Shifting the Burden to the Client

[FLM2]

I have a client whose wife was dropped from pregnancy Medicaid so wanted to add her to his plan. Of course this meant a new application and a new policy with the same carrier (UHC).

He delayed until just before June 15th but we finally got it done except he didn't want to pay the premium yet.

I send him an email on June 19th and tell him that his current plan needs to be cancelled but I won't do it until he pays for the new plan and that the current plan wouldn't be cancelled as of July 1st unless he did that promptly.

He emails me today at 5PM to submit payment and cancel the policy, which I do, except the earliest termination date for the current policy is, of course, July 13th.

So now there are two policies in the system for him and we all know this will get completely screwed up, right?

I am not willing to do anything more to fix these kinds of problems and sent him an email confirming the payment and termination but also told him it was up to him to fix any problems due to system errors.

How many of you would still make all the phone calls necessary to fix the inevitable problems caused by the client's delay?

 

[houcoogster]

New plan should cancel out old plan.

 

[AllenChicago]

How many of you would still make all the phone calls necessary to fix the inevitable problems caused by the client's delay?

I might. It depends on what I could lose...

 

[TxOnline]

For future reference, try this:
Do NOT click on that BRIGHT orange bar to TERMINATE an existing plan.
That's when you run into that 14-day cancellation-delay date.

For an SEP, this WORKS for me:
(Disclosure: I have NOT done this to ADD-back a spouse to an existing app.)
- Click on client's EXISTING 2015 application.
- Then, click on the "Report a Life Change" tab...in left column.
- Proceed to fill out the whole app (with the changes) to the END.
- Get your new Determination Letter
- Pick your NEW Plan (which can be SAME plan as the old plan)

Then, LOOK at the "My Plans & Programs" tab.
It should show that the NEW plan is effective x/1/2015....(7/1/2015).
And, that the OLD plan was TERMINATED on x/1/2015.....(7/1/2015).

I do NOT terminate the old plan myself.
The system automatically does it...immediately after SEP is processed.

I don't promise that this will work for every situation.
But, I'm CERTAIN that it's been working for me....for SEP's.

 

[bill3173]

I have one like that now, that has taken more of my time than writing 10 applications during SEP. I've allowed it because he has been a client for a long time, and has life, long term DI and a short term DI policy with me.

It started with him waiting until the end of his SEP period to decide that he wanted to change plans, next, the new carrier back dated his policy two months to the beginning of his SEP.

It would all have been straightened out with fewer phone calls, emails, etc..but he felt the need to call and email me every other day for the last month.

One thing that I've noticed is the carriers don't always know the rules themselves and ask for things that don't concern them, and convey these things to the client when they call. It's not easy training people how to respond and what's relevant on all of this stuff.

 

[FLM2]

For future reference, try this:
Do NOT click on that BRIGHT orange bar to TERMINATE an existing plan.
That's when you run into that 14-day cancellation-delay date.

For an SEP, this WORKS for me:
(Disclosure: I have NOT done this to ADD-back a spouse to an existing app.)
- Click on client's EXISTING 2015 application.
- Then, click on the "Report a Life Change" tab...in left column.
- Proceed to fill out the whole app (with the changes) to the END.
- Get your new Determination Letter
- Pick your NEW Plan (which can be SAME plan as the old plan)

Then, LOOK at the "My Plans & Programs" tab.
It should show that the NEW plan is effective x/1/2015....(7/1/2015).
And, that the OLD plan was TERMINATED on x/1/2015.....(7/1/2015).

I do NOT terminate the old plan myself.
The system automatically does it...immediately after SEP is processed.

I don't promise that this will work for every situation.
But, I'm CERTAIN that it's been working for me....for SEP's.

I would have gladly done that but his first app was through a carrier direct link so no Marketplace account so I had to create a new application for the SEP.

What I've learned this year, I think, is that without a Marketplace account all of these changes for Marketplace plans become really difficult, next year I will just work directly through the Marketplace for my clients who purchase through the Marketplace and create accounts for all of my clients so changes are much easier. Am I doing something wrong in this?

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I might. It depends on what I could lose...

$48 per month in commissions for the rest of the year and renewals next year...

----------

New plan should cancel out old plan.

Not if there are two applications in the system because there wasn't a Marketplace account.

 

[G.Gordon]

FLM2

Yes, you putting them through the marketplace even if no subsidy is eligible will enroll them in the marketplace version of their selected plan. In my area, that makes them lose access to two major hospital networks. Going off-ex or carrier direct provides better coverage if your paying the full price you might as well have full access.

 

[FLM2]

FLM2

Yes, you putting them through the marketplace even if no subsidy is eligible will enroll them in the marketplace version of their selected plan. In my area, that makes them lose access to two major hospital networks. Going off-ex or carrier direct provides better coverage if your paying the full price you might as well have full access.

I don't understand why you feel like that explanation is needed given my posting history on this forum.

More than half of my book is Off Exchange and I have that conversation with every client before enrollment. This client was on an Assurant PPO last year, he didn't want to pay the extra premium for 2015.

In this case, they are receiving a subsidy for half of the premium, where does it say this is a Marketplace plan with no subsidy in my original post?

 

[kgmom219]

I have a client whose wife was dropped from pregnancy Medicaid so wanted to add her to his plan. Of course this meant a new application and a new policy with the same carrier (UHC).

He delayed until just before June 15th but we finally got it done except he didn't want to pay the premium yet.

I send him an email on June 19th and tell him that his current plan needs to be cancelled but I won't do it until he pays for the new plan and that the current plan wouldn't be cancelled as of July 1st unless he did that promptly.

He emails me today at 5PM to submit payment and cancel the policy, which I do, except the earliest termination date for the current policy is, of course, July 13th.

So now there are two policies in the system for him and we all know this will get completely screwed up, right?

I am not willing to do anything more to fix these kinds of problems and sent him an email confirming the payment and termination but also told him it was up to him to fix any problems due to system errors.

How many of you would still make all the phone calls necessary to fix the inevitable problems caused by the client's delay?

I do not. What I do is tell them whats going to happen next if they don't do what I say and that they can't yell at me when there are problems, nor will I help.

Once I explain the next steps, I get 99% compliance on doing things "correctly". The other 1% email me, apologize and ask for guidance. I send them an email with the steps.

 

[G.Gordon]

I would have gladly done that but his first app was through a carrier direct link so no Marketplace account so I had to create a new application for the SEP.

What I've learned this year, I think, is that without a Marketplace account all of these changes become really difficult, next year I will just work directly through the Marketplace and create accounts for all of my clients so changes are much easier. Am I doing something wrong in this?

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.

That is why I responded with that. What good is creating marketplace accounts for off-ex members?