Chargebacks for Oct, Nov and Dec Enrollments who used AEP for another switch

[wehotex]

110.7.1 – Rapid Disenrollment

42 CFR §§ 422.2274, 423.2274

Rapid disenrollment applies when an enrollee makes any plan change (regardless of Parent Organization) within the first three (3) months of enrollment. Additionally, rapid disenrollment compensation recovery applies when a beneficiary uses OEP to make an enrollment change.Rapid disenrollment compensation recovery does not apply when a beneficiary enrolls effective October 1, November 1, or December 1 and subsequently uses the Annual Election Period to change plans for an effective date of January 1.

I've heard of this before, but unsure if MA plans adhere to it?
I had 2 such enrollments for 11-1-20 with United Health Care who ended up switching (not with me) to other plans for Jan 1 and I still receive chargebacks on both. I sent an inquiry to UHC and will share the reply once I receive it.

 

[vic120]

I went through this with UHC one year Had client did UHC 11/01 and we did a new Aetna plan for 01/01

I had to go back and forth with them for 2 or so months and sent them the proof that is should not be chargeback from the medicare site before they reversed and paid me

Especially because the first Enrollment was new to medicare

 

[wehotex]

I went through this with UHC one year Had client did UHC 11/01 and we did a new Aetna plan for 01/01

I had to go back and forth with them for 2 or so months and sent them the proof that is should not be chargeback from the medicare site before they reversed and paid me

Especially because the first Enrollment was new to medicare

thanks. If the mb was NEW to Medicare, they

I went through this with UHC one year Had client did UHC 11/01 and we did a new Aetna plan for 01/01

I had to go back and forth with them for 2 or so months and sent them the proof that is should not be chargeback from the medicare site before they reversed and paid me

Especially because the first Enrollment was new to medicare

Thanks Vic. I think that I remember when you wrote about that. If its NEW, they should pay within the Plan Year? (pro-rated commish + true-up) for the policy year. Then renewals would start on Jan 1 of the following year. It makes sense that the same would hold true for the ones who are NOT NEW to Medicare.

 

[vic120]

thanks. If the mb was NEW to Medicare, they


Thanks Vic. I think that I remember when you wrote about that. If its NEW, they should pay within the Plan Year? (pro-rated commish + true-up) for the policy year. Then renewals would start on Jan 1 of the following year. It makes sense that the same would hold true for the ones who are NOT NEW to Medicare.

It is true for not new to medicare as well

maybe look up that thread there was somewhere in there I was able to get the documentation needed to get paid

 

[wehotex]

It is true for not new to medicare as well

maybe look up that thread there was somewhere in there I was able to get the documentation needed to get paid

Fast Reply:

The rapid disenrollments were correctly processed as these members were on their UHC plans for two months.

For information on how you are paid for your policies, we ask that you please refer to your contractual agreement. If after reviewing this information you have further questions, please contact your Agent Manager for further assistance.

Should you have additional information to add to this request, please refer to the Service Request number when you contact us. Thank you for your continued partnership with UnitedHealthcare.

I guess that UHC doesn't have to follow Medicare guidelines?

 

[BibH]

With united healthcare you can't track your business . You must go threw your commission statements weekly to figure out if any clients dropped. They do this on purpose so you can't track your business to move your clients as readily .

 

[wehotex]

With united healthcare you can't track your business . You must go threw your commission statements weekly to figure out if any clients dropped. They do this on purpose so you can't track your business to move your clients as readily .

I've noticed that. It's aggravating as hell. Though, it seems like a better system with membership base would enhance member retention. Why don't they see that?

 

[vic120]

With united healthcare you can't track your business . You must go threw your commission statements weekly to figure out if any clients dropped. They do this on purpose so you can't track your business to move your clients as readily .

Most are the same way

 

[BibH]

Not Humana . There site is awesome . It shows all active and inactive policy's . The worst is WellCare .

 

[vic120]

Fast Reply:

The rapid disenrollments were correctly processed as these members were on their UHC plans for two months.

For information on how you are paid for your policies, we ask that you please refer to your contractual agreement. If after reviewing this information you have further questions, please contact your Agent Manager for further assistance.

Should you have additional information to add to this request, please refer to the Service Request number when you contact us. Thank you for your continued partnership with UnitedHealthcare.

I guess that UHC doesn't have to follow Medicare guidelines?

I got that 3 times I continued to fight, Even after I gave documentation showing it needs to be paid got that message and I took it up the latter

My thing was It already cost me so much time I wasn't going to let up

As bad as they are to deal with on this Humana is worse on so many other things