I have a 77 year old female who was with bcbs plan F in MO. She calls to ask her effective date a few months ago, which raises a red flag, so I ask her what's up and she says another agent has quoted her MOO at a lower rate, while giving her the 12% household discount BC she lives with her kid (that's sketchy but not even what I'm referencing). So I reach out last week to switch her on anniversary date, get everything squared away with new company, plan F and think its puy to bed when she calls again and says she is switching to Essence HMO 1/1/15. She said an agent came out last week, went over all the 2014 stuff, checked the provider list, gave her the old max oop is $2300 why pay $200/MO for plan F close, and is going to mail the 2015 Essence info during the AEP to switch. Also for what it's worth, I write with Essence, have handled this gals insurance for 7 years or so, and have done a ton of stuff for her. Thoughts?
Is this Compliant/how Would You Handle this
- Thread starter kstein
- Start date
- 781
don't chase that one anymore, focus on other business. She's nuts if she leaps around like that and doesn't call you at all.
- 2,177
As to the other agent's compliance, he likely crossed a line regarding early marketing of MA plans, but you'll likely never know.
It seems like when you reached out you missed out by not telling her this next AEP may be the year to consider trying an MA plan given her annual premium has increased to the point where it was comparable to the MA OOP in your area.
I lost a couple two AEP seasons ago who I would have ranked among my most loyal med supp clients. They moved to an MA carrier I am contracted with but with another agent. When I talked to them they said they didn't know I did those types of plans because I never mentioned them to them. I never would have taken them as ever being interested in MA plans. They felt bad for not calling me. Me, too.
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Why was she on bcbs Plan F to begin with. If their rates are anything like in IL, I would have already had her on a different policy (since it sounds like she was medically qualifying for a different policy).
In any case, this other agent is definitely out of compliance. Since you work with Essence, maybe shoot them an e-mail (time stamping before 10/1/2014) indicating that this client was approached by another agent and solicited prior to AEP...forward whatever details you have. It's out of your hands at that point but at least you've done your duty of reporting non-compliant behavior.
In any case, this other agent is definitely out of compliance. Since you work with Essence, maybe shoot them an e-mail (time stamping before 10/1/2014) indicating that this client was approached by another agent and solicited prior to AEP...forward whatever details you have. It's out of your hands at that point but at least you've done your duty of reporting non-compliant behavior.
- 781
nothing happens when non compliance is reported. There is an agent in my town who every year cold calls in Sept. to invite to seminars, advertises in the paper and online in Sept to invite to seminars and 8 years later he is still selling.
This person, I am told, this agent was reported many times this year already and nothing is happening.
I don't know how much work goes into reporting non compliant agents but whatever it is, i would not waste my time.
Good luck to her and her choices.
This person, I am told, this agent was reported many times this year already and nothing is happening.
I don't know how much work goes into reporting non compliant agents but whatever it is, i would not waste my time.
Good luck to her and her choices.
- Thread starter
- #9
Anthem BCBS is pretty competitive in MO. She was at 240/MO for F and I was switching to Stonebridge at $214 on anniversary. In hindsight I should have switched her to MAPD or at least steered the conversation that way rather than Stonebridge. She is in horrible health, just had a major heart operation in March, tracels with an RV, in my opinion not a good mapd fit.
- 2,177
12 years on F may cause her to regret the OOP costs and doctor/hospital restrictions of an HMO. The other agent probably didn't talk to her about her MA trial right (assuming she's never had an MA). If I were in your situation I'd make sure she understood her GI rights if she wants to go back to her BCBS F.
Here's hoping she makes that move in the first three months, handing the other agent a rapid disenrollment and full chargeback.
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