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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

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

Medicare Marketing Changes in 2024: New TPMO Disclaimer

Posted by www.psmbrokerage.com Admin on Wed, Aug 30, 2023 @ 10:44 AM

TPMO DisclaimerAnother Year, Another New Rule from CMS…

Yes, we feel your pain.

It seems like every year there’s a new set of compliance rules that agents must follow when selling Medicare Advantage and Part D plans. Some are a minor nuisance; others require scrambling to find and put new systems in place before the deadline (call recording, anybody?).

Remember why CMS does this: They are trying to protect Medicare beneficiaries against misleading and confusing sales and marketing tactics, and make sure these consumers get the right help to end up with the appropriate plan for their needs. This is the same goal that most independent agents have when selling Medicare plans.

While most independent agents focus on providing the best service possible, there are some bad actors. According to CMS, the number of consumer complaints rose from 15,497 in 2020 to 39,617 in 2021.

Medicare Marketing Changes in 2024: New TPMO Disclaimer

There are many resources you can turn to that dive into the changes for 2024. We won’t go over all of them here. But there is one specific rule that directly affects AgentMethodscustomers and the service we provide: the TPMO (Third Party Marketing Organization) Disclaimer.

To make sure it’s clear to customers what companies and plans an agent can offer them, CMS has provided an updated TPMO disclaimer that agents must use in communication and marketing materials such as email, online chat, advertisements, and websites. The new disclaimer is:

“We do not offer every plan available in your area. Currently, we represent [insert number of organizations] organizations which offer [insert number of plans] plans in your area. Please contact Medicare.gov, 1–800–MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.” (source: https://www.ecfr.gov/current/title-42/part-422/subpart-V#p-422.2267(e)(41))

But there’s one tiny problem with the new disclaimer…

The New Disclaimer Doesn’t Work on Websites

While this new disclaimer is helpful for direct mail campaigns and one-on-one communications, it creates a problem when communicating with anonymous website visitors who don’t know their local area. In that case, you aren’t able to provide a correct number for organizations you work with and plans you offer within their area.

We are seeing creative solutions, such as:

  • Some agents are simply stating the number of organizations and plans they work with in their area. However, this is often misleading and inaccurate. If you are located in Texas and someone from New York visits your site, you are providing them misleading information that could create the impression that you can offer more plans to them than you actually do.
  • Other agents are replacing the “in your area” with “in my area.” While this makes the number accurate, it doesn’t provide useful information to the consumer. Again, this can easily be misread, leading to customer confusion.

The Correct TPMO Disclaimer to Use on Insurance Websites Marketing Medicare Plans

To make sure we are getting this right, Agent Methods went to the source and asked CMS directly what TPMO disclaimer agents should use on their websites. Here is what they said:

“It is acceptable for plans to use the old generic TPMO disclaimer on landing pages where no zip code can be provided, as long as they use the new disclaimer on the page where beneficiaries can input the zip code.”

They further confirmed that the old disclaimer can even be used on screens where the zip code can be entered because the consumer has not yet been located and identified. CMS also confirmed the previous, generic TPMO disclaimer that should be used on websites with anonymous traffic:

"We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.”

PSM is proud to be a partner with AgentMethods and the resources they make available to our agents. To learn more, please go here.

Source: https://www.agentmethods.com/blog/selling-medicare-products-here-s-the-tpmo-disclaimer-you-should-use-on-your-insurance-website-in-2024 

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Tags: Medicare Advantage, Part D, Compliance, TPMO, AgentMethods

We are excited to announce the initial launch of SunFire’s Med Supp Quoting and Enrollment Experience

Posted by www.psmbrokerage.com Admin on Wed, Aug 30, 2023 @ 08:52 AM

SunFire Medicare Supplement Quoting and Enrollment

We are excited to announce the initial launch of SunFire’s Med Supp Quoting and Enrollment Experience, arriving 10/1! We believe they have created a revolutionary platform that will significantly improve your efficiencies and profitability. As with any new product, their goal is to build a strong foundation with key features and continue to enhance the system over time, including additional carrier integrations.

Features Included in the Initial Launch

  • Accurate quoting for 49 carriers with enrollment capabilities for 17 carriers:
    • Full enrollment integration with Aetna, Cigna and Anthem.
    • With MOO, UHC, Humana, and Aflac slated for the new year.
    • Link outs for the other 11 carriers, where the application will be completed within the carriers’ portal.
  • A Med Supp specific needs assessment, which captures drug and medical condition data, with the intention of alerting agents to carriers that will be unlikely to pass the applicant through underwriting.
  • If our algorithm suggests that Med Supp may not be the best path, the agent can easily transition into the MA/MAPD Quoting and Enrollment flow with all client data staying intact.
  • Post enrollment, our new bundling experience creates real agent efficiencies by providing the ability to capture drug and demographic data one time and pass that information to the DVH and PDP applications displayed post sale.
    • The DVH partners currently integrated for quote and enroll include NCD and Aetna with a more robust suite of DVH integrations, including MOO, UHC, Cigna, Humana, Aflac, GTL and others slated for the coming months.
    • PDP plans are available and will be shown to agents who are ready to sell pre-filled, with pricing based on previously captured pharmacy and drug cabinet info.
  • Please keep in mind we will only quote plans that are RTS for the agent

 

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

Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs

Posted by www.psmbrokerage.com Admin on Fri, May 13, 2022 @ 12:06 PM

Tags: Medicare Advantage, Medicare, Part D, New Med Advantage Rules, Special Needs Plans

Video: Don't Make This Common PDP Enrollment Mistake

Posted by www.psmbrokerage.com Admin on Thu, May 12, 2022 @ 10:15 AM

Tags: Sales Tips, Part D, Training

PSM YouTube: Getting Started in Medicare Sales

Posted by www.psmbrokerage.com Admin on Fri, Jan 14, 2022 @ 01:59 PM

Tags: Sales Tips, senior market news, Medicare Advantage, Medicare Supplement, Medicare News, Sales Leads, Part D, Incentives, sales ideas, YouTube

Guide: Hosting a Medicare Sales or Educational Event

Posted by www.psmbrokerage.com Admin on Thu, May 06, 2021 @ 10:42 AM

 

Tags: Medicare Advantage, Medicare Supplement, Part D, Sales Event, Seminar, Educational Event

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