Scroll down for a discussion on Reasons for chargebacks? within the Senior Insurance Forum.
I'm a rookie in California, passed the state exam, awaiting license#, became interested in selling MA , especially Secure Horizons'. After reading some posts in ...
I'm a rookie in California, passed the state exam, awaiting license#, became interested in selling MA, especially Secure Horizons'. After reading some posts in this forum, looks like chargebacks occur frequently. I'm trying to find out from those who had chargebacks why they did come back so I can try to avoid that situation altogether. Thanks for any constructive input.
I'm a rookie in California, passed the state exam, awaiting license#, became interested in selling MA, especially Secure Horizons'. After reading some posts in this forum, looks like chargebacks occur frequently. I'm trying to find out from those who had chargebacks why they did come back so I can try to avoid that situation altogether. Thanks for any constructive input.
In the interest of full disclosure, I do not participate in the senior market.
A friend of mine who does the MA thing tells me it's not at all uncommon for seniors to attend the free lunch meetings (it'a actually a sport here in the Sunshine State, especially this time of year) and sign up for a different one at each stop! I would imagine that would lead to chargebacks.
I don't know what Shoney's does the other 46 weeks of the year....
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[COLOR=blue]Don't steal - the government hates competition.[/COLOR]
I'm a rookie in California, passed the state exam, awaiting license#, became interested in selling MA, especially Secure Horizons'. After reading some posts in this forum, looks like chargebacks occur frequently. I'm trying to find out from those who had chargebacks why they did come back so I can try to avoid that situation altogether. Thanks for any constructive input.
Chargebacks should not be a problem because unless the person is dual eligible, they can only change plans bascially once a year (there are a few exceptions).
Send me a PM if you'd like information on contracting with them.
Rick
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Training, Community, Support, and Success Independent Life Insurance Agents Assn rick@iliaa.org
Most charge backs are because the agent sold the prospect something they didn't need or couldn't afford. Agents using high pressure techniques are the ones who get the most charge backs.
The other reason is that the agent didn't know the product very well and failed to point out the important benefits of the policy.
Agents should use logic in their explanation of the policy, not the hype and scare tactics that a lot of agents are taught to use.
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Most charge backs are because the agent sold the prospect something they didn't need or couldn't afford. Agents using high pressure techniques are the ones who get the most charge backs.
The other reason is that the agent didn't know the product very well and failed to point out the important benefits of the policy.
Agents should use logic in their explanation of the policy, not the hype and scare tactics that a lot of agents are taught to use.
One recruiter is looking for agents to sell Medicare Part C by Secure Horizons. (supposedly Kingdom Group has done the pre-set appt, verified client already has Medicare Parts A and B and no kidney failure, and thus its no additional charge to sign up for Part C which will pay for the 20% co-pay required for Part B. Supposedly, when I visit the client, the Part C sells itself because I don't need to leave with a check and since its a $0 additional charge for signing up for Part C since its already included in the premium for Part B and Part C pays for the 20% co-pay required for Part B, easy street is here. Client only needs to sign a 3 pager form. Disregarding the quality of the appointment made by Kingdom (assuming that's possible to separate from the chargeback issue), why would a client cancel later if its an apparent "can-only-win" proposition by signing up for Medicare Part C?
One recruiter is looking for agents to sell Medicare Part C by Secure Horizons. (supposedly Kingdom Group has done the pre-set appt, verified client already has Medicare Parts A and B and no kidney failure, and thus its no additional charge to sign up for Part C which will pay for the 20% co-pay required for Part B. Supposedly, when I visit the client, the Part C sells itself because I don't need to leave with a check and since its a $0 additional charge for signing up for Part C since its already included in the premium for Part B and Part C pays for the 20% co-pay required for Part B, easy street is here. Client only needs to sign a 3 pager form. Disregarding the quality of the appointment made by Kingdom (assuming that's possible to separate from the chargeback issue), why would a client cancel later if its an apparent "can-only-win" proposition by signing up for Medicare Part C?
There are a couple of reasons you might be "afraid", especially from Kingdom. The first reason is that in my opinion, they set terrible appointments and are not always the most ethical people to deal with. This is from experience.
Second, if the person is Medi-Medi, they can (and probably will) cancel very quickly. In fact, it is likely not appropriate to sign a dual eligible into a SH plan - especially the PFFS.
However, Secure Horizons REPLACES Medicare with private insurance. It doesn't pay the 20%, it doesn't pay the deductible, it is no a "can-only-win" situation. The benefits are per their policy and in no way does it interact with Medicare. In fact, Medicare basically does not exist as far as paying any claims.
This is not meant to be nasty, but you better learn about Medicare and Medicare Advantage plans before you start seeing clients. Based upon your statement, you have little knowledge about these programs and are one of the reasons CMS is on all of our backs.
If you are located in the Los Angeles area, I'll be happy to meet with you and give you a quick run-down on Medicare and Part C. It's not terribly complicated but if you don't know what you're doing, not only will you screw up yourself, but you could put you client in a position where he or she cannot receive medical care.
If, and only if, you are going to sell Med Advantage, please do your due dilligence. That's it; or you're asking for problems, BIG PROBLEMS.
This is not a time for rookies (no disrespect) to think it's easy, big money.... not suggesting you are or thinking this way.. just saying...
Some agents posted some really good advice. While I may not necessarily agree with all posters' feedback, much is accurate and correct. You have to yes, know Medicare as best as you can, know the various programs, ask the questions, know your products, the duals, the competitors, compliance, provider relationshins, claims, marketing, bunch of stuff... just A TON OF WORK... and your but it on the line... BIG TIME!
Just dig and learn all there is if and only if you plan to sell this.
There are a lot of really good people in this forum that are willing to help. Ask. Learn, and when in doubt... keep asking.. .eventually you'll find the answer.
P.S. Chargebacks are inevitable, whatever you write for various reasons that are sometimes not controllable by the writing agent. The key is to minimize it as much as possible on the front end if you're able.. again.. due you d.d., be ethical, professional, and proceed with caution. If it means you walk from the deal, then walk.
Good luck. Let us know how we can help.
P.S. Secure horizons is not for dual medi medis. if they're, howeve, on a different lower level of Medicaid, or on spend down, it may help, perhaps. You have to asses their costs and benefits and if they'll really be saving or paying more out of pocket.
Now A Special Needs Program for duals would be Evercare under UHC for those Medi Medis and it may not always be good for them to enroll - you could hurt them more than help. Further, doing a SNP, TRUSTME, is a whole other animal and world when the state takes care of those folks and will vary greatly per county and what area you work and how helpful those case workers are!
So in your opinion,would you sign a dually on Evercare or Wellcare Concert plan,if those where the choices
You should only consider signing a full dual on a SNP plan specific for duals. WellCare does NOT have such a plan although they are pushing an inappropriate plan strongly.
Those with a share of cost might benefit from an MA plan.
Thanks for your reply Rick,my state manager actually told me to enroll this client in a Wellcare Duet plan,.So if you where enrolling duallys who would you use.Thanks
Thanks for your reply Rick,my state manager actually told me to enroll this client in a Wellcare Duet plan,.So if you where enrolling duallys who would you use.Thanks
This depends on the state. In California, Health Net has a true SNP plan for duals and it's very good.
The problem with the duet plan is the same as with any PFFS. Their doctor does not have to accept the plan. So you take someone off Medicaid where they have no problem seeing their current providers and put them on a plan that may not be accepted. There is no incentive (like higher reimbursement) for a provider to want the Duet plan.
I don't specialize at all in duals. I wrote maybe 3 this year. From what I understand, they drop faster than Britney's breasts. There are so many other products you can sell - specifically Med Supps - that working with duals is not too attractive.
Now, if you are talking about chronic illness SNP plans, that's a different story. In some counties, Evercare has a SNP PPO (not here in Calif) and that is a very attractive option.
[quote=GreenSky;43618]
.....if the person is Medi-Medi, they can (and probably will) cancel very quickly. In fact, it is likely not appropriate to sign a dual eligible into a SH plan - especially the PFFS.
If you are located in the Los Angeles area, I'll be happy to meet with you and give you a quick run-down on Medicare and Part C. It's not terribly complicated but if you don't know what you're doing, not only will you screw up yourself, but you could put you client in a position where he or she cannot receive medical care.
Rick
How I wish I were in your area, but I'm in NorCal (Silicon Valley). Much appreciated though as I'm inclined you could help a great deal on this steep learning curve. Any alternatives\recommendations for getting a "quick run-down on Medicare and Part C" that's not an in-person meeting?
If the person is medi-medi, what typically is done, if anything?
Chargebacks should not be a problem because unless the person is dual eligible, they can only change plans bascially once a year (there are a few exceptions).
Send me a PM if you'd like information on contracting with them.
Rick
Is that the MA rules in California? Illlinois states you can change twice during AEP/OEP. If you have LIS or the state wrap around prescription coverage it's all year just like duals. I though Medicare rules were nation wide.
Is that the MA rules in California? Illlinois states you can change twice during AEP/OEP. If you have LIS or the state wrap around prescription coverage it's all year just like duals. I though Medicare rules were nation wide.
It's a federal law.
I said they could change "basically once in an year." Most people only will move in the AEP. I don't think there will be much movement in the OEP so chargebacks won't be a big issue.
If you're working duals, you are setting yourself up for chargebacks. LIS people are a little different but they tend to stay put.
I said they could change "basically once in an year." Most people only will move in the AEP. I don't think there will be much movement in the OEP so chargebacks won't be a big issue.
If you're working duals, you are setting yourself up for chargebacks. LIS people are a little different but they tend to stay put.
Rick
Yeah I know. I shy away from dualies,but have about 25 who have been on the books for a couple years. We help them apply for dual eligibility when they join our MAPD and then move them into our Total Care plan. It covers everything at zero co-pay and extra benefits like transportation, cash in an account to pick medically related items from a members only magazine, and other extras. Our state is 100 days behind to pay out for medicaid claims so alot of private practices are not taking medicaid people. Lately I've been following a former agent who used to be with my regular MA plan. He goes in and switches them to his new crappy plan with $195/day-20days co-pay for inpatient hospital (no annual max.) I show them $175/day for 3 days($1500 annual max) and it's a done deal. He tells them the plan just changed names and to sign here for the new years benefits. During AEP the last agent to sign them gets the client. These people are really grateful and are good referral sources since they know others in the hood who had seen this jerk. He used to be with Humana and spent 2 years switching his book of business to our plan. Now he is with Secure Horizons and moving them again. Real creative, huh.
Reasons for chargebacks?
.So if you where enrolling duallys who would you use.Thanks
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