Clear Spring Health will be exiting the Medicare Advantage market as of June 1, 2026.
Per Clear Spring Health, agents should notify any clients who recently enrolled in a Clear Spring Health Plan policy with an effective date between June 1st, 2026, and August 1st, 2026, that their coverage will NOT go into effect. We kindly ask that you begin working with these clients to help them secure alternative coverage as soon as possible.
They also encourage them to begin transitioning their current Clear Spring Health Plans member clients to new coverage with an effective date of June 1st.
Members have a SEP beginning June 1st through July 31st to choose a new plan.
If they are auto enrolled, they will also be eligible for the SEP and can choose a plan between June 1st and July 31st.
If they do not choose a new plan, they will revert to original Medicare and be enrolled in a Humana Basic RX PDP with a $0 premium.
Clear Spring Health's Agent FAQs:
1. What happened to Clear Spring Health?
After careful consideration, it was decided to exit the Medicare Advantage business.
2. When will my members be notified?
Members will be notified by mail between May 6th and May 11th. Members will begin receiving calls on Wednesday, May 6th.
3. How can I access my Book of Business so I can make outreach to my clients?
You can log into Evolve, https://account.evolvenxt.com/, to download your book of business. You can reach broker services at 888-296-2506.
4. When will my members' plan end?
Members' coverage will end on May 31st, 2026.
5. Is there an SEP?
Yes, all Clear Spring Health members will have a special enrollment period through July 31st, 2026.
6. If they do not select a new plan by May 31st, will CMS auto-enroll them in a prescription drug plan, or will they only have original Medicare?
Yes, they will revert to Original Medicare and will be enrolled in the Humana Basic Rx Plan. If auto-enrolled, the beneficiary has until July 31st, 2026, to choose a new plan.
7. Will I be compensated for all of my enrollments?
You'll receive a final reconciliation payment in early August, including pro-rated May effectives and completed HRA's.
8. Will I be charged back for April and May effectives?
We'll process rapid disenrollment (voluntary before May 31st) for April-May, and members affected by the plan termination will not incur chargebacks.
9. Will Clear Spring Health take back the advanced commission that I have been paid for June through December?
No, Clear Spring Health will not perform any chargebacks for the advanced commission.
10. Will I be paid for May renewals on my current book of business?
Yes, the renewals effective prior to May 31st, 2026, will be paid.
11. Who should I contact if I have questions or need assistance for my clients?
Please call our Broker Services team at 888-296-2506.
12. Will my clients still be able to use all their benefits in May?
Yes, we encourage you to let your clients know they should continue using their benefits in May, as there is no disruption in their coverage for the month.
13. Will Clear Spring Health continue to pay claims?
Yes. Our systems have been restored, and we are currently working through our backlog. We will continue to process all claims.
14. Will I still be able to log into Evolve? When will I lose access?
Yes, the portal will be available until May 31st.
Additional Resources
If you have any questions please contact Producer Support. Producer Support is available by phone at (866) 568-9649, by email at [email protected], or by chat directly from your MyMFG account.