How are we expected to sell?

[DHK]

So you are saying that every insurance agent who sells medicare supplements by cold calling through the process of door knocking and speaking to folks on their front porches and in their kitchens and living rooms is doing so illegally?

And maybe every agent who responds to a post card request for information by delivering a salestalk about medicare supplements is doing so illegally?

I checked out this thread because I was curious as to how a non-insurance agent was going to talk about the thread title "How are we expected to sell?"

And here I am... quite surprised with the idea that a CONSUMER on this forum is DEFENDING the agents' right to have a conversation with people??? Wow!

While I am by NO means an 'expert' on Medicare Supplements and Medicare Advantage, I do know there are DISTINCT differences in how they are allowed to be marketed.

I'd listen to Greensky's post if I were you.

 

[midwestbroker]

"To recap the rules: A producer cannot approach a beneficiary in person to solicit business without first being approached (in person) by said beneficiary. If the producer claims that he or she was simply approaching a beneficiary in person in order to solicit "only MedSupp," my point is that the solicitation is still improper and subject to CMS sanctions against the producer (and potentially any MAPD or PDP carrier that producer is contracted with). This is because, by definition, the vast majority of people eligible for MedSupps also are eligible for MAPD and PDP. If you are sitting at a Marketing Booth designated for MA or Part D, it is true you cannot approach people."

Disclaimer: I am a trainer at an FMO and also sit on the compliance board.

The marketing booth rules apply to the market booth and not necessarily to the rest of the market. Case in point, it is March. AEP is over. Most people do not have a SEP to change their MA or Part D plan. Yes, the prospects are eligible for an MA or Part D plan, but a Medicare Supplement only appointment is very plausible since it is during the lock-in.

What if you are going door to door and a prospect has an MA plan? Well, sell them a HIP, DVH, FE, Cancer plan, etc. There are a lot of ways to pivot from MA and Part D and stay compliant.

What about the T65 market? They are eligible for everything! Yep, they are, but if your intent as the agent (which most compliance complaints will default to) was to sell a Medicare Supplement plan, then there should not be an issue. It is also important to remember that it is only a compliance issue in the vast majority of cases if the client decides to make it one. If the client is happy with their decision, the agent's intent was to sell a Med Supp but an MA plan was a better fit, there should not be a compliance issue.

Last point, if compliance was such an issue in the field, why would CMS relax the rules for SOA forms? NAHU is pushing for SOA forms to go away, and according to them they predict in the next few years, SOA forms will no longer be required (we will wait and see on that one).

 

[insurancechic127]

The way I'm understanding this is that, when dealing with a T65 'virgin' they are eligible for everything: MA, MAPD, PDP, and Med Supps. If someone who knew nothing about Medicare but was approaching their 65th birthday asked me "what are my options?" I'm going to present them ALL...and so i would get an SOA.

The telephone solicitation confuses me. I know people telemarket only Med Supps. I mean no offense to anyone, but is that ethical? Isn't our job so serve the public and advise potential beneficiaries of all their choices? How can you honestly advise someone turning 65 about Supps and ignore their option to join an HMO...and in many states, at $0/month. Regarding tackling a potential Med Supp client, I"m sure the OP was exaggerating for effect; the point being that it is OK to approach a potential client cold...and that could be in person or on the phone.

I'm not whining or complaining about these regs, I just want to have a CLEAR GRASP of the fundamentals. Isn't that the purpose of this forum? To be able to come on and ask honest questions, share opinions, help each other?

Thanks to those of you that tried to help me understand this.

 

[LostDollar]

I checked out this thread because I was curious as to how a non-insurance agent was going to talk about the thread title "How are we expected to sell?"

Here is the statement that made the red haze slowly descend behind my eyelids.

Any producer truly not able to market PDP plans has no business marketing MedSupps.

 

[LostDollar]

The telephone solicitation confuses me. I know people telemarket only Med Supps. I mean no offense to anyone, but is that ethical?.

Yes.

The only reason I don't have an MA plan is because the Coventry guys weren't at the grocery store when I needed them. In retrospect I consider that to be good, rather than bad, fortune.

Isn't our job so serve the public and advise potential beneficiaries of all their choices? How can you honestly advise someone turning 65 about Supps and ignore their option to join an HMO...and in many states, at $0/month.

A number of regularly posting agents indicate there are ways to generally advise people about their Medicare insurance options without violating CMS rules or actually being contracted to sell some of those products.

A Medicare beneficiary can sign up for a PDP themselves on a CMS website.

 

[JimmyCrappedCorn]

I think this dude is an informant . . . I mean why else stalk an insurance agent forum?

That is what I was thinking too. He either is up to something or out of his gourd.

 

[sman]

That must be a UHC requirement it certainly isn't CMS. I can hold a marketing event take an application at the marketing event and not have an SOA signed.

I

The topic I was responding to was NOT "cold calling" beneficiaries for MedSupps, nor did it have anything to do whatsoever with determining if and when an SOA was required. Rather, the topic was approaching a beneficiary in person, in this case, by tackling said beneficiary in a store. Two completely different types of solicitation, and thus, different solicitation rules. Read the details; that's where the devil resides.

To recap the rules: A producer cannot approach a beneficiary in person to solicit business without first being approached (in person) by said beneficiary. If the producer claims that he or she was simply approaching a beneficiary in person in order to solicit "only MedSupp," my point is that the solicitation is still improper and subject to CMS sanctions against the producer (and potentially any MAPD or PDP carrier that producer is contracted with). This is because, by definition, the vast majority of people eligible for MedSupps also are eligible for MAPD and PDP.

What is so difficult to understand about that rule folks? If you don't understand the logic therein, perhaps you should consider a new career in automobile sales.

It is something quite different to initialize solicitation of a MedSupp via phone. So long as MedSupp is ALL you are soliciting (excluding MA, MAPD, PDP, etc.) then CMS does not technically prohibit such solicitation. That being said, a significant percentage of complaints against producers are lodged due to soliciting PDP or MAPD via phone under the guise of soliciting "only MedSupps."

Tread lightly folks. Again, if you don't understand the rationale behind the rules, the car business is hopping. They need peddlers, bad, especially truck sales. And you don't have to pay too close attention to details.

So what you're saying is that an agent cannot approach another person (in person) and ask them about a Medicare Supplement, BUT they CAN approach them via a phone call? I'm sorry, but you are incorrect. If I want to walk up to every person I see in a grocery store who I think might be a Medicare beneficiary and ask them about a Medicare Supplement, there are no CMS rules against that. Of course, I wouldn't be marketing in such a way, but it is permissible no matter how ineffective it might be.

Claiming that you are a compliance officer and therefore more knowledgeable than the rest of us is just ridiculous. You can ask compliance from 5 different companies and get 5 different answers. Hell, just until last year, I had a company tell me I couldn't mail MAPD enrollment kits to a potential client, have them mail the completed application back to me and then I submit it and get paid. Yet, several other companies had no issue with it. That was because their interpretation of the rules were different than the other company.

How's the view from your horse?

 

[DS4]

Please call me collect from anywhere in the world if CMS ever comes down on someone for selling a Medicare supplement. Or, a Part D.
CMS is after the bigger fish.
With experience, you can easily fly under CMS' radar.

 

[LostDollar]

I think this dude is an informant . . . I mean why else stalk an insurance agent forum?

Well.... there have been reports of someone going around talking to our seniors about home security systems and then trying to sell them medicare supplements.....

 

[sman]

The way I'm understanding this is that, when dealing with a T65 'virgin' they are eligible for everything: MA, MAPD, PDP, and Med Supps. If someone who knew nothing about Medicare but was approaching their 65th birthday asked me "what are my options?" I'm going to present them ALL...and so i would get an SOA.

The telephone solicitation confuses me. I know people telemarket only Med Supps. I mean no offense to anyone, but is that ethical? Isn't our job so serve the public and advise potential beneficiaries of all their choices? How can you honestly advise someone turning 65 about Supps and ignore their option to join an HMO...and in many states, at $0/month. Regarding tackling a potential Med Supp client, I"m sure the OP was exaggerating for effect; the point being that it is OK to approach a potential client cold...and that could be in person or on the phone.

I'm not whining or complaining about these regs, I just want to have a CLEAR GRASP of the fundamentals. Isn't that the purpose of this forum? To be able to come on and ask honest questions, share opinions, help each other?

Thanks to those of you that tried to help me understand this.

I know agents who don't sell MAPD/PDP. Only Med Supps. However, they review the benefits of the MAPD plans available in the area (Summary of Benefits booklets can be downloaded from the carrier website) so that they can go over the highlights with a potential client. Many of these same agents also assist the client in reviewing their PDP options by running a comparison for them on the Medicare Plan Finder site. Since they don't contract with or certify to sell MAPD/PDP plans, they don't have to worry about getting a SOA signed. If the client wants a Med Supp, the agent enrolls them. If they want a MAPD, a couple of agents I know who only do Med Supps refer those prospects to me.

To imply they are somehow unethical for not offering MAPD/PDP is a bit of a stretch. That isn't to say there aren't unethical agents out there who mislead about a particular product.