments you submitted but a system issue prevented you from being attributed as AOR. Since we have not yet received any enrollments for Arkansas Works, it is not possible for us to know if you have been attributed as AOR. Please hold any AOR forms for Arkansas Works until after we have processed all the November 1 and December 1 enrollments.
- Please hold any January 1, 2018, enrollments you do not see until we begin processing these; it may be mid-December before we begin receiving these enrollments.
- During our training, we highlighted the upcoming changes to Arkansas Works and indicated we would send you more information when it was available. Nothing has changed with status of pending waiver, and we have no news to report. If/when the Arkansas Works amended waiver is approved, we will share the details, timeline, etc. As for now, the current eligibility rules apply. This means that members between 100% and 138% of federal poverty level (FPL) will continue receiving $13 bills. We will let you know if this changes.
Arkansas Works Update #2The Arkansas Department of Human Services (DHS) has switched to a new system, and there are some major issues we need to report. They are working to correct any problems. Below is a summary and the current plan communicated from DHS.
Arkansas Blue Cross received a termination file of 8,022 terminations/cancelations for November 1 and 7,815 terminations/cancelations for December 1.
- Though these are higher than normal, we do normally receive a high number of terminations each month.
- What is unique is Arkansas Blue Cross has not received a corresponding switch/add file. Many on these monthly termination files are immediately reinstated into a new Arkansas Blue Cross Arkansas Works plan (i.e., going from 100%-138% plan to below-100% FPL plan and vice versa). These changes are usually all done behind the scenes.
DHS told carriers (Arkansas Blue Cross, Ambetter and QualChoice) that a portion of these November 1 and December 1 terminations are still eligible and will be reinstated. Per DHS officials, we believe most have access to Medicaid while waiting to be reinstated to the carrier from which they were termed. Unfortunately, we cannot tell you which members or when we will get this file.
- DHS is “hoping” to have the approvals for November 1, December 1 and January 1 to carriers by December 15.
We understand this is frustrating. About 1,500 of these terminations have agents attributed. We had to send termination letters to these members, and they will be confused and alarmed. Most have not received termination letters from DHS because they are not being terminated. Our primary concern is how to help these inquiring members concerned about coverage eligibility, and how they can seek the coverage they need.
We're directing all inquiries to DHS-affiliate AFMC at 1-888-987-1200.
You will see incremental Arkansas Works approvals come across your status reports over coming days/weeks, but it is the big auto-assignment/reinstatement file that will bring relief to your impacted clients.
- Information on the grandmother/grandfather contract number changes we reviewed in our training is coming. You will see some changes to impacted members on your Blueprint for Agents Current Enrollment Listing in early December. Details and FAQs will be shared in the next couple of weeks in advance of this change.
- The health risk assessment (HRA) questions are now at the end of all U-65 medical e-app submissions, which will easily allow you to capture this information during the new enrollments and/or active re-enrollments. These submissions help us understand your clients' needs and earn you points toward our 2018 Bonus Program. Many of you have already helped us by completing with your clients.
- In early December, Arkansas Blue Cross will be adding the ability for you to complete the HRA through the member detail page of your current enrollment listing.
- Toward the end of December, all U-65 major medical metallic members will receive a new ID card, regardless of whether they made a plan change. No action is required, we just wanted you to be aware.
- We will share more information and FAQs in a few weeks on the new Member Rewards Card, which will be available to your Arkansas Works clients who are our members that complete a free wellness visit with their PCP in 2018. Like the HRA, you earn bonus points toward the 2018 Bonus Program when they do this.