Cold calling rules

[jdeasy]

This is some info from an email I got today;


Background: CMS (Centers for Medicare and Medicaid Services) announced changes to the regulations affecting all who market Medicare Advantage products. Listed below are some highlights and recommended changes that need to be made to your activities in order to remain in this marketplace.
Call Center Activity:
As of Thursday, September 18, 2008, you will no longer be able to call prospective members to set sales appointments unless you have the permission of the beneficiary to call. This permission may be by invitation or as a result of a business reply card. The wording from CMS is:

Beginning September 18, 2008, the prohibition on door-to-door solicitation extends to other instances of unsolicited contact that may occur outside of advertised sales or educational events. Prohibited activities include, but are not limited to, the following:
​

• Outbound marketing calls, unless the beneficiary requested the call. This includes contacting existing members to market other Medicare products, except as permitted below.
• Calls to former members who have disenrolled, or to current members that are in the process of voluntarily disenrolling, to market plans or products, except as permitted below.
• Calls to beneficiaries to confirm receipt of mailed information, except as permitted below.
• Calls to beneficiaries to confirm acceptance of appointments made by third parties or independent agents.
• Approaching beneficiaries in common areas (i.e. parking lots, hallways, lobbies, etc.)
• Calls or visits to beneficiaries who attended a sales event, unless the beneficiary gave express permission at the event for a follow-up call or visit.

This is what Call Centers may do:
Organizations may do the following:

• Conduct outbound calls to existing members to conduct normal business related to enrollment in the plan, including calls to members who have been involuntarily disenrolled to resolve eligibility issues.
• Call former members after the disenrollment effective date to conduct disenrollment survey for quality improvement purposes. Disenrollment surveys may be done by phone or sent by mail, but neither calls nor mailings may include sales or marketing information.
• Under limited circumstances and subject to advance approval from the appropriate CMS Regional Office, call LIS-eligible members that a plan is prospectively losing due to reassignment to encourage them to remain enrolled in their current plan.
• Agents/brokers who enrolled a beneficiary in a plan may call that beneficiary while they are a member of that organization.
• Call beneficiaries who have expressly given permission for a plan or sales agent to contact them, for example by filling out a business reply card or asking a Customer Service Representative (CSR) to have an agent contact them. This permission applies only to the entity from whom the beneficiary requested contact, for the duration of that transaction, or as indicated by the beneficiary.

All outbound scripts must be submitted for review and approval prior to use in the marketplace. When conducting outbound calls:

• Scripts must include a privacy statement clarifying that the beneficiary is not required to provide any information to the plan representative and that the information provided will in no way affect the beneficiary’s membership in the plan.
• Plans are prohibited from requesting beneficiary identification numbers (e.g., Social Security Numbers, bank account numbers, credit card numbers, HICN).
• Plans are allowed to say they are contracted with Medicare to provide prescription drug benefits or that they are Medicare-approved MA-PD/PDP.
• Plans cannot use language in outbound scripts that imply that they are endorsed by Medicare, calling on behalf of Medicare, or Medicare asked them to call the member.

All calls must be recorded!
This means that beginning this Thursday, you cannot do any cold calling to set appointments.
There are several items of concern beyond the “no cold calling” that we are continuing to explore. For clarification on some, we need to hear back from the insurance carriers. These issues include new commission rates, chargeback rules and future commissions on replacements across carriers.
Please take note of these requirements so that no cold calls are made after this Wednesday! We will notify you as soon as we receive clarification on the other subjects covered

 

[xrac]

Re: Cold calling rules;

This is some info from an email I got today;


Background: CMS (Centers for Medicare and Medicaid Services) announced changes to the regulations affecting all who market Medicare Advantage products. Listed below are some highlights and recommended changes that need to be made to your activities in order to remain in this marketplace.
Call Center Activity:

As of Thursday, September 18, 2008, you will no longer be able to call prospective members to set sales appointments unless you have the permission of the beneficiary to call. This permission may be by invitation or as a result of a business reply card. The wording from CMS is:

Beginning September 18, 2008, the prohibition on door-to-door solicitation extends to other instances of unsolicited contact that may occur outside of advertised sales or educational events. Prohibited activities include, but are not limited to, the following: ​

• Outbound marketing calls, unless the beneficiary requested the call. This includes contacting existing members to market other Medicare products, except as permitted below.
• Calls to former members who have disenrolled, or to current members that are in the process of voluntarily disenrolling, to market plans or products, except as permitted below.
• Calls to beneficiaries to confirm receipt of mailed information, except as permitted below.
• Calls to beneficiaries to confirm acceptance of appointments made by third parties or independent agents.
• Approaching beneficiaries in common areas (i.e. parking lots, hallways, lobbies, etc.)
• Calls or visits to beneficiaries who attended a sales event, unless the beneficiary gave express permission at the event for a follow-up call or visit.

This is what Call Centers may do:
Organizations may do the following:

• Conduct outbound calls to existing members to conduct normal business related to enrollment in the plan, including calls to members who have been involuntarily disenrolled to resolve eligibility issues.
• Call former members after the disenrollment effective date to conduct disenrollment survey for quality improvement purposes. Disenrollment surveys may be done by phone or sent by mail, but neither calls nor mailings may include sales or marketing information.
• Under limited circumstances and subject to advance approval from the appropriate CMS Regional Office, call LIS-eligible members that a plan is prospectively losing due to reassignment to encourage them to remain enrolled in their current plan.
• Agents/brokers who enrolled a beneficiary in a plan may call that beneficiary while they are a member of that organization.
• Call beneficiaries who have expressly given permission for a plan or sales agent to contact them, for example by filling out a business reply card or asking a Customer Service Representative (CSR) to have an agent contact them. This permission applies only to the entity from whom the beneficiary requested contact, for the duration of that transaction, or as indicated by the beneficiary.

All outbound scripts must be submitted for review and approval prior to use in the marketplace. When conducting outbound calls:

• Scripts must include a privacy statement clarifying that the beneficiary is not required to provide any information to the plan representative and that the information provided will in no way affect the beneficiary’s membership in the plan.
• Plans are prohibited from requesting beneficiary identification numbers (e.g., Social Security Numbers, bank account numbers, credit card numbers, HICN).
• Plans are allowed to say they are contracted with Medicare to provide prescription drug benefits or that they are Medicare-approved MA-PD/PDP.
• Plans cannot use language in outbound scripts that imply that they are endorsed by Medicare, calling on behalf of Medicare, or Medicare asked them to call the member.

All calls must be recorded!
This means that beginning this Thursday, you cannot do any cold calling to set appointments.
There are several items of concern beyond the “no cold calling” that we are continuing to explore. For clarification on some, we need to hear back from the insurance carriers. These issues include new commission rates, chargeback rules and future commissions on replacements across carriers.
Please take note of these requirements so that no cold calls are made after this Wednesday! We will notify you as soon as we receive clarification on the other subjects covered

I do not work the senior market so my response is that we are no longer a free country are we? Are our seniors so incapable that they need this much protection?

 

[policy doctor]

Re: Cold calling rules;

No we're not a free country and these new rules are anti-competitive, anti- free market(or capitalistic) and interferes with commerce.

And this may be the spread of further regulation into other business arenas.

Make everyone a wage slave instead of commission so taxes can be collected immediately and full control over their economic life.

AHHHH...don't get me started.

But i've stated before on some past posts, that we agents are being used in this MA arena, then we will be trashed.

 

[midwestbroker]

Re: Cold calling rules;

These rules are not new. Humana got in trouble in Wal Mart (when they had booths there). Agents were walking around the store approaching seniors. As of early 2007, CMS said no more, that you have to be approached by a senior.

No cold calling? Have you talked to a senior that was not on the DNC list? They are getting slammed by telemarketers.

As far as I know, this does only apply to MA and Part D. Supplements, final expense, and other plans are still a free for all, and there is the loop hole.

 

[Cheech]

Re: Cold calling rules;

I thought the "cold calling/telemarketing" rules weren't going to be in effect till Jan. 1 2009?

Wondering where this e-mail you received was orginally generated?

I do work in the senior market and do "cold call"

 

[jdeasy]

Re: Cold calling rules;

I thought the "cold calling/telemarketing" rules weren't going to be in effect till Jan. 1 2009?

Wondering where this e-mail you received was orginally generated?

I do work in the senior market and do "cold call"

That particular email came from a FMO that I am contracted with. It quotes CMS. I spoke to another FMO by phone this morning and was told that they got the same info yesterday from CMS. I talked to another GA and he said that he was told that the restrictions start Oct. 1.

I'm just passing the info along. How accurate it turns out to be, I don't know.I personally do not cold call, but, I do buy preset appointments and those are generated by cold calling I'm sure.

 

[yeager]

Re: Cold calling rules;

CMS Releases Updated Rules and Regulations for 2009 Selling Season ​

On September 15, 2008 the Centers for Medicare & Medicaid Services (CMS) released its updated rules and regulations for marketing Medicare Advantage and Medicare Prescription Drug Plans with 2009 effective dates. These plans may be sold beginning with the Annual Enrollment Period (AEP) starting November 15, 2008.
The new requirements listed below are in addition to current rules, which remain in effect.
New Regulations for 2009 Enrollment Periods
• No cold calling/telemarketing - Agents may no longer purchase a list, scrub it against Do Not Call (DNC) and call prospects. The agent also may not call a referral, unless the individual has contacted the agent first. The potential client must have solicited us for information (meaning they must have responded to a mailer or contacted us requesting information in some other documented way).
• No more meals at sales seminars
• No cross-selling at MA / PDP appointments - Agents must make an appointment prior to going to the house and must stipulate what they will be presenting. Sales presentations can be grouped as follows:
1) MA/PDP - Medicare Advantage (PFFS, PPO, HMO, SNP), and Medicare Prescription Drug Plans. Medicare Supplement may be discussed here.
2) Traditional products (i.e. life, cancer, dental), Medicare Supplement may also be discussed at a traditional products appointment. If during the traditional product(s) appointment, the prospect expresses interest in Medicare Advantage or Medicare Prescription Drug Plans, a 48-hour cooling-off period is in place. The agent must schedule an appointment at least 48 hours later to discuss MA/ PDP products. This rule goes both ways (that is, MA/PDP may not be discussed at a traditional appointment and traditional products may not be discussed at a MA/PDP appointment).
• No sales presentations, distribution or acceptance of applications in provider offices or anywhere health care is delivered
• No sales activities, distribution or acceptance of applications at educational events or seminar setting
• Agents must be both licensed and appointed in accordance with state laws in all states where they will solicit and sell MA/PDP Plans.
In addition, CMS will be doing the following:
• Tripling the number of "secret shopper" activities
• Reviewing plans' local print and broadcast advertisements
• Reviewing recordings of enrollment calls to ensure compliance with new regulations
• Ensuring that plans properly enforce regulations and report agent/broker misrepresentation.
The 2009 Enrollment Periods can be enormously successful for you if you take the time to review and then follow these new regulations.Stay compliant and have a successful AEP!

 

[MedSuppPro]

Re: Cold calling rules;

I don't do cold calling or do I? When I call an existing client about a new plan for 2009 that I believe is in their best interest -- it may be a cold call by CMS definition.

I have heard that we Rent-A-Agents will also need to complete yet another form explaining how we made contact with our applicant. Keep in mind that your subjecting yourself to other federal rules that extend beyond CMS.

This reaches a point of diminishing returns. My cost of acquiring a new client and servicing that new client will most likely fall short of a decent living. I also risk my way of making a living if one of these rules trip me up.

I’m for levelized commissions and not for the Rent-A-Agent crap. I may downsize my operation back to a "Frank" level of offering MedSupp's only. Less governMENTAL crap and a return to 45 days of my life.

MA and PDP's will become an "Oh, by the way -- sale"! Or if I can't place them into a MedSupp due to their health I'll reach into my tool bag and pull out an MA plan -- after a 48 hour cooling off period!

 

[Cheech]

Re: Cold calling rules;

I got word from my FMO we have until- Fri.

On Sat- no more cold calling/telemarketing

I

 

[Cheech]

Re: Cold calling rules;

I got word from my FMO we have until- Fri.

On Sat- no more cold calling/telemarketing

I think we'll see alot of companies falling off