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Medicare Scope of Appointment Form Download

Posted by www.psmbrokerage.com Admin on Wed, Sep 27, 2023 @ 02:14 PM

soa rules-Sep-27-2023-07-23-53-3377-PM

The Scope of Appointment (SOA) process is a crucial aspect of Medicare marketing and sales activities designed to protect the interests of Medicare beneficiaries and ensure compliance with regulations. The SOA process is primarily associated with Medicare Advantage (Part C) and Medicare Prescription Drug Plans (Part D) but can also apply to other Medicare-related products.

Here's an overview of the Medicare Scope of Appointment process:

  1. What is the Scope of Appointment (SOA)?

    The Scope of Appointment is a document that outlines the specific topics and types of information that a Medicare sales agent or broker intends to discuss with a Medicare beneficiary during a face-to-face or telephone appointment. It is a critical tool to ensure that the beneficiary understands the purpose of the meeting and has consented to discuss certain Medicare-related topics.

  2. Purpose of SOA:

    The SOA process serves several important purposes:

    • Ensures that beneficiaries have control over the topics discussed during the appointment, preventing agents from presenting unwanted or unnecessary information.
    • Helps prevent instances of coercion or aggressive sales tactics.
    • Demonstrates compliance with Medicare regulations, specifically the Medicare Marketing Guidelines.
    • Protects beneficiaries by ensuring they only receive information they've agreed to hear about.
  3. When is an SOA Required?

    The SOA process is typically required when a Medicare sales agent or broker wants to have a one-on-one, in-person or telephone conversation with a Medicare beneficiary to discuss specific Medicare-related products, such as Medicare supplement plans, Medicare Advantage plans or Medicare Part D prescription drug plans. It's important to note that unsolicited contact without an SOA can lead to penalties.

  4. Completing the SOA Form:

    To initiate the SOA process, the agent or broker must provide the beneficiary with an SOA form, which includes the following information:

    • Beneficiary's name and contact information.
    • Date of the appointment.
    • The agent's or broker's name and contact information.
    • A list of the specific topics or products that will be discussed during the appointment.
  5. Obtaining Consent:

    Before discussing any topics not listed on the SOA form, the agent or broker must obtain explicit consent from the beneficiary. The beneficiary can either agree to discuss the additional topics or decline.

  6. Documenting the SOA:

    The agent or broker is required to document the SOA process, including a record of the beneficiary's consent or refusal to discuss additional topics. Documentation is essential for compliance purposes and to provide a record of the beneficiary's choices.

  7. The 48 Hour Rule:

    Introduced in the autumn of 2023, the recently implemented 48-hour rule is designed to combat deceptive marketing tactics and safeguard the well-being of beneficiaries. As per the rule, agents are required to furnish beneficiaries with a Scope of Appointment (SOA) form at least two days prior to a scheduled appointment.

    To adhere to the rule, beneficiaries must sign the SOA form at least 48 hours before their appointment. However, walk-in appointments and appointments that occur within four days of the end of the enrollment period are exempted from this requirement. It is important to note that Scope of Appointment forms remain valid for a period of up to twelve months from the beneficiary's signing.

  8. Penalties for Non-Compliance:

    Failing to adhere to the SOA process and other Medicare marketing regulations can result in penalties, including fines, suspension of sales activities, or revocation of agent/broker licenses.

It's important to note that the specific requirements and regulations regarding the SOA process can change over time. Therefore, Medicare sales agents, brokers, and organizations involved in marketing Medicare supplement plans should stay up-to-date with the latest guidance and requirements issued by the Centers for Medicare & Medicaid Services (CMS) to ensure compliance. 

Questions? Call us at 800-998-7715 and we would be happy to assist.
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Tags: Online Enrollment, Medicare Advantage, Part D, Scope of Appointment, SOA

How To Scale Your Agency – A Guide For Insurance Agents

Posted by www.psmbrokerage.com Admin on Mon, Sep 25, 2023 @ 01:43 PM

How to Scale Your Agency

All agents share a common goal: to increase their business.

It's not just a matter of luck; it takes careful planning and hard work to achieve growth in this industry.

In today's discussion, we'll delve into the essential principles necessary for scaling your business. I'll reveal the key factors that top call centers and agencies prioritize to ensure their success.

By the end of this blog post, my aim is for you to have a deeper understanding of how you can effectively expand your agency and boost your productivity.

How to Scale Your Agency - 3 Factors to Consider

To start, we need to quickly go over three essential factors in any agency’s business—Cash flow, Cost per acquisition (CPA), and Lifetime value (LTV)

1. Cash flow is the net amount of cash transferring in and out of a business.

2. CPA stands for cost per acquisition. This refers to the average amount it cost for you to get a policy issued & paid.

    • CPA is broken down into two sections. Media CPA and fix cost CPA.

      • Media CPA is the average amount you spend on leads or marketing to acquire a sale.

      • Fixed-cost CPA refers to everything else.

    • For an individual agent the fixed cost part is simple, but if you plan on hiring additional agents it gets more complicated.

      • How much did you have to pay that agent for the sale?

      • Are you paying admin to follow up on policies or to handle phones?

      • Office space, computers, dialer‘s, licensing fees, etc.

    • It’s imperative that you are able to calculate your total CPA because you need to make sure it is lower than the third key factor, lifetime value or LTV.

    3. LTV, or Lifetime Value, is simply the average amount of commissions you earn over the life of a policy.

    • This will vary from agency to agency based on many factors. If you know your LTV and your CPA you know how much total profit you are going to make for every client you put on the books.

    • An important thing to keep in mind is we are talking about “LIFETIME” value. Major companies don’t judge the profitability of their business on just what they make the first year and neither should you.

    • As long as your LTV is higher than your CPA you are making profit.

      • If it cost you $300 to acquire a policy and the first year the commission is only $200, it may at first glance look like a bad investment.

      • But if the LTV on that policy is $1000 over the course of five years then you came out way ahead. You paid $300 to profit $700, it just took you five years to realize those profits.

    • Too often I talk to agents who are hesitant to invest in their business because they are only looking at first year profit margin. You are running a business and just like any other business you are going to have to invest in it to see it grow.

    • How much you want to grow the business is a personal goal, but once you know your CPA and LTV, you know exactly how much each policy is worth and from there you can figure out how many policies you need to reach your goal.

What's Your Budget?

Now that we know how to calculate how much business it will take to reach your goals, we need to talk about your budget. Your budget is how much you have to spend on your business.

    • This could be renewal commissions, savings or even a bank loan, but without a budget you won’t be able to scale your business.
      • Maybe you’re an established agent who is just looking to increase your sales by a few policies a month and your budget is $200 per week.
      • Maybe you’re looking to build out a 15 person call-center and your budget is $1.5 million per year.
      • Whatever it is, you need to have it defined and make sure it is available to be used as needed for leads and marketing.

Managing Agents

  • Once you’ve got your budget squared away it’s time to consider the management side of starting an agency. The hardest part of running an agency is managing agents and managing leads.

    • Leads - Even if you’re looking to just grow your personal business this still applies, you need to make sure you have enough leads coming in that you and your agents can hit their sales goals and remain happy.

    • Agents - You also need to make sure that you always have enough agents available to work the leads you are purchasing.

    • Lead Management - Let’s say you decide to run a five man call-center and purchase 20 leads per day for each of your agents. You now have 100 leads coming in per day.

      • What happens when two of your agents call in sick?

      • Are you keeping their work days so full that they can’t absorb the extra 40 leads you purchased?

      • For you individual agents, do you have a plan to pause your lead generation for times when you are out of the office?

    • It’s important to plan and find a balance that keeps the agents busy with leads but doesn’t over expose your business.

Managing Leads

You also want to have procedures in place to make sure that you are getting the most out of your leads. When I say this most people’s minds immediately go to selling techniques and how to close more sales.

Often, it’s more effective to focus on solidifying the sales you are already making to reduce attrition.

If you can reduce the percentage of clients who leave you yearly from 15% down to 5% then you will most likely see more profit from that than you would by increasing your closing percentage.

Here at PSM we focus on Medicare Advantage so I’m going to use that as an example, but this will apply to any product line.

  • First, align your agents with how the agency is paid. You can bonus your agents after the rapid disenrollment period is up and charge them back if a client disenrolls during that period.

    • The idea is that the agent gets paid when the company gets paid, and charged back when the company does. This pushes the agent to not only write cleaner business, but also to engage in post-sale activities ensuring the business stays in force.

  • Second, you also want to have sales monitoring procedures to make sure your agents are following proper procedures. Make sure they are looking up doctors and drugs on every presentation. Make sure they are assigning a PCP on every call. Make sure all compliance requirements are being met. And make sure they are doing an HRA on every call.

  • Lastly, you want to have a plan for post-sale activities. Follow up with your clients when the policy is issued and then at regular intervals. 30, 60, 90 days and then again every six months or so. Make sure they know how to use their plan and if they are happy with it.

By doing all of this you will drastically increase your placement and persistency rates. Placement and persistency are vital to your success. You spent the money to acquire these clients, so you need to make sure you keep them.

Do the Math

So far we’ve covered the key factors you need to consider when planning to scale your business. How to maximize commissions, managing your leads to workforce ratio, and how to calculate the profitability of your business using LTV and CPA.

The last thing I want to leave you with is how to calculate the value of your business using a ratio. This simple method will give you a snapshot of the overall health of your business model.

  • Take your LTV and divide it by your customer acquisition cost, or CAC. CAC is similar to CPA but measures placed policies rather than submitted policies.

  • For Medicare advantage this will be any policy that clears the rapid disenrollment period.

    • For many of you this will be nearly identical to your CPA, but for tele-sales models or call centers, your CAC will be higher than your CPA.

  • If your LTV to CAC ratio is 1.0 or lower that’s bad. You are only breaking even because the LTV is the same as what you are paying to acquire that policy. Aim for 3.0 or higher—This means your profit is twice as much as you invest.

If I told you I’d give you $300 tomorrow for every hundred dollars you give me today would you take that deal? I know I would, and I’m sure most of you would, too. 

If you have any questions or want to talk about how to best scale your business please give us a call and ask to speak with one of our marketing directors.

We’ll be happy to take the time to go over any of this in more detail and can even run a personalized calculation for you on what kind of ROI you can expect.

Thank you for your time, and Happy Selling.





Tags: Business, Sales Strategies

SunFire Agent Reporting

Posted by www.psmbrokerage.com Admin on Thu, Sep 21, 2023 @ 02:32 PM

SunFire Agent Reporting

Agent Reporting

Coming September 2023... Agent Reporting - a new feature designed to enhance the SunFire Blaze and Blaze Connect experience by providing agents transparency into their individual performance.

Agents will have visibility into their production since January 1, 2023. To access this new function, click the graph icon on the left side of your screen and select the “Performance” tab at the top.

This report will showcase:

  • Total number of enrollments submitted across Blaze & Blaze Connect through the instance you are utilizing, broken down by Carrier, Product Type, and Servicing Area.
  • Eligible HRA completion rates, identifying enrollments with an HRA still available.
  • Eligible Value-Based Care submission rates, identifying enrollments with a VBC Opportunity still available.
  • Eligible Mail-Order Pharmacy Consent Form completion rates, identifying enrollments with a Consent Form still available.
  • Individual book of business footprint across the country, visualized by heat map.
  • Access to a helpful suite of unique SunFire quoting flow features to aid in beneficiary information gathering such as, Customer Look Up, Doctors and Drugs collected and Health Utilization Frequency.
  • An enrollment trend algorithm showcasing estimated monthly projections based on current month’s production.
  • A drop-down filter allowing you to easily view data on a specific day or within a selected time frame.

SunFire Enrollment Center-2

Independent agents play a vital role in helping seniors secure the most cost-effective Medicare plans for their individual needs. This comprehensive tool simplifies the sales process with multi-carrier shopping and enrollment platforms wrapped into a single online experience.

And best of all, this platform is available at no cost to PSM agents. Request details today and make sure you have access to this cutting edge technology at your fingertips.

Request Access Today!
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Tags: Online Enrollment, Medicare Advantage, Medicare Supplement, Part D, SunFireMatrix

Preparing for the 2024 Annual Enrollment Period

Posted by www.psmbrokerage.com Admin on Thu, Sep 07, 2023 @ 03:58 PM

Prepare for AEP

Preparing for the 2024 Annual Enrollment Period (AEP)

Preparing for the 2024 Annual Enrollment Period (AEP) in the Medicare market requires strategic planning and a proactive approach to effectively meet the needs of beneficiaries. As this critical period approaches, there are several key steps to consider in order to maximize your success and provide valuable services to your clients.

First and foremost, staying updated on changes to Medicare regulations, plan offerings, and industry trends is paramount. The healthcare landscape is constantly evolving, and being well-informed positions you as a reliable source of information for beneficiaries seeking the right coverage. Attend seminars, webinars, and training sessions provided by insurance carriers to ensure you're up-to-date with the latest developments.

Reviewing your marketing and outreach strategies is essential to engage potential clients during the AEP. Refresh your online presence by updating your website, social media profiles, and other digital channels. Consider creating informative content such as blog posts, videos, and downloadable guides that address common questions and concerns about Medicare plans. Tailoring your messaging to highlight the advantages of different plans can help beneficiaries make informed decisions.

Focusing on compliance is also crucial during the AEP. Familiarize yourself with the Medicare Marketing Guidelines issued by the Centers for Medicare & Medicaid Services (CMS). These guidelines outline the dos and don'ts of marketing Medicare plans. Ensuring that your marketing materials are accurate, transparent, and compliant will maintain your reputation and prevent potential legal issues.

Lastly, anticipate the surge in inquiries and be prepared to offer personalized assistance to beneficiaries. Consider implementing systems to manage incoming queries efficiently, whether through your website, email, or phone. Providing clear and concise information, as well as addressing concerns promptly, can set you apart as a trustworthy advisor. By offering exceptional customer service, you'll establish strong relationships with clients that extend beyond the AEP.

By strategically approaching this period, you'll not only serve your clients effectively but also position yourself as a knowledgeable and reliable Medicare advisor.


At PSM, we are committed to providing our agents with a range of resources and support to help them succeed. From personalized marketing materials to interactive sales strategies, our goal is to empower agents with the latest tools, technology and mentorship to achieve new levels of success this AEP.

AEP Resources:

Powerful Partnerships:

We are committed to providing our agents with a range of resources and support to help them succeed: Our powerful partnerships include:

Strong relationships with insurance carriers and industry experts to provide agents with access to the best products, tools, and support.

Capital infusion and acquisition strategies to help agents expand their business and reach their ultimate goals.

Dedicated service and mentorship from experienced professionals to help agents build a successful business.

Proprietary lead, training, marketing and enrollment platforms to streamline your sales process and business practices.

Compliance oversight to ensure agents are meeting regulatory requirements and operating ethically.

Succession planning and agency building support to help agents plan for the future and achieve long-term success.

AEP Helpful Guides:

AHIP Certificationmedicare enrollment periodsSEP Guide

Best Practices for Medicare Sales or Educational EventsSell Medicare Plans Onlinean agents guide to dual eligible special needs plans (DSNP) 

Cross-Selling Hospital Indemnity Plans GuideSelling Medicare Supplement PlansSelling Medicare Advantage Plans

We are here to support!

As a reminder, We pride ourselves on a "Do the Right Thing" approach and will go above and beyond to service the needs of our agents. We look forward to having a successful AEP and supporting you with products, technology and the personalized service you have come to expect from PSM. We appreciate the opportunity to earn your business and wish you the best!


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Tags: Medicare Advantage plans, CMS, AEP, medicare supplement insurance, Compliance, Marketing, Best Practices, 2024

BULLETIN NO. 10-2023: New Medicare Supplement Enrollment Requirements for Oklahoma

Posted by www.psmbrokerage.com Admin on Thu, Sep 07, 2023 @ 02:14 PM

New Medicare Supplement Rules for Oklahoma-1

Effective September 1, 2023, amendments to the Oklahoma Insurance Department (“OID”) Medicare supplement regulations create new enrollment requirements for Medicare supplement issuers.

OAC 365:10-5-129(f)

Amendments to Oklahoma Administrative Code (“OAC”) 365:10-5-129(f) create new enrollment opportunities for Medicare supplement policyholders. The regulation requires Medicare supplement issuers to provide new supplement policies with the same or lesser benefits to current Medicare supplement policyholders—regardless of current issuer—who have had no gap in coverage greater than ninety (90) days since initial enrollment. Previously, these policyholders have had no opportunity after initial enrollment to move to any other Medicare supplement policies or issuers, trapping the policyholders in policies with rising premium costs and no opportunity to search for lower premium rates.

Issuers offering a new (i.e., succeeding) supplement policy shall waive medical underwriting or preexisting exclusions if the new supplement policy offers the same or lesser benefits. Issuers of the current (i.e., prior) policy are required to furnish a statement of benefits or other pertinent information sufficient to permit verification of benefit determination to any new issuer upon request.

OAC 365:10-5-129(g)

Amendments to OAC 365:10-5-129(g) require issuers of Medicare supplement policies to provide notice to individuals under the age of sixty-five (65) enrolled in Medicare by reason of disability of their eligibility for open enrollment to Medicare supplement policies upon reaching the age of sixty-five (65). Issuers must provide this notice sixty (60) to ninety (90) days prior to the first day of the first month in which the individual becomes sixty-five (65) years of age.

About OID

The Oklahoma Insurance Department, an agency of the State of Oklahoma, is responsible for the education and protection of the insurance-buying public and for oversight of the insurance industry in the state.


If you have any questions or would like additional guidance on this topic, please call us at (800) 998-7715 and speak with one of our experienced Marketing Representatives. We will gladly assist you.

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Tags: Medicare Supplement, Compliance

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