This communication shares important updates regarding the Flex Card program for Highmark D-SNP members, along with key reminders related to agent protocols and call handling. Understanding and cooperation are essential as a high volume of new members is onboarded and efforts continue to ensure a smooth experience for everyone.
Flex Card Program Updates
Patience is appreciated as new benefits are implemented for the large number of members beginning services in January 2026. While established and compliant processes are in place to activate Flex Card benefits for SSBCI-qualified members, the early-year volume can create additional pressure on operations. This includes the significant number of Provider Attestations received daily that must be entered into the system.
These processes are functioning as intended and meet CMS requirements for SSBCI benefits. Highmark ensures members have the opportunity to use their Flex Card benefits by providing a one-month rollover during the first month of qualification. Additionally, the “once approved, always approved” policy means that once members receive SSBCI approval for Highmark D-SNP plans, they will not need to repeat the process if they leave the plan and later return.
Key Information to Share with Clients
- Eligibility Form Requirement: Members must have the eligibility form fully completed by their provider to be considered for SSBCI qualification. Incomplete forms will result in processing delays.
- Eligibility Verification Process: Once the Provider Attestation eligibility form is processed, members will receive a phone call and/or letter confirming their eligibility status or notifying them if additional information is required from their provider.
- Qualification and Approval Timeframe: Provider Attestations are being prioritized and processed as quickly as possible. Members will be notified by phone and letter once their attestation is reviewed, confirming approval or requesting further documentation. This notification process also applies to members approved through the claims sweep process. These benefits are important, and every effort is being made to complete reviews promptly.
- Gas Station Payments: When using the Flex Card at gas stations, members must pay at the pump. Transactions made inside the convenience store are not permitted and will be declined.
- Flex Card Balance Inquiries: Agents are unable to check Flex Card balances. Members should visit MyHealthyFlex.com or contact PayForward directly for balance information or other card-related questions. Members should also be reminded to activate their Flex Card before use, as funds will not be accessible until activation is complete.
Agent Protocols & Call Handling
A high volume of calls is currently being experienced, and adherence to the following protocols will help ensure timely and effective support for both agents and members.- Sharing Contact Information: Under no circumstances should agents share the Producer Hotline number with members. Members should always be directed to the appropriate Member Services channels for any questions or concerns.
- Proper Use of the Producer Hotline:Agents should not contact the Producer Hotline while with a member or while on a conference call that includes a member. The Producer Hotline is intended solely for agent-specific support and is not designed to handle member inquiries directly.
- Directing Member Service Inquiries: An increased number of broker calls are being received due to extended Member Services hold times. Members with questions about Flex Card funds or available balances should be directed to MyHealthyFlex.com or instructed to contact PayForward directly at 833-623-2619 (Monday–Friday, 8:00 a.m.–8:00 p.m.). Members must have their Member ID available when calling.