Class Descriptions

Class Name Class Number Credit
2012 BCBSM/BCN Group Medicare Advantage Certification #00001 None
This course is required to certify agents to market and sell Blue Cross Blue Shield of Michigan's private-fee-for-service Medicare Advantage plans for 100+ size groups and an overview of Blue Care Network's Medicare Advantage product for all size groups. This course is approved by the Centers for Medicare and Medicaid Services and incorporates the federal compliance rules and guidelines for marketing these plans.

The course objective is for agents to interpret Medicare Advantage enrollment/election periods, policies and procedures as well as decipher between the differences of a private-fee-for-services plan and an HMO. Specific language as it relates to the products and services are detailed during this program, to include, but not inclusive to, Blue Cross Blue Shield of Michigan's group coverage options premiums and Part D, as well as Blue Care Network's provider network and enrollment/eligibility requirements.

Blue Care Network #58217 3
The purpose of this course is to educate agents on Blue Care Network of Michigan products. Agents will be instructed on managed care components, the delivery system and detailed benefit information.

Preauthorization #51220 3

The purpose of this course is to educate agents on the changes taking place in the direction of healthcare and associated costs. Managed care programs are losing ground in the attempt to contain costs. The new focus is in preauthorization, specifically, case management and disease management. Case management has been in place for some time, while disease management has only recently been developed. This course will take an in-depth look at both types of preauthorization.

COBRA #57519 3

The purpose of this course is to educate agents on the features of the Consolidated Omnibus Budget Reconciliation Act (COBRA): what it is, who must comply, who it affects, and how employers must comply.

Consumer-Directed Health Care #57520 3
This course is to educate agents on the original IRS tax structure of certain employer paid fringe benefits and the IRS tax code updates that have created tax advantages for employees when those same fringe benefits are paid for by employees. The main focus will be on health care plans. The program will also include information for each plan, which types of employers are eligible to sponsor certain plans, and the requirements and restrictions so the plans meet all IRS eligibility guidelines.

Dental/Vision/Medical Connection #55764 3
This course is designed to provide agents with information highlighting the systemic relationship of oral health to overall health as well as vision health to overall health. Terminology, provider networks, benefits and plan features will be discussed. Additionally, insurance industry trends specific to the ancillary market, and emerging individual dental and vision products will be featured.
Ethics #55762 3
This course focuses on the concept of ethics and the values and principles associated with ethical behavior. It discusses the complexities of ethical decision-making, including how to recognize what are important decisions, what are effective and ineffective decisions, the steps to making better decisions and the obstacles that prevent us from making ethical decisions. The program addresses Federal and State legislation that impacts the health insurance industry and provides an overview of the State’s regulatory agency, the Office of Financial and Insurance Regulation (OFIR). It also discusses unfair trade practices as well as the roles and responsibilities of an ethical health insurance professional.
Medicare, Supplemental and Medicare Secondary Payer #58316
This class provides an overview of the components of Medicare, the Medicare enrollment process and time frames, and examples of supplemental coverage. The various Medicare Secondary Payer, TEFRA/DEFRA (Tax Equity & Fiscal Responsibility Act/Deficit Reduction Act), Omnibus Budget Reconciliation Act, and ESRD (End-Stage Renal Disease) laws that impact Medicare are discussed.

Preferred Provider Organizations (PPO) #58215 3
The purpose of this course is to educate the agent community of the PPO network program, doctors and hospitals and how services are delivered while managing costs and medical services. Agents will learn how a facility or other providers that contract with Blue Cross Blue Shield Michigan provide care or services under specific reimbursement terms and conditions. Agents will be instructed on the program terms, policies, and procedures, determining in-network and out-of-network services, practices, penalties, products and features of the program. At the end of this course, agents will be able to identify all benefits and advantages of a PPO network program.

Prescription Benefit Management #56504 3
The purpose of this course is to educate agents on prescription drug terminology and trends, including why drug costs are rising, generic drugs versus brand-name drugs, affects of Direct-to Consumer Advertising, prescription dug plan options available to group customers, prescription drug pricing, and what is being done to slow the growth of rising drug costs.