You can fill out the app starting October 1st with the client.
However, you cannot take it with you. They will have to mail it in or you will have to go get it after November 15th.
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"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
You can fill out the app starting October 1st with the client.
However, you cannot take it with you. They will have to mail it in or you will have to go get it after November 15th.
It's my understanding that you can write the Today's Options MA for anyone aging in for the remainder of 2007 after you have completed the recertification process. See below:
RYE BROOK, N.Y.--(BUSINESS WIRE)--Aug. 9, 2007--Universal American Financial Corp. (NASDAQ: UHCO) announced today that it has received approval from the Centers for Medicare and Medicaid Services ("CMS") to resume marketing its Medicare Advantage Private Fee-for-Service ("PFFS") plans pending training of its broker and agent force. As of June 23, 2007, the company voluntarily suspended marketing its individual PFFS plans while it implemented all of the new marketing requirements that CMS had recently announced. The company has now demonstrated to CMS that it meets these new requirements and that it has the appropriate procedures in place for training and monitoring the sales practices of its extensive network of career agents and independent brokers to safeguard the interests of Medicare beneficiaries.
In accordance with CMS guidance, all of our agents and brokers will be re-trained and certified to market our 2007 PFFS plans. Since the extended open enrollment period for 2007 has ended, PFFS enrollments will be limited for the balance of 2007 to people becoming newly eligible for Medicare and certain other limited categories. In addition, the company will move forward with training and certification of its agents and brokers for the 2008 open enrollment period which begins on October 1, 2007.
Richard A. Barasch, Chairman and CEO, said, "We are gratified that we were able to work quickly with CMS to demonstrate our compliance with the enhanced marketing and sales requirements that will further protect Medicare beneficiaries. PFFS has become a popular product because it offers an affordable package of attractive benefits to Medicare beneficiaries. We are committed to making sure that this valuable coverage is offered in an appropriate manner."
You can write T65's at any time since they are aging in to Medicare and have to make a decision.
For people who are currently in Medicare and want to change PDP's or MA plans, for January 1st effective dates, you can start writing Oct 1st and start turning in November 15th.
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"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
Each carrier seems to have their own interpretation on this rule but I agree with the idea of marketing October 1, but not removing the app from the house. The client may mail the app November 15, but you may want to give them a call a few days before to remind them.
Until then I would stick with T-65's and SEP's.
Each carrier seems to have their own interpretation on this rule but I agree with the idea of marketing October 1, but not removing the app from the house. The client may mail the app November 15, but you may want to give them a call a few days before to remind them.
Until then I would stick with T-65's and SEP's.
Kimber:
I agree with everything, but the client is able to mail the application anytime 10/1 or after (client doesn't need to wait until 11/15) and the plan sponsor is REQUIRED to accept these applications and process on 11/15.
Only issue with "pre-selling" before 11/15 is that the agent cannot "take possession" of the application, as you stated.
You can write T65's at any time since they are aging in to Medicare and have to make a decision.
For people who are currently in Medicare and want to change PDP's or MA plans, for January 1st effective dates, you can start writing Oct 1st and start turning in November 15th.
Not PFFS plans. Remember, they had the moratorium that began 06/22/07. That is specifically what I was talking about.
I thought that some of the carriers were starting back up...like Pyramid.
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"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
Pyramid is up and running T65's at this time.
I have heard that some companies actually will write a MA plan October 1 or even earlier, the agent will take the app and submit it. The company will advance the agent on all apps submitted like this. Now that seems to be a six week window that they are out of bounds on. CMS may just show up at one of their seminars and oh boy, fireworks and fines.
I agree with everything, but the client is able to mail the application anytime 10/1 or after (client doesn't need to wait until 11/15) and the plan sponsor is REQUIRED to accept these applications and process on 11/15.
Only issue with "pre-selling" before 11/15 is that the agent cannot "take possession" of the application, as you stated.
Craig
Craig, the only catch to the client mailing prior to 11/15 is that some companies have said that if they get too many of a single agents clients, that they will assume the agent is telling them to submit early and the agent will be terminated. I guess one or two is an accident, but too many more and it's a hobby.
I thought that some of the carriers were starting back up...like Pyramid.
All carriers are up and running with T-65's that started about a month ago.
Originally Posted by Kimber
Craig, the only catch to the client mailing prior to 11/15 is that some companies have said that if they get too many of a single agents clients, that they will assume the agent is telling them to submit early and the agent will be terminated. I guess one or two is an accident, but too many more and it's a hobby.
I heard from one company that if they get submitted before the 15th that they the company and CMS will honor the application but that agent will not get paid.
I plan on giving clients a self addressed envelope for the application to be sent to me after the 15th so that I can fax it in and keep track of and get my copy of the application. I will call to remind them to put it in the mail and also remind them that they will be getting a call from the company verifying that they want to enroll.
Four Health Insurers To Resume Marketing Of Medicare Advantage Plans After Suspension
27 Sep 2007
CMS on Monday said that four health insurers can resume marketing of private fee-for-service Medicare Advantage plans after they entered into a voluntary agreement in June to suspend marketing of the plans amid allegations of illegal and aggressive sales practices, the Tennessean reports (Ward, Tennessean, 9/25).
I am not real sure what this means. Evidentally, there are quite a few MA plans that have/can market the plans again.
I am wondering if all the rulings are vague intentionally so that it can be interpretted as you want. Silly legal big wigs.
I have heard ideas of agents placing the application in the mail as they leave the house they have an envelope dated and stamped USPS-dated. I think this is interpretting things a LITTLE too leniently!
You can write T65's at any time since they are aging in to Medicare and have to make a decision.
For people who are currently in Medicare and want to change PDP's or MA plans, for January 1st effective dates, you can start writing Oct 1st and start turning in November 15th.
This is what I was told as well. My understanding is that as soon as the marketing material for 2008 is available, you can start presenting it, but that no apps can be accepted until 11/15.
Another thing to keep in mind is the outbound verification call this year. One way or another it would be irresponsible just to swoop in on 11/15 and pick up the apps without going over at least the key points of the plan again and making sure that the member knows exactly what they are enrolling in. But with that call coming within 10 days or so of the enrollment being submitted to the company, this is a must, IMO.
Seems we need another confusing compliance issue. And of course, if anything goes wrong -- it's the agent's fault.
My 2 cents...
CMS is requiring a "Receipt Date of Application" in addition to the app date. They are requiring apps to move within 5 days of receipt. It seems that CMS needs to loosen up on the October 15th rule. CMS should allow enrollments now till the end of the year for PDP's.
"The Increases in monthly premiums by Medicare's top prescription-drug plans next year will force as many as 1.6 million low-income beneficiaries to switch plans... and people with existing plans will on average experience an 21% increase", an analysis of government data shows according to the WSJ. Also, we should be able to help the snowbirds, avoid two major holidays, winter weather and ect...
Each carrier is interpreting and training us differently on the application submission issue. What is the purpose of this rule. Doesn't it do more harm then good?
Wow, now its not even clear about the date to send in an App???
I have to start scratching my head here and wonder, why even bother? Oh well, someone has to deal with the idiocy of the CMS, and some suggest everyone should get the H/C via the government.
Why not just offer them up year round and all Dr's that takes Medicare has to take the MA? I guess that would just be to dang simple.
James you are correct. Simple is not in CMS's vocabulary.
You are not allowed to accept an app prior to Nov 15th.
If the client sends in the app ahead of time, then the carrier can hold it and them process it Nov 15th. However, CMS wants that to be the exception rather then the rule.
If your carrier has return envelopes:
Fill out the app with the client.
Have them sign it
Stuff the envelope
Throw a post it note on the outside for them to mail it in Nov 14th.
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"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
October 1 or November 15
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