New ACA Consent Rules - Clients being taken

[Ryan LeGrand]

I have grown increasingly frustrated over the last couple of weeks, and hoping to get a little insight from everyone else.

Seemingly multiples times a day, I speak with a client who has received a call and had their plan changed. However, in nearly all of the cases they did not expressly authorize any changes to their plan and are put on a "free" insurance plan without their knowledge.

To make matters worse, in many cases I will attempt to fix the situation. However, in a very recent case, the unauthorized agent is simply changing it back to their NPN. What does everyone do in this instance?

 

[Jim Wright]

I'm assuming you're getting them corrected by calling the marketplace with your client (I know it's a horrible experience). Next step is to report them to the marketplace and the DOI of the state your client is in.

If you're appointed with the carrier this other agent keeps enrolling them in, you may be able to talk to your rep and see if there is anything they can do on the carrier side. As long as you have written consent and they don't you will win.

 

[Yagents]

Big problem for many agents. Mostly coming from FL call center agents and these "no call" lead centers. All you can do is report it to CMS, DOI, Sherpa, the carrier, etc. Some entities are taking action against these agents, other complaints go nowhere. An FB has a group called Marketplace Mastery has MANY discussions on this topic.

 

[Ryan LeGrand]

Big problem for many agents. Mostly coming from FL call center agents and these "no call" lead centers. All you can do is report it to CMS, DOI, Sherpa, the carrier, etc. Some entities are taking action against these agents, other complaints go nowhere. An FB has a group called Marketplace Mastery has MANY discussions on this topic.

100% this. I actually called the person today and he had the audacity to say that once he gets consent one time, he can constantly change the member back to their NPN. That is so absurd.

I see the same people/names over and over and it is sickening. I guess I really just have to constantly report them..

 

[Yagents]

100% this. I actually called the person today and he had the audacity to say that once he gets consent one time, he can constantly change the member back to their NPN. That is so absurd.

I see the same people/names over and over and it is sickening. I guess I really just have to constantly report

This problem is finally getting some press:

https://www.npr.org/sections/health-shots/2024/04/01/1241747442/aca-health-insurance-brokers-obamacare-fraud?

 

[DonP]

This problem is finally getting some press:

https://www.npr.org/sections/health-shots/2024/04/01/1241747442/aca-health-insurance-brokers-obamacare-fraud?

I laughed at the last paragraph of the agent staying up till midnight on new yrs even to catch switches . I actually checked my book at 11:50 on news yrs eve for Ambetter to catch poachers . Didn’t find any . A month ago I got an aor switch on Ambetter . It was local agent . It was Medicare client who’s wife had Ambetter threw agent for a yr . Premium went up big and they called me oep . He tried to switch in Nov and I caught . He tried in Jan again . I told client that he was going to screw your plan up . She called him and reamed him

 

[Tahoe Ray]

I laughed at the last paragraph of the agent staying up till midnight on new yrs even to catch switches . I actually checked my book at 11:50 on news yrs eve for Ambetter to catch poachers . Didn’t find any . A month ago I got an aor switch on Ambetter . It was local agent . It was Medicare client who’s wife had Ambetter threw agent for a yr . Premium went up big and they called me oep . He tried to switch in Nov and I caught . He tried in Jan again . I told client that he was going to screw your plan up . She called him and reamed him

That last paragraph is wild.

 

[DonP]

What ain’t funny is after i wrote the above note i checked my Ambetter actives and 2 were missing . Pulled the client on the marketplace and some sucker went in there and took my client from a smoker to a non smoker dropping their premium $150 a month . Irregardless the AOR is locked . I called Ambetter and thank God got a sharp agent broker . He said Ambetter was running an audit at month end march and the system is open to new apps at that moment . Anyway he sent it back up to put me back as the AOR. Takes 3-5 days . Thats $60 a month . Thats the problem with mapd and aca . You got to always be tracking your book as vultures always picking at it.When i replace a mapd i always ask if they have an agent that stays in contact with them . If they say yes i walk .But 90% don’t

 

[Yagents]

What ain’t funny is after i wrote the above note i checked my Ambetter actives and 2 were missing . Pulled the client on the marketplace and some sucker went in there and took my client from a smoker to a non smoker dropping their premium $150 a month . Irregardless the AOR is locked . I called Ambetter and thank God got a sharp agent broker . He said Ambetter was running an audit at month end march and the system is open to new apps at that moment . Anyway he sent it back up to put me back as the AOR. Takes 3-5 days . Thats $60 a month . Thats the problem with mapd and aca . You got to always be tracking your book as vultures always picking at it.When i replace a mapd i always ask if they have an agent that stays in contact with them . If they say yes i walk .But 90% don’t

Ummm.....Ambetter doesn't charge for tobacco use. Agent had to have changed income to lower premium if stayed at Ambetter

 

[DonP]

Ummm.....Ambetter doesn't charge for tobacco use. Agent had to have changed income to lower premium if stayed at Ambetter

Bingo that’s what he did . I was confused how he wrote the exact same plan and the premium was much lower .