What Would You Do in this Situation?

[Chazm]

I've never reported another agent in my 9 years in the biz but I'm thinking this may be my first attempt. What would you do in my situation?

I signed up a client at the beginning of Sept. for a Dec. 1 effective date onto a Humana HMO.

Client calls me today and said someone from Bankers Life and Casualty drove up to his house last week (before Oct. 1) and asked him about his Medicare. He said he already joined Humana and the girl from Bankers informed him that she can save him $70 on his Medicare premiums with Humana's new HMO.

First off, she talked about a 2018 plan prior to October 1. Secondly, she made an unsolicited home visit and tried to sell a MAPD. Third, Humana doesn't have a Part B rebate plan in Duval County, it's their sister company Careplus.

What should I do? I normally do nothing, but in my area, I'm tired of Bankers doing the same illegal tactics over and over. All while I make sure I follow the rules.

 

[Todd King]

I've never reported another agent in my 9 years in the biz but I'm thinking this may be my first attempt. What would you do in my situation?

I signed up a client at the beginning of Sept. for a Dec. 1 effective date onto a Humana HMO.

Client calls me today and said someone from Bankers Life and Casualty drove up to his house last week (before Oct. 1) and asked him about his Medicare. He said he already joined Humana and the girl from Bankers informed him that she can save him $70 on his Medicare premiums with Humana's new HMO.

First off, she talked about a 2018 plan prior to October 1. Secondly, she made an unsolicited home visit and tried to sell a MAPD. Third, Humana doesn't have a Part B rebate plan in Duval County, it's their sister company Careplus.

What should I do? I normally do nothing, but in my area, I'm tired of Bankers doing the same illegal tactics over and over. All while I make sure I follow the rules.

You do realize that YOU won't get action on this if YOU are the one to make the report, right? The DOI's don't even take a second look when one agent reports another. The complaint has to come from the consumer.

I'm not sure if making a complaint straight to CMS would work or not.

 

[Fisher]

Personally, I'd bust her ass. Have the client call it in as Todd pointed out.

 

[Chazm]

You do realize that YOU won't get action on this if YOU are the one to make the report, right? The DOI's don't even take a second look when one agent reports another. The complaint has to come from the consumer.

I'm not sure if making a complaint straight to CMS would work or not.

Oh ok. The client wasn't pissed at all, he just wanted to know if it were true.

Anyhow I looked up her on the DOI and she was licensed on 7/27/17 and contracted with Bankers on 8/10/17. So it makes perfect sense that she doesn't realize that she can't do that.

 

[sman]

I've never reported another agent in my 9 years in the biz but I'm thinking this may be my first attempt. What would you do in my situation?

I signed up a client at the beginning of Sept. for a Dec. 1 effective date onto a Humana HMO.

Client calls me today and said someone from Bankers Life and Casualty drove up to his house last week (before Oct. 1) and asked him about his Medicare. He said he already joined Humana and the girl from Bankers informed him that she can save him $70 on his Medicare premiums with Humana's new HMO.

First off, she talked about a 2018 plan prior to October 1. Secondly, she made an unsolicited home visit and tried to sell a MAPD. Third, Humana doesn't have a Part B rebate plan in Duval County, it's their sister company Careplus.

What should I do? I normally do nothing, but in my area, I'm tired of Bankers doing the same illegal tactics over and over. All while I make sure I follow the rules.

I've never reported an agent to the DOI, but I did report one to a carrier. Met with a couple who had a MAPD that was terminating and we were going to enroll them in a new MAPD.

During the conversation he mentioned a supplement to pay the doctor visit copays the MAPD didn't pay. I told him I wasn't aware of a supplement like that. I told him there were hospital indemnity plans for hospitalization and that I wasn't a big fan of those. He then pulled out ID cards for an Aetna Med Supp. I asked him if he had that while he had the MAPD. He said he did. I asked if he told the agent who wrote it that he had the MAPD. He said he did. The Med Supps were effective in May of that year. I explained to him why he shouldn't have both. I again asked if he was sure he told the agent that they had MAPD's. He was certain that he did. He said he even showed the agent the ID cards.

At that point I gave him instructions on what to say when he called Aetna. He was given a full refund for the 7 months of premiums he paid.

I went back to my office and contacted the Regional Director for Aetna and let him know what happened. Told him I didn't know if the agent was new and just didn't know the rules, but either way he needed additional training. The good news is my clients got refunded their money and have been with me ever since.

 

[billyb]

I live in the FL panhandle and a lot of locals here in FL have 2nd homes on lakes just north of here in AL. Most spend time there, but their DL and permanent residence is in FL. A local agent writes them Medicare Supplements using their AL address and quotes AL rates. Had several people ask me about it and I refuse to do it.

 

[Matthew King]

Hopefully, it's just a case of being a little overzealous. However, with having to go through AHIP, then Humana's certifications it's a bit hard to miss the Do's and Don't's. As far as agent's reporting other agents. The carriers technically do have to investigate and respond to reports, they even tell you in the training to report. (I have not had the experience of actually reporting someone though, haven't had to yet).

 

[MedicareMillionair]

Oh ok. The client wasn't pissed at all, he just wanted to know if it were true.

Anyhow I looked up her on the DOI and she was licensed on 7/27/17 and contracted with Bankers on 8/10/17. So it makes perfect sense that she doesn't realize that she can't do that.

I wouldn't report her, especially if it took time and effort to do so. My reasoning is she may very well be a good person with bad training. It would be a shame for her to have a complaint on her record when she is just getting started. She probably won't be there much longer and will learn the correct way to do business.

If it was going to make an impact, perhaps it would make sense to report her. I don't think it will.

 

[kpbdy99]

I'd call the local Bankers' manager and tell him/her this is their one "gimme," and if it happens again, then you'll ask the client to call the state, and you'll call the carrier. Unfortunately, a lot of young Bankers agents are thrown into this with crappy - if any - training and a real need to sell quickly to survive.

 

[Cenla Agent]

Maybe I'm just a mean SOB or in an uncharitable mood today, but with all of the very easily accessible detailed info online about Bankers and similar companies, the excuse of "I didn't know Bankers was a bunch of thieves and liars" that newbie agents might use in a situation like this really doesn't wash with me at this point. 15-20 years ago? Maybe. Today? No way. And as noted above, this agent had to have taken AHIP and Humana's training which repeatedly state that what she did was prohibited.

If the client is at all willing, my advice is to nail her to the wall if you can.