I want to address our ACA No Call Leads system and the confusion it has created. As a leader in this market we’ve drawn a lot of attention and we’ve taken a lot of heat. There have been untruths posted about this system, even on this forum. The funny part of that is these same people have contracted agents that previously worked with us to help create their systems. They change a couple things and then say we don’t know what we are doing.

Below are a couple points to make regarding NoCall Leads and our system.

  1. Our competitors state we are not compliant, this is their ignorance to the rules. We are 100% compliant and this has been proven with our interactions with CMS. We write thousands of deals every week. We’ve received several inquiries from CMS regarding our business practices. We have addressed these inquiries and been given their blessing. The individuals insinuating we are not compliant are simply ignorant to the rules or, as I suspect, simply working a marketing angle. (these guys don’t know what they are doing, so do business with us)


  2. Things will change, but we don’t know what the changes will be. Recent HHS proposals have been focused more so on DACA Recipients, Transgender Reassignment, Hormone Therapy, Gender Discrimination, but very little in the way of changing the enrollment rules. Having said this, there are items under consideration that will affect what we do.


  3. Regarding potential changes, the biggest changes that will affect this system are elimination of electronic consent to enroll, the requirement of all documentation with submission of application.


  4. Regarding documentation needed to submit applications; Healthcare.gov does not require all information to be submitted with the application. They want Americans to get access to health insurance immediately. Many of the people insured on zero premium plans don’t have the very basics of their information available. That’s why they are given time to produce this information. That’s why it’s compliant to submit applications without this information.

What’s the biggest issue? AGENTS are the biggest problem regarding this system. The only complaints we’ve received have been from agents and these go away immediately. The only people complaining about our system on the internet are agents. Agents will create the issues for other agents, not the consumer. This is reminiscent of the foolish agents/gurus, that for many years, said “Don’t sell Medicare Advantage or you might lose your license”. That was a big lie and only hurt agents. By the way, most of those agents now market or sell MAPD. They certainly provide it to their downline.

We are insuring tens of thousands of people. Many of these people would not be insured without us. Our agents are earning tens of thousands of dollars every month. We are quite content to push forward.
 
So, you are saying this won't impact your business?




I want to address our ACA No Call Leads system and the confusion it has created. As a leader in this market we’ve drawn a lot of attention and we’ve taken a lot of heat. There have been untruths posted about this system, even on this forum. The funny part of that is these same people have contracted agents that previously worked with us to help create their systems. They change a couple things and then say we don’t know what we are doing.

Below are a couple points to make regarding NoCall Leads and our system.

  1. Our competitors state we are not compliant, this is their ignorance to the rules. We are 100% compliant and this has been proven with our interactions with CMS. We write thousands of deals every week. We’ve received several inquiries from CMS regarding our business practices. We have addressed these inquiries and been given their blessing. The individuals insinuating we are not compliant are simply ignorant to the rules or, as I suspect, simply working a marketing angle. (these guys don’t know what they are doing, so do business with us)


  2. Things will change, but we don’t know what the changes will be. Recent HHS proposals have been focused more so on DACA Recipients, Transgender Reassignment, Hormone Therapy, Gender Discrimination, but very little in the way of changing the enrollment rules. Having said this, there are items under consideration that will affect what we do.


  3. Regarding potential changes, the biggest changes that will affect this system are elimination of electronic consent to enroll, the requirement of all documentation with submission of application.


  4. Regarding documentation needed to submit applications; Healthcare.gov does not require all information to be submitted with the application. They want Americans to get access to health insurance immediately. Many of the people insured on zero premium plans don’t have the very basics of their information available. That’s why they are given time to produce this information. That’s why it’s compliant to submit applications without this information.

What’s the biggest issue? AGENTS are the biggest problem regarding this system. The only complaints we’ve received have been from agents and these go away immediately. The only people complaining about our system on the internet are agents. Agents will create the issues for other agents, not the consumer. This is reminiscent of the foolish agents/gurus, that for many years, said “Don’t sell Medicare Advantage or you might lose your license”. That was a big lie and only hurt agents. By the way, most of those agents now market or sell MAPD. They certainly provide it to their downline.

We are insuring tens of thousands of people. Many of these people would not be insured without us. Our agents are earning tens of thousands of dollars every month. We are quite content to push forward.
 
What I'm saying is that our agents are 100% compliant. We have been vetted by CMS. I typically don't use random videos to make decisions, instead CMS guidelines. Yes changes will come to this platform, but our system is proven compliant. We hear the talk and we see the nonsense posted online. Then we go to CMS and get the facts.
 
What I'm saying is that our agents are 100% compliant. We have been vetted by CMS. I typically don't use random videos to make decisions, instead CMS guidelines. Yes changes will come to this platform, but our system is proven compliant. We hear the talk and we see the nonsense posted online. Then we go to CMS and get the facts.
Fair enough, so post the facts (from CMS) are SSN now required to sign someone up?
 
Not an ACA agent here. But why is SSN such a big deal? Cant they just add that to the app process they are doing now? Are yall saying that most people on zero premium policies dont know their SSN so it will negatively impact these systems? Or that they will not want to put that on the form out of trust issues?

I dont get the big deal.
 
Not an ACA agent here. But why is SSN such a big deal? Cant they just add that to the app process they are doing now? Are yall saying that most people on zero premium policies dont know their SSN so it will negatively impact these systems? Or that they will not want to put that on the form out of trust issues?

I dont get the big deal.


because its not relationship based, they are using ads saying they can have and agent find them the best plan $0 without ever speaking with an agent

thats the hook

then the prospect filles out a form where they check wavers allowing the agent to run apps for them
 
Basically, they are using massive amounts of tax payor dollars, to fully pay for the ACA plan of up to $800/mo, where the client gets a free plan, without even providing a social security number, sometimes a fake address, no email address or phone number, and the client never knows that the policy just continues renewing at $0, doesn't file taxes, or reconcile the tax credits..........but the agent keeps getting paid the $20/mo commission. ACA is still the wild west, with lots of fraud being done by bad apple agents. Not saying it's Medicare Millionaire, as I don't know his model.
 
Basically, they are using massive amounts of tax payor dollars, to fully pay for the ACA plan of up to $800/mo, where the client gets a free plan, without even providing a social security number, sometimes a fake address, no email address or phone number, and the client never knows that the policy just continues renewing at $0, doesn't file taxes, or reconcile the tax credits..........but the agent keeps getting paid the $20/mo commission. ACA is still the wild west, with lots of fraud being done by bad apple agents. Not saying it's Medicare Millionaire, as I don't know his model.


I thought if you don’t file a return in 18-24 months they yank the subsidy ?
 
Sorry, after all the years I've been in business, all the training, all the compliance and even working with Medicare peeps this is not compliant.

If this is the company I am trying to work with they are in their webinars advising agents to commit fraud.

If they don't qualify for an SEP just say they lost Medicaid during the application process..

I was just in a webinar that this was stated per a member of this forum as the proper handling to create an SEP.

Per the FEDS:

"The civil FCA protects the Government from being overcharged or sold shoddy goods or services. It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent. Filing false claims may result in fines of up to three times the programs' loss plus $11,000 per claim filed. Under the civil FCA, each instance of an item or a service billed to Medicare or Medicaid counts as a claim, so fines can add up quickly. The fact that a claim results from a kickback or is made in violation of the Stark law also may render it false or fraudulent, creating liability under the civil FCA as well as the AKS or Stark law.

Under the civil FCA, no specific intent to defraud is required. The civil FCA defines "knowing" to include not only actual knowledge but also instances in which the person acted in deliberate ignorance or reckless disregard of the truth or falsity of the information. Further, the civil FCA contains a whistleblower provision that allows a private individual to file a lawsuit on behalf of the United States and entitles that whistleblower to a percentage of any recoveries. Whistleblowers could be current or ex-business partners, hospital or office staff, patients, or competitors.

There also is a criminal FCA (18 U.S.C. § 287). Criminal penalties for submitting false claims include imprisonment and criminal fines. Physicians have gone to prison for submitting false health care claims. OIG also may impose administrative civil monetary penalties for false or fraudulent claims, as discussed below."

This org has heavily brought on agent with zero care of the law. Let alone that of anyone doing this crap will lose carrier appointments and state licensure. This will effectively put you out of the industry...

You have points on getting the rights to do an AOR change, this $hit is totally different.

I suggest the forum member in question lawyer up and FAST!
 
Back
Top