VA Health Benefit Exchange update

Virginia is transitioning its Exchange from healthcare.gov to its own State-based Exchange platform (SBE) – Virginia’s Insurance Marketplace – for plan year 2024. The Exchange requirements include:

• Agents must maintain an active license in Virginia
• Agents must complete a free training and certification course, which opened August 11, 2023, and should be completed by October 10th for November 1st exchange certification
• Agents must create or claim their agent portal – which is available October 10th
• Agents must fill out the Required Agent Information Form (office.com) no later than 5:00pm on 9/7/23. This information is critical for the automated data load that will create accounts and generate notices. This information will also be used to link agents to consumers once the consumer data migration is complete in late September. Agents who are unable to meet this deadline will need to manually build their own book of business once their account has been created.

Kaiser Permanente’s Enhanced Direct Enrollment site will be decommissioned for OE 2024 as the new exchange will not support this function. It can still be used to sell 2023 plans.

Below is a list of resources to support this transition.

• Virginia’s Insurance Marketplace (VIM) Learning Management System Flyer
• Virginia Insurance Marketplace Website for brokers
• FAQs
• Virginia Insurance Marketplace Town Hall meetings for brokers
• Email questions for VA to ExchangeAgents@scc.virginia.gov

Kaiser Permanente copay waiver for children under 5

For several years, Kaiser Permanente has waived the copay for non-preventive primary care visits for children under the age of 5. For regulatory reasons, when plans renew for 2024 this benefit will no longer be offered in Maryland.

Kaiser Permanente will continue to cover in-person preventive care visits, such as for immunizations and annual well-child check-ups, at no charge. Telehealth options like video and phone visits, chat, and e-visits are also covered at no charge.

Kaiser Permanente remains committed to providing convenient, quality care to our members and the communities we serve. Please contact your Sales Executive or Account Management representative with any questions.

Coming soon: New small group self-service prospect quoting and enrollment features on account.kp

Quoting and buying Kaiser Permanente small group plans is about to get easier, and we will be offering you lunch and learn forums as we get closer to the launch date. We will show you how you will be able to quote Kaiser Permanente plans quicker, submit new group enrollment application, and easily track your status.

New Self-Service online features will allow you to:

• Generate quotes for all plans and/or select plans
• Compare high-level plan benefits
• Submit a new group enrollment application in one click
• View the status of in-progress transactions

Be sure to sign in or register on account.kp to get started before the launch of the new features.

Updated process for some off-exchange plan changes

If you have clients who are members of a Kaiser Permanente for Individuals and Families (KPIF) off-exchange plan, please be aware that we updated the switching roles enrollment process for dependents when subscribers terminate their KPIF coverage for group or Medicare coverage. Learn more about this updated process.

Medicaid redetermination video

The U.S. Department of Health and Human Services estimates that 15 million people nationwide, with 3 million in Kaiser Permanente’s commercial footprint, may no longer be eligible for Medicaid coverage and may seek healthcare coverage through other channels. Watch and share the Medicaid redetermination video to understand the process.

Please contact your Kaiser Permanente Sales Executive or Account Management representative with any questions.