It’s that time again… the frantic whirl of both bid submission and material development in anticipation of the upcoming plan year and sales/enrollment activities.

If you are a health plan with multiple contracts and/or plan benefit packages (PBPs), you know how daunting material development and review can be.

If not delayed, the Centers for Medicare and Medicaid Services (CMS) will publish the plan year (PY) 2021 model materials by the end of May. Major changes to the Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) are not anticipated, since they have been approved by the Office of Management and Budget (OMB) through December 2021. Regardless, ensuring accuracy of materials is critical as errors can lead to enforcement actions by CMS. Things to consider when developing PY2021 materials:

• CMS model use
• Following instructions found both in models and separate Health Plan Management System (HPMS) memo(s)
• Applying the correct benefits to all of the documents
• Submission and distribution timelines
• Including fulfillment activities
• Technology requirements (website changes)

How We Can Help

GHG has been assisting our clients with both development and review of required materials for over a decade. We have a long, successful history of supporting these efforts. Our team undergoes re-training every year prior to deployment of any engagement, and we have a standardized process in place that is adaptable to any of your particular needs. In addition, we have HPMS access and can submit materials on your behalf. Contact us today to discuss how we can best support you.