As AEP gets underway, many agents are asking the same questions about Humana’s Member Benefit Activation Initiative (MAI): Do I need a seperate certification? Do I have to use MedicareLINK? What’s the difference between HRA and MCA? How do I get credit for completed assessments?
You’re not alone.
Humana’s Member Activation process adds several important steps after enrollment, and understanding the requirements can help you stay compliant, ensure your clients receive the benefits and support through their plan, and maximize your eligible compensation opportunities.
If you’re writing Humana business this AEP, this guide covers everything you need to know.
Complete Both Certifications Before You Begin
One of the biggest misconceptions this year is that completing Humana’s annual certification is enough.
As discussed during October Office Hours, agents who completed their standard Humana certification may still need to complete the seperate Member Activation Initiative (MAI) certification. This additional training is required for agents participating in Humana’s Member Activation program and applies to both SNP and non-SNP enrollments.
Before writing Humana business, verify that you have completed:
- Humana annual certificaiton
- MAI certificaiton/training
Failing to complete both requirements could impact your ability to receive credit for eligible assessments and compensation opportunities associated with the program.
What Is The Member Activation Initiative (MAI)?
The Member Activation Initiative is Humana’s post-enrollment engagement program designed to help new members better understand, access, and utilize their plan benefits.
Through a guided workflow, agents can help members:
- Learn about available benefits
- Complete required assessments
- Connect with healthcare resources
- Explore pharmacy and wellness programs
- Understand the important next steps after enrollment
The initiative is designed to improve member engagement early in the member experience while helping beneficiaries access the services and resources included in their plan.
Clearing Up the MedicareLINK Confusion
One of the common questions agents have is whether they must log into MedicareLINK separately to complete Member Activation activities.
For Tidewater agents using IntegrityCONNECT, the answer is often no.
After submitting a Humana enrollment through IntegrityCONNECT, you can launch the Member Activation workflow directly from the client’s record through Explore Opportunities. This allows you to seamlessly transition from enrollment to activation without leaving your workflow.
If you don’t complete the process immediately after enrollment, you can return later through MedicareLINK (Sunfire) to access the opportunity and complete any remaining required activities.
How to Access MedicareLINK
If you do need to return to a Humana Member Activation opportunity, you can access MedicareLINK directly through IntegrityCONNECT.
Simply click your profile photo or initials in the upper-right corner of the platform and select Health Tools from the dropdown menu. On the next screen, choose MedicareLINK from the available health platform options. This will launch MedicareLINK, where you can locate your member’s enrollment and complete any outstanding Member Activation, HRA, or MCA requirements before the 10-day deadline.
Step-by-Step Completion in IntegrityCONNECT
Step 1: Submit the Humana Enrollment
During the enrollment process, you’ll complete required enrollment activities such as:
- Application details
- Medicare information
- PCP selection
- Payment preferences
- Disclosures and agreements
- Electronic signatures
After enrollment is submitted, download the enrollment PDF and upload it back into the client’s IntegrityCONNECT record for documentation purposes.
Step 2: Access Member Activation
Once the application is submitted:
- Open the client’s record.
- Select Explore Opportunities.
- Locate the Humana Member Activation opportunity.
- Launch the guided workflow.
This is the fastest way to begin the required post-enrollment activities.
Step 3: Start Recording
Before beginning the activation process, ensure your recording method is active.
Recording is required for:
- Telephone appointments
- Virtual appointments
- In-person appointments
The entire interaction must be recorded, including required script language, assessment questions, and member responses.
Step 4: Complete the Guided Workflow
The system will automatically display the activities applicable to the member.
These may include:
- Onboarding and consent
- HRA or MCA assessments
- CenterWell Pharmacy outreach
- Preventive care opportunities
- Annual Wellness Visit discussions
- Benefit education
Not every member will see every module. Complete the components presented.
Step 5: Follow the Script Exactly
Humana’s workflow contains required compliance language.
Agents should:
- Read prompts exactly as displayed
- Ask all required questions
- Document responses accurately
- Avoid paraphrasing required language
- Complete every required workflow step
The platform uses member responses to determine which modules appear next.
Reminder: Humana requires agents to complete Member Activation within 10 days of application submission. Do not miss this window.
Understanding HRA vs. MCA Assessments
One area that creates confusion is understanding which assessment a member receives.
Health Risk Assessment (HRA)
Members enrolled in Special Needs Plans (SNPs) generally complete a Health Risk Assessment (HRA).
The HRA helps identify:
- Existing health conditions
- Care coordination needs
- Potential health risks
- Opportunities for additional support services
Member Care Assessment (MCA)
Non-SNP members may recieve a Member Care Assessment (MCA). The MCA gathers information about a member’s healthcare needs and helps identify opportunites for support and engagement.
Members will complete either an HRA or an MCA based on their eligibility and plan type.
Why HRA and Member Activation Matter
It’s easy to view Member Activation as just another compliance requirement, but it serves an important purpose.
These assessments help:
- Connect members with healthcare resources
- Improve understanding of plan benefits
- Identify care needs and support opportunities
- Encourage preventive care engagement
- Help members take full advantage of their coverage
Most importantly, completing these activities can help members access supplemental benefits and resources available through their Humana plan, including food card-related benefits and other support services when eligible.
By completing Member Activation promptly, you’re helping your clients get the most value from the coverage they’ve selected.
What Must Be Completed for Credit?
While each workflow is unique, agents should understand that simply completing an enrollment does not satisfy Member Activation requirements.
The workflow may vary, but core components generally include:
- Onboarding and consent
- HRA (for SNP members) or MCA (for non-SNP members)
- CenterWell attempt
- Required closing activities and script
Additional modules may appear based on member eligibility and responses.
To receive credit for eligible assessments, agents should complete all required components presented by the system, ensure the interaction is properly recorded, and finish the workflow within Humana’s required timeframe.
Clarification on Agent Commissions:
- HRAs = $25 for the Health Risk Assessment & $25 for the Member Activation Survey
- MCAs = Must complete the ENTIRE assessment to receive $50
Don’t Overlook the CenterWell Requirement
Another area agents sometimes miss is the CenterWell component.
If a CenterWell Pharmacy opportunity appears within the workflow, agents should complete the required outreach attempt and document the outcome appropriately.
Even if a member declines participation, the interaction should still be documented according to the workflow requirements.
Recording Is Required Every Time
This is one of the most important compliance reminders for AEP.
All Member Activation assessments must be recorded.
That includes:
- Phone appointments
- Virtual appointments
- In-person appointments
Even face-to-face appointments require recording.
The recording should capture:
- Required disclaimers
- Consent language
- Assessment questions
- Member responses
- Benefit discussions
- Closing activities
Failure to properly record and document the interaction can create compliance issues and may impact compensation.
Common Mistakes to Avoid
As you complete Humana enrollments this AEP, watch out for these common errors:
- Assuming annual Humana certification automatically includes MAI certification
- Waiting longer than 10 days after enrollment to complete Member Activation
- Forgetting to start the recording before the assessment begins
- Skipping required scripting
- Paraphrasing compliance language
- Completing the enrollment but forgetting to launch Member Activation
- Failing to upload the enrollment PDF back into IntegrityCONNECT
- Assuming in-person appointments do not require recording
- Stopping after the assessment and missing additional required workflow activities
Avoiding these mistakes can help ensure a smoother experience for both you and your clients.
Your Humana MAI Checklist
Before Enrollment
- Complete Humana annual certification
- Complete MAI certification
- Verify your recording capabilities
- Confirm access to IntegrityCONNECT and MedicareLINK
After Enrollment
- Launch Member Activation through Explore Opportunities in IntegrityCONNECT
- Start recording before beginning the workflow
- Complete the assigned HRA or MCA
- Complete onboarding and consent activities
- Complete CenterWell outreach when prompted
- Follow all scripting exactly as written
- Complete all required workflow activities
- Finish everything within 10 days of enrollment
- Upload the enrollment PDF back into IntegrityCONNECT
Stay Compliant and Receive Credit This AEP
Humana’s Member Activation Initiative adds several steps after enrollment, but those steps are designed to help members better understand and use their benefits while creating opportunities for improved health outcomes and engagement.
To stay compliant and receive credit for eligible assessments, remember the fundamentals: complete both Humana and MAI certifications, record the entire interaction, follow Humana’s script exactly as written, complete all required activities, and finish everything within 10 days of enrollment.
The simplest strategy is often the most effective way to address this process, and that is to complete the Member Activation immediately after enrollment whenever possible. Doing so helps ensure nothing is missed, keeps the process fresh in the member’s mind, and helps your clients begin accessing the benefits they’ve enrolled to receive.
Contact the Tidewater team with any questions or confusion about the process, and we’re happy to help.
Office Hours with Tidewater October Recap
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