That doesn't sound right. I thought that a woman swallowed a watermelon seed.
That doesn't sound right. I thought that a woman swallowed a watermelon seed.
- 8,707
This will be my only comment on trusting carriers to interpret CMS rules. I was using a carrier for their SNP plan up here in Maine...1 Week I recieved an email that stated a certain video was a required part of the presentation...the next week I received a new email saying DO NOT use the video as it had not been approved by CMS...SHortly thereafter that carrier lost the ability to sell MA plans....
- 15,319
I refused to sell Arcadian when they made their DVD mandatory. They told me that "agent's loved it." I knew that was BS then and I still think it's BS now.
After a few weeks we received the email to stop using it. I called my RSM and simply said "I told you so."
It's impossible for an agent to truly help their client and still be 100% in compliance. I'd love to take some of the geniuses that make these rules into the field with me for a few weeks.
Rick
I never thought of them as geniuses.
- 14,809
Of the very few agents I speak with who sell MA plans, all confess that they don't follow all the CMS rules and none frankly care.
These are not unethical agents, just agents who are going to do things their way and if they get caught...oh well, off to another career.
These are not unethical agents, just agents who are going to do things their way and if they get caught...oh well, off to another career.
- 15,319
It's impossible to be 100% in compliance. Any agent that says that if they get caught they'll find another career are unethical. Not caring about your career means you really should find another career, and now.
I do my best to serve my client while staying within the spirit of the rules. I do not do things "my way" and really can't image any agent that is a professional to take that attitude.
Rick
RFNAPLES
Expert
Be careful which bible you use, the current edition is:
http://www.cms.gov/ManagedCareMarketing/Downloads/2011_MMG_060410.pdf
- 2,024
I love how they constantly change the rules, then change them back, and expect anyone to understand them.
The carriers don't understand the rules and all of them put their own interpretation on the rules.
I currently am appointed with 2 carriers that both say you cannot sell any product in their zip codes except their products, and I asked them specifically how I could do that without being in CMS violation for steering people into that policy.
Could hear crickets chirp on that one.
It is flatly impossible to follow both CMS's rules and the carrier rules and be 100% in compliance all the time. It isn't that hard to do the right thing 100% of the time and tell them if they want to punish you for it that's their call.
If they told me I couldn't sell any MA plan again tomorrow it wouldn't hurt my feelings much, and I know that I've never once pushed a client into something they didn't want or done anything unethical, even if there were times that I broke a carriers compliance rules that conflicted with either my ethical standards or CMS guidelines or both.
The carriers don't understand the rules and all of them put their own interpretation on the rules.
I currently am appointed with 2 carriers that both say you cannot sell any product in their zip codes except their products, and I asked them specifically how I could do that without being in CMS violation for steering people into that policy.
Could hear crickets chirp on that one.
It is flatly impossible to follow both CMS's rules and the carrier rules and be 100% in compliance all the time. It isn't that hard to do the right thing 100% of the time and tell them if they want to punish you for it that's their call.
If they told me I couldn't sell any MA plan again tomorrow it wouldn't hurt my feelings much, and I know that I've never once pushed a client into something they didn't want or done anything unethical, even if there were times that I broke a carriers compliance rules that conflicted with either my ethical standards or CMS guidelines or both.
SeniorInsuranceGuy
Expert
- 75
I remember replying to the email they sent mandating that we watch that DVD with the client and telling them how assinine and over-the-top that was...literally. I stopped marketing their plan right there. No way in HELL would I sit there with a client and watch a BS DVD about their regs. I didnt even bother watching it when they sent it. I just said right there, CYA! so I have no idea what was on it.
April marks one year that Aetna is banned. As big as Secure Horizons is, I'm surprised they haven't been hit. Healthnet and Arcadian? who knows when......there are several small MAPD's in SoCal with damn good benefits. One has transportation included in basic plan and competitive benefits. I think the little guys are going to step in and take some market share here. I can't help but think there are politics behind the sanctions. How? Why? dont know......just kinda feel it.
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Dang it, you are right. Same statement about the 48 hour rule, but its on page 90.
Dan
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