Helping Clients with Part D Can Be a Violation

[WCMason]

It is what it is, but you better believe I will have clients email me in the future stating that they completed the enrollment on their own.

I speak from experience when I say that no agent should expect that even written documentation from your client that you were compliant makes any difference at all. I will leave it at that.

 

[FLM2]

I still see it. In fact I copied and paste

http://www.mymedicareenroll.com/

I was thinking of something else (attestation on the consumer enrollment site), I didn't even know the above site existed but wouldn't have a client use it because of potential compliance issues.

 

[sman]

I speak from experience when I say that no agent should expect that even written documentation from your client that you were compliant makes any difference at all. I will leave it at that.

So you still had to do the course? The lady I spoke with recommended having the client send an email after they completed their enrollment. If I understand you correctly, that isn't enough?

 

[yorkriver1]

The only time I have not been the agent on an RX plan and I had anything to do with enrollment was to show him the plan that seemed to match the prescriptions and gave him their phone # to enroll while I filled out the app for med supp. Since they only do RX plans, I don't think there will be cross selling to him from that carrier.
I have someone else who I just wrote for an MAPD (LEC, long story) that had enrolled in a PDP with Medicare phone rep. She knew absolutely nothing about the full cost of her drugs for the year, or what is the "gap". 15 prescriptions.

It's hard down here for agents, do a thorough job, no good deed goes unpunished.

All the experiences on this thread are a reinforcement to keep 'em separated from me if not serving as agent.

 

[WCMason]

I was thinking of something else (attestation on the consumer enrollment site), I didn't even know the above site existed but wouldn't have a client use it because of potential compliance issues.

If a confused client tells a plan that something happened that did not, and the plan does not accept evidence the agent produces proving he acted compliantly, then there is no way to enroll anyone by any method that can avoid potential compliance issues.

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So you still had to do the course? The lady I spoke with recommended having the client send an email after they completed their enrollment. If I understand you correctly, that isn't enough?

I was required to complete the course.

 

[TDS551]

I use Medicare.gov alot. In the future I will begin just mailing them the report and washing my hands from it. I had Humana tell me that I could not use the mail and no matter how you help them enroll you mustngive a compliant presentation.

When Medicare.gov removes the "assisting someone" it will be a great loss to seniors, and especially social workers and such that I have taught to use it at retirement homes and disabled/handicapped places.

senseless

 

[FLM2]

If a confused client tells a plan that something happened that did not, and the plan does not accept evidence the agent produces proving he acted compliantly, then there is no way to enroll anyone by any method that can avoid potential compliance issues.

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I was required to complete the course.

It's funny that all of the focus seems to be on PDP plans, something I rarely do (I just make a recommendation(s) to the client and have them enroll through Medicare.gov) and not MAPD.

It seems to me that UHC had some kind of internal audit (or external) and was told to 'clean' this up and this is the route they chose-when I spoke with their internal compliance person she just said take the module and as long as you never use this enrollment channel again there will not be an issue; that's also fine with me.

 

[yogooglethis]

It's funny that all of the focus seems to be on PDP plans, something I rarely do (I just make a recommendation(s) to the client and have them enroll through Medicare.gov) and not MAPD.

It seems to me that UHC had some kind of internal audit (or external) and was told to 'clean' this up and this is the route they chose-when I spoke with their internal compliance person she just said take the module and as long as you never use this enrollment channel again there will not be an issue; that's also fine with me.

I believe the reason for this is that CMS/MA carriers think too many agents who aren't certified to sell PDP/MA because they don't want to deal with the marketing restrictions are using knowledge of PDP as a crowbar to get in to seniors homes/lives to sell med supps,FE etc..Most seniors don't realize what they are forfeiting by not having an agent of record for their PDP and I believe this is what they are trying adress.

 

[Norwayguy]

I believe the reason for this is that CMS/MA carriers think too many agents who aren't certified to sell PDP/MA because they don't want to deal with the marketing restrictions are using knowledge of PDP as a crowbar to get in to seniors homes/lives to sell med supps,FE etc..Most seniors don't realize what they are forfeiting by not having an agent of record for their PDP and I believe this is what they are trying adress.

In a real court a senile senior would not be proof to convict....but it is with CMS.

 

[PCBI]

Head up from UHC's compliance:

If you are assisting clients with Part D enrollment (not as the agent of record) through a consumer facing website, such as Medicare.gov, this is a violation and may be considered fraud.

COMPLIANCE ALERT - ONLINE ENROLLMENTS - SMS University

Don't shoot the messenger

U better have ur clients sign a SOA before u even talk to them about anything