Reporting IMO to CMS

[Billy Sierra]

2018 AEP was my first time dealing with medicare. Obviously, you have to have the SOA filled out prior to the appointment, but our IMO required us to have several documents signed and/or initialed. One of which was a business reply card. Well after my team wrote over 1000 MAs for the 2019 year, we had a big party to celebrate. It was there that I learned that the BRCs that we were getting signed we not for the upcoming year, but they were being backdated because the IMO has a call center in the Philippines that are calling seniors without permission. I have reported this to both Centene and UHC, but I cant find the right phone number to report it to CMS. I immediately quit when I found out, but after about a month, the rest of my team quit because we feared that we might lose our licenses for involvement once we knew what was really going on.

Please advise.

Billy

 

[Brandon Sterneker]

I don't believe they could come back on you or your agents as long as yo have proof that they requested or required you to do that. Hopefully there is something in email that you have. As for reporting it, I've never had to do so but the phone number I've always seen in training and such is 1-800-HHS-TIPS. Good Luck

 

[Chazm]

Ouch that sounds sketchy. Good luck.

Only thing I can help with only helps if you’re still selling. You no longer need to have a soa signed prior to an appt.

 

[joe92275]

Ouch that sounds sketchy. Good luck.

Only thing I can help with only helps if you’re still selling. You no longer need to have a soa signed prior to an appt.

I’m not sure if I misread you’re post...it’s seems as though you are implying you don’t need a SOA prior to conducting a sales appointment...and you do. The 48 hour rule is eliminated and the rules give some flexibility using language such as obtaining the SOA “when possible” but you need it signed before you begin your appointment (face to face or remotely over the telephone).

 

[Chazm]

I’m not sure if I misread you’re post...it’s seems as though you are implying you don’t need a SOA prior to conducting a sales appointment...and you do. The 48 hour rule is eliminated and the rules give some flexibility using language such as obtaining the SOA “when possible” but you need it signed before you begin your appointment (face to face or remotely over the telephone).

Well yes I don’t mean you can do the appt before a soa but same day soa is now ok. Have them sign (electronic) and do it over the phone or sit down. No more 48 hr rule.

Reading what I said in that post doesn’t make sense. But I knew what I was trying to get across lol

 

[joe92275]

Well yes I don’t mean you can do the appt before a soa but same day soa is now ok. Have them sign (electronic) and do it over the phone or sit down. No more 48 hr rule.

I had a feeling that’s what you meant but did not want to assume. I’m in FB groups with 1,000s of agents and you literally get a different answer for every question...I tend to doubt who really knows what they are talking about these days.

 

[Newby]

I had a feeling that’s what you meant but did not want to assume. I’m in FB groups with 1,000s of agents and you literally get a different answer for every question...I tend to doubt who really knows what they are talking about these days.

If they have won carrier convention trips on the product you are asking about you are pretty safe. If they have never won a carrier convention they might know the right answer but 90% of them are in faking it till they make it mode.

 

[Chazm]

If they have won carrier convention trips on the product you are asking about you are pretty safe. If they have never won a carrier convention they might know the right answer but 90% of them are in faking it till they make it mode.

I’ve never won one, but they don’t offer it for MAPD sales. So it’s pretty tough to do in FL with T65’s.

 

[Newby]

I’ve never won one, but they don’t offer it for MAPD sales. So it’s pretty tough to do in FL with T65’s.

Yes there are going to be a lot of you guys in that 10% in the Medicare market that are experienced and knowlegible but focused more on Advantage than supplements. But I still think the ratio is still about 9 to 1 overall.

With most products that is a definite separater of the agent’s who are doing well vs the ones who aren’t. Because unlike leaderboards the carriers do track only issued and paid business and require persistency levels to qualify for convention trips.

So I would say if an agent has earned several conventions off business he wrote he is fairly knowlegible of his part of the industry. If he has never earned any then he has about a 10% chance he is knowlegible (from his own experience) and 90% chance he only knows stuff he has read or has been told.