Wrote an application in July asking for a 9/1 effective date. Applicant turned 65 in August, but had emoyer coverage until 8/31. Policy issued 8/1and premium paid. I noticed the error so I contacted the company and was told to submit an Enrollment Correction Form. Did so and thought all was well until the client called today about a letter he received stating CMS denied his enrollment because he attempted to enroll outside of an enrollment period. He is T65 and losing employer coverage? Spent 2 hours on a conference call with SS and all they could tell us to do was to reapply for a 10/1 effective date. Is am afraid CMS is going to deny him again even though he is eligible. He wants his $26.40 back that he paid in August. All SS said about the drugs he needed this month was to use a discount drug card like GoodRX. If he wanted to use GoodRX he wouldn't have bought SS. I am just lucky he is a patient man or I would have gotten an earful.
SilverScript screwup
- Thread starter billyb
- Start date
- Thread starter
- #4
He was a teacher and had coverage. The SS app ask "Requested Coverage Effective Date" so I am not sure what you mean when you say you can't ask for a start date. Why does he use his IEP when it was SS who made the error? Why can't they make the adjustment? If he used IEP then use loss of employer coverage because he was eligible from both. Is there something that I did wrong?
- 2,177
You only did one thing wrong. You were unfamiliar with the rule that only CMS determines one’s effective date (so not the agent, the beneficiary, the SSA, or the carrier) and in IEP it’s always the earliest date they’re eligible for. You didn’t know that the only way to give your client a 9/1 start date was to wait until August to write the app. Loss of employer coverage is not a factor during IEP.
The good news is you won’t do that again and you’re now a more experienced agent. That’s how most of us got to know this stuff.
- Thread starter
- #6
Truth.
You learn by doing and making mistakes.
This one was minor. You should be able to salvage the client relationship. Admit your mistake and move on.
