New CMS Regs

[kstein]

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"

I call BS on a single broker contacting his book of 10k every aep. That's 150 clients per day for the aep. Exaggerate much?

 

[WCMason]

I call BS on a single broker contacting his book of 10k every aep. That's 150 clients per day for the aep. Exaggerate much?

And even if possible it must be hard to resist the urge to switch all those people in order to make exactly the same income than if none of them changed plans.

 

[Ins.Man]

Thank you!!! The Voices of Reason have risen!!!

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My God Ins Man...take a pill...relax. Don't know how long you have been doing this but CMS has been stacking rules and new rules on us every year. You mention getting around the rules. get a life....you get reported one time you
have a hornets nest. Yes I do reviews every year in AEP. I have my client ask
"what do you think is best for me"? Legally (you do take AHIP do you not?) you cannot answer that question. You have agents that will make unsolicited phones calls, knock on doors, and lie their asses off as far as benefits and SOA I guess they are cutting corners and making extra efforts to help the client as you mentioned. Give me a break.

I agree I do not like the regulations but it is what it is. So dont be such a snip with an attitude with people that are not only trying to be ethical but follow the law.

Ok. I really hate to keep arguing with people on here but for those that want to tell me to take a pill and then take something I say and turn it into something else, I don't feel that I have a choice! You tell me to get a life and then try to tell me that if you get caught 1 time you have a hornets nest! What part of my repeated statements where I say ways around the rules "LEGALLY" IS SO HARD TO UNDERSTAND! Maybe you should get hooked on phonics... I guess some of you need this drawn out in crayon. Have you ever watched a movie or TV show where the prosecution loses and the defense wins! Maybe on a technicality or maybe the person didn't really break the law. Maybe there is a LEGITIMATE loophole in the law that would allow a person to not be in violation of the law. I'm sure your first thought here is that these people are still crooked and guilty they just got off unfairly! These people are just manipulators of the system, etc. Maybe, they are just not letting the system take advantage of them. This is also not a TV show or a movie. The scenario revolves around CMS creating a rule that affects my ethical obligations to my clients and a service I provide that they appreciate. So by finding a way around the rule I am saying a person can analyze it and find a different way to accomplish the same goal! The rule pertains to "Telephone" contact with current clients. So the point is how many other LEGAL ways can I still communicate and provide the service to my clients.

Don't misquote me just because I said there are ways around CMS rules LEGALLY! Reading and comprehension skills are apparently lacking with a few on this forum. The things you mention, I never said!

As for your statement, "I have my client ask, "what do you think is best for me"? Legally you cannot answer that question."

Man! Are we on the same planet??? You're telling me that if a current client asks you that question that you don't feel that you can "Legally" answer???!!! Furthermore, you are going to tell them to ask you that question and then not answer them! What is wrong with this statement!?!?

I'm glad you're not my agent! You must have cheated when you took AHIP huh. LOL

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I call BS on a single broker contacting his book of 10k every aep. That's 150 clients per day for the aep. Exaggerate much?

THANK YOU! THE VOICES OF REASON HAVE RISEN!

 

[MedSuppPro]

IMHO it is pretty naive to believe that at least one of the big 4 carrier’s is NOT behind this rule change.

This wouldn’t be the first time a carrier requested a CMS rule change and then acted like they can’t believe it and “are working hard to modify this CMS rule”.

It's really hard to believe that some CMS rule maker has enough contact with the real world of agent client relations to dream up this rule change let alone recognize the need for such a restrictive anti consumer rule.

Nope I’m with the camp that believes this rule was precipitated by a very large MA carrier. They requested the change and the CMS rule maker interpreted the change without a foggy idea of the unintended consequences to the consumer.

Do I think CMS will redact or modify this rule? HELL NO!!!

 

[Guest]

I agree pro, the last big cms reg was the scope i believe and that came about through Humana, or so i'm told.
I wonder if the blues are behind this one, would not surprise me one bit since they are one of the last captive companies around, the want to prevent agents who left them to write what they left behind.

 

[midwestbroker]

Carriers can definitely influence the rules and make suggestions.

Now, here is the thing...are any of your current clients going to report you to CMS for calling them about new plans in the area? Probably not. Mind you I am not saying anyone should bend the rules, but I do speed from time to time...

I judge most of the complaints that CMS receives outside of secret shoppers are competition. I have actually called 1-800 MEDICARE at a clients house to request a SEP for a Nov 1 effective date during AEP since they clients I was helping were door knocked and their plans were changed without them knowing the full ramifications. 1-800 MEDICARE said sorry to hear that and since it was AEP there was really nothing they can do. Then I realized 1-800 MEDICARE is a contracted call center populated with the cheapest labor possible.

 

[MedSuppPro]

CMS doesn’t need to be involved in order to make the case that an agent violated a CMS rule.

I believe it’s possible that a carrier with an agent they suspect has been migrating their block would have an extra employee whom could target and investigate his/her activities to find at least 2 or 3 members who describe that they were improperly contacted?

If an agent violates any CMS rule with a carrier they are SOoL! According to at least one carrier's contract, commissions would end and it would be retro to the date of the infraction.

I don’t care if an agent has 10k or ten clients; these rules were written by lawyers for lawyers.

 

[bpenn9]

CMS doesn’t need to be involved in order to make the case that an agent violated a CMS rule.

I believe it’s possible that a carrier with an agent they suspect has been migrating their block would have an extra employee whom could target and investigate his/her activities to find at least 2 or 3 members who describe that they were improperly contacted?

If an agent violates any CMS rule with a carrier they are SOoL! According to at least one carrier's contract, commissions would end and it would be retro to the date of the infraction.

I don’t care if an agent has 10k or ten clients; these rules were written by lawyers for lawyers.

I am sure the agent with 10k clients has a pretty good lawyer.

 

[wehotex]

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?

Fine, I don't see how this precludes a "review" of the client's current policy. Once they see how wretched their benefits are, they will be inclined to ask what else there is like they usually do. I think that the MA companies had some say-so in mandating that they can call their Medicaid long term services members to inform them of their available dual Medi-Medi MAPD. I know of some of these medicaid members who have been hustled into these dual plans when the MA/medicaid company gave the Medicare agents some lists that they call from to get them on the dual plan (United Healthcare). Another plan (Bravo Healthspring) would give their PDP mb lists to try to enroll them into the MAPD plans. Not sure if Healthspring still does this though.

 

[yogooglethis]

In regards to the agent that calls his book to flip them every year that i was speaking about, yes this is a true statement. Did i say he flips his whole book? No, i said he calls them all during aep to flip.
Yes this is possible, he hires 5 or 6 girls and they call non stop starting in Sept to accomplish this.

Do you need to take a pill? Yes you do, a very large one. I feel sorry for the clients that have you as an agent, your very mean with your words. Go attack someone else, I don't back down sweetheart.

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The ignore button is a wonderful thing.

Wow 10,000.00 clients.I have heard of a guy in Fl. who supposedly had the largest book of business with UHC but i heard he had about 4-5000 clients ( first name starts with B ) which is still an unreal amount.I would be too scared of writing new business and inadvertently doing something wrong if I had that many clients because what's another $200.00 when you have $170,000.00 monthly in renewals at risk .