After Open Enrollment

[FLM2]

Do you think any of these agents will get into any real trouble this year..trying to figure if playing it straight was worth it.

There is a big difference between making up numbers and trying to help someone who is self employed figure out their income one year in advance.

Let's take someone who just changed careers (I have a bunch of them) and have no clue about what they will make this year-are they supposed to estimate $0 because they haven't started earning anything yet (as an example, a new realtor) or estimate enough income to live on (which they need to do)?

Either of these is a complete guess so they might as well guess enough to receive a subsidy rather than have to pay $400-$600 for an unsubsidized plan.

 

[AllenChicago]

You don't say?

Will there be enrollment periods?

SEP's?

CMS running the show?

That'll be the day!.................lol

What witty sarcasm, HouCoogster! But I think Gordon was implying that CMS might require agents to take a multi-module course in order to sell on the Marketplace, if we abuse the system.

 

[somarco]

if we abuse the system.

I guarantee many agents already are.

The MA market was the wild west in 2005 - 2007 or so. Anyone who could fog a mirror was jumping on board. I probably attended 5 roll out meetings and got "certified" for all of them. Money promises were flowing like water. IMO's were promising $500/app or maybe even more.

Some would even set appointments for you, as many as 5 a day. All you had to do was show up, go through a flip chart about their "free" Medicare coverage. Promises of writing 20+ apps a week for a 3 day week.

Didn't take that deal long to peter out. Agents that had to toe the line bailed real quickly.

Kind of like agents that were in the health insurance business before then got out because health insurance got too expensive when premiums jumped over $200/month.

Make money now while you can. Let the good times roll because the party will be over before too long.

 

[AllenChicago]

I guarantee many agents already are.

The MA market was the wild west in 2005 - 2007 or so. Anyone who could fog a mirror was jumping on board. I probably attended 5 roll out meetings and got "certified" for all of them. Money promises were flowing like water. IMO's were promising $500/app or maybe even more.

Some would even set appointments for you, as many as 5 a day. All you had to do was show up, go through a flip chart about their "free" Medicare coverage. Promises of writing 20+ apps a week for a 3 day week.

Didn't take that deal long to peter out. Agents that had to toe the line bailed real quickly.

Kind of like agents that were in the health insurance business before then got out because health insurance got too expensive when premiums jumped over $200/month.

Make money now while you can. Let the good times roll because the party will be over before too long.

When agents committed fraud/abused the Medicare Advantage program, what was the nature of these abuses, in general? Was it hurting the Seniors Financially and/or Medical Benefits-wise?

The abuse of the Subsidy Qualification process produces enrollment numbers, which is what the Obama Admin wants, and there's minimal downside risk to enrollees, unless they end of making over 400%FPL.
ac

 

[somarco]

As I recall it was mostly agents doing really stupid stuff.

Like telling people it was free.

Never bothering to explain networks and OON penalties.

Selling an MA plan then adding on a Medigap to fill in the holes.

Biggest downside risk to those who buy Obamacrack based on faulty applications is the clawback (albeit limited for many) but even bigger is the fact you lied on a federal document in order to receive a subsidy.

Of course we know the "victim" will say the agent never told me any of this stuff.

Kind of like those who got $350k mortgage loans on a $20k income.

They had no idea they would eventually have to actually PAY the loan back.

 

[russelltw]

Agents enrolling people in "cheap slim network plans"
Telling seniors this MA plan was just as good as their med sup
Selling this PFFS and telling them their doctor was in their network, while never checking meds/drs to see if they were in the network.

- A coworker watch a lady go into the doctor one day and the receptionist told the lady they don't take that MA plan and she would have to go see someone else. The lady starting crying about not being able to see her doctor. Evidently the agent didn't check the networks.

I personally had a client's daughter call me this year and told me that an agent showed up at her mother's (my client) house unannounced and recommended the mother switch from PPO to HMO (with my same carrier). She said she did not want to. Daughter was worried something else happened. I checked her on Medicare.gov for 2015 enrollment. Sure enough that agent had rolled her to a HMO plan. I had to go back out and switch her back to the PPO. I am in the process of reporting the agent for his actions. I hope he had a legit reason to drop in...we will see. If he has a mailer she filled out, I am okay with that, but if he drops in cold knocking, I hope he loses his contract.