4 Racing Tips to Help You Win This AEP
TIP #1: STUDY THE COURSE
Keep your book of business organized from day one. Know the plans and products available to you so that you’ll have time to map out a strategy. The more you can prepare now, ahead of Oct. 15, the less you’ll be scrambling at go-time. It’s also important to lighten your load at home. Knowing your work will become much busier in October can be helpful when planning your work-life balance for the next few months. Consider any potential personal commitments or important family holidays — like Thanksgiving — now. Plan ahead and minimize your stress during AEP. TIP #2: START YOUR ENGINES
Friendly, pre-AEP reminders to Medicare beneficiaries are a great way to get ahead. Just remember: Communications can’t include anything specific regarding plans, like pricing or benefit details. AEP lasts 54 days. It’s a race to Dec. 7, where your focus could be the difference between achieving your goals and not. How are you planning to fuel your growth this year with a goal of 25% YoY growth in your submitted app count? TIP #3 STAY EFFICIENT
Leverage available technology for important services like scheduling and comparing plans. You have access to the YourMedicare Enrollment Center — a multicarrier platform where agents can compare plans, get quotes and enroll their clients. Agents have turned to the YourMedicare Enrollment Center as their “goto” platform for enrolling beneficiaries into Medicare Advantage and Part D prescription drug plans. And with AEP coming up, using the YourMedicare Enrollment Center is a double win: For every submitted application mad through the platform, YourMedicare donates at least 10 meals to Feeding America. With more than 550,000 meals donated already, YourMedicare is well on its way to reaching its goal of donating 1 million meals in 2022. Agents also have access to YourFMO.com, a one-stop shop for growth with Medicare TIP #4 ALWAYS LOOK AHEAD
Remember: Your contacts are also someone else’s prospects. If you’re not planning ahead, chances are, someone else is. Year-round communication can help you stay top of mind. Try things like birthday cards, newsletters or quarterly mailers. The simple act of following up can help create lifelong customers and relationships. And remember to keep preparing for AEP all year long. When one AEP ends (or even during this AEP), start thinking about the next. Mastering the art of the AEP sale comes with practice. As you find what serves the client’s best interest, you’ll build on your success and your business will thrive. Have a great 2023 AEP! ![]() |
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4 Racing Tips to Help You Win This AEP
Posted by www.psmbrokerage.com Admin on Fri, Sep 09, 2022 @ 11:13 AM
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Tags: Medicare Advantage plans, Medicare Advantage News, CMS, Compliance, call recording
Coming Soon for AEP! YourMedicareSunFire Recording Capabilities
Posted by www.psmbrokerage.com Admin on Fri, Sep 09, 2022 @ 10:29 AM
On that day, the Centers for Medicare and Medicaid Services (CMS) released its 2023 Final Rule, and in this extensive document, there are two important guidelines we’d like to highlight in a more simplified manner. New Required Disclaimer
Aside from that, this disclaimer needs to be added to any previously approved materials and resubmitted to CMS for approval. Calls With Beneficiaries Must Be Recorded Agents making calls to beneficiaries must record ALL calls in their entirety. In addition, This includes calls that are part of the chain of enrollment into a Medicare Advantage or This rule applies to telephonic conversations only, not face-to-face meetings. The YourMedicare team was well aware of this change and immediately took action in
This is just the beginning of what is to come. As new information becomes available, we’ll keep you updated on all new enhancements, news and more specific details ![]() |
Tags: Medicare Advantage, Medicare Part D, Prescription Drugs, AEP, SunFireMatrix, Compliance, 2023, call recording
Set for Launch - Compliance Tips for AEP
Posted by www.psmbrokerage.com Admin on Thu, Sep 08, 2022 @ 12:39 PM
As you are well aware, agents will juggle vast amounts of activity during this time. Unintended actions may be a pathway to making compliance mistakes, which may derail the AEP application process. Before we lift off into a new AEP season, let's consider a few significant points related to compliance in order to remain on the right trajectory for a successful launch. Scope of Appointments detail the exact topics beneficiaries would like to discuss with an agent. CMS requires agents to have beneficiaries sign an SOA prior to discussing Medicare Advantage or Part D Prescription drug plans. Every appointment with a beneficiary requires an SOA and these forms must be kept on file for 10 years, even if the appointment doesn't result in a sale. Also, starting this year, a new CMS ruling requires agents to read a disclaimer to all potential clients at the beginning of a sales call. Reading this during the SOA process is an optimal time for this disclosure. These calls must be recorded and stored for 10 years.
Before agents can help a client with a Medicare plan, they must know the physicians and the specialists a client sees for their healthcare services. Many beneficiaries are happy with their healthcare providers and don't want to change. Compare their current providers with the providers in the plan's network to ensure there isn't a disruption in services. It's important to review a client's prescriptions in order to help them clearly understand the cost of drugs for a particular plan. An unexpected increase in drug prices can quickly turn an exceptional client experience into an unsatisfactory one. Make sure to review enrollment data with your clients, this way, if there is an error, you can fix it on the spot rather than having the application returned. Reviewing a client's prescriptions will ensure they are given options for the most comprehensive coverage for their individual needs. A Summary of Benefits must be provided to beneficiaries at the time of enrollment to provide clarity regarding coverage. Although beneficiaries will receive a hard copy of this document after enrollment, agents must summarize key features such as covered benefits and cost sharing. The Summary of Benefits needs to be thoroughly discussed prior to signature-collection and verification of intent-to enroll. Agents are certainly busy during AEP and sometimes put off submitting an application to a carrier. This can result in the application not being submitted in the required 24-48 hour time frame. An agent's primary responsibility is to ensure a clients' insurance needs are met. It's important to take the extra time and double check to make sure your clients' applications have been taken care of within this time frame. ![]() |
Tags: Medicare Advantage, Medicare Part D, Prescription Drugs, AEP, Compliance, 2023
Celebrity Medicare Sales Pitches Are Toned Down After Scrutiny
Posted by www.psmbrokerage.com Admin on Wed, Sep 07, 2022 @ 04:25 PM
Soaring complaints and aggressive sales efforts result in tighter rules from regulatorsIf it’s football season, you can count on seeing Joe Namath on television, along with William Shatner and Jimmie “J J” Walker. They are the most prominent pitchmen for what has become an annual fall selling frenzy for Medicare Advantage policies. After a surge in consumer complaints, and stiffer government rules, the sales pitches will likely be tamer this year. If there is confusion, “we’ll change things so it satisfies everybody and eliminates the confusion,” said Mr. Shatner, best known for his role as Captain Kirk in the “Star Trek” franchise The federal Centers for Medicare and Medicaid Services toughened its oversight after consumer marketing complaints surged 165% last year to 41,136 compared with 2020. Brokerages, agents and other marketing businesses tried to convince Medicare recipients to switch plans, with promises of perks in their new plans such as home-delivered meals, rides to doctors’ appointments and cash. In some cases, beneficiaries would effectively pay for the perks with more-limited provider networks, forcing them to find new doctors, regulators say. The celebrity pitchmen haven’t been accused of violating any rules. The aggressive sales efforts by marketers are the result of billions invested by private-equity firms, financial-services companies and stock-market investors into virtual call centers, internet-based lead-origination firms and other marketing businesses over the past several years. The investors all focused on the annual sign-up period for Medicare Advantage plans, which are an alternative to the traditional fee-for-service Medicare plans. Enrollment in the plans, which are offered by private insurers and paid for by the government, grew 8% last year to 28.4 million in 2022, according to the Kaiser Family Foundation. Consumers can sign up for new plans every year, making them a prime opportunity to generate sales commissions for brokers. “Seniors are being bombarded,” said Ron Henderson, a deputy insurance commissioner in Louisiana. The sign-up period runs from Oct. 15 to Dec. 7. The stiffer rules are targeted at marketers that sell policies on behalf of health insurers. They will need to disclose more to their customers while CMS clarified that insurers will be responsible for what their marketers say. ![]() |
Tags: Medicare Advantage plans, Medicare Advantage News, CMS, Compliance, call recording
Medicare 2023: What Agents and Clients Need to Know
Posted by www.psmbrokerage.com Admin on Wed, Sep 07, 2022 @ 04:07 PM
Many of the general rules governing Medicare remain the same, said Harriett, though some plans and benefits will change. Some rules are specific to agents while others may be helpful to their clients. However, Harriett said, there are always a few general rules agents need to know when dealing with clients. Here is an overview of what agents need to know for 2023, according to Harriett: General enrollment period dates have changedThere are a number of reasons someone did not enroll in Medicare when he or she was first eligible. In that case, most reasons qualify them to enroll during a Special Election Period, Harriett said. But some people who did not enroll when they were first eligible and had no special election period were restricted to enroll only between Jan. 1-March 31 of each year, with their effective enrollment date beginning July 1. This year, things have changed. For those paying for Medicare Part A, and for those enrolling in Part B, Harriett said, their effective date will be the first day of the month after they enroll. Applicable penalties will still apply. Coverage gap continues to get smallerThe Medicare Part D Prescription Drug program has always had a phase, known as the coverage gap (previously known as the “doughnut hole”). This is a period in prescription-drug coverage when a client’s coverage is reduced if costs escalate to a certain point, and the client pays more for a period of time. Since its inception, Harriett said, the coverage gap has been a point of political contention, with several attempts over the years to fix the burdens this gap created for those who need expensive drugs. In the last few years, Medicare has broadened the definition of “True out of Pocket Costs,” including how the gap is calculated. Now, once in the coverage gap, drug manufacturers pay 70% of the cost of a drug, the insurer pays 5%, and the client covers 25%. But 100% of those costs count toward the beneficiary’s total spending, which gets them out of the gap more quickly and into catastrophic coverage. For example, Harriett explained, a drug with a true cost of $100 in the coverage gap would be paid as follows: The manufacturer covers $70, and the insurance company pays $5. The beneficiary is responsible for $25. But the Explanation of Benefits will show that the beneficiary has paid $100 in out-of-pocket costs. Disclosures must increaseThe huge number of marketing calls from call centers in recent years has led to a striking increase in the number of complaints to the Centers for Medicare and Medicaid Services (CMS) regarding AEP enrollments. Because of this, there have been a few alterations to the rules, Harriett said. This year, marketing organizations must disclose when and if their information is being transferred to a licensed agent (if they were not talking with one originally). Also, there is a new general disclaimer, which must be read to all beneficiaries within the first minute of their telephone call to agents. A full copy of this disclaimer can be found in the insurance company’s Medicare Advantage/PDP compliance bulletins, Harriet said. Marketing, enrollment calls must be recordedAs the rules stand today, all calls that market and enroll beneficiaries in Centers for Medicare and Medicaid Services (CMS)-regulated Medicare products must be recorded from beginning to end and stored safely and securely for at least 10 years. “How this will look in the future is anyone’s guess as it is being challenged by a number of organizations,” Harriett pointed out, “but it appears that for now, the rule is here and will be in place. So, if you are going to be marketing products during AEP, be sure to set up a recording system. If you won’t be marketing, be sure to tell your clients they will be recorded when they talk with someone about it.” The call recording is a big change, Harriett said. But apart from the general change in Medicare costs or numbers (the bulk of which will most likely not be published until at least the end of October), many things in Medicare carry over from this year, Harriett said. “But that does not mean you or your clients should relax,” she said, adding “Always check over benefits with your clients. Prescription drug plans and Medicare Advantage plans change each year. And next year’s plan may not meet your client’s health or financial needs for 2023.” Always use this opportunity to talk to everyone about it.”
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Tags: Medicare Advantage plans, Medicare Advantage News, CMS, Compliance, call recording
3 ways to navigate the new CMS call recording rules
Posted by www.psmbrokerage.com Admin on Thu, Sep 01, 2022 @ 04:51 PM
It’s 2008, and the Centers for Medicare & Medicaid Services just published what quickly would be deemed as “industry-shaking” new Medicare communication and marketing guidelines. From rules regarding scopes of appointment and other requirements intended to clean up poor business practices, many marketers and agents were beside themselves. A palpable panic began to emerge as we scrambled to understand the implications of these new rules to our businesses, our client engagements and our future prospects. Let’s face it – we were living perfectly fine before these rules were published and our industry was riding high. But these new rules weren’t just some one-off requirement. They were a watershed moment for our industry, and they started a cascade of new guidelines from CMS designed to protect consumers and help agents maintain credibility, transparency and trust with those very consumers. Fast forward to today and we find ourselves in a similar position with CMS’s recently published requirements regarding call recordings. As in 2008, I’ve received many of the same questions: “How will this impact me and my business?” “What tools or resources are available to help me do this?” and “What does this mean for engagements with existing clients versus prospective clients?” These are perfectly understandable questions for agents to ask. Compounding the confusion and hard feelings is the notion that CMS likely implemented these new rules in reaction to one particular bad actor and now we all have to deal with the repercussions (not to mention the vagueness of the rules themselves and their release so close to the all-important annual enrollment period selling season). Many of us remember a time when door-knocking dominated our industry, and face-to-face interaction played a vital role in developing client trust. But as we’ve shifted to telephone and e-selling approaches, you can’t help but feel as though today’s agents are being punished for the natural evolution of our industry and consumer engagement. However, rather than continue to bemoan yet another layer of compliance, it’s important to see the opportunity in front of us. Simply put, we always can do better. The biggest threat to our business always has been the commoditization of the agent-consumer relationship, and these rules help ensure that we continue to be perceived and operate as the trusted advisors we need to be.
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Tags: Medicare Advantage plans, Medicare Advantage News, CMS, Compliance, call recording
Gearing Up for AEP - Compliance Bulletin
Posted by www.psmbrokerage.com Admin on Tue, Aug 23, 2022 @ 01:36 PM
As you'll recall, the annual enrollment period is a time when your clients can essentially make any change they are eligible for. Among other things, these changes may include enrolling in Medicare Advantage for the first time, switching from one Medicare Advantage plan to another, or joining a Medicare prescription drug plan. As you may know, AEP only lasts from October 15 through December 7th. This only gives you roughly seven and a half weeks to close on sales. With such a small window of time to enroll potential clients, it's important to take care of all your contracting, certifications, and training as soon as possible. Here are a few important points to consider before you can jump into AEP.
Now that we've gotten the general information out of the way, let's look into a few tips regarding what to avoid saying to current and potential clients in order to stay CMS compliant. "Free premiums!" "Is your spouse eligible for Medicare?" - "How about your friends?" - "Can I have their number so I can call them?" "If you're liking this Medicare plan, you should check out this life insurance plan." "Let me get your contact information so that you are able to come to my event." "While you're waiting for your doctor, let me tell you about your Medicare options." As you are well aware, there are many other requirements to consider in order to remain CMS compliant. Our aim today was to help you gear up as October 15th quickly approaches. Remember to complete your contracting and certifications, order your supplies, read up on any compliance changes, and set your goals. Thanks for tuning in, and we'll see you next month with some more compliance tips. We hope you find this information informative and we are always happy to assist with any questions. You can review a video summary of this information here. ![]() |
Tags: Medicare Advantage, Medicare Part D, Prescription Drugs, AEP, Compliance, 2023
Sunfire: Integrated Telephony for Field Agents
Posted by www.psmbrokerage.com Admin on Mon, Aug 15, 2022 @ 02:16 PM
REQUIREMENT
Effective October 1, 2022 Field Agents will be required to record all sales and marketing calls in their entirety. The recordings must be retained in a HIPAA compliant manner for 10 years. View details on the new CMS rule here.
This pertains to calling leads, scheduling appointments, collecting drug and provider lists and conducting phone enrollments. ![]()
Only in person, face to face appointments are excluded, however any follow up calls related to sales and completing the enrollment process must be recorded.
Additionally, a new disclaimer must be verbally conveyed within the first minute of a sales phone call.
Now is a great time to make sure you have access to Sunfire's enrollment platform and have a solution in place for the upcoming 2023 AEP.
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Tags: Medicare Advantage, CMS, AEP, SunFireMatrix, Compliance, 2023
Latest in Medicare Compliance - CMS Ruling Notification
Posted by www.psmbrokerage.com Admin on Wed, Jul 20, 2022 @ 03:23 PM
RE: Third- party Marketing OrganizationsOn May 9, 2022, CMS issued new requirements for third-party organizations (TPMOs) with an effective date of June 28, 2022 and an applicable date of January 1, 2023.
More details to come as we receive more updates and guidance. Helpful Resources: ![]() |
Tags: Online Enrollment, CMS, Compliance
Video: Referral Fees, Marketing Gifts and Inducements
Posted by www.psmbrokerage.com Admin on Wed, Jun 29, 2022 @ 10:40 AM
Check out the video here There is an exception to this rule which states that marketing representatives may provide gifts, prizes, or promotional items to beneficiaries for marketing purposes as long as:
Check out the video here It’s important to note that agents are not permitted to provide anything of value (e.g., gift card, flowers) to a consumer/member in exchange for a referral (i.e. contact information including name and telephone number/email). The key difference is the purpose of the gift. If it’s given in exchange for a referral, it’s not allowed. ![]() |
Tags: CMS, Compliance