Insurance Agent Forum

[Winter]

What are the rules for telesales by carriers in regard to PDP plans? Suppose they hear an ad on TV and call and want to discuss a pdp plan. Does the carrier have to mail them an appointment approval form and they have to have it 48 hours in advance or are the carriers special?

I am going to guess that they are special because this whole shlock process is about driving more sales through telesales. Anyway, does anyone know?

Winter

[retread]

Originally Posted by Winter

What are the rules for telesales by carriers in regard to PDP plans? Suppose they hear an ad on TV and call and want to discuss a pdp plan. Does the carrier have to mail them an appointment approval form and they have to have it 48 hours in advance or are the carriers special?

I am going to guess that they are special because this whole shlock process is about driving more sales through telesales. Anyway, does anyone know?

Winter

The carriers are immune. It is because of unscrupulous agents that the rest of us have the burden of onerous rules to contend with.

[AgentOrange]

Carriers are not immune ... the only regulation they have lee-way on is agent commissions.

[Winter]

Originally Posted by AgentOrange

carriers are not immune ... the only regulation they have lee-way on is agent commissions.

Alright, so how does that work logistically? Customer calls AARP/UHC for info and potential enrollment in a PDP plan. What's the next step?

[retread]

Originally Posted by Winter

Alright, so how does that work logistically? Customer calls AARP/UHC for info and potential enrollment in a PDP plan. What's the next step?

I don't agree with AgentOrange... I am not sure he/she knows what they are talking about. If a carrier uses outbound telesales, they follow a script, usually record it, and field interested parties. They then either send an agent out to discuss the plans, no SOA needed, or give the party the inbound number for them to call in and enroll over the phone. They still cannot enroll on an outbound call if that is what AgentOrange is referring to.

My contention is that they are the carrier providing the coverage, and need not require an SOA to send out an agent because they are responding to an inbound inquiry. If an independent agent wants to contact a prospect, it must be done by direct mail or referral. In any case, other than being sent by the carrier, an agent must get an SOA signed before making a presentation for a MA or PDP plan unless they use an approved direct mail lead card.

[AgentOrange]

Carriers can not do out bound calls to solicate sales. They cn call existing members to provide info on changes and offer extras like dental. If a prospect calls in they have a recorded wave file of prospect soliciting an agent. The agent can then follow up and fill out the scope of appointment before giving the presentation. this isnt rocket science, just follow the instructions. and you dont disagree with me you disagree with the new rules.

[jdeasy]

Originally Posted by AgentOrange

carriers can not do out bound calls to solicate sales. They cn call existing members to provide info on changes and offer extras like dental. If a prospect calls in they have a recorded wave file of prospect soliciting an agent. The agent can then follow up and fill out the scope of appointment before giving the presentation. this isnt rocket science, just follow the instructions. and you dont disagree with me you disagree with the new rules.

This is incorrect. If the person calls the carrier and the carier records the call, no SOA is needed. The carrier can alos enroll the person on that same call as can an agent if a person calls the agent.

[Slim]

All this confusion cutting is causing more confusion.

[retread]

Originally Posted by Slim

All this confusion cutting is causing more confusion.

It is only made confusing by people making statements of fact as if they were true when they aren't.

[Frank Stastny]

The "bottom line" is that everyone posting is guessing what CMS is requiring. Any agent who comes here to find out "exactly" what is or isn't "legal" is going to "hang their hat" on the explanation that best suits their needs.

Each agent needs to read the CMS guidelines and decide for themselves how they are going to market MA plans. Grow a pair and make the best decision you can and stand by it. By design even CMS cannot tell us precisly what we can and can't do.

Personally I'm going to act in the best interest of the prospect I'm trying to help. I am giving them all the facts and doing everything I can to help them make a well informed, intelligent decision regarding what is the best option for them.

In my humble opinion that is all that I need to be concerned about. As an agent the only thing I have going for me is my credibility. I'm sure not going to put that in jeopardy because some pencil-neck at CMS thinks that seniors are not entitled to have all of the information available to make an intelligent decision regarding the best investment of their premium dollar.

[retread]

Originally Posted by Frank Stastny

The "bottom line" is that everyone posting is guessing what CMS is requiring. Any agent who comes here to find out "exactly" what is or isn't "legal" is going to "hang their hat" on the explanation that best suits their needs.

Each agent needs to read the CMS guidelines and decide for themselves how they are going to market MA plans. Grow a pair and make the best decision you can and stand by it. By design even CMS cannot tell us precisly what we can and can't do.

Personally I'm going to act in the best interest of the prospect I'm trying to help. I am giving them all the facts and doing everything I can to help them make a well informed, intelligent decision regarding what is the best option for them.

In my humble opinion that is all that I need to be concerned about. As an agent the only thing I have going for me is my credibility. I'm sure not going to put that in jeopardy because some pencil-neck at CMS thinks that seniors are not entitled to have all of the information available to make an intelligent decision regarding the best investment of their premium dollar.

Agreed.

The flap over commissions, SOAs, and other MIPPA implementation shows us how poor CMS is at communicating. It is systemic to the way bureaucrats think... too many are lawyers who can't relate to people so can't make a living dealing with people face to face... that's why they find a job behind a desk making remote directives. Unable to communicate clearly only makes for more job security, because they have to issue more and more directives to clarify the last one, and so on ad infinitum. Couple this with the lack of ability to make a decision and stick to it, is appalling.

Another example in the news recently, is Sec. Paulson's switch on buying the toxic loans that was part of the original "bailout" plan. This has undone what had been a turnaround in the economic free-fall. Expect more insanity from government officials.

[Frank Stastny]

Everything that is going on now is very reminiscent of what was happening in the senior market prior to 1993. Until then, insurance companies were at liberty to design any kind of plan that they felt would supplement Medicare. Most of the plans were full of crap that looked good on paper but left lots of holes, co-pays and deductibles.

To fill those "holes" agents would sell multiple policies to their prospect. Commissions were high and agents made a lot of money, not unlike the kind of commissions that have been paid the last two years for MA plans.

Back then we apparently had intelligent, responsible, compassionate people handling Medicare. They saw that the system was not working to the benefit of the senior population. Only putting lots of money in the hands of insurance companies and their agents.

Guess what? The government actually did "right thing", stepped in and put a stop to everything that was going on.

That is when the Standardized Medicare Supplement plans were released, 1993, requiring all companies that had been selling policies to supplement Medicare to stop marketing those plans. From that point forward Medicare said that companies could only offer the Standard Plans.

It is very interesting that Medicare really did come up with plans offering very good coverage. At that time no one, I repeat NO ONE, attempted to tell agents how they could sell them or what the commission would be.

Medicare Supplement sales have been going very smoothly since then. Agents have been able to actually help seniors understand Medicare and the supplement options available to them.

One would think that someone at CMS would remember what a cluster mess things were prior to 1993. Obviously insurance companies cannot be trusted to design a plan to supplement Medicare. All one has to do is look at some of the crappy Part C plans that are out there.

There is a place for Part C plans and they can help a certain percentage of the senior population. However, I see the same problems occurring today with them that existed in 1992 and before. The only difference is that they are much worse today than they were then.

Back then only the seniors were getting "screwed". Now CMS has decided that they have become so "horny" that there aren't enough seniors to satisfy their "hunger" so they have decided to "screw" us also.

[policy doctor]

LOL
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Sorry folks...that was a laugh of exasperation!

Thought you might like to read this if it hasn't been posted already.

Top Medicare Drug Plan Premium Hikes - The Best Life (usnews.com)