Yet Another BS Rule from CMS

Apr 23, 2008

  1. GreenSky
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    Just got this crap from one of my carriers....

    New cooling-off period for prospects is required when selling all Medigap, Medicare Advantage and PDP plans.

    It is important that all Health Net producers who sell our Medicare plans identify all products to be discussed, including but not limited to Medigap, MA/MAPD plans and PDP to clients prior to any in-home meeting. New CMS requirements state that you must now notify your client, prior to an in-home appointment, all Medicare plans that will be discussed during your meeting. In the event where you want to present other plans not mentioned when scheduling the appointment, CMS is now requiring that you reschedule another in-home meeting at least 48 hours after the initial one with your client. The time between your two scheduled in-home appointments is referred by CMS as the cooling off period. CMS's goal, by implementing this requirement, is to help ensure that your client has accurate information for all recommended Medicare plans, so they can make an informed choice about their benefits without being pressured. You may leave materials and brochures on the additional products you plan to discuss at the ensuing appointment but you may not discuss them during the initial visit.

    Rick
     
    GreenSky, Apr 23, 2008
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  2. Crabcake Johnny
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    Good grief. Thank God I sell health insurance
     
  3. senior-advisor-indiana
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    CMS needs to pay for the gas t o get to our appointments then. Bastards.
     
  4. Crabcake Johnny
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    This is what happens when a bunch of bored people sit around all day trying to come up with new regulations. This is a classic case of "boot camp 101" where the entire platoon gets punished when one recruit messes up.

    Unfortunately, the good agents can't get into a closed door session with the rotten agents. Would solve a lot. It shaped up many a recruit.
     
  5. theinuranceguy
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    This would suck during AEP/OEP...

    But in the off season when I target low income all I would have to say is that these Plans are called EverCare and WellCare...

    Thats all the SNPs I got in my area...
     
  6. Crabcake Johnny
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    When the gas/electric deregulation occurred I managed TG&E for almost four years. We did door to door residential sales and the public utility commissions just couldn't stand it.

    A few bad reps generated complaints and they decided to crush door to door in the 1st five states.

    How? They instituted a rule; upon signing the contract all registered people had to call a toll free number. They listened to a message and at the end received a code that had to be put on the contract.

    The recorded message? In a nutshell basically said "don't sign ****." Almost no one continued and we were out of business 3 days after that rule took effect.

    The bottom line is if they want to hamper new sales, it's gonna happen.
     
  7. craig_ritter
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    I'll check with one of my compliance guys who listens to the weekly CMS calls with all of the MA Plans and get his take on this. Most likely, this was covered in a call. I'll post what I find out.

    Craig
     
  8. GreenSky
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    I don't think that works. You can only talk about one MA plan per visit.

    Just today I went out to see a client who needed to move his plan. I did not know if he still had Medicaid or not. I needed to bring 2 plans with me. I think I technically violated CMS rules by even mentioning there were possibly two choices.

    The choice is either to honor CMS requirements or do a good job for a client. It just like we cannot ask what drugs they take. How the hell do you recommend a plan unless you know if their meds are on the formulary?

    Rick
     
    GreenSky, Apr 23, 2008
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  9. craig_ritter
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  10. craig_ritter
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    Rick:

    I've been thinking about this and I'm guessing that CMS is trying to "codify" a regulation to avoid the following practice:

    Agent knocks on prospects door to sell, say, a final expense product (maybe even $0 premium final expense :D).

    Prospect answers and lets agent in.

    Agent discusses product and prospect is not interested. Agent says, "Hey, there is something else you may be interested in. . .(SNP plan, $0 premium PFFS plan, HMO, etc.). The information's in my car, let's set up an appointment for, say, 5 minutes from now.

    Agent returns in 5 minutes and enrolls client.

    Craig

    PS, my contact replied to my e-mail and we will be discussing this tomorrow, FWIW.
     
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