- 2,370
I thought that some of the carriers were starting back up...like Pyramid.
October 1 or November 15
- Thread starter tommyk
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- #12
Pyramid is up and running T65's at this time.
I have heard that some companies actually will write a MA plan October 1 or even earlier, the agent will take the app and submit it. The company will advance the agent on all apps submitted like this. Now that seems to be a six week window that they are out of bounds on. CMS may just show up at one of their seminars and oh boy, fireworks and fines.
I have heard that some companies actually will write a MA plan October 1 or even earlier, the agent will take the app and submit it. The company will advance the agent on all apps submitted like this. Now that seems to be a six week window that they are out of bounds on. CMS may just show up at one of their seminars and oh boy, fireworks and fines.
Craig, the only catch to the client mailing prior to 11/15 is that some companies have said that if they get too many of a single agents clients, that they will assume the agent is telling them to submit early and the agent will be terminated. I guess one or two is an accident, but too many more and it's a hobby.
All carriers are up and running with T-65's that started about a month ago.
I heard from one company that if they get submitted before the 15th that they the company and CMS will honor the application but that agent will not get paid.
I plan on giving clients a self addressed envelope for the application to be sent to me after the 15th so that I can fax it in and keep track of and get my copy of the application. I will call to remind them to put it in the mail and also remind them that they will be getting a call from the company verifying that they want to enroll.
Four Health Insurers To Resume Marketing Of Medicare Advantage Plans After Suspension
27 Sep 2007
CMS on Monday said that four health insurers can resume marketing of private fee-for-service Medicare Advantage plans after they entered into a voluntary agreement in June to suspend marketing of the plans amid allegations of illegal and aggressive sales practices, the Tennessean reports (Ward, Tennessean, 9/25).
According to acting CMS Administrator Kerry Weems, an agency review of the four health insurers -- BlueCross BlueShield of Tennessee, UnitedHealth Group, Humana and Sterling Life Insurance -- "found vast improvements to their internal controls and oversight processes consistent with regulations." Three other health insurers that entered the voluntary agreement -- Coventry Health Care, Universal American Financial and WellCare Health Plans -- resumed marketing of the plans last month after a similar review (Wisenberg Brin, Wall Street Journal, 9/25).
I am not real sure what this means. Evidentally, there are quite a few MA plans that have/can market the plans again.
I am wondering if all the rulings are vague intentionally so that it can be interpretted as you want. Silly legal big wigs.
I have heard ideas of agents placing the application in the mail as they leave the house they have an envelope dated and stamped USPS-dated. I think this is interpretting things a LITTLE too leniently!
27 Sep 2007
CMS on Monday said that four health insurers can resume marketing of private fee-for-service Medicare Advantage plans after they entered into a voluntary agreement in June to suspend marketing of the plans amid allegations of illegal and aggressive sales practices, the Tennessean reports (Ward, Tennessean, 9/25).
According to acting CMS Administrator Kerry Weems, an agency review of the four health insurers -- BlueCross BlueShield of Tennessee, UnitedHealth Group, Humana and Sterling Life Insurance -- "found vast improvements to their internal controls and oversight processes consistent with regulations." Three other health insurers that entered the voluntary agreement -- Coventry Health Care, Universal American Financial and WellCare Health Plans -- resumed marketing of the plans last month after a similar review (Wisenberg Brin, Wall Street Journal, 9/25).
I am not real sure what this means. Evidentally, there are quite a few MA plans that have/can market the plans again.
I am wondering if all the rulings are vague intentionally so that it can be interpretted as you want. Silly legal big wigs.
I have heard ideas of agents placing the application in the mail as they leave the house they have an envelope dated and stamped USPS-dated. I think this is interpretting things a LITTLE too leniently!
- 1,162
This is what I was told as well. My understanding is that as soon as the marketing material for 2008 is available, you can start presenting it, but that no apps can be accepted until 11/15.
- 1,162
Another thing to keep in mind is the outbound verification call this year. One way or another it would be irresponsible just to swoop in on 11/15 and pick up the apps without going over at least the key points of the plan again and making sure that the member knows exactly what they are enrolling in. But with that call coming within 10 days or so of the enrollment being submitted to the company, this is a must, IMO.
- 1,255
Seems we need another confusing compliance issue. And of course, if anything goes wrong -- it's the agent's fault.
My 2 cents...
CMS is requiring a "Receipt Date of Application" in addition to the app date. They are requiring apps to move within 5 days of receipt. It seems that CMS needs to loosen up on the October 15th rule. CMS should allow enrollments now till the end of the year for PDP's.
"The Increases in monthly premiums by Medicare's top prescription-drug plans next year will force as many as 1.6 million low-income beneficiaries to switch plans... and people with existing plans will on average experience an 21% increase", an analysis of government data shows according to the WSJ. Also, we should be able to help the snowbirds, avoid two major holidays, winter weather and ect...
Each carrier is interpreting and training us differently on the application submission issue. What is the purpose of this rule. Doesn't it do more harm then good?
My 2 cents...
CMS is requiring a "Receipt Date of Application" in addition to the app date. They are requiring apps to move within 5 days of receipt. It seems that CMS needs to loosen up on the October 15th rule. CMS should allow enrollments now till the end of the year for PDP's.
"The Increases in monthly premiums by Medicare's top prescription-drug plans next year will force as many as 1.6 million low-income beneficiaries to switch plans... and people with existing plans will on average experience an 21% increase", an analysis of government data shows according to the WSJ. Also, we should be able to help the snowbirds, avoid two major holidays, winter weather and ect...
Each carrier is interpreting and training us differently on the application submission issue. What is the purpose of this rule. Doesn't it do more harm then good?
- 2,152
Wow, now its not even clear about the date to send in an App???
I have to start scratching my head here and wonder, why even bother? Oh well, someone has to deal with the idiocy of the CMS, and some suggest everyone should get the H/C via the government.
Why not just offer them up year round and all Dr's that takes Medicare has to take the MA? I guess that would just be to dang simple.
I have to start scratching my head here and wonder, why even bother? Oh well, someone has to deal with the idiocy of the CMS, and some suggest everyone should get the H/C via the government.
Why not just offer them up year round and all Dr's that takes Medicare has to take the MA? I guess that would just be to dang simple.
- 2,370
James you are correct. Simple is not in CMS's vocabulary.
You are not allowed to accept an app prior to Nov 15th.
If the client sends in the app ahead of time, then the carrier can hold it and them process it Nov 15th. However, CMS wants that to be the exception rather then the rule.
If your carrier has return envelopes:
Fill out the app with the client.
Have them sign it
Stuff the envelope
Throw a post it note on the outside for them to mail it in Nov 14th.
You are not allowed to accept an app prior to Nov 15th.
If the client sends in the app ahead of time, then the carrier can hold it and them process it Nov 15th. However, CMS wants that to be the exception rather then the rule.
If your carrier has return envelopes:
Fill out the app with the client.
Have them sign it
Stuff the envelope
Throw a post it note on the outside for them to mail it in Nov 14th.
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