- 1,199
Be afraid be very afraid.....I have been doing this a long time and I get more paranoid every year about accidently or out of ignorance of a recent change in the rules saying the wrong thing to a consumer.
I knew this before this but I was just refreshed on these tidbits when doing my certification for UHC this weekend:
It is a violation to tell a consumer that will go in the part D coverage gap. This is a damn if you do and damn if don't situation
It is a violation to estimate a consumers LEP dollar amount. You can only tell them how the penalty is calculated
This issue of compliance has always bothered me. It seems that there could be more harm to client if we are not allowed to compare plans, coverage for doctors, and rx. How many times have we met clients and they said they didn't know about other plans, etc
This is why I'm nervous about govt run healthcare...it will only be administered by those that stick to compliance and at the end of the day people won't be helped.
This is why I'm nervous about govt run healthcare...it will only be administered by those that stick to compliance and at the end of the day people won't be helped.
- 16,907
Medicare supplements do not replace their Medicare coverage. The pay in addition to Medicare and fill the gaps.
It's a much bigger deal when someone is agreeing to give up their Medicare coverage and move completely to private (for profit) health insurance. They want to make certain that people are not slammed with out understanding it.
Like most things the government (politicians) do, they take a fairly simple topic and make it so convoluted and confusing, that the public could never really understand it.
- 2,094
I went through the training in like 2005 or 2006, it was two or three days of crazy rules. I could see why the rules exist, to protect the consumer, but what the heck? It was like, they did not want agents out there at all -selling it. It was very strict, and it's probably changed since then -and become more strict. I wonder if the affordable care act is going to morph into this somehow, so there is no longer pre-65 and post age 65 health insurance, and it all becomes one big governmental and political cluster? I'm thinking that's the goal.
- 11,280
I do not inadvertently commit violations...
What I love is how CMS rules apply only to licensed insurance agents (and insurance companies).
But walk into an office on aging and they can do or say anything they want, no different than getting Medicare advice from your barber or hair dresser.
And then there's calling 1-800-MEDICARE. I'm sure everyone who works there is subject to internal rules and policies but again, the CMS rules for insurance agents don't apply to them.
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As to the original question, I present each plan sequentially but don't compare them. Where I fall short on compliance is the presentation, not going over every single item on all the plans. There are just not enough hours in the day to do that.
I don't understand why the rules say you can't compare plans. Because that would be entirely too helpful for the beneficiary and allow them to make a more informed decision?
I have to think it was the insurance companies who pushed for that rule.
But walk into an office on aging and they can do or say anything they want, no different than getting Medicare advice from your barber or hair dresser.
And then there's calling 1-800-MEDICARE. I'm sure everyone who works there is subject to internal rules and policies but again, the CMS rules for insurance agents don't apply to them.
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As to the original question, I present each plan sequentially but don't compare them. Where I fall short on compliance is the presentation, not going over every single item on all the plans. There are just not enough hours in the day to do that.
I don't understand why the rules say you can't compare plans. Because that would be entirely too helpful for the beneficiary and allow them to make a more informed decision?
I have to think it was the insurance companies who pushed for that rule.
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