BUSTED: Last Minute PFFS Hustle...


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I received a call from a client yesterday (and it WAS NOT the first) about a pushy agent who basically got in the door (don't you love the loyalty.... NOT) and the agent lied his but off to the client about Coventry's PFFS Plan.

The client sensed wrong and called me to confirm. He was pushy, flat out lied about copays (ALL ZERO, ALL DOCS ACCEPT) and the worst is if he had written the deal, he would have knocked her out of her PDP b/c the plan I put her in was comingled in one.

I have warned ALL OF MY CLIENTS about the notorious calls they would get and some I have talked to (after the AEP) have told me agents have called and they have not let those agents in 'the door,' while others I guess feel 'hey they're may be a better deal out there for me' (don't you love the loyalty... and my loyalty of having every brand in my car so I can do what's right). - then the agent starts to put his or her foot in his or her mouth and tells these clients lies. I warned them and foreshadowed what I knew what some agents would say.... Most have listened to me regarding the lies other agents would say - those whom both have and have not let in the door b/c I also told them what to watch for 'on the phone.'

I have this agent's contact info. and I'd like to report this SOB. I'm tired of this shat! One reason why we are now on 'suspension' is because of agents like this; and further, why we have to work that much harder to prospect, service, and remain compliant in our industry. I'm done! THIS ONE'S GOING DOWN.... (i've let others go but not now.. oh no, I'm done).

So how do I and or the client report this person?

Anybody know? Do we call Medicare, the DOI, or both? I'm thinking about calling him but opted not to; I'd rather him awake to a grievance; I feel that will be far more efficacious.
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Don't seek confrontation

Unless an agent went around slandering me, or impugning my reputation, I don't run around being a cop.

That client knew enough to call you but they don't know where to call-in a complaint? They can start by calling the last company the agent enrolled them with.

Client loyalty doesn't mean you're all married. Some stick, some fall off, majority shop around. Hey, that's how you found them, right? They responded to a phone call or mailer? Now they should stop because you inked paper together(like breaking bread?) Just do your best in an ethical manner, the Large Law of Averages takes care of you.
Stay focused on your business

I wouldn't exert the effort to report the salesperson, either. It would be a lot of negative energy that would bleed over into your other activities. The fact that the suspension exists tells us that there may be better monitoring for unscrupulous agents like this. Let CMS handle it.
The DOI puts almost no stock into agent vs agent complaints. They know we're all competing. They will however listen to client complaints so when I have a real pissed off client going on and on about how they got lied to I send them the link to the DOI and they can file a complaint online. Whether or not the DOI takes action isn't the point. The point is two-fold:

1) The agent gets a copy of the complaint and has to respond. Then they at least know they're busted.

2) It's now strike 1 with the DOI. A few more complaints and now the license is toast.
Policy, Kinde, and John,

You 3 are all correct; and after much thought and talking to a really good friend (who is also an excellent agent) she, as all of you suggested to leave to the client and not exert any more energy (which I'm already running low on). Thank you all.

Neat reply John, it's nice to see how that 'strike' method works conspicuously.

Btw, a special thanks to my special friend, who is also a member on this board! Hi Miss ____ !!!! ;)
I was wondering the same thing today Honestagent. I am having my client file a complaint. This agent door knocked to switch this 84 yr old lady from a supp to a MA. That is not right 1st of all. 2nd, this is the 2nd agent that has done this from the same company. IT is my old carrer agency that is hitting my clients hard. They have slandered me, they sued me for $300(for switching clients that called me) when I had enough biz left on the books to pay waaaay more than $300. Then they had the guts to call me and get me to work with them again.WTF! Anyway, the client wants to file so I will be more than happy to show her how. I can't wait. I have finally gotten my revenge on these SOB's
Hey Senior - Glad to hear you'll be reaping your revenge; I will advise my client accordingly how to partake and I hope she follows through; I'd love to see the dude's face awake to a complait/violation. One by one, eventually they'll go. Just as Policy Doc said, the law of large #s should take care of us good ones and my dad has a saying that goes, "eventually if one does wrong, it's just a matter of time before it'll catch up with that person." I believe that too. :biggrin:
I know in Indiana, if you want to move a client after the open enrolllment period you have to move like to like. So, if you had your client on a PDP, then the other agent would have had to move the client to a similar plan. Do you not have the same requirements?
I know in Indiana, if you want to move a client after the open enrolllment period you have to move like to like. So, if you had your client on a PDP, then the other agent would have had to move the client to a similar plan. Do you not have the same requirements?

After the OEP, as you know, beneficiaries can elect a 1 time switch from a like to like (Part Cers only who have elected an MA already previously) can switch. After, during the LOEP, there are absolutely NO SWITCHES for these folks, unless they file for a formal disenrollment through Medicare.

For the LOEP, I know virgin MA beneficiaries can switch back to original Medicare but I'm not sure if they can switch to an MA only - (like to like)??? I've gotten different responses on this. Does anybody know for certain during LOEP if virgin MAers can switch to a like to like MA only to MA only? I have never gotten a clear answer on this one. And I'm not 100% clear here how the Med Sup works in this case either. Does anybody know this if they've elected and MA (first time) during LOEP, can they switch to a Med Sup or will that depend on the company and if so, would that be considered an SEP?

Guess this is why we do need to re-certify... eh.....

At times, when I've called Medicare on specific questions, I've gotten different responses too!!!
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