RESOURCE CENTER

Broker Briefs
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Required outreach for IRS Reporting to begin
The mailing will target subscribers (as well as their covered dependents) if they’ve been identified as having either missing or incorrect SSNs/ITINs since our last outreach in October 2016. Subscribers will be asked to resubmit this information...
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Broker Briefs - August 2017
Monthly recap of updates, changes, or events involving Amerihealth NJ: Out-of-network reimbursement methodology update; LabCorp to become exclusive outpatient lab; Flu vaccines for upcoming season; and more...)
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2018 IRS HSA limits
The IRS has set up Revenue Procedure 2017-37, which determines the inflation-adjusted contribution, deductible, and out-of-pocket spending limits for HSAs for 2018. The limits are as follows...
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New medications added to the Most Cost-Effective Setting Program
Effective 9/1/17, 7 medications were moved from medical program to Most Cost-Effective Setting program; meaning this highly used and expensive medications will only be covered in setting approved by AHNJ pre-certification review.
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Incorrect out-of-pocket maximum in SEH renewals
Small group renewals for customers with effective dates from July thru October 2017 include incorrect 2017 OOP maximum amounts in the renewal’s Current Coverage Costs and Savings Options section. This does not impact claims or actual benefits.
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Medicare Exclusion mailing for group members to begin
Monthly outreach to Medicare-eligible group members encourages them to maximize their health benefits and minimize expenses.
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Broker Briefs - July 2017
Monthly recap of updates, changes, or events involving Amerihealth NJ: AtlantiCare now part of AmeriHealth Advantage and Tier 1 Advantage plans; LabCorp to become exclusive outpatient lab; and more...)
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SEP Pre-enrollment Verification process begins
June 23 marked the first day of availability for the new Special Enrollment Period Pre-enrollment Verification (SEPV) process for the Individual Marketplace.
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Flu vaccines for 2017
Flu season is around the corner and we want to remind you of the ways AmeriHealth New Jersey helps protect our members against the flu.
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Annual notifications to members
Provides members with updates about their health benefits to comply with standards from the National Committee for Quality Accreditation as well as privacy and legal requirements.
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LabCorp to become exclusive outpatient lab
Effective 5/1/18, LabCorp will become the exclusive outpatient lab for all AHNJ commerical HMO, POS, PPO, EPO, and self-funded business; enabling us to deliver a consistent member experience across all markets.
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AtlantiCare now part of AmeriHealth Advantage and Tier 1 Advantage plans
AHNJ large, small, and consumer members enrolled in AH Advantage and Tier 1 Advantage plans will now have access to southeastern NJ’s largest healthcare organization comprised of more than 900 physicians in 90 locations at the Tier 1 level!
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Broker Briefs - June 2017
Monthly recap of updates, changes, or events involving Amerihealth NJ: Annual collection process for MLR and MSP data begins; Out-of-network reimbursement methodology update; and more...)
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2017 Large Group Certification Form Update
The Large Group Certification form will now only be required for new business groups that are currently small group with another health insurance carrier, or considered large group with another carrier, but with less than 51 enrolled contracts.
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Out-of-network reimbursement update for Public Sector
AHNJ will be updating its out-of-network (OON) reimbursement methodology for SEH products and plans with an OON benefit, effective for public sector as of July 2017, upon renewal.
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