SEP after one SEP was already used?

[axeman462]

I have a customer that had joe namath call her and churned her to another plan. She says it wasn't her intent to change.
Now she wants to switch back. The plan has not taken effect yet.

I realize she could just call the insurance company and cancel the application, but I want to make this as easy as possible for her.

We think he used an SEP to do this.
Could we use another SEP to switch her back?

 

[Special Agent]

I have a customer that had joe namath call her and churned her to another plan. She says it wasn't her intent to change.
Now she wants to switch back. The plan has not taken effect yet.

I realize she could just call the insurance company and cancel the application, but I want to make this as easy as possible for her.

We think he used an SEP to do this.
Could we use another SEP to switch her back?

the SEP is not used up yet if plan not in effect yet but IMO it's better to do a 3 way to just cancel future plan and for extra credit if client rally thinks call center did her dirty she can file a grievance on the same call.BTW if you do an application for the same plan she was on it is not considered a new enrollment so they wont pay HRA or bump up to a new FMV commission rate if that matters.

 

[axeman462]

the SEP is not used up yet if plan not in effect yet but IMO it's better to do a 3 way to just cancel future plan and for extra credit if client rally thinks call center did her dirty she can file a grievance on the same call.BTW if you do an application for the same plan she was on it is not considered a new enrollment so they wont pay HRA or bump up to a new FMV commission rate if that matters.

I agree, but in my experience, most people just want things fixed as fast and simply as possible. And an e-app would be that route.
But I will certainly give her that option.

I aint worried about the HRA, or new commission rate.

Thank you for your help

 

[DonP]

I agree, but in my experience, most people just want things fixed as fast and simply as possible. And an e-app would be that route.
But I will certainly give her that option.

I aint worried about the HRA, or new commission rate.

Thank you for your help

Just call the carrier she was switched to and cancel the app before it becomes effective . Takes 5 mins . Just say " I have a Medicare beneficiary on the phone and they want to cancel a future July 1st effective date app and keep their present plan" . Give there name and mbi # . If it's a carrier to carrier app give there member ID # . What special agent said about something isn't correct . If your client has plan 350 and is rolled to plan 500 with the same carrier or he was flipped to another carrier plan . Let's say you cancel the pending future app. Client really like the new plan but wants you to be the agent . So you cancel the pending new app and rewrite him same app . Your the agent now on the new app you rewrote right ? I mean YOU cancelled the old app and rewrote it . Wrong . Outside AEP if you rewrite the same plan the aor will revert back to the agent who wrote the first app . During aep it's truely last app in is the aor even if the same plan was written , cancelled 5 times during all aep .If client really wants new plan just wait until the next month and rewrite it

 

[vic120]

Just call the carrier she was switched to and cancel the app before it becomes effective . Takes 5 mins . Just say " I have a Medicare beneficiary on the phone and they want to cancel a future July 1st effective date app and keep their present plan" . Give there name and mbi # . If it's a carrier to carrier app give there member ID # . What special agent said about something isn't correct . If your client has plan 350 and is rolled to plan 500 with the same carrier or he was flipped to another carrier plan . Let's say you cancel the pending future app. Client really like the new plan but wants you to be the agent . So you cancel the pending new app and rewrite him same app . Your the agent now on the new app you rewrote right ? I mean YOU cancelled the old app and rewrote it . Wrong . Outside AEP if you rewrite the same plan the aor will revert back to the agent who wrote the first app . During aep it's truely last app in is the aor even if the same plan was written , cancelled 5 times during all aep .If client really wants new plan just wait until the next month and rewrite it

Ive been through a nightmare doing the 2 aeps ago

I had a client had me sign her for one AARP plan and then wanted a different one, and then wanted to go back to the first plan

I had called to cancel the last app and got confirmation, and name of rep

I called several more times because there was no cancel in the portal and I was told this is normal procedure not to worry the correct plan will be in effect

then when the wrong plan was in effect I told them date time and person I spoke with and they just said sorry they told me this they were misinformed

I had to get FMO involved to fix this and it was SUPER time consuming

 

[DonP]

Ive been through a nightmare doing the 2 aeps ago

I had a client had me sign her for one AARP plan and then wanted a different one, and then wanted to go back to the first plan

I had called to cancel the last app and got confirmation, and name of rep

I called several more times because there was no cancel in the portal and I was told this is normal procedure not to worry the correct plan will be in effect

then when the wrong plan was in effect I told them date time and person I spoke with and they just said sorry they told me this they were misinformed

I had to get FMO involved to fix this and it was SUPER time consuming

On that Scenerio just look in vantage to see future 1/1 effective date . I get around 4 plans a month flipped by call centers and save 3 . I now have access to marx so I see the last plan the last 2 plans they had and it will show future plan . So when I call up to cancel a pending app I always check to make sure my orginal plan is the plan that stays in force . Takes cms around 24-48 hrs to cancel future apps . Pending terms won't show on vantage for 4-5 days . Vantage is the best online lookup but it's been down for 2 plus weeks . Somebody told me there not coming back up . We'll see

 

[Special Agent]

Just call the carrier she was switched to and cancel the app before it becomes effective . Takes 5 mins . Just say " I have a Medicare beneficiary on the phone and they want to cancel a future July 1st effective date app and keep their present plan" . Give there name and mbi # . If it's a carrier to carrier app give there member ID # . What special agent said about something isn't correct . If your client has plan 350 and is rolled to plan 500 with the same carrier or he was flipped to another carrier plan . Let's say you cancel the pending future app. Client really like the new plan but wants you to be the agent . So you cancel the pending new app and rewrite him same app . Your the agent now on the new app you rewrote right ? I mean YOU cancelled the old app and rewrote it . Wrong . Outside AEP if you rewrite the same plan the aor will revert back to the agent who wrote the first app . During aep it's truely last app in is the aor even if the same plan was written , cancelled 5 times during all aep .If client really wants new plan just wait until the next month and rewrite it

The last app in thing for AEP is correct if for example client is on UHC plan 1 submits application for Humana ( that is officially approved) then you rewrite for UHC plan 1 however if were not the original AOR of UHC plan 1 and application for UHC plan 2 is submitted then you switch them back to UHC plan 1 then you are not AOR.

As a side note i know with UHC at least if one of your UHC members who has been active since before 1/2020 makes a switch and you save it and rewrite it on same plan with UHC without a break of being on the same plan it does not bump it up to new FMV whether it is AEP or not nor does it pay HRA

 

[DonP]

The last app in thing for AEP is correct if for example client is on UHC plan 1 submits application for Humana ( that is officially approved) then you rewrite for UHC plan 1 however if were not the original AOR of UHC plan 1 and application for UHC plan 2 is submitted then you switch them back to UHC plan 1 then you are not AOR.

As a side note i know with UHC at least if one of your UHC members who has been active since before 1/2020 makes a switch and you save it and rewrite it on same plan with UHC without a break of being on the same plan it does not bump it up to new FMV whether it is AEP or not nor does it pay HRA

Let me clarify . I've been through every scenario you can imagine . But let me clarify something with Uhc . I had this happen during aep 2 yrs ago . I was Uhc Aor . Somebody moved them to Humana and that got approved . 1 day later he rewrote them my United plan . I was no longer the Aor . I complained uhc what happened . They reinstated me as the Aor . If you catch it they'll put you back as Aor . But the above scenario very rare. Heres another situation that will happen more often during aep using leads . Client has plan 370. I write plan 350 . Somebody comes in and writes plan 390 . Near end of aep somebody writes plan 350 the plan I wrote . I'm no longer the Aor on that 350 because me pending app was cancelled and rewritten . BUT the above only happens during aep . If the above happened during oep or any other time and another agent wrote my 350 plan again after it was cancelled my app is reinstated and I'm the Aor . Had that happen several times .

Here's one few few few agebts know . My client has plan 350 . Somebody comes in and writes plan 370 . I catch it and cancel the future app . No big deal the orginal 350 plan is back in force as it's not pending future term . BUT. What if 2 new plans were wrote during the one . 2nd new plan knocked out the first plan . I cancelled that plan so all's good as min back in force . No No . I didn't know there was a plan written before the one I cancelled . So what happens when I cancelled the app I saw going active at the first of the month the first app now is reinstated as the new future plan . Nobody would assume 2 plans written on top of each other outside aep . Had that happen to me . I was shocked when my plan was termed .

 

[StephanieCJ]

If you send in a new app for her current plan, the carrier will likely reject it since she is already enrolled in that plan. The easiest thing I have found is to do a 3-way with the client as mentioned above. Takes 5-10 minutes and you don't have to get together face to face or do any of the e-signature stuff (which people in my area seem to be intimidated by).

 

[Special Agent]

If you send in a new app for her current plan, the carrier will likely reject it since she is already enrolled in that plan. The easiest thing I have found is to do a 3-way with the client as mentioned above. Takes 5-10 minutes and you don't have to get together face to face or do any of the e-signature stuff (which people in my area seem to be intimidated by).

it won't be rejected as duplicate plan application IF future plan was already approved by CMS but the " new enrollment" back in the same without a break of coverage is not paid a lump sum it just continues the renewal rate you were already receiving but still holds you liable for all marketing compliance issues as if it was a new member enrollment and it would also use up that SEP needlessly.