Rules

[The Rabbi]

Re: Rules?

A defining moment in my career: I was sitting in the conference room of an acquaintance I met in a Toastmasters group I was a member of. In with me, since it was my first group case at the time, was the gentleman who mentored me, and got me into the business. We were discussing an employee who had cancer at the time, and how it would affect the underwriting. My associate suggested the employer, my acquaintance, leave him off the census, get the policy issued, then "slip" him in as a new employee.

(wink, wink)

The acquaintance looked at both of us and said, "That may be how things are done in your business, but I don't run my business that way."

There's more to it than I am mentioning here, but the gist of it is, the acquaintance did not want anything to appear to be "not-above-board", since he had a business to run.

That stuck with me, and whether or not it you approve of my way of doing business (which makes no difference to me), that's how "I roll".

It's okay to disagree.

Of course your analogy is wrong. In your case, it was complicity to dupe the insurance company.

 

[mfrost]

CMS wants us to get the SOA signed before we meet with our clients, and enroll them in a plan thats in their best interest. Being independent agents we write for multiple plans, how do you know which plan is right for them until you sit down and discuss their needs? And each plan has their own SOA they want you to use.This is a stupid ruling.

 

[policy doctor]

Universal Scope of Appointment Form FAQ.....​

Can I use this form for any Carrier appointment? The attached may be used with any carrier for your scheduled appointments. If you use a form with a carrier name on it, you may discuss other carrier options with them without having to make another appointment or fill out additional forms.
Is it required the form be in my hands prior to the appointment? Yes, but at this time, there are no guidelines to adhere to as to when you must receive the form, as long as it is BEFORE the start of your scheduled meeting.
What happens if a (perspective) client should walk into my office requesting information and assistance? You may have them sign the form at that time and begin your meeting.
What if I walk into my scheduled meeting and my client has invited others to sit in??? As long as you have the original "Scope of Appointment Form" signed you do not need to schedule another appointment. Just have the additional members sign the forms on site.

 

[IOA-MI]

Universal Scope of Appointment Form FAQ.....​

Can I use this form for any Carrier appointment? The attached may be used with any carrier for your scheduled appointments. If you use a form with a carrier name on it, you may discuss other carrier options with them without having to make another appointment or fill out additional forms.
Is it required the form be in my hands prior to the appointment? Yes, but at this time, there are no guidelines to adhere to as to when you must receive the form, as long as it is BEFORE the start of your scheduled meeting.
What happens if a (perspective) client should walk into my office requesting information and assistance? You may have them sign the form at that time and begin your meeting.
What if I walk into my scheduled meeting and my client has invited others to sit in??? As long as you have the original "Scope of Appointment Form" signed you do not need to schedule another appointment. Just have the additional members sign the forms on site.

Yet another thing I am not versed on...SOA is not something that is included with my sell pack from my MA...so is this some other thing that is going to come back and haunt me from a couple previous sales?

Perhaps someone that has this procedure down pat could give us the low-down on exactly their routine so CMS does not swoop done on us that are not as experienced and jab us with their federal talons!

 

[MedSuppPro]

SOA is not something that is included with my sell pack from my MA...so is this some other thing that is going to come back and haunt me from a couple previous sales?

YES!

 

[Taxlady120]

I'm new to insurance and to MA. I plan to do my utmost to follow the rules regardless of how silly they are. I'm sure sometimes I will be remiss, but I'll do my best.

I've been in tax work since 1991 and have run my own tax business since 1995. In that amount of time, not a single one of my clients has even been audited. Is it because I'm such a good tax preparer? I'd like to think so....but the truth of the matter is, the government is hurting for money and they just don't have the manpower at the IRS to audit very many tax returns.

I think the same will be true of CMS. Don't you think if the government has extra money lying around for employees, it would be better spent hiring IRS auditors than CMS Mystery Shoppers? I think it's just a bunch of crap. I don't fear IRS Audits, so why in the world would Mystery Shoppers make me shake in my shoes?
But yes, I'll do my best to comply.

 

[MedSuppPro]

I understand your IRS experience. However, CMS is a shell and they contract 3rd parties to do all the grunt work. Pay claims and answer the phones. The secret shopper is not a CMS employee. They are contracted-out hired guns.

I do fear CMS in a different way. Enforcement is especially problematic as carriers are held responsible by CMS and their zero tolerance rules could end your commission stream over an allegation. Coventry and Pyramid say it is up to their "discretion" if you violate.