AmeriLife Agents Dialing For Dollars To Orphaned Book Of Universal Members

[wehotex]

I think UHC does that and I know pup out here does that too. Hell, if I talked to someone who told me they just got approved for Medicaid, I'd put them in a Medicaid plan and hope to be the aor

I've tried that some, but they tend to protect the original AOR except if you are changing their product type, ie to PDP to MAPD or HMO to PPO and vice versa. UHC is unique in these parts that it pays to switch from HMO to HMO product, the only one that does it like that.

 

[yogooglethis]

Isn't Aetna easier to do with maybe? I'm always hearing from my friends that sell UHC how screwed up it is. When I tried to get paid on an overlooked renewal, they denied my request because it was OVER six months ago. Haven't had a problem like that with other carriers.

3 of the applications I wrote yesterday have already been approved.I believe I will be paid Tuesday.That's not to bad

From the consumers point of view their customer service is very good.In fact I sometimes use a call to UHC 800# as a demonstration of UHC 's customer service to my prospects. Usually having a live person who speaks the American type of English to talk to within 30 seconds.I know when trying to call other MA plans customer service lines it can be a menu maze.
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Yes, I understand that they pay OK in those situations. But one thing that I was told was that if agent enrolls T65 prospect into MAPD complete, then prospect qualifies for QMB medicaid a couple of months later and wants to enroll into D-SNP that it's a "chargeback" and then they also lose the "true-up". In San Antonio, UHC pays when an agent switches the member from Complete to Chronic/Dual Complete and vice versa. If I were a UHC rep, I'd be very reluctant to enroll a prospect in some contracted clinics that are known to switch their patients frequently because of agents that camp out there 24/7.

Supposedly if it's it done after they have been on plan for 4 months you won't lose true up but I recently did this and did lose the true up.I was able to appeal it but whether they pay me is based on what CMS reports back.Best thing to do is to help them apply for their Medicaid if you know its a no brainer that they will be approved and then start them on the SNP plan.

 

[policy doctor]

I've never bothered to investigate this further but I was told that a regular medicare advantage plan can serve as a dual because the client is showing their medicaid card for the 20%. The providers are not allowed to charge more than what medicaid approves in that state. Only thing they don't have are the extra value benefits.

Perhaps someone more learned will come along and correct me.

 

[yogooglethis]

I've never bothered to investigate this further but I was told that a regular medicare advantage plan can serve as a dual because the client is showing their medicaid card for the 20%. The providers are not allowed to charge more than what medicaid approves in that state. Only thing they don't have are the extra value benefits.

Perhaps someone more learned will come along and correct me.

It must be SNP plan to intergrate with Medicaid for full QMB Medicaid.I understand in some states that beneficiaries with share of cost Medicaid will be covered for co pays on a regular MA plan if they exceed share of cost level in a given month but only if they get services from providers that bill medicaid.In Florida I have been told they don't,then I was told they do,then i was told they don't so to be safe i tell clients their share of cost doesn't help them with co pays on a non SNP MA plan.Anybody know anything different for Florida?

 

[BobbyMcGee]

Had a potential client who had share of cost with the Care Plus Care One HMO in Lake County FL. She was Q1.

 

[wehotex]

In North Fl the AmeriLife Agency agents wrote a good chunk of Universal's enrollment during the last 6 years and now their agents - not necessarily the AOR seem to be cold calling the orphaned book of business.I have received many inbound calls from Universal members in the last 2 days who other clients have referred to me and most of them told me by the time I was able to meet with them that they have been called by AmeriLife In fact today as I was completing an UHC MA application to replace Universal and I could see on the prospects caller ID that an AmeriLife agent was calling. We knew it wasn't the AOR however the new agent that was calling was mentioning the AOR's name to try to get in the door.Turns out I personally know the original AOR and she happened to be related to the prospects but is no longer in the business.

I received a lead yesterday requesting a UHC plan but by the time I called the lead an AmeriLife agent who wasn't the AOR had cold called and razzled his way in to an appointment saying he could show all the plans at once including UHC.

I have probably more than 100 old leads of people I know are on Universal and many would likely remember me and take my call but I can't and won't call them because the permission to call has expired so it sucks to see agents skirting the rules and getting to these people before they decide to make outbound inquiries.

Thank goodness Banker's Life agents don't have a roster of Universal's enrollment and don't market MA in Florida.

Just a question...if the AOR is no longer in the business, does the up line have the right to call those prospects?

 

[yogooglethis]

Just a question...if the AOR is no longer in the business, does the up line have the right to call those prospects?

No.Only the AOR has permission to call but some Amerilife agencies here in Florida are not following the rules and cold calling the orphaned Universal members.

 

[Joe101]

Amerilife is a Horrible company...Head of the company is the worth person I ever met in Tim North, trained by the monster Gary Boesch!!

 

[yogooglethis]

It does suck and its not fair.
I was in a home yesterday and an Amerilife agent called and a Freedom agent knocked, rediculous !!

Insgal are you seeing this get worse like I am here in North Fl. I can't say it's all AmeriLife but there is an agency or agencies that have a list of orphaned Universal members that are bombarding these people with cold calls. I know of 2 instances at least where they used telemarketers to set appointments for other agents.

Case in point.:

Friday I went back to enroll a Universal refugee in UHC and she told me she had at least 7 cold calls in the last week including on Sunday from agents who allegedly made statements such as - your doctor wanted me to call you.

Tonight I enrolled another Universal member who had got my name from the doctors office and called me.I did things the right way and had went to the doctors office and introduced myself and they gave me permission put flyers in lobby.

I almost lost the sale tonight when at the customers home he was going to wait to make his decision to enroll until he got a chance to talk to a lady who had cold called him after he had called me this morning to set an appointment.He thought his doctor had recommended that he should consult with this lady about his insurance. Turns out this was a telemarketer cold calling to set appointments from an orphaned list.Of course the telemarketers know who the prospects PCP is because they have a copy of the Universal enrollment application so they are using the " your doctor recommended you consult with us about your Medicare health plan " angle to slam them in to an appointment.These agents and telemarketers also aren't concerned about the rules against using high pressure tactics either.

This particular doctor only took Universal and UHC and I have an inside track at this PCP office when patients ask about a contact for UHC so I know this is complete BS these cold calling agents are telling these people.

The agents breaking the rules are taking money out of the pockets of agents following the rules and it is made all the worse for us because of the limited window of opportunity.
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Just a question...if the AOR is no longer in the business, does the up line have the right to call those prospects?

I am not 100% sure of this but I believe that technically now that these people are no longer on Universal even the AOR can't call these people if they didn't update a permission to call beyond the expiration of the DNC list window.

 

[AngelBand]

Have people call the Florida Department of Consumer Complaints at

1 877-693-5236

They need to play by the rules like the rest of us.