AHIP Outbound Calls - Does This Prohibit Medigap Prospecting?

[DecisionMan]

A little bit of a stumper here when going through the 2012 AHIP certification, part 4 "Marketing Medicare Advantage and Part D Plans", slide 46 reads:

"Prohibited outbound telephonic activities include:
- Unsolicited outbound calls to beneficiaries about other business as a means of generating leads for Medicare plans. Examples of other lines of business include discount prescription drug card, Medigap plan, needs assessment, educational event, a review of Medicare coverage options, or any other service that is not an MA plan or PDP"

Suppose in T-65 cold-calling for med supps we offer a brief educational review of how medicare works, what it covers and the two coverage choices you have, and assistance in how to choose which option is best.

Would that be a violation of the CMS marketing rules, if your intent is to sell medicare supplements?

What if in the appointment the T-65 wants an Advantage Plan? Does that now violate this rule? Or would you get an SOA and come back in two days?

 

[captain94]

If you cold call for medsupps and sell a Ma or Part D you are in Violation. Even if the prospect wants. MA. That's why I won't offer MA or Part D. I will go over them and if they want a MA I tell them who to contact and leave. I don't make any money off the refferal.

 

[pbbaseball]

if the prospect brings it up, you are ok, but you can't bring it up....

if you want to sell MA after lock-in, I would chase the LIS people instead of the T65's, much less to worry with in my opinion, and if they aren't happy, can pull out when they want to.

 

[captain94]

if the prospect brings it up, you are ok, but you can't bring it up....

CMS states that if you set a appt. for a medigap, Discount Card or Medicare review and a MA or PDP sale results from that appointment you are in Violation. It does not matter who brings it up.


Sales of Medicare health plan products are subject to our scope of appointment guidance, even if conducted during a sales appointment for a Medigap policy. This includes the
requirement for a beneficiary-completed agreement form prior to the appointment and a 48-hour waiting period.

Any plan sponsor or its representative that accepts an appointment to sell an MA or PDP product that resulted from an unsolicited contact with a beneficiary, regardless of who made the contact, will be in violation of the prohibition against unsolicited contacts.
If during the course of an outbound call by a Medigap issuer the beneficiary requests additional information on a MA or PDP product, at this time a discussion can be held on the MA or PDP product, as long as the call is being recorded.
Furthermore, third-parties may not make unsolicited MA or PDP marketing calls to beneficiaries (other than to current plan members if contracted by a plan, as described below) to set up appointments with potential enrollees. Third-parties may not make unsolicited calls to beneficiaries for non-MA and PDP products (for example, a “benefits compare” meeting) and provide those contacts to plans for ultimate use as an MA or PDP sales appointment. Sales of MA and PDP products are subject to CMS’ scope of appointment guidance, even if conducted during a sales appointment for a Medigap policy.

 

[0b1kanobee]

This should make for an interesting thread LOL

 

[YouGotMyMoney]

eff it like I say the rules were made to be broken.

 

[cadylou]

All of these regulations make it very difficult for a consumer to make a good comparison of their options . . . .terrible. . . .

 

[senior-advisor-indiana]

If you can't follow the rules then you shouldn't sell them.

 

[0b1kanobee]

If you can't follow the rules then you shouldn't sell them.

I have yet to hear how someone follows the rules 100% selling these plans successfully.

 

[Guest]

I have yet to hear how someone follows the rules 100% selling these plans successfully.

I have always followed the rules thank you very much. Its not that tough really.