PFFS -- Apparently It Is OK To Keep Selling

[Frank Stastny]

This is a partial copy of an e-mail I received earlier today. I guess we can keep selling.

You should probably contact your PFFS company for more details


CONTINUOUS OPEN ENROLLMENT FOR MEDICARE ADVANTAGE PROGRAMS THROUGH 2008.

The rumor is NOW OFFICIAL - Before adjourning, Congress attached an amendment to existing legislation (H.R. 6111, TO AMEND THE INTERNAL REVENUE CODE OF 1986 TO PROVIDE THAT THE TAX COURT MAY REVIEW CLAIMS FOR EQUITABLE INNOCENT SPOUSE RELIEF AND TO SUSPEND THE RUNNING ON THE PERIOD OF LIMITATIONS WHILE SUCH CLAIMS ARE PENDING). SEC. 205. of the legislation, "MEDICARE DRA TECHNICAL CORRECTIONS". This creates "LIMITED CONTINUOUS OPEN ENROLLMENT PERIOD FOR "MA-ONLY" PLANS". (Copy of H.R. 6111 --

President Bush signed the bill into law!!!

 

[furlover]

I thought there was another thread on this topic, but could not find it.

Spent today talking with several GA's about MA selling after March 31st. They insist that what Pyramid says about extension of selling time to December 31, 2008 is wrong.

Does anyone know where we can go to verify this? I have spent hours online and cannot find anything.

Thank you,

Linda

 

[Frank Stastny]

I would suggest that you give Anthony a call. He is the Pyramid person that I go to for help and answers. His number is 877.205.4648 Ext 2337.

He sounds like a super nice guy over the phone and always has time to talk to me.

 

[furlover]

Thank you!

Linda

 

[midwestbroker]

According to everything I have heard, all stand alone PFFS plans can be sold through Dec 31, 2008.

Medicare beneficiaries only have 1 option to change from Jan 1st - Nov 14th. So if they have already elected a change, then they will have to wait until November 15th (AEP) to elect another change. The same rules apply to 2008 as well.

 

[honestagent]

I received a memo by one of my FMOs in the mail; and I regretfully am unable to scan it right now but yes, you can sell MAs year round any company that offers the plan in the designated areas. Just as Midwest alluded to about switching, be cautious of what box you check or some apps. may not have written in the the proper code of L-OEP. (Limited Open Enrollment Period). On Pacificare's apps, for instance, that's not on there. They have OEP and OEPNEW so after the 31st, if I wrote Pacificare MA, I would write in L-OEP.

 

[furlover]

Well, I finally got to the bottom of this. Pyramid is the only company who has been open and honest about this change. Just could NOT understand why there was no one else who seemed to know anything about this change. Finally got BCBS to explain why.

BCBS (only Blue Care Network), Humana and many other major players do not have stand alone MA plans approved in Michigan (without Part D).

So, for two reasons they are pretending to know nothing about the law change.

#1 They don't want agents or customers to know there is more time. Will be interesting to see if there is a change in tactic after 3/31!

#2 They cannot sell their MA plans after 3/31 since they do not have any without drugs attached. I am confused by this. I can't believe it is THAT hard to resubmit to State for plan approved without the Part D drug attached.

I did a MA training class a few weeks ago with BCBS and the instructor told the class there was NO free-look period!! Also, she knew nothing about GAP policies! I am amazed in my area how this MA product is just being ignored.

From my very limited knowledge as a new agent, I cannot understand how you can properly sell this product, if you do not understand GAP policies and you do not KNOW what the free-look period is! Must less teach a class in it :?

Linda

 

[Frank Stastny]

Linda,

IÂ’m glad that Anthony was able to help you. He has always be up-front and honest with me, itÂ’s almost as though he doesnÂ’t work in the insurance industry. :lol:

That type of thing seems to be so prevalent among insurance companies today. Do they honestly think that if they donÂ’t tell us that we arenÂ’t going to find out?

If someone asks me a question about my computer program I give them a straight forward answer. If it doesnÂ’t do something I tell them that it doesnÂ’t. I donÂ’t give them a bunch of double talk and BS like a lot of companies do.

 

[policy doctor]

CMS wants people to join MA. So anybody who has a med supl can change anytime to an MA. All year long, just as they can switch their medicare supl anytime. The drug coverage (for a first-timer) is between NOV_DEC).

 

[Guest]

I just spend 15 minutes on the phone with Unicare arguing this L-OEP. They said it does not apply to PFFS plans, but only HMO and PPO. I wish these MA companies would get their facts straight. The call ended with the Unicare rep telling me they would check with CMS...unbelievable.