Okay so I started my new job at an insurance brokerage back in September. I had been selling auto/home/life insurance at State Farm before that for 3 years. Health insurance was totally new to me and unfortunately I started at a VERY crazy time. Here in Minnesota cost plans were getting eliminated and 1000+ clients at our agency had to be helped to determine a new plan choice either between MA-PD or Medigap. I was sort of thrown into the fire and had to learn very quickly lol. I ended up signing up around 250 people into new policies. One customer though I think I royally f***ed up on. She wanted to go onto a Blue Cross Medigap policy which was totally fine we filled out the application and everything went smooth. From what I learned my supervisors kept saying the phrase "if they dont like their policy they do have a one-time change the first couple months of the year because they lost there cost plan". I had told my Medigap client that as well and I got an email from her yesterday saying she wanted to go back down to a MA-PD. I called Blue Cross and they told me she already used her SEP so she wouldnt be able to get back into a MA-PD until the next open enrollment. Does anyone have any ideas what else she could do or what I could tell her? Any advice is greatly appreciated.
Enrollment Periods...
- Thread starter Gilly
- Start date
She used her SEP so she has to wait until the next annual enrollment period, not the next open enrollment period.
Don’t confuse the two.
Your boss was saying if they don’t use that sep by the end of the year they still have time. But your client used it.
At this point you’d be best advising the client how much better a Med supp will be for her. You screwed up but it happens. Best to ask next time.
BTW if someone is on a MAPD plan right now they can switch to another MAPD plan or drop it and pick up a Med supp and part D. Because we are in OEP
Also, you are posting this in the health exchange forum (the ACA) you want to be in the senior forum
Don’t confuse the two.
Your boss was saying if they don’t use that sep by the end of the year they still have time. But your client used it.
At this point you’d be best advising the client how much better a Med supp will be for her. You screwed up but it happens. Best to ask next time.
BTW if someone is on a MAPD plan right now they can switch to another MAPD plan or drop it and pick up a Med supp and part D. Because we are in OEP
Also, you are posting this in the health exchange forum (the ACA) you want to be in the senior forum
- 6,457
http://mn.gov/commerce-stat/pdfs/cost-plan-transition.pdf
you need to do some checking with your state. It appears that MN has some special rules for this season that agents in other states may not know about.
The link above also suggests that your boss was partially correct, but seriously careless in what he told you. The way I read the document is that there is a special 2 month extension for MN cost plan holders, but that it applies to MAPD/PDP only, not to Medigap. Medigap app should have been a waving red flag for your boss.
However you should do some further checking to be sure that is the correct interpretation.
(note, I am not an agent.)
you need to do some checking with your state. It appears that MN has some special rules for this season that agents in other states may not know about.
The link above also suggests that your boss was partially correct, but seriously careless in what he told you. The way I read the document is that there is a special 2 month extension for MN cost plan holders, but that it applies to MAPD/PDP only, not to Medigap. Medigap app should have been a waving red flag for your boss.
However you should do some further checking to be sure that is the correct interpretation.
(note, I am not an agent.)
- 6,457
I was just rereading that document. The first time I read it, I was looking specifically for the 2 month 2019 period I had seen before.
On rereading, I noticed the oct 15 to mar 4 enrollment period. If supplement selection in this period is not limited to one choice, you may be able to use that period to help your client choose a less expensive Medigap plan option.
On rereading, I noticed the oct 15 to mar 4 enrollment period. If supplement selection in this period is not limited to one choice, you may be able to use that period to help your client choose a less expensive Medigap plan option.
I assume along with the Medigap plan you enrolled her into a PDP. When was that application taken and when did the plan go into effect?
- Thread starter
- #6
I enrolled her into a medigap policy with a pdp in October. Everything was effective for 01/01/2019. She had some procedures done and now wants to drop down to a MA-PD.
OK, so the PDP app was done during AEP. She still has an SEP due to the cost plan not being renewed for 2019. It runs until 2/28.
From CMS:
SEP for Individuals Enrolled in Cost Plans that are Non-renewing their Contracts - An SEP will be available to enrollees of HMOs or CMPs that are not renewing their §1876 cost contracts for the area in which the enrollee lives.
This SEP is available only to Medicare beneficiaries who are enrolled with an HMO or CMP under a §1876 cost contract that will no longer be offered in the area in which the beneficiary lives. Beneficiaries electing to enroll in an MA plan via this SEP must meet MA eligibility requirements.
This SEP begins December 8 of the current contract year and ends on the last day of February of the following year.
Enrollment requests received from December 8 through December 31 will have an effective date of January 1. Enrollment requests received in January will have an effective date of February 1. Enrollment requests received in February will have an effective date of March 1.
With that said, do what Chazm suggested.
- Thread starter
- #9
Yeah I know its a little shifty lol but I am the one who told her she had this one time change available to her. So she had a cost plan she lost. I signed her up for a medigap and a PDP. There is nothing she can do besides either staying in her plan or dropping to original Medicare right? Appreciate your guidance and help.
- Thread starter
- #10
She used her SEP to get enrolled into the medigap plan. She is out of luck correct?
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