Anybody else Get the "warning" from Coventry?
- Thread starter sman
- Start date
- 1,255
Great timing sman!
Today, I was trying to figure out the CMS rules, time lines, and how to help my clients.
Which CMS marketing rule dictates how or when we contact our clients? I'm asking this question for the Forum.
Don't departing carriers have till November 1st to notify PPFS members? Although they could start October 1st. Once my clients get their letter, I'm all about servicing them.
I can see where I had better not proceed prior to the carrier's notification.
The other question I need an answer to is; Can't these people opt out of their plan early starting November or December? Seems I heard this rule from another agent.
- 2,452
f*ck Coventry. I could write a book on that company, they are the most crooked company I know of (even worse than Humana).
If they weren't pulling out voluntarily, CMS would be booting them eventually, if they could get their OWN act together.
If they weren't pulling out voluntarily, CMS would be booting them eventually, if they could get their OWN act together.
- 107
The carrier is required to notify the customers 90 days in advance.
Great timing sman!
Today, I was trying to figure out the CMS rules, time lines, and how to help my clients.
Which CMS marketing rule dictates how or when we contact our clients? I'm asking this question for the Forum.
Don't departing carriers have till November 1st to notify PPFS members? Although they could start October 1st. Once my clients get their letter, I'm all about servicing them.
I can see where I had better not proceed prior to the carrier's notification.
The other question I need an answer to is; Can't these people opt out of their plan early starting November or December? Seems I heard this rule from another agent.
- 19,648
Yes, I got it. I had already thrown their application packets in the trash 2 days ago. Still have the PDP though.
- 1,255
LouriRutl,
I thought they could start contacting 90 days in advance but no later than 60? I like the 90 days answer.
The other question I need an answer to is; Can't these people opt out of their plan early starting November 1st and or December 1st?
Thanks for info...
I thought they could start contacting 90 days in advance but no later than 60? I like the 90 days answer.
The other question I need an answer to is; Can't these people opt out of their plan early starting November 1st and or December 1st?
Thanks for info...
- 107
I was told 90 days. You got me thinking so I went to Medicare.gov and found nothing. Went to CMS and didn't find anything definitive. What I did find shows the carrier does need to notify the beneficiary by Nov. 2.
I found this info and thought I would share.
http://www.cms.hhs.gov/PrescriptionDrugCovContra/Downloads/2010CallLetter.pdf
This is the timeline for things to be done in the MA/MAPD world.
I am not positive about the answer to your other question. I am curious as I have a few carriers pulling out of my area. I will let you know what I find.
I found this info and thought I would share.
http://www.cms.hhs.gov/PrescriptionDrugCovContra/Downloads/2010CallLetter.pdf
This is the timeline for things to be done in the MA/MAPD world.
I am not positive about the answer to your other question. I am curious as I have a few carriers pulling out of my area. I will let you know what I find.
- 19,648
For plans not being renewed, the member can get out after Oct. 1. They could be disenrolled as early as Oct. 31. They could then get a med sup with an effective date of Nov 1. If they disenroll in Nov., they could get an effective date of Dec. 1.
However, getting plans to do the disenrollments in a timely manner will be a bear to get done. If the plan doesn't get them disenolled, they can't use their med sup. It would get fixed eventually, but, you would have many hours spent baby sitting an upset client.
I was discussing this very thing with another agent today because of Wellcare and Coventry both pulling out here. We decided that we would not enroll anyone with effective dates earlier than Jan. 1 except in special cases. For example, I have an MA client that is going to have a kidney transplant, he needs to get out of the MA plan ASAP. We will try to get him into a med sup on Nov. 1.
The other agent contacted Pyramid, Humana, UHC, Wellcare, Coventry and CMS today. Every single one told him that a person could get into a plan a early as Nov. 1. They all indicated that it would not be a problem to get a person disenrolled early in the situation of a plan leaving the area.
I still do not trust that the companies and CMS would follow thru in a timely manner.
- 107
Timely manner is the key. This is a problem always on both the company (Humana) and CMS sides. I hardly ever see anything get done in a "timely manner".
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