Can Someone Explain this Situation?

[wehotex]

In my market, there is a full risk medical group that dominates the market. It contracts with two MAPDS (MA #1 & MA #2). MA1 has about 50% of the MA market, while MA2 has slightly richer benefits and also includes comprehensive dental as an added bonus, but newer and less market share. MA2 actually provides an allowance for dental, it's not JUST a "discount". Yet, MA1 is sold to prospects EVEN when there is an obvious need for dental benefit, which it does not provide.
A certain well-connected agent (AGENT ZERO) has produced over 800 MA1 apps YTD. I believe that this agent's Upline has an "SGA" contract with MA1. It is RUMORED that AGENT ZERO was NOT PRESENT with the prospect at many of these appointments. Agents under AGENT ZERO or medical group personnel merely gave AGENT ZERO some completed applications, which AGENT ZERO signed name and agent code to. According to other agents, AGENT ZERO's procedures have resulted in stricter rules for every other writing agent in the market.
QUESTION:
Is there some kind of financial incentive why AGENT ZERO would write his/her own name instead of allowing his/her downlines to write their names with Override going to AGENT ZERO?
Not saying that AGENT ZERO is right or wrong. ZERO just may have come up with a legit way to beat the system, although maybe at other agents' expense.

 

[AllyriaRedbird]

A certain well-connected agent (AGENT ZERO) has produced over 800 MA1 apps YTD. I believe that this agent's Upline has an "SGA" contract with MA1. It is RUMORED that AGENT ZERO was NOT PRESENT with the prospect at many of these appointments. Agents under AGENT ZERO or medical group personnel merely gave AGENT ZERO some completed applications, which AGENT ZERO signed name and agent code to. According to other agents, AGENT ZERO's procedures have resulted in stricter rules for every other writing agent in the market.
QUESTION:
Is there some kind of financial incentive why AGENT ZERO would write his/her own name instead of allowing his/her downlines to write their names with Override going to AGENT ZERO?
Not saying that AGENT ZERO is right or wrong. ZERO just may have come up with a legit way to beat the system, although maybe at other agents' expense.

Wow, sounds crooked. You do not want to be Agent Zero! Stand firm in your integrity, and report it.

He will be sanctioned to his eyebrows I hope. If his behavior has effectively changed/created the need for stricter rules for all other agents in the area then the change will rub off on him.

May the CMS Gods get him.

Yes, there is a reason for writing the applications under his name instead of the down line agent. He gets to keep all the commissions!

 

[wehotex]

Wow, sounds crooked. You do not want to be Agent Zero! Stand firm in your integrity, and report it.

He will be sanctioned to his eyebrows I hope. If his behavior has effectively changed/created the need for stricter rules for all other agents in the area then the change will rub off on him.

May the CMS Gods get him.

Yes, there is a reason for writing the applications under his name instead of the down line agent. He gets to keep all the commissions!

On the contrary, MA1 has turned AGENT ZERO into some kind of demigod. AZ was applauded at a recent Benefits Meeting for his/her accomplishment.

 

[somarco]

 

[bobby dazzels]

Remember in Officer and a Gentleman when Mayo AKA Richard Gere gets busted with the boots and buckles in the ceiling and Gunny Foly busts him and says in every company there is someone who thinks they are smarter than I am that is what's going to happen here if this case has merit. Its tough following the rules I have been in the MA game along time and I don't even come close to those kind of numbers. At the end of the day you have to look at yourself in the mirror and when your life is done here on this earth you have to answer to our creator and all the cheating lying conning and not following the rules will have to be answered for. So whoever this is better enjoy all the crap they are buying because they will be some SPLAYNING to do.

 

[pfg1]

I know a small life agency that requires all his captive downline to submit the apps through him. He is the agent on the policy, not them. He gets the credit with the company (bonuses and trips) and more importantly... the renewals. His play is - he pays the downline agents directly, provides them training, etc. Problem (to me) is... you leave or get asked to leave.... you have zippo. Not sure if this is legal with medicare, could be what is going on.

 

[axeman462]

I know a small life agency that requires all his captive downline to submit the apps through him. He is the agent on the policy, not them. He gets the credit with the company (bonuses and trips) and more importantly... the renewals. His play is - he pays the downline agents directly, provides them training, etc. Problem (to me) is... you leave or get asked to leave.... you have zippo. Not sure if this is legal with medicare, could be what is going on.

I have a hard time imagining how that is legal with any product.

 

[yogooglethis]

On the contrary, MA1 has turned AGENT ZERO into some kind of demigod. AZ was applauded at a recent Benefits Meeting for his/her accomplishment.

The reason for this is because of the differing motives between sales/distribution dept. and the compliance dept..I have never heard of marketing side of MA carrier bust an agent with outlying production levels but eventually a complaint will come from a consumer and the scheme will unravel.

 

[wehotex]

The reason for this is because of the differing motives between sales/distribution dept. and the compliance dept..I have never heard of marketing side of MA carrier bust an agent with outlying production levels but eventually a complaint will come from a consumer and the scheme will unravel.

That will be the day!! San Antonio seems to be a VERY crooked city. Agents get away with murder here because the all-powerful medical groups favor UHC very heavily. UHC disenrollments are routinely called after cancellation to get them back in to UHC. Every one of the clinics has agents that sit there to put people into UHC. One of the head witches did get ejected though about a year ago because she was outbitched. So, I guess that karma does work sometimes, just not soon enough