New CMS Regs

[yogooglethis]

CMS released the attached addendum to the Medicare Marketing Guidelines.

The part that raises concerns is this:

Section 70.6 Telephonic Contact
Section 70.6 of the MMG outlines permissible and prohibited telephonic activities of both agents/brokers and Plans/Part D Sponsors. We are clarifying that “plan business” means the member’s current plan. Agents may not contact members, via the telephone, to discuss other plan options. This is considered an unsolicited contact.

From what I understand this to read is agents cannot call non-clients who are in the same plan they are offering. In the original MMG it says agents can call clients as long as they are not baiting and switching topics.

Any other thoughts on this?

Original wording was it was ok to call a MA client to sell med supp or pdp and now they are saying it's not ok to do that but you can call existing ma client to switch to another ma .not sure but that's my take away after reading original wording.

 

[Guest]

I'm going to go with... I'll do whats best for my customer, period.

 

[Bluz]

I'm going to go with... I'll do whats best for my customer, period.

Amen. That is the only way to go.

 

[Ins.Man]

Wow! Everyone has this wrong! This is referring to your current customers. They are saying that you cannot contact them during the AEP and discuss any plan options/changes, etc. AGAIN THIS IS FOR YOUR CURRENT CLIENTS! You can only talk about the plan they are in currently. In order to talk to them about other plans they have to request it as if they are a new prospect. Yes, this is incredibly stupid and will likely not last! However, this is what they are saying in regards to this rule change.

For those who are thinking this applies to new prospects and only talking to them about the plan they are currently in, this is incorrect! It has always been a rule that we cannot contact a beneficiary unless they request by replying to an ad, reply card, etc. New prospects are obviously looking for new options.

A few companies have already issued mass emails indicating they are aware of the impact of this ruling and are working with CMS to fix/correct it.

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To add to my previous reply. The key phrasing to interpret this is discussing "plan business". In the marketing rules this has always been referred to what we can discuss with CURRENT CLIENTS. CMS is now re-defining "PLAN BUSINESS" to mean that we can only discuss with our clients the plan they are currently in. So, in other words we can't talk to our own clients about new/differnet plan options that may be better suited for them. In order to talk about different plans they would have to INITIATE a request to discuss other options with each of us. Even though they are already our clients! HOW RIDICULOUS CAN THIS GET! EVERY YEAR MORE AND MORE BS OUT OF OUR WONDERFUL GOVERNMENT/CMS!!!

 

[Guest]

I cannot wait to hear how the lying cheating scumbag agents are going to get around this new rule. The complaints will be flying in their direction.
We have one agent in our area that calls his book from uhc every year (he has over 10k) to switch them to whatever koolaid he's selling that year, this will be fun !!!

 

[Ins.Man]

Just for clarification, are you implying that I am one of the lying, cheating scumbags here? I certainly hope not. I certainly don't want to get off on the wrong foot with anyone on this forum! I simply was clarifying what everyone seemed to be quite confused about.

It is a little ridiculous that CMS is going to try to keep us from talking to our own clients about their options for the upcoming year! Most customers consider what I call "Annual Reviews" a fantastic service and changes are only made at their request after reviewing their situation and all available options.

I don't believe this new rule is likely to last very long. Even if it does, based on all the confusion there is just on this board most agents are not going to understand it to follow it. There are also ethical arguments that can be made here as well as ways around the rule. As everyone else has said. The goal is to do what is best for our clients. Doing what is best for our clients is also one of the simplest, and strongest ethics principles we all are to abide by from the day we decide to join this business! I will stand by the rules of ethics over the dictators/regulators.

Ultimately, I think this will be changed/modified and if not there are always to accomplish the same goal by other methods. (Hint) this rule relates to "Telephonic" contact...

 

[Guest]

Just for clarification, are you implying that I am one of the lying, cheating scumbags here? I certainly hope not. I certainly don't want to get off on the wrong foot with anyone on this forum! I simply was clarifying what everyone seemed to be quite confused about.

I do not believe we are confused at all.

It is a little ridiculous that CMS is going to try to keep us from talking to our own clients about their options for the upcoming year! Most customers consider what I call "Annual Reviews" a fantastic service and changes are only made at their request after reviewing their situation and all available options.

We all do the reviews, this is how we keep our book.

I don't believe this new rule is likely to last very long. Even if it does, based on all the confusion there is just on this board most agents are not going to understand it to follow it. There are also ethical arguments that can be made here as well as ways around the rule. As everyone else has said. The goal is to do what is best for our clients. Doing what is best for our clients is also one of the simplest, and strongest ethics principles we all are to abide by from the day we decide to join this business! I will stand by the rules of ethics over the dictators/regulators.

Ultimately, I think this will be changed/modified and if not there are always to accomplish the same goal by other methods. (Hint) this rule relates to "Telephonic" contact...

I do not think you have gotten off on the right foot here ins.man. You have stated that you do not think agents are smart enough to understand this new rule? You are not good at making new friends.

 

[Ins.Man]

That's funny Insgal! First of all not all agents do reviews! Second, my comments about the confusion regarding the rule we are discussing was based on other posted comments on this board. Based on those postings it didn't appear there was a very good understanding of what was meant by the change.

Furthermore regarding this absurd post by you:

I cannot wait to hear how the lying cheating scumbag agents are going to get around this new rule. The complaints will be flying in their direction.
We have one agent in our area that calls his book from uhc every year (he has over 10k) to switch them to whatever koolaid he's selling that year, this will be fun !!!

You are referring to fellow agents as lying, cheating scumbags. I'll bet you run around saying that to people all the time. Bad mouthing other agents only gives the regulators more reason to create these types of rules. I'll bet you are also the type that likes to turn in other agents and/or get clients to file complaints against other agents! Your comments allow anyone to read you and the type of person you are like a book!

And by the way, for agents who are "going to get around this new rule" as you put it. What is so wrong with that if they do it legally? The rule doesn't just affect your so-called scumbag agents! It affects the good agents that provide a quality service to their clients. Maybe you should think a little harder before you lay out comments that are insulting and a little severe not to mention stupid. Apparently you are just going to follow this rule and not find a way to service your clients I guess! There is nothing wrong with finding a way around a rule if it is legal and especially if it is in the clients best interests. It also sounds like this other agent probably makes a lot more money than you and likely smarter! If I'm wrong and he is really a crooked scumbag agent then maybe you should turn him in! Otherwise, I would say your a little jealous.


Quote: "Chance favors the prepared mind"
Quote: "Anyone who views Health Insurance or Medicare as black and white is in the wrong business because it is all shades of gray"

 

[Cornelius]

Do you guys ever run into people with Medicare but no supplement? I would think with all the regulations dealing with MA plans and marketing many may fall through the cracks. It seems like less agents in the big picture to service the senior market.

 

[Ins.Man]

I have only ran into it a few times where they have only A and B. Otherwise they usually have MA or MS.