What Do I Start with First?

[WCMason]

The problem does persist with any mailed in MA application though, even without postage paid PO Box mailing it still takes 2 to 3 days to receive that app back. The carriers will still give you a hard time if you do that many times over.submissions, so this would mean I never did it before and only know about it because of AHIP testing.

The problem persists only for you because you made up a rule that doesn't exist. It doesn't exist in AHIP training, CMS marketing guidelines, or any other relevant source. I've had many clients sign and date applications then get around to mailing them days or even weeks later and there has never been a problem, because I submit them within 48 hours after I receive them and carriers go by the rules that exist, not invented ones.

 

[sman]

The problem persists only for you because you made up a rule that doesn't exist. It doesn't exist in AHIP training, CMS marketing guidelines, or any other relevant source. I've had many clients sign and date applications then get around to mailing them days or even weeks later and there has never been a problem, because I submit them within 48 hours after I receive them and carriers go by the rules that exist, not invented ones.

I haven't had weeks, but I have had a several day spread. Had one this AEP with a 10 day difference between the date the app was signed by the client and the date I received it. I signed it, dated it the day I received it and faxed it in. No problem whatsoever.

It's probably a good thing he's anonymous on here because if a carrier knew who he was and that he was recommending a beneficiary not date an application and then he dates it when he receives it, he'd likely get in some trouble. But then again, he has 10 years experience.

 

[agentjhc]

They aren't HIPPA or HIPPO compliant. I've never heard that they weren't HIPAA compliant.

Oops, I guess they aren't HIPPA compliant!

I was told a couple of years back they were not HIPAA compliant.

Not sure how a traditional fax would be anymore secure.

 

[goillini52]

Oops, I guess they aren't HIPPA compliant!

I was told a couple of years back they were not HIPAA compliant.

Not sure how a traditional fax would be anymore secure.

It could have been just single company's interpretation. I remember a few years ago that one of the MA carriers wouldn't accept faxes from places like Staples, the library, etc. because they didn't feel it was secure enough.

 

[Brian F 11]

I have worked in the past as a Medicare Telesales Agent in the past, as a captive agent for the largest MAPD Plan Provider around. I currently work as an Independent F2F Agent. Since I have done both, I will share what I know.

You CANNOT cold call a Medicare Recipient to market a Medicare Health Plan. The only exception I know of is if the recipient is already a client of yours, and must already be enrolled in some other products for the same insurance carrier. Here is the big gotch;, if you call about MedSupp and they request an appointment or want to enroll in MAPD then they must call you back another time. SOA or Enrollments processed on an out bound or cold phone call will result in =instant Section A Violation. We would literally have to make each recipient attest to, while being recorded, that 'they' contacted us and that we did not contact them on that call.

Keep in mind two things;

First, as rule of thumb, you cannot initiate contact with a medicare recipient, including cold calling. Second, always do the right thing. Always act with the clients bests interests or wishes in mind. NO Exceptions.

As for an SOA, those are needed for F2F Contact, for CMS regulated plans (MAPD, MA Only, PDP) only. If, and only if, while talking to a medicare recipient by phone, in regards to a CMS regulated plan, you schedule a F2F meeting, then an SOA is mandatory. The SOA must be recorded, mandatory disclosures must be read verbatim. If an SOA can not be completed, as in the case that you are making an appointment for a recipient and the spouse wants to attend, but is unavailable to answer the phone, then the agent conducting the F2F meeting must call ahead and complete the SOA. Do it not, or do it wrong = MIPPA Violation. 3 in one year will have you banned from selling MAPD.

As for selling MAPD over the phone, the insurance carriers have some type of special arrangement with some insurance carriers. All calls must be recorded and mandatory disclosures given, EOB and plan details must be presented properly, there is a very long laundry list of do's and don'ts. Do it not, or do it wrong, or skip a step, and you roll the dice with your license. Medicare Recipient complains to CMS and says they did not understand something or you didn't explain something or feels you mislead them, really any complain for any reason, CMS will pull the recording of the enrollment, you made a mistake = instant Section A violation. Bye bye license for 5 years.

When I first went out on my own, we wanted to offer MAPD enrollments over the phone. We were already doing it for years, have proven to be successful at it, why not start with that?

I searched for a GA, FMO, asked carrier account executives, asked broker services for each company, anyone that I could find, called and asked CMS directly, no GA will facilitate it, no one will tell you how to sell MAPD over the phone. Every account exec blew the question off and looked at me as if I had lost my mind. The carriers don't want the competition. Imagine the tens of millions or maybe hundreds of millions spent advertising during AEP, every tv commercial, radio ad, online SEO Campaigns, all tell the viewer to "call us now". Those phone calls go to carrier call centers where they either enroll the caller, offer in-home F2F Appointments, or reserve seats for a locally held seminar. It seemed to me like they are doing their best to keep it all quiet.

If anyone reading this knows of an FMO or GA that allows for or facilitates MAPD Telephonic Enrollments for independent agents, please let me know. You will be doing me a HUGE favor. I would consider myself in your debt.

Sent from my iPhone using InsForums

 

[RWKAgency]

I don't see why you would need a Scope on a mailed app. The Scope was designed to limit and document what would be discussed in a meeting. If you are doing a sales seminar and you hand that Medicare recipient a compliant sales kit with a self addressed stamped envelope to mail the app back to, I don't see the need for the Scope as one on one sales meeting or presentation took place. I worked a lot of retail these past few AEP's and i can tell you that even though I did not need a Scope in a retail setting, I got one signed anyway for both our protections. As for mailing, getting a Scope would almost be fraudulent. Think about it. What does the Scope say? It says check all products that will be discussed in the meeting. What meeting do you speak of as no meeting actually took place.

 

[sman]

I don't see why you would need a Scope on a mailed app. The Scope was designed to limit and document what would be discussed in a meeting. If you are doing a sales seminar and you hand that Medicare recipient a compliant sales kit with a self addressed stamped envelope to mail the app back to, I don't see the need for the Scope as one on one sales meeting or presentation took place. I worked a lot of retail these past few AEP's and i can tell you that even though I did not need a Scope in a retail setting, I got one signed anyway for both our protections. As for mailing, getting a Scope would almost be fraudulent. Think about it. What does the Scope say? It says check all products that will be discussed in the meeting. What meeting do you speak of as no meeting actually took place.

The meeting would be what you discussed on the phone with the client. And on the form, I've started writing the application was mailed to the client in the date of meeting section.

I'm with you, the Scope should be for F2F meetings. But I started getting them signed on mailed apps as well. I'd rather have it if the carrier requires it than not have it and not get paid. Again, I write on the Scope that the application was mailed.

 

[Brian F 11]

I don't see why you would need a Scope on a mailed app. The Scope was designed to limit and document what would be discussed in a meeting. If you are doing a sales seminar and you hand that Medicare recipient a compliant sales kit with a self addressed stamped envelope to mail the app back to, I don't see the need for the Scope as one on one sales meeting or presentation took place. I worked a lot of retail these past few AEP's and i can tell you that even though I did not need a Scope in a retail setting, I got one signed anyway for both our protections. As for mailing, getting a Scope would almost be fraudulent. Think about it. What does the Scope say? It says check all products that will be discussed in the meeting. What meeting do you speak of as no meeting actually took place.

The SOA is all about the 'how you came in contact with said person'. The purpose of it is to ensure that you maintained ethical marketing practices with that contact. On a mailed app, I would complete it as 'other'. For MAPD, if there is no recording of the call, or proof that the recipient initiated contact, I would reach out to CMS or your account executive for the company you are writing business for. If you are not sure, I would complete an SOA just in case. You are asking for trouble otherwise.

Sent from my iPhone using InsForums

 

[vic120]

The SOA is all about the 'how you came in contact with said person'. The purpose of it is to ensure that you maintained ethical marketing practices with that contact. On a mailed app, I would complete it as 'other'. For MAPD, if there is no recording of the call, or proof that the recipient initiated contact, I would reach out to CMS or your account executive for the company you are writing business for. If you are not sure, I would complete an SOA just in case. You are asking for trouble otherwise.

Sent from my iPhone using InsForums

Scope is not required for mailed app. Except for some strange reason with Aetna

 

[vic120]

Hi guys. I am a 34 year old 10 year licensed agent who previously worked at a Medicare agency as an Assistant Manager type and handled most customer service, did telemarketing early on in my tenure, and sold a few policies over that 10 years to walk-in clients if agent was not available. I am very well versed in all Medicare regulations and understand superbly how Medicare works and fully understand Med Supps, MA, and PDP plans. The agency I worked for was very successful as the top 2 agents there make well over $150,000 even with 50% commissions. They are beasts and have over 1,000 clients each. I left the agency due to lack of pay for my experience and commitment to the business and am now wanting to become an independent broker dealing only with Medicare. This is the time to focus on Medicare with the Baby Boomers and the agency I used to work for started to focus too much time with the ACA and I wanted nothing to do with it (most of their ACA business was lower income people and half of them stopped paying their $24/m ACA premiums and those agents got hit hard with chargebacks). I sat back with a nice grin on my face oh so saying I told you so. My salary was $30,000/yr and found out most other agency STARTS pay at my position at $35,000/yr no experience so yeah that was the final straw for me. I realized if I want to change my life that I must change it and not wait for others to change it for me so here I am.

I have $25,000 saved and only have about $1,500 month overhead to pay all my bills every month. I need help/advice on where I should start. First of all do I want to start as an LLC agency or self-employed contractor for tax reasons? I want my tax to be rock bottom to start since I will make 0 profit Year 1. I know about Westfall and will soon sign up for his site and check it out but I'm not sure if Chris covers my missing gaps as I am versed in Medicare already. I never did underwriting before and not that familiar with it since I wasn't in a sales position. The gist of it is if they answer Yes to any Q they are denied (but not always). I have no laptop, smartphone, GPS, landline, or suits so here what do I need for a presentation pitch in a client's home? I pass AHIP every year so I know what I have to disclose just not what consumers want to hear. I'm thinking to go with Magic Jack for a landline but then I need to fax and need help with a home fax setup. Chris's deal on unlimited cold calling numbers for $50/m sounds great. I have 6 years cold calling telemarketing experience and this is a strong suit of mine. I only did 1 year direct sales selling T-Mobile cell phones at a mall and that's it. I am familiar though with things like F.O.R.M. (family, occupation, recreation, message) and understand the psychology behind selling. Is it better to buy logoed polos or just start with a suit and tie? What technology is needed for presentations? Even though I could sell over phone I want to start with the traditional way of selling and that is cold calling for appointment and selling in client's home.

I plan on writing 50 apps my first year with a goal of 60 every year after that. I am not unethical at all and am not in this industry for the money although I know the money is great. I'm not afraid to spend all my money to support myself the first couple years and me making $30,000 year would have me no longer in the red financially as I live a very modest life. The agency I used to work for used JSA as primary FMO but also went with SMS for Mutual of Omaha. I'm thinking if the agency likes JSA they must be a good FMO to work with and my experience with them on customer service has been favorable in my working years with them. So this is where I am and would greatly appreciate some advice/feedback on what to start with. I never was self-employed before so I need help how and where to start. Thanks in advance.

............................................................................................................