I hear Lehman Brothers had a lot of employees leave recently... maybe there will be a vacancy there!
------------------------------------
To be truly independent, an agent should not be dependent on a government bureaucrat for contracts or commissions.
Urgent Update: Changes to CMS Marketing Guidelines CMS recently implemented new guidelines for 2009 Medicare Advantage marketing activities. As such, it is WellCare’s responsibility to ensure that all contracted producers are aware of these changes and comply with the new guidelines. WellCare is in the process of seeking clarification of certain specifics of the new CMS measures, and producers will be informed as WellCare refines its policy with respect to these new regulations. In the meantime, Producers need to be aware of the following marketing guidelines and restrictions with which they must begin to comply as of October 1, 2008:
Before meeting with a beneficiary, producers must document the beneficiary’s advance consent to engage in a sales meeting and the scope of products to be discussed. This consent may be in writing or recorded, and must be maintained by the producer.
Use of food at sales meetings must comply with guidelines; providing meals to beneficiaries as part of marketing activities is prohibited.
All outbound telemarketing activities without prior beneficiary consent are prohibited effective October 1, 2008.
Producers must ensure that only appropriate activities and materials are used for educational events (i.e., producers may not conduct sales activities or distribute or accept enrollment applications at group events).
Interactions with beneficiaries must be initiated by the beneficiary. Producers cannot contact any beneficiary in an unsolicited manner, including door-to-door sales, outbound telemarketing, and conducting sales presentations or distributing and accepting plan applications in provider offices or other places where health care is delivered.
WellCare is developing comprehensive Producer education concerning these new guidelines that will be delivered as part of our 2009 Compliance and Product Training. In the meantime, producers are encouraged to read the CMS memo (see link below) to learn more about the coming changes.
If you have any questions, please contact your FMO.
Sincerely,
WellCare Health Plans, Inc.
Note:WellCare is developing communication regarding new compensation guidelines, which will be forthcoming shortly. Producers should continue to monitor e-mail for updates on these developments as they become available.
What I'd like to know is how CMS and the insurance companies plan to watch us? The inbound calls they made us do last year? I checked the box that the client didn't want to do it, and let the client know they'd be getting a call from the insurance company to go over the plan. I flat out told my clients I didn't want to waste our valuable time going over the plan AGAIN with some CSA at the company. My clients agreed!
How will they monitor me if I decide to bring up LTC or Financial planning while at their kitchen table? I'm a full service agent. I will present that to my client. I don't like those calls that start with "guess what I just did!" and end with "gee, I didn't know you did that!"
What if I coach my clients, let them know what to expect when that "verification" call comes in? Let them know that they don't have to answer any of their questions, and they won't lose their plan. What will the companies do to me? The client was the one they called. . .
So, they cut our commissions and then they cut our ability to make a living with the other products we sell. If CMS feels the need to regulate everything so much, they should just do everything themselves and cut us out of the loop! It will give us more time to actually make money!
I am so looking forward to this years Medicare season!
What I'd like to know is how CMS and the insurance companies plan to watch us? The inbound calls they made us do last year? I checked the box that the client didn't want to do it, and let the client know they'd be getting a call from the insurance company to go over the plan. I flat out told my clients I didn't want to waste our valuable time going over the plan AGAIN with some CSA at the company. My clients agreed!
How will they monitor me if I decide to bring up LTC or Financial planning while at their kitchen table? I'm a full service agent. I will present that to my client. I don't like those calls that start with "guess what I just did!" and end with "gee, I didn't know you did that!"
What if I coach my clients, let them know what to expect when that "verification" call comes in? Let them know that they don't have to answer any of their questions, and they won't lose their plan. What will the companies do to me? The client was the one they called. . .
So, they cut our commissions and then they cut our ability to make a living with the other products we sell. If CMS feels the need to regulate everything so much, they should just do everything themselves and cut us out of the loop! It will give us more time to actually make money!
I am so looking forward to this years Medicare season!
If you get a secret shopper and do as you just said, you won't be selling any plan or any other type insurance for that matter.
There is still lots of opportunities to do well this season and there will be legal and ethical methods to do this, The different companies will let us know here as soon as they go through and confirm it with CMS.
Monday Pyramid has a conference call and will at least give us some idea of what the heck is going on and the other plans will be soon to follow.
Stay smart and stop the thought process you are on or you will not have to worry about checking on this forum any more.
...
Stay smart and stop the thought process you are on or you will not have to worry about checking on this forum any more.
ABSOLUTELY!! This goes for many others on this forum, too, including ME. I have resolved to learn to deal with it... you can't shovel sand against the tide, and it's coming in!
If you can figure out a way to play within bounds, you will stand a chance to win, just like in tennis, volleyball, etc. It doesn't guarantee you'll win, but if you are out of bounds, it's a guarantee that you won't!
I am working on two separate strategies designed to stay completely within bounds... one is a web site (people come to you as CMS is demanding), and the other I don't want to comment on at the present, but it's a no-brainer, just hard to do.
These type challenges separate the pros from the wanna-bes. I'm not immune to belly-aching and whining, but either I kick myself in the butt or someone else will...
I don't know why ANYBODY would want to put up with this ever-increasing red tape having to do with Medicare. It was the same way in Florida with Medicaid. First, the state wanted private HMO's to take over to save the state money. So the HMO's hired agents to sign up Medicaid people. They were paid PER application. So what'd they do? They sought out the Medicaid people (won't go into which neighborhoods they frequented for this.) Anyway.. the state got too many complaints from the marketing tactics and took away virtually every sales avenue for the agents. The market dried up.
Same thing will happen (has happened now) with Medicare. Not a place for a new agent at all..
Originally Posted by OkWhy
Heck, I sure picked a fine time to start out in the insurance business. Sigh! (Well, it was either this or real estate.)
I heard today that cold calling rules do not effect the 2008 MA and PDP plans so you can still cold call these prospects through November for 12/1/08 effective.
I heard today that cold calling rules do not effect the 2008 MA and PDP plans so you can still cold call these prospects through November for 12/1/08 effective.
I believe you are incorrect. The rules went into effect on 9/18.
Please post your source.
Rick
------------------------------------ ILIAA
Training, Community, Support, and Success Independent Life Insurance Agents Assn rick@iliaa.org
One thing that I have seen is the larger producing agencies going to the carriers saying, if you want us to sell your product this year, what are you going to do to help us?
With cold calling out, they are looking to the carriers for co-op money.
What I see is that agents who just pop in for AEP and OEP will stop doing so since all the new rules and regulations have come into place. The agents who do this all year (like myself) will just have to see clients more then we do now, which is not such a bad thing.
------------------------------------
"Government's view of the economy could be summed up in a few short phrases: If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it." Ronald Reagan
I have not verified with other sources but email i received
Was from management of large ( very large ) carrier that cold calling for 2008 plans is OK according to compliance dept. and i don't think it is specific to this carrier. I would have thought other carriers would be disiminating information by now as well.
Cold calling for 2009 plan rules did go into effect 9/18/08
I heard today that cold calling rules do not effect the 2008 MA and PDP plans so you can still cold call these prospects through November for 12/1/08 effective.
The new CMS rules were effective 9/18/08 and apply to all marketing activities in connection with Medicare 2009 plans.
These plans can be marketed starting 10/01/08 and the new rules must be used from October 1 forward.
The new CMS rules were effective 9/18/08 and apply to all marketing activities in connection with Medicare 2009 plans.
These plans can be marketed starting 10/01/08 and the new rules must be used from October 1 forward.
From what I've read of the rules, I think that's what they say, too. However, the companies I had conversation with about so far, Coventry, Pyramid, UHC and Wellcare, all say that the rules are in effect now even for '08 enrollees either T65 or SEP.
Now, here's another nugget that Pyramid threw out there on their national call yesterday; They say you can't call up the AEP file that you have been building since OEP ended. For example, I have a huge file of people that I meet on final expense appointments. They wish to talk about an MA plan or a PDP. I tell them I'll call them for the AEP. Or, I get calls for the same and I tell someone that I can't do anything until AEP. These all go into my "Nov" file. Most MA agents that I've met have a similar file. Pyramid says that it is now unlawful for me to call those folks unless the request was made within 90 days of the AEP.
I disagree strongly with that position and feel it's just Pyramid's take, but, that's the only info I have right now. I sent an email to Wellcare about this issue. They responded that they would have to take it up with compliance and get back to me.
Pyramid threw out there on their national call yesterday; They say you can't call up the AEP file that you have been building since OEP ended. For example, I have a huge file of people that I meet on final expense appointments. They wish to talk about an MA plan or a PDP. I tell them I'll call them for the AEP. Or, I get calls for the same and I tell someone that I can't do anything until AEP. These all go into my "Nov" file. Most MA agents that I've met have a similar file. Pyramid says that it is now unlawful for me to call those folks unless the request was made within 90 days of the AEP.
Let us know were they have pulled this rule out of!
F. Scope of Appointments
42 CFR 422.2268(g) and (h); 423.2268(g) and (h) -- CMS 4138-IFC
Effective date: September 18, 2008
Under current Medicare Marketing Guidelines, marketing representatives are to clearly identify the types of products that will be discussed before marketing to a potential enrollee. To ensure beneficiaries have accurate information to make an informed choice about their Medicare benefits without being pressured, marketing representatives that initially meet with a beneficiary to discuss specific lines of plan business (Examples of separate lines of business include Medigap, MA, and PDP) must inform the beneficiary of all products that will be discussed prior to the in-home appointment.
Effective September 18, 2008, prior to any marketing appointment, the beneficiary must agree to the scope of the appointment and that agreement must be documented by the plan. ...
Additional products may not be discussed unless the beneficiary requests the information.
Let us know were they have pulled this rule out of!
F. Scope of Appointments
42 CFR 422.2268(g) and (h); 423.2268(g) and (h) -- CMS 4138-IFC
Effective date: September 18, 2008
Under current Medicare Marketing Guidelines, marketing representatives are to clearly identify the types of products that will be discussed before marketing to a potential enrollee. To ensure beneficiaries have accurate information to make an informed choice about their Medicare benefits without being pressured, marketing representatives that initially meet with a beneficiary to discuss specific lines of plan business (Examples of separate lines of business include Medigap, MA, and PDP) must inform the beneficiary of all products that will be discussed prior to the in-home appointment.
Effective September 18, 2008, prior to any marketing appointment, the beneficiary must agree to the scope of the appointment and that agreement must be documented by the plan. ...
Additional products may not be discussed unless the beneficiary requests the information.
They can't tell you where they get it. I spoke to a Pyramid manager today. He insists that it's CMS rules even though he can't give the rule or regulation.
Coventry sent out their version today, it seems to mirror Pyramid's take.
I haven't heard back from Wellcare yet.
- - - - - - - - - - - - - - - - - -
This is the response I got from a Wellcare rep in regards to my question of being able to call the people in my callback file;
Hey, JD! The regs are still being evaluated for the specifics. Let's wait until they give us more details and then we'll be able to go from there. We want to be compliant, and right now, we need more specifics from CMS. We should get those soon...
Last edited by jdeasy : 09-24-2008 at 12:12 PM.
Reason: Automerged Doublepost
Stricter rules, 'secret shoppers' greet Medicare sales season
Carol Gentry
Florida Health News
Published: Thursday, September 25, 2008 at 1:01 p.m.
Last Modified: Thursday, September 25, 2008 at 1:04 p.m.
Insurance agents that enroll Medicare beneficiaries into drug and HMO-style plans are being warned that the rules have changed to protect against marketing abuses and that government agents – "secret shoppers" -- will be watching.
The Centers for Medicare and Medicaid Services is tripling the number of undercover agents it will send to sales events this season, a CMS advisory warns. Last year CMS had 300 secret-shopper events -- many of them in Florida -- and took action on four companies, the agency says.
The new rules, released Sept. 15, apply to the marketing for 2009 enrollment in Medicare drug plans and all-inclusive Medicare Advantage plans, such as HMOs. Plans may begin marketing Oct. 1, with sign-ups allowed beginning Nov. 15.
"It's unfortunate that a few scurrilous salespeople and overzealous regulators are making life more difficult for the rest of us," says The Complete Advisor, a newsletter to agents from North American Life Plans. It urges agents to be "diligent about protecting yourself by staying informed, documenting everything and erring on the side of caution in all of your sales and marketing efforts."
A news release at the CMS Web site explains that the regulations are intended to "protect Medicare beneficiaries from deceptive or high-pressure marketing tactics…"
Another change that CMS is proposing would also have a major effect on agents. It would not allow plans to give agents big up-front commissions each time they enroll a new member, but would require that the payment be structured so that the agent wins if the member stays in the plan. CMS says this is aimed at removing the incentive to switch a beneficiary from one plan to another – a process known as "churning."
Florida has been the site of some of the most flagrant examples of churning and deceptive sales practices to Medicare beneficiaries, as described in press accounts and Congressional hearings.
While most beneficiaries have not been subjected to abuses and are pleased with their drug and Medicare Advantage plans, CMS says in its releases, "we will monitor activities throughout this year's enrollment period to ensure that beneficiaries are protected from aggressive marketing behavior from agents and brokers."
In addition to the change in commissions, the new regulations say:
--No more cold-calling or telemarketing. An agent may not call a Medicare beneficiary unless that person has contacted the agent first, according to an e-mail from Universal American. "Even then, the agent must set up an appointment with the individual before visiting the person's home," it says.
-- No more meals at sales seminars. Light snacks are OK, but it's the end of the Red Lobster sales talks.
-- No cross-selling. When agents are making presentations on one product, such as a drug plan, they may not push other products, such as an HMO. If the beneficiary wants information on the HMO, the agent must schedule another appointment to allow "a 48-hour cooling-off period."
-- No selling materials in certain areas, such as clinic waiting rooms, dialysis centers, pharmacy counters, or educational seminars.
CMS has told plans it will check on their ads in print and broadcasts and review recordings of enrollment calls to make sure companies are complying with the new regulations.
Re: Cold calling rules
. 
or you will not have to worry about checking on this forum any more.
Linear Mode
