CMS Reverses Rule

[Frank Stastny]

I just received this e-mail. It says "With this change underway...". It may very well be "underway" but it might be best, with all the rumors floating around, to wait to hear it directly from CMS.

CMS could turn around and change their mind again before the bell rings and the agents come out swinging. What a cluster ah, mess.

CMS Reverses Rule: Plans May Contact Existing Members to Present Additional Products Good news! CMS will soon issue guidance that permits companies to contact their existing members for any reason, including to market other products. This decision is a reversal of the organization's earlier position, in which it had decided not to allow this type of activity for 2009. With this change underway, we will be better able to assist our agents in conserving their business and maintaining their clients.
If you have any questions, feel free to contact Independent Agency Sales:
American Progressive: 1-800-332-3377, ext. 183; [email protected]
Pyramid Life 1-800-538-1053, ext. 8810; [email protected].
For licensed insurance agents only. Not intended for distribution to the insurance buying public

 

[michellea]

I had a conference call today with my FMO and he said for us to basically be on stand by for a good many conference calls as rules are interpretted and CMS decides what they are going to do. It ought to be fun and interesting watching this unfold. I can't wait to see the agents that do wrong run out of this business as fast as they ran in and messed people up.

 

[Winter_123]

I had a conference call today with my FMO and he said for us to basically be on stand by for a good many conference calls as rules are interpretted and CMS decides what they are going to do. It ought to be fun and interesting watching this unfold. I can't wait to see the agents that do wrong run out of this business as fast as they ran in and messed people up.

Also running out of the field will be many who are completely competent and ethical but do not want to work in a field where almost nothing will be an allowable practice by the time CMS is done unless you want to follow the daily updates to see if CMS says you can pee that day without an appointment. The notion that CMS rules will only drive out the bad is misquided. They are regulating the field to death trying to kill it because Congress has not defunded it yet which is what they want.

Also, many of the plans are crap and filled with many uncertainties that no agent explain away no matter how articulate and disclosing they are. So, there will be many unethical agents running from the plans but at the same time there is an increasing number of highly ethical agents who will not associate themselves with MA's. Yes, I know that there are instances where an MA is appropriate and suitable and most agents in the field believe that they they only sell in those instances. If only it were so.

 

[jdeasy]

Also running out of the field will be many who are completely competent and ethical but do not want to work in a field where almost nothing will be an allowable practice by the time CMS is done unless you want to follow the daily updates to see if CMS says you can pee that day without an appointment. The notion that CMS rules will only drive out the bad is misquided. They are regulating the field to death trying to kill it because Congress has not defunded it yet which is what they want.

Also, many of the plans are crap and filled with many uncertainties that no agent explain away no matter how articulate and disclosing they are. So, there will be many unethical agents running from the plans but at the same time there is an increasing number of highly ethical agents who will not associate themselves with MA's. Yes, I know that there are instances where an MA is appropriate and suitable and most agents in the field believe that they they only sell in those instances. If only it were so.

Actually, what CMS will do is drive out the good agents leaving only the bad ones. The good agents do everything in their power to follow the rules to the letter and the intent. In doing so, it makes doing business too cumbersome to make a decent living. The bad agents aren't following the rules now, so, it's not that bothersome to them. Those same agents won't worry about the new rules.

I ran into one of my Coventry clients yesterday. He had gotten his letter from Coventry that his premium was going up to $31/mo from $0. He said he was expecting me to call. I told him that would not be able to call him and that it was just a lucky coincidene that I had met up with him. He was completely flabergasted that I was under restrictions to not call him. I did tell him that I was planning on sending letters to clients, but, since that letter had to CMS approved, I wasn't sure how to proceed with that either.

He said, "it sounds like they are trying to put you out of business". Nothing I could do except agree.

 

[Winter_123]

Actually, what CMS will do is drive out the good agents leaving only the bad ones. The good agents do everything in their power to follow the rules to the letter and the intent. In doing so, it makes doing business too cumbersome to make a decent living. The bad agents aren't following the rules now, so, it's not that bothersome to them. Those same agents won't worry about the new rules.

I ran into one of my Coventry clients yesterday. He had gotten his letter from Coventry that his premium was going up to $31/mo from $0. He said he was expecting me to call. I told him that would not be able to call him and that it was just a lucky coincidene that I had met up with him. He was completely flabergasted that I was under restrictions to not call him. I did tell him that I was planning on sending letters to clients, but, since that letter had to CMS approved, I wasn't sure how to proceed with that either.

He said, "it sounds like they are trying to put you out of business". Nothing I could do except agree.

Good agents are held to a double standard. The essence of being a good agent is suitability analyis. You get to the clients home and find out that they have several critical illnesses which would qualify them for an SNP. However, they responded to advertising for some other plan. Or maybe they are very sick and would exceed the MOP every year and really just need a med supp or a better rate on their med supp.
You cant show them the med supp. You cant show them the other plan, except that there are some lawyers and agents who argue that you can such that if you do it you never know whether you are in compliance or not.

Good agents dont like to operate that way and you end out looking like you are just churning the client around by trying to negotiate these factors. That evening the clients daughter drops by and just tells her mother to call the AARP number on TV and just sign up for one of their plans. "At least you know if can't be too bad if it is endorsed by AARP."
So CMS precluded you from being able to do a full suitability analysis and selecting the right plan (unless you want to come back and all of that). As a consequence the client calls a telesales number where they do no suitability analysis and have only one tool in their tool box so guess which one they recommend.

Winter

 

[michellea]

Actually, what CMS will do is drive out the good agents leaving only the bad ones. The good agents do everything in their power to follow the rules to the letter and the intent. In doing so, it makes doing business too cumbersome to make a decent living. The bad agents aren't following the rules now, so, it's not that bothersome to them. Those same agents won't worry about the new rules.

You guys are both right I guess. I never thought of it that way. I know personally I am not planning on actively seeking out clients anymore. I will enroll a med. supp. or med. adv. as I run across them but as far as being my main source of income as it was before, no thank you. In my area the plans are still decent. Network and benefits are good and still no monthly premium.

 

[Non-golfing Agent]

Still waiting for commissions.

Spent all day taking 5 tests all the while not knowing what I will be paid for offering the plans. Please tell me, does this happen in any other profession? It's absolutely ridiculous. The government and the lobbyists who pushed these ridiculous rules should be ashamed of themselves.

 

[jdeasy]

You guys are both right I guess. I never thought of it that way. I know personally I am not planning on actively seeking out clients anymore. I will enroll a med. supp. or med. adv. as I run across them but as far as being my main source of income as it was before, no thank you. In my area the plans are still decent. Network and benefits are good and still no monthly premium.

I'm the same way. This will be my last active AEP. I'm not taking any leads from anyone even for this AEP. I have a large file of people that I have met during lock in or while Wellcare's Duet/Melody has been shut down in Ky and IN that I have promised to call back during AEP or wheneven Duet/Melody comes back available.

I intend to honor my word to those people. The only MA plans I will do in the future will be referrals and when that need comes up from my other work of life insurance, final expense and med sups. If there is a genuine need for an MA plan, I will follow the rules and schedule another appointment or refer then to another agent that can fit their needs.

The implication from CMS that I am guilty until proven innocent is just a hurdle that I'm not willing to jump anymore.

 

[Frank Stastny]

Actually, what CMS will do is drive out the good agents leaving only the bad ones. The good agents do everything in their power to follow the rules to the letter and the intent. In doing so, it makes doing business too cumbersome to make a decent living. The bad agents aren't following the rules now, so, it's not that bothersome to them. Those same agents won't worry about the new rules.

You are exactly correct. The "good agents" are bailing out and only the sleazy ones will be left. I'm speaking about those who got into insurance just to sell PFFS plans.

The good agents are following the rules and not pushing that crap just for the commission. So, who are they punishing? Those who follow the rules and who are not a part of the problem.

The bottom feeders in the PFFS market really don't give a damn what CMS says. If they lose their license it is no big deal to them. They will just go back to their MLM company and continue to rip people off.

I'm becoming more disenchanted with the senior market every day.

 

[Non-golfing Agent]

We're all so quick to blame the agents. We're the last in line on the food chain...where is the outrage for the bigger fish that made these plans what they are?

These plans should've been standardized like Medicare Supplements and CMS should've been the ones to introduce the specific plan changes each year.

Commissions should've been handled by the respected companies and the states should've had oversight of all companies and agents participating in their state.

I just don't understand why these plans, specifically the drug plan, was made so difficult to understand. Did the government think that seniors would have an easy time understanding the cumbersome benefits?

Now seniors are dumb and helpless? Or is it our politicians are in the pocket of the insurance, drug, and AARP lobby?

This isn't about rogue agents, IMO. It's about a government asleep at the wheel.