Medicare Broker Resources

Tools and resources to support Medicare sales, enrollment and member support

Latest Broker News

More options for your clients. More support for you.

AEP is underway, and we’re here to help you make the most of every client conversation between now and Dec. 7.

We know your job doesn’t end when your client enrolls. Ours doesn’t either. We’re committed to delivering excellent service and support to your clients after enrollment, helping you feel confident putting Jefferson Health Plans in front of the people who count on you.

Have clients with Medicare and Medicaid? Start with D-SNP.

Many of the clients you serve may be eligible for $4,330 in extra benefits. For individuals with both Medicare and Medicaid, a D-SNP plan from Jefferson Health Plans could offer an excellent combination of low costs and extra benefits to help cover the cost of food, utilities, OTC products, and other health-related spending.

Special: Our flagship D-SNP, features competitive supplemental benefits across benefit categories, including a $215 monthly food and utilities allowance, $5,000 dental allowance, and $250 vision allowance.
Select: Ideal for clients looking to maximize their food, utilities and other health spending benefit, with a $315 monthly food and utilities allowance, and a $550 Flex Card for dental, vision, and hearing services.
Dual Pearl: Our partial dual-eligible plan features dental implant coverage along with strong supplemental benefits and a $100 monthly food and utilities allowance and a $200 vision allowance.

All three D-SNP plans feature $0 medical copays and $0 copays on many covered drugs.

And there’s an added opportunity for you: Complete an HRA with your client at the time of enrollment and receive an administrative payment for each new Jefferson Health Plans member. Completing the HRA also gives your client access to Special Supplemental Benefits for the Chronically Ill (SSBCI). HRAs must be completed for members to qualify for SSBCI benefits when their coverage starts.

More choices for your Medicare clients

Jefferson Health Plans also offers competitive HMO options:

Prime in Pennsylvania: An affordable monthly premium, competitive supplemental benefits and a strong option for clients who qualify for Extra Help. In fact, the premium can be $0 for those with Extra Help.
Complete in Pennsylvania: A $0-premium plan with competitive medical copays plus dental, vision, and hearing coverage.
Elite in New Jersey: A $0-premium option with competitive medical copays and a Flex Card for dental, vision, and hearing services.

Let’s make the most of AEP together. When Jefferson Health Plans takes great care of your clients, it makes your job easier and helps you build the lasting client relationships that drive your business.

Submit enrollment applications through Connecture.

2027 sales kits and marketing materials are available. If you need materials for upcoming client conversations, order through the marketing storefront.

Thank you for your partnership, and let’s keep building a strong AEP together!

Jefferson Health Plans is making a change to how Medicare Advantage member ID cards are distributed for the plan year starting Jan. 1, 2027. Use the information below to help your clients know when to expect their new ID cards.

Medicare Advantage members enrolling in a 2027 plan during the Annual Enrollment Period (AEP) will receive their ID cards in December, about one month before their effective date. This change helps to ensure that members have their ID cards on time so they have them in January once their coverage becomes effective.

New members enrolling with effective dates of Nov. 1, 2026, or Dec. 1, 2026, will continue to receive their plan year 2026 ID card shortly after enrollment. If they renew with Jefferson Health Plans, they will receive a new card in December for plan year 2027.

In addition, existing members continuing their coverage with Jefferson Health Plans in 2027 will receive a new 2027 ID card in December to reflect the new PBM and copay changes.

Members should begin using their new cards on Jan. 1, 2027.

What to Tell Members

New enrollees should expect to receive their ID card before their coverage effective date. They will receive enrollment confirmation from Jefferson Health Plans after enrolling.
Renewing members will receive a new ID card with new pharmacy information due to our PBM change in December and should begin using it after Jan. 1, 2027.

Thank you for helping members understand what to expect during this year's enrollment season and ensuring a smooth transition into 2027.

Our Sales Kits and marketing materials for PY2027 are ready! Please read the instructions below on how to log into our storefront. The link to the storefront is below.

If you are a new user, follow these instructions:

Contact Alexus Robinson to ensure your information is added to the Broker Additions excel sheet.
Look out for an email from programmingsupport@commanddirect.com with login instructions

For reference, below are the login instructions in the email automatically sent to new users once their account has been created:

Go to https://login.commandprinting.com
Enter your email address as the username
VERY IMPORTANT - Select FORGOT PASSWORD – important not to enter a password as that will result in continued failures
Enter the OTP code that is sent to the email provided
Set the password and you will be on the landing page to access the portals.

Login instructions for existing users:

Go to https://login.commandprinting.com
Enter your username (your email address)
Enter Password (if prompted)
Click Command Storefront option

For many Dual Eligible Special Needs Plan (DSNP) members, Supplemental Special Benefits for the Chronically Ill (SSBCI), such as food and utility benefits, can play an important role in supporting their health and well-being. As you prepare for the upcoming Annual Enrollment Period (AEP), it's important to understand recent CMS rule changes that affect how members qualify for these benefits.

What's changed?

CMS now requires health plans to verify eligible chronic conditions before SSBCI benefits can be activated. Members can no longer self-attest to qualifying conditions. Instead, eligibility must be confirmed through:

Claims data received by Jefferson Health Plans, or
Full completion of an accurate Health Risk Assessment (HRA) that discloses a qualifying condition

In addition, Jefferson Health Plans can no longer offer a grace period for submitting proof of eligibility. That means members who enroll during AEP and do not have a verified qualifying condition by Jan. 1, 2027, will not have access to food and utility benefits at the start of the plan year.

Completing an HRA

Brokers can still help members complete an HRA during the enrollment process using the Jefferson Health Plans HRA form.
Click here to access the HRA form.
Brokers will continue receiving administrative payments for completed and accepted HRAs for DSNP members.
The following sections will now be required:
Member Information
Wellness Health Planning
Health Information
Activities of Daily Living
If a member’s HRA is completed and approved before their effective date and shows they have a qualifying health condition, they can use their SSBCI benefits starting on their effective date.

What we need from you

To ensure a smooth member experience and avoid delays in accessing valuable supplemental benefits, we strongly encourage brokers to complete an HRA with every DSNP enrollee at the time of enrollment.

Taking a few extra minutes during the enrollment process can help your clients receive the benefits they're entitled to on day one.

CMS has finalized several changes to Scope of Appointment (SOA) requirements that will take effect October 1, 2026. While these updates provide greater flexibility for brokers, SOAs remain a required part of the Medicare enrollment process.

What's Changing

The 48-hour waiting period between completing an SOA and holding an appointment has been eliminated.
For appointments that do not occur in person, an electronic signature, electronic record, audio recording, or audio/video recording can satisfy the requirement for a documented SOA.
Brokers may now collect SOAs at educational events.

What Stays the Same

SOAs remain valid for 12 months from the date signed.
Brokers may collect SOAs before October 1 for upcoming plan year offerings, such as HMO and D-SNP products.
Discussions must be limited to the plan types identified on the SOA. If a beneficiary wants to discuss additional plan types, a new SOA must be completed before those discussions occur.

Action Required

Although a few rules have changed, brokers are still required to obtain and maintain SOAs when meeting with Medicare beneficiaries.

Please continue to ensure SOAs accurately reflect the products being discussed and are submitted according to the requirements of the enrollment platform.

Certification is now open for PY2027. Jefferson Health Plans encourages you to complete certification and become Ready to Sell as soon as you can.

You can complete your training and certification through our broker portal, EvolveNXT. Once you log in, you'll be able to access the training module. After reviewing the training, you will need to take a short quiz and score 85% or higher. This, along with the successful completion of AHIP for 2027, will certify you as Ready to Sell for Jefferson Health Plans for PY2027.

Along with the certification, Evolve is a complete experience for brokers, and will be a valuable resource for you during AEP and for managing your clients throughout the year.

Access Evolve

America's Health Insurance Plans (AHIP) training program meets CMS requirements and positions you to help your clients make a smart health insurance decision. Training for 2027 is now available.

You'll get $50 off if you access AHIP training via the link below.

Reminder

AHIP certification is required to be designated Ready-to-Sell with Jefferson Health Plans.

Receive $50 off AHIP Training

Jefferson Health Plans (JHP) will be making some changes related to the administrative fee paid to agents that are directly or indirectly associated to the completion of Health Risk Assessments (HRAs).

Starting with an effective member date of July 1, 2026, JHP will only provide the administrative payment for the completion and validation of an HRA for the following plans:

Jefferson Health Plans Special (HMO D-SNP)
Jefferson Health Plans Dual Pearl (HMO D-SNP)
Jefferson Health Plans HMO Select (HMO D-SNP)

The change is to discontinue paying the administrative fee for completing an HRA for members with enrollment dates after June 1, 2026, for effective dates of July 1, 2026, and beyond for the following plans: