ACA - NoCall Leads Compliance

[MedicareMillionair]

I'm glad everyone could have their say. There are some opinions here and there are some facts. As I stated previously, we get all the information we need for every client we sign up. We've been vetted by CMS more than once with no issues. Also, we do get SSN's. As for AOR's, healthcare.gov should never let an agent change the agent of record. That's not something we control. Perhaps agents shouldn't change them, but they do!

The funny part is, there were groups of agents and agency owners that had exclusivity on this system that we have. They have been pissed off that we brought it to the masses. Some of those agents are on this forum regularly. We changed the game and others, also regulars on this forum, followed suit. They hired people that were with us, then copied our system; facts. I'm happy for them!

Lastly, there are 10's of thousands of Americans now getting insurance, that we have provided them access too. We write thousands of new clients every week. We have dozens of agents that have a thousand or more clients. Also, we have agents with over a thousand clients that are not even derived from Facebook ads.

We're good, Thank You

Oh, I'll add that we never select loss of Medicaid or Cred Coverage as an SEP. That's something else those in their glass houses practice regularly. We don't do that.

 

[Tkruger]

Oh, I'll add that we never select loss of Medicaid or Cred Coverage as an SEP. That's something else those in their glass houses practice regularly. We don't do that.

That's something to hear. I was personally on serval webinars where the presenter did exactly that. This particular is getting new agents in droves who simply don't know better to practice exactly what I had outlined.

Now we have over the years seen stuff like this get busted by FBI, DOI and other 3 letter agencies.

Maybe we should be chatting directly.

 

[MedicareMillionair]

That's something to hear. I was personally on serval webinars where the presenter did exactly that. This particular is getting new agents in droves who simply don't know better to practice exactly what I had outlined.

Now we have over the years seen stuff like this get busted by FBI, DOI and other 3 letter agencies.

Maybe we should be chatting directly.

Sure, we can chat.

I don't know of one application, in all the applications we've written, that falls under the loss of coverage/medicaid SEP. I'm sure they are out there as we've got a lot of agents, but that's not in our business model.

 

[Tkruger]

All agents, brokers, and web-brokers are required to abide by all statutory requirements when assisting consumers on the FFMs. These requirements will take effect beginning June 18, 2023.

Beginning June 18th, 2023, agents, brokers, and web-brokers will need to meet the new consent requirements listed in 45 C.F.R. 155.220(j)(2)(iii) and all agents, brokers and web-brokers will be required to document and maintain consumer consent. 155.220(j)(2)(iii)(B) requires this documentation include:
• a description of the scope, purpose, and duration of the consent provided by the consumer or the consumer's authorized representative;
• the date the consent was given;
• the name of the consumer or their authorized representative;
• the name of the agent, broker, web-broker, or agency to whom consent was granted (Note that this could include additional names of agents or brokers if the consenter authorized multiple agents or brokers within the same organization);
• a process through which the consumer or their authorized representative may rescind the consent.
This documentation must be maintained for a minimum of 10 years

Beginning on June 18th, 2023, CMS will also require agents, brokers, and web-brokers to meet the new requirements under 45 C.F.R. 155.220(j)(2)(ii) to document a consumer or their authorized representative reviewed their application and attested to the information being accurate. CMS does not require all parties on an application review their information and confirm it is accurate or provide consent. While it is a best practice to ensure all parties on an application do these things, it is not a realistic expectation in all scenarios. Therefore, CMS allows either a consumer or a consumer's authorized representative designated in compliance with § 155.227 to take the action that produces a record that can be maintained by the assisting agent, broker, or web-broker attesting they have reviewed their application information and it is accurate.

The documentation created by the consumer or the consumer's authorized representative must contain the minimum requirements listed in 155.220(j) to be compliant. 155.220(j)(2)(ii)(A)(1) requires the documentation must include:
• the date the information was reviewed;
• the name of the consumer or their authorized representative;
• an explanation of the attestations at the end of the eligibility application; and
• the name of the assisting agent, broker, or web-broker
This documentation must be maintained for a minimum of 10 years.

The Centers for Medicare & Medicaid (CMS) does not prescribe a standard format or process for obtaining the documentation of consent or application review or for maintaining these records, provided the requirements listed in 45 C.F.R. § 155.220(j)(2) (ii) and (iii) are met. Additionally, you may obtain consent or confirmation of application review verbally (such as over the phone), electronically (such as via email), or in person. Thus, you have flexibility to determine how you will meet the documentation requirement. While CMS does not require a form, or specify that a form must be signed, you can use the draft model consent form that CMS has developed, available by downloading the ZIP file found at [EXTERNAL LINK] - CMS-10840 | CMS. This form is optional, but if it aligns with state law in your state, it may provide a template for meeting the consent documentation requirement. You can also use a Broker of Record (BOR) form from an issuer or state Department of Insurance (DOI) or the applicable state regulatory agency to satisfy this requirement. If you are assisting verbally (such as over the phone), you may obtain consent and confirmation of application review by reading a script that contains, at a minimum, the required elements summarized above, and must maintain a record demonstrating that the requirements were obtained. As CMS does not prescribe a particular method, any recording method that contains the elements required is acceptable.

For the most up-to-date information on the roles and requirements of agents and brokers in the Marketplace, visit https://go.cms.gov/CCIIOAB

If you need additional assistance, please do not hesitate to contact us again via email at [email protected]

Thank you,
FFM Agent/Broker Email Help Desk Staff

 

[sshafran]

All agents, brokers, and web-brokers are required to abide by all statutory requirements when assisting consumers on the FFMs. These requirements will take effect beginning June 18, 2023.

Beginning June 18th, 2023, agents, brokers, and web-brokers will need to meet the new consent requirements listed in 45 C.F.R. 155.220(j)(2)(iii) and all agents, brokers and web-brokers will be required to document and maintain consumer consent. 155.220(j)(2)(iii)(B) requires this documentation include:
• a description of the scope, purpose, and duration of the consent provided by the consumer or the consumer's authorized representative;
• the date the consent was given;
• the name of the consumer or their authorized representative;
• the name of the agent, broker, web-broker, or agency to whom consent was granted (Note that this could include additional names of agents or brokers if the consenter authorized multiple agents or brokers within the same organization);
• a process through which the consumer or their authorized representative may rescind the consent.
This documentation must be maintained for a minimum of 10 years

Beginning on June 18th, 2023, CMS will also require agents, brokers, and web-brokers to meet the new requirements under 45 C.F.R. 155.220(j)(2)(ii) to document a consumer or their authorized representative reviewed their application and attested to the information being accurate. CMS does not require all parties on an application review their information and confirm it is accurate or provide consent. While it is a best practice to ensure all parties on an application do these things, it is not a realistic expectation in all scenarios. Therefore, CMS allows either a consumer or a consumer's authorized representative designated in compliance with § 155.227 to take the action that produces a record that can be maintained by the assisting agent, broker, or web-broker attesting they have reviewed their application information and it is accurate.

The documentation created by the consumer or the consumer's authorized representative must contain the minimum requirements listed in 155.220(j) to be compliant. 155.220(j)(2)(ii)(A)(1) requires the documentation must include:
• the date the information was reviewed;
• the name of the consumer or their authorized representative;
• an explanation of the attestations at the end of the eligibility application; and
• the name of the assisting agent, broker, or web-broker
This documentation must be maintained for a minimum of 10 years.

The Centers for Medicare & Medicaid (CMS) does not prescribe a standard format or process for obtaining the documentation of consent or application review or for maintaining these records, provided the requirements listed in 45 C.F.R. § 155.220(j)(2) (ii) and (iii) are met. Additionally, you may obtain consent or confirmation of application review verbally (such as over the phone), electronically (such as via email), or in person. Thus, you have flexibility to determine how you will meet the documentation requirement. While CMS does not require a form, or specify that a form must be signed, you can use the draft model consent form that CMS has developed, available by downloading the ZIP file found at [EXTERNAL LINK] - CMS-10840 | CMS. This form is optional, but if it aligns with state law in your state, it may provide a template for meeting the consent documentation requirement. You can also use a Broker of Record (BOR) form from an issuer or state Department of Insurance (DOI) or the applicable state regulatory agency to satisfy this requirement. If you are assisting verbally (such as over the phone), you may obtain consent and confirmation of application review by reading a script that contains, at a minimum, the required elements summarized above, and must maintain a record demonstrating that the requirements were obtained. As CMS does not prescribe a particular method, any recording method that contains the elements required is acceptable.

For the most up-to-date information on the roles and requirements of agents and brokers in the Marketplace, visit https://go.cms.gov/CCIIOAB

If you need additional assistance, please do not hesitate to contact us again via email at [email protected]

Thank you,
FFM Agent/Broker Email Help Desk Staff

@HoosierLife

 

[kgmom219]

Here's a link to the draft model from CMS. (Because TK is great, but it took me a bit to find it from the link above)

Look at Page 2

[EXTERNAL LINK] - Adobe Acrobat

I am just adding it as a required checkbox on my booking page.

 

[MedicareMillionair]

Here's a link to the draft model from CMS. (Because TK is great, but it took me a bit to find it from the link above)

Look at Page 2

[EXTERNAL LINK] - Adobe Acrobat

I am just adding it as a required checkbox on my booking page.

There still must be confirmation all information on the application is accurate.

 

[DonP]

Here's a link to the draft model from CMS. (Because TK is great, but it took me a bit to find it from the link above)

Look at Page 2

[EXTERNAL LINK] - Adobe Acrobat

I am just adding it as a required checkbox on my booking page.

I see no reason place for signature . Will people we sign up have to sign that next yr ? I read somewhere a verbal consent is ok

 

[MedicareMillionair]

I see no reason place for signature . Will people we sign up have to sign that next yr ? I read somewhere a verbal consent is ok

It's not next year, it's June 18th. They do not have sign it if there is electronic or verbal confirmation. This may be debatable.

 

[lperez]

I just wanna know what process you use to qualify people who don't have an SEP. They have not asked to verify the proof of coverage lost SEP in the last 2 years. Is this what you guys are doing?