The Broker Bulletin

A New Way to Access Broker Resources

We’re evolving how we share Broker information. This page transforms our traditional PDF newsletter into a streamlined, digital resource hub built for easy access and ongoing use. By organizing content into clear sections with direct links, this page helps Brokers quickly find updates and resources – all in one centralized location. This page will be updated regularly to reflect the most current information.

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Life Changes. Coverage Options Should Too.

When Members experience major life changes, they may qualify to enroll in Marketplace coverage outside of Open Enrollment. Helping them navigate Special Enrollment correctly ensures a smoother experience and protects against coverage gaps.

Key Broker Reminders:

Verify the qualifying life event before assisting with enrollment
Collect required documentation
Submit plan selections within the eligibility window (typically 60 days)
Review effective dates to help prevent interruptions in coverage

Common Qualifying Events Include: loss of coverage, marriage, birth or adoption, permanent move, household income changes.

Integrated Coverage. Stronger Outcomes.

Highly Integrated Dual Eligible Special Needs Plans (HIDE SNPs) bring Medicare and Medicaid benefits together to create a more coordinated and simplified healthcare experience for individuals who qualify for both programs.

Why It Matters:

Enhanced Coordination: seamless coordination between medical, behavioral health, and long-term services and support (LTSS) benefits
Single Point of Contact: eliminating the confusion of navigating separate Medicare and Medicaid systems
Streamlined Provider Networks: ensuring the Member’s medical team works together more effectively
Comprehensive Care Management: for dual-eligible members with complex health needs and chronic conditions
Improved Health Outcomes: including better care coordination, reduced hospital re-admissions, and more personalized treatment plans tailored to each Member’s unique needs
Enhanced Regulatory Requirements: including unified grievance and appeals processes and coordinated quality measurement
Focus on Whole-Person Care: providing a more holistic approach to member well-being

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Stay Ahead of CMS Integration Requirements

Federal and state initiatives continue to prioritize coordination between Medicare and Medicaid, reinforcing the growing role of integrated care models like D-SNP paired with STAR+PLUS.

Why This Matters for Brokers:

Regulatory Alignment: CMS and the Texas Health and Human Services Commission (HHSC) are implementing new requirements that mandate higher levels of coordination between Medicare and Medicaid benefits for dual-eligible individuals.
Texas Integration Timeline: Texas HHSC is transitioning to an integrated D-SNP model beginning in Contract Year 2027, requiring all D-SNPs in the state to meet enhanced integration standards with corresponding STAR+PLUS Medicaid plans.
Quality-Focused Initiatives: Enhanced integration standards prioritize improved health outcomes, reduced care fragmentation, and better member experience through unified care management.

Competitive Advantage: Brokers who understand integrated coverage can position themselves as experts in complex dual-eligible enrollment scenarios, differentiating from competitors.

Why Choose Community?

As a local nonprofit health plan, Community Health Choice gives you plenty of reasons to join our Community. From the benefits and special programs we offer to the way our Member Services team helps you make the most of them, Community is always working life forward for you and your family.

“Community Health Choice is always there to answer my questions and help me and my family with our medical needs. I truly appreciate and value their customer support and service.”
– Cecily
Member of Community Health Choice