My Mom, My Responsibility

[Bob_The_Insurance_Guy]

After listening to me go on about both Medicare Supplements and Medicare Advantage Plans, my father and mother finally became candidates for Medicare options, when my father went from full time to part time at his job.

On May 26th, we sat down, and, after researching their physicians and medications, I concluded dad would be better off with the Advantra Freedom 2, and Advantra Freedom Rx. Mom, on the other hand, would be better served with Humana Choice PPO.

Got a June 1 effective date for both, and all was right with the world. Until...

My dad calls me on June 3rd to inform me that his group benefits actually go through June, and don't stop the end of May, as he previously told me.

So, I call both carriers. Coventry instructs me to to tell my dad to call them, provide his Medicare number and date of birth, and they will change the proposed effective date.

Humana's another story. I had to e-mail the situation to [email protected] and explain what happened, and that I want the proposed effective date to change from June 1 to July 1. Here was their response:

The agent of record will need to submit a Statement of Agent Error to the Enrollment Department at [email protected] or to fax number 502-508-8421. Once this is done, a new proposed effective date can be in effect.

So, I write them a "To Whom It May Concern" letter, and fax it to them. I explain that I was the agent, and was told by the Medicare Beneficiary one date, but was then advised of a new effective date, and that is the reason for the date change. To which they instructed me to admit the fault of the incorrect date, and then, and only then, will they change the effective date.

To which I did, and added at the bottom of the letter that a copy of this correspondence will be submitted to CMS for documentation purposes (a CMA reason), and that the oversight was neither malicious nor egregious.

Before you ask: the reason my mother is on Humana, and not on Coventry, as Dad is, is because the doc that she wants to keep takes only the Evil Empire or Humana, and not Coventry. Otherwise, I would move her over.

P.S. A copy of it also went to my attorney.

 

[somarco]

Any idea what kind of jail time you will be doing at the CMS dungeon?

I am sure glad there are guys like you, willing to take it in the shorts for the good guys at CMS.

 

[moonlightandmargaritas]

A copy of it also went to my attorney.

He'll probably charge you $150 to read it. If you're lucky, that is.

 

[Winter_123]

After listening to me go on about both Medicare Supplements and Medicare Advantage Plans, my father and mother finally became candidates for Medicare options, when my father went from full time to part time at his job.

On May 26th, we sat down, and, after researching their physicians and medications, I concluded dad would be better off with the Advantra Freedom 2, and Advantra Freedom Rx. Mom, on the other hand, would be better served with Humana Choice PPO.

Got a June 1 effective date for both, and all was right with the world. Until...

My dad calls me on June 3rd to inform me that his group benefits actually go through June, and don't stop the end of May, as he previously told me.

So, I call both carriers. Coventry instructs me to to tell my dad to call them, provide his Medicare number and date of birth, and they will change the proposed effective date.

Humana's another story. I had to e-mail the situation to [email protected] and explain what happened, and that I want the proposed effective date to change from June 1 to July 1. Here was their response:

The agent of record will need to submit a Statement of Agent Error to the Enrollment Department at [email protected] or to fax number 502-508-8421. Once this is done, a new proposed effective date can be in effect.

So, I write them a "To Whom It May Concern" letter, and fax it to them. I explain that I was the agent, and was told by the Medicare Beneficiary one date, but was then advised of a new effective date, and that is the reason for the date change. To which they instructed me to admit the fault of the incorrect date, and then, and only then, will they change the effective date.

To which I did, and added at the bottom of the letter that a copy of this correspondence will be submitted to CMS for documentation purposes (a CMA reason), and that the oversight was neither malicious nor egregious.

Before you ask: the reason my mother is on Humana, and not on Coventry, as Dad is, is because the doc that she wants to keep takes only the Evil Empire or Humana, and not Coventry. Otherwise, I would move her over.

P.S. A copy of it also went to my attorney.

What a crock they are. What the hell did you get into all that with them for by admitting to an oversight etc. There was no oversight. You asked the right questions and the client gave you different information. If the client says one thing but you record it wrongly that is another matter. I would not admit to any agent mistake period in this instance. Their bureaucratic process says that there must be an agent mistake to make a change so therefore you must admit to a mistake. Screw that. I would tell them that you are complaining to CMS compliance about their half assed fraudulent process and failure to respond to legitimate customer requests and rights.

Winter

 

[The Rabbi]

Humana is the only name I hear when people say they want out of their current plan. That's why I won't contract with them.

 

[honestagent]

I'm not surprised to read this about Humana; they got into a LOT OF VERY HOT WATER with their first roll out of part c pffs plans and ate a lot of chargebacks and had many many compliance issues and it was told me from another trusted - agent/friend who was told from the director of delegated reps in a private setting: they will target at best to put any and all of any 'errors' on the indy agents. FYI. hth

I will never write Humana.

 

[theinuranceguy]

I got chargebacks from Humana the begining of this year from people I wrote two years ago!

Someone explain that one?

 

[Bob_The_Insurance_Guy]

I can explain it.

On your renewals, if you did not opt for an "as earned", then you received a big check the beginning of the new Medicare season.

While I'm all for getting paid annually for the first year with Medicare Advantage Plans, the renewals I have set up as "as earned". That way there is no charge back in subsequent years.

As for my mom's situation. I did include in the second paragraph of that letter that, even though PER THEIR INSISTANCE I am admitting error, that it was a miscommunication.

That way, they got what they wanted, and I got what I wanted. More importantly, they e-mailed me today that the new effective date was changed this morning. That's the important part.

 

[MedSuppPro]

I got chargebacks from Humana the begining of this year from people I wrote two years ago!

Someone explain that one?

I've experienced the same thing with ANTHEM. I know ANTHEM is simply that far behind. They are still sending monthly commissions for policies lapsed Jan 1st. They're driving forward while looking out the rear view mirror. They know they will get their money, eventually.

When any carrier discovers this they can charge back -- two + years!

I can't speak for Un-Human, but they still suck.

BTW: Carrier's whom have bank deposit authority, also have bank withdrawal authorization. It is at that point only a loan.

 

[theinuranceguy]

I've experienced the same thing with ANTHEM. I know ANTHEM is simply that far behind. They are still sending monthly commissions for policies lapsed Jan 1st. They're driving forward while looking out the rear view mirror. They know they will get their money, eventually.

When any carrier discovers this they can charge back -- two + years!

I can't speak for Un-Human, but they still suck.

BTW: Carrier's whom have bank deposit authority, also have bank withdrawal authorization. It is at that point only a loan.

Ive had problem with Anthem (with getting paid, not with chargebacks)

But as for Humana my renewals are paid as earned, and I have people that had a 1-1-06 or 07 effective date that I am getting charged back for, but I am almost certain it is with the FMO that I am through...

Any guesses?

Dayton OHIO Medicare Health Plans