This article contains answers to frequently asked questions about the Anthem for SOCA Benefit Plan. Please select any of the links below to view specific questions on each topic:
- General Questions
- Prescreen Questions
- Plans & Pricing Questions
- Sold Group Questions
- Ongoing Management Questions
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General Questions
What is the relationship between Anthem and FormFire in regards to this SOCA MEWA product?
FormFire is contracted by the SOCA MEWA organization to provide and support the MEWA platform’s technology needs. Anthem is the Carrier of choice for the SOCA MEWA, and as such, has a number of requirements for FormFire to fulfill their quoting, compliance obligations and customer service needs. FormFire is an independent company.
How do I get setup as a Broker with SOCA access in FormFire?
You'll need to be approved by Anthem before you have access to the SOCA MEWA product in FormFire. Anthem will contact FormFire with the names of Brokers who are approved to use their MEWA product.
What if my Agency is appointed with Anthem under one name but uses a DBA to contract with FormFire? Will this create issues with using the SOCA MEWA product?
As a qualified and appointed Broker to the SOCA MEWA program, any conflict of DBA names shouldn't be an issue. Your account details with FormFire can be modified if an issue occurs. Please contact FormFire Client Services team with any concerns.
How much does it cost to quote SOCA in FormFire?
If you aren't already a FormFire customer, $99/month is the base SOCA MEWA rate for accessing FormFire and the Group Prescreen system. This fee gives you full access to the tools and Group support needed to qualify, gather MHQ information and fully quote the SOCA MEWA for you and your Groups. Once the Group has selected the SOCA program, the fees for the Group’s participation and 1094/95 tracking is taken over by the Group’s membership in the plan. From that point forward, with the SOCA MEWA product range, there is no further fee to the Broker, and the Broker is able to support the Group according to the Broker’s own service commitment. The Broker and Group are able to add other lines of coverage to the installed Benefits Admin system – in these cases additional fees may apply depending on the Carrier chosen. Please contact FormFire’s Sales team to fully understand the options available.
Why won’t Anthem accept my handwritten forms?
Anthem SOCA MEWA is paperless. All forms must be uploaded through the Document Center for Anthem SOCA MEWA. The Document Center is accessible by selecting the Manage Documents option in the Client menu in the orange context menu next to the Client’s name.
Why can’t I see the Anthem for SOCA Benefit Plan forms? How do I make sure my Client has SOCA enabled?
There are a few steps you will need to take before you will be able to access the MEWA applications and documents in FormFire.
- Select Client Details from the orange box next to the Client's name.
- Select SOCA under MEWA Info. If you are working under a General Agent, you can select your applicable GA after selecting SOCA from the MEWA Info section.
Once all these changes are saved, you can download and view the Anthem SOCA Benefit Plan documents.
Prescreen Questions
Will Employees be required to fill out medical history information even when waiving for SOCA MEWA Prescreens?
No, they will not be required to fill out the medical history information if they are waiving the insurance coverage.
What is an ASO option?
ASO stands for Administrative Services Only plan. The SOCA Benefit Plan is an ASO option available to Employers with a minimum of 2 enrolled and on average no more than 50 total Employees. These Groups must be a member of one of the following chambers: Southern Ohio Chamber Alliance, Northern Ohio Area Chambers of Commerce, Central Ohio Chambers of Commerce, Dayton Area Chamber of Commerce or Youngstown/Warren Regional Chamber.
Who completes the Employer Questionnaire?
Brokers complete the Employer Questionnaire on the Broker Portal. Brokers can review the questions listed on the Employer Questionnaire with your Client to make sure that you're answering them correctly.
The Employer Questionnaire will be split into 3 sections:
- Employer Information
- Prior Medical Coverage
- Eligibility, Participation and Contribution
Refer to the help article titled How Brokers can complete the Anthem for SOCA Benefit Plan Employer Questionnaire for more information.
Where is the Prescreen checklist for the Anthem SOCA MEWA?
The Prescreen checklist is available on the send forms page when Prescreen is selected as the submission type and the Anthem for SOCA Benefit Plan Carrier is selected.
What documents are listed in the Prescreen checklist?
The Prescreen checklist consists of 3 Auto Loaded Documents:
- SOCA Benefit Plan Employee applications
- Census of all eligible Employees
- Employer questionnaire
The Employee applications, Employer Questionnaire, and census will populate automatically in send forms once those have been completed
If you answered Yes on the Employer Questionnaire for the ASO question, you’ll see 1 Broker Uploaded Document:
- If ASO: Claims, Large Claims, and Fixed Costs
The additional document regarding claims, large claims, and fixed costs will need to be attached through the document center and submitted with the rest of the forms.
What are the Rules of Engagement for requesting a Prescreen quote from Anthem for SOCA Benefit Plan?
A Group can join the SOCA Benefit Plan at any point during the year but will renew on a common renewal date of May 1. All requests submitted through FormFire will be sent directly to Anthem. Quote proposals will be returned within 5-7 days from your Anthem sales representative.
The following is required to request a quote from Anthem:
- SOCA Benefit Plan Employee applications including medical
- Census of all eligible Employees
- Employer Questionnaire
- If currently ASO, claims, large claims, and fixed costs are also required
Discounted ancillary plan offerings are also available through Anthem to any Group that joins the SOCA Benefit Plan. The quote proposals, including the discounted rates and benefits, for dental, vision and life are available via the link below. Short-term and long-term disability options are also available. The options available are also included below; however, the quote must be requested from your Anthem sales representative.
If you CC someone on a Prescreen submission, does that create issues with the email going through?
Sending a carbon copied (CC’d) email does not cause any issues in the delivery of items. Currently the facility on the SOCA MEWA send process is tied to the Anthem master password. This is not a password distributed outside of Anthem. FormFire is working on an option to create a new way for the Broker to obtain a full copy of the transmission. At this time, all items that are bundled for sending are viewable through other mean (Preview Forms or in the Client's Document Center), and all transmissions are logged with their send status – viewable through the Sent Forms screen.
Plans & Pricing Questions
My Client is only offering one plan, do I need to add it into FormFire?
Yes, each plan is required to be added to the Group's Manage Plans page. However, pricing is NOT required to be entered.
How can I make the plan selection process easier on my Client’s Employees?
Group Plan Assign is a feature that allow Brokers to affirm the plan elections for their Clients. Once Carrier plans and pricing are obtained through Quote, Brokers will still follow the same steps to assign that plan under Manage Plans. More information on that process is available here.
After the Broker has selected the plan or plans, the Broker will return to the Client Dashboard. More information on the Group Plan Assign process is available here.
How can I see what plan an Employee selected if my Client is offering more than one plan?
FormFire provides Brokers with the ability to download a Plan Selection Report by clicking the link in the a Client’s orange context menu. This excel file will show each Employee and their product selections when using the system for sell (plan selection) and enrollment.
Is it required to add pricing information?
As of 5/26/2020, pricing information will no longer be required to add for your Clients enrolling in the Anthem for SOCA Benefit Plan.
Sold Group Questions
Where do I attach documents for Anthem for SOCA Benefit Plan plans?
Any documents attached for Anthem for SOCA Benefit Plan plans must be added through the document center. The document center is accessible by selecting the Manage Documents option on the Client Dashboard in the orange box next to the Client’s name. Documents can then be added from your desktop by selecting Add Document, then selecting the browse button. There is an article on this process available here: How to use the Document Center. Once loaded, those files will be accessible on the send forms page and you can simply select those documents that need to accompany the submission.
Where is the Sold Group checklist for the Anthem SOCA MEWA?
The documents you will need will depend on whether you are using SOCA for Medical, Dental, Vision, or Life and Disability. The list of what is required for each type of submission can be found here: Anthem for SOCA Benefit Plan required Sold Case submission documents.
In addition, the Sold Group submission checklist is available on the Send Forms page when Sold Group is selected as the type and the Carrier Anthem for SOCA Benefit Plan is selected. The requirements will appear on the right.
What documents are required for a medical Sold Group submission for Anthem SOCA MEWA?
A Medical Case Submission for a Sold Group for Anthem SOCA MEWA requires:
- SOCA Benefit Plan Participation Agreement
- SOCA Benefit Plan Participating Business Acknowledgement Employer Agreement
- SOCA Benefit Plan Employer application (2020 version)
- SOCA Benefit Plan Employee applications with medical (2020 version)
- Signed rates and benefits
- Anthem excel census enrollment template (IM01), loaded and submitted via FormFire
- Proof of chamber membership (ONLY acceptable formats shown below)
- A letter from the Chamber of Commerce stating that the Employer is a member in good standing. The letter must be on letterhead that is specific to the Employer’s declared Chamber of Commerce.
- An email from the Employer’s declared Chamber of Commerce stating that the Employer is a member is good standing. The email must specify the sender’s name and title, and must also show the sender’s email address, date, and time stamp. It is acceptable for the Broker to obtain this email from the Chamber of Commerce on behalf of the Client and to forward it to SOCA.
- A copy of a cancelled check or credit card receipt that indicates payment of membership dues in the Employer’s declared Chamber of Commerce.
- SOCA Benefit Plan Electronic Funds Transfer (EFT) banking form and voided check (required)
— 1st months premium rate will be billed or withdrawn via EFT as applicable - Annual Rate and Census Reconciliation Form
- SOLE PROPRIETORS ONLY:
- Cover page for form with schedule C OR
- Cover page for form 1040 with schedule F and a schedule SE
The Employer Application, Employee Applications with Medical, and the Anthem Census will be generated automatically under Send Forms once the Group is complete and all required information has been filled out.
Where can I find the Plan Participation Agreement, Business Acknowledgement Agreement, and Electronic Fund Transfer documents?
The SOCA Benefit Plan Participation Agreement, SOCA Business Acknowledgement Agreement, and SOCA EFT forms can all be found under Preview Forms. Here you will need to select Employer Medical and type SOCA into the search field. These documents will need to be previewed and saved to your desktop. The Broker will need to make sure all required fields are filled out for these documents. Once these are complete, they can be added to the Group through the document center by selecting Manage Documents and uploading the completed versions of these documents there.
All other required documents such as the signed rates, benefits and quote stipulations will be uploaded through the Document Center as well. Any document added to the Document Center will appear under the attachment list in the Send Forms screen to be submitted to Anthem with the rest of the forms.
What does it mean if the error message under “Send Forms” says information is missing from the Employer application?
If you are trying to send forms and the error message says information is missing on the Employer application, you and the HR Manager will need to go back to the Employer interview and make sure all required fields have been filled in.
If you CC someone on a Sold Group submission, does that create issues with the email going through?
Sending a carbon copied (CC’d) email does not cause any issues in the delivery of items. Currently the facility on the SOCA MEWA send process is tied to the Anthem master password. This is not a password distributed outside of Anthem. FormFire is working on an option to create a new way for the Broker to obtain a full copy of the transmission. At this time, all items that are bundled for sending are viewable through other mean (Preview Forms or in the Client's Document Center), and all transmissions are logged with their send status – viewable through the Sent Forms screen.
Ongoing Management Questions
Not all Employees have email addresses when they create their accounts. Is it acceptable to use the Broker’s email address in these instances?
Anthem has requested that Broker email addresses not be used when creating Employee accounts. This will help to ensure Anthem is able to contact a Group via email in the event the agent of record changes Instead, use the email address of the HR Group contact or a family member.
How can I terminate an Employee from my Client?
Brokers and HR Managers have the ability to terminate an Employee from a Client in FormFire.
- Brokers can terminate an Employee from their Client's Employee List page
- HR Managers can terminate an Employee from their Manage Employee page
Does the termination automatically get sent to Anthem or do I have to manually send the termination to Anthem?
FormFire will no longer be used for member benefit administration for member effective dates May 1, 2020, and after. Any changes for effective dates prior to May 1, 2020, should still be entered on FormFire via the current process. Employer Access will be the required source of employee eligibility and enrollment information.
Does my Client have to use Anthem's COBRA administrator?
myCobraPlan is the exclusive continuation provider for the Anthem for SOCA Benefit Plan. Participating Employers are required to use myCobraPlan.
What happens if you only want to terminate a dependent?
The dependent termination will need to be entered in Anthem's system through the Employer Access portal.
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