We will go over how to become a Medicare GA and what you need to set up a Medicare General Agency. A Medicare GA (General Agency) is an agency that has a contract with one or more Medicare carriers above street level. The GA has a Medicare contract and two or more licensed, producing sub agents.
Each year, CMS releases the maximum, street level commission that agents can receive for either a Medicare Advantage or Prescription Drug Plan sale. If an agency has a GA contract or higher, they are elgibile to receive compensation above the street level. The additional compensation you receive is an override. GAs receive an override payment on every sale made by it’s sub agents.
How to become a Medicare GA
For an agency to receive a GA contract, they must work with an up line agency that is willing to provide a GA level contract.
Agencies must also meet the qualifications for each carrier. Each insurance carrier requires a specific number of sub agents in order to qualify as a GA. For example; Aetna requires 3 total contracted producers (this can include the principal). In other words, you need the agency and producer connected to it and 2 licensed, certified, producing sub agents. Please note; each company has it’s own requirements. In general, insurance carriers require anywhere from 2 to 5 licensed, certified and producing sub agents in order to get a GA contract.
Agency principals
In order to receive overrides, Medicare requires GAs to complete licensing and certifications. This applies to their own production as well as production from sub agents. This is sometimes an issue if, the agency owner no longer writes business and has no desire to complete the certifications required to sell Medicare plans.
If the GA is an entity, the entity must be licensed. Each agency must have a licensed, certified affiliated person. (Even if they are not going to sell anything).
Who can recieve GA compensation
An individual agent can receive an GA level agent contract as long as they meet the requirements. This means the compensation is paid to the individuals bank account. In some cases, an entity hold the GA contract (LLC, S-Corp, Corporation, etc..) with the compensation paying to the entity. Again, for an entity to receive payment, they must be connected to a licensed, certified agent.
Downline commission payments
Street level direct payments – Under this set up, the agent recieves street compensation directly from the insurance company. This includes both initial commission and renewal comp. The GA receives overrides directly from the carrier.
LOA or Assigned Commission– In this scenario, all compensation (street commission and override) is paid to the agency regardless of who places the cases.
See what Crowe has to offer it’s agents
GA Contracting
Crowe and Associates can set up GA levels for just about any company and product type. We use one contracting kit to appoint with almost all carriers. The GA should notify our office if adding subagents. The sub agents fill out the online contracting link, check off the companies they want and add the name of their immediate upline so we can properly align them. Please have them note if they are an LOA agent. It is easy to put additional carrier requests in by either completeing a link, emailing or calling our office. There is no need to fill out additional paperwork.
Please note; many carriers take about a week to process contracts. They process the GA contract first and then they process the sub agents. As a result, this may cause a delay in the processing of the sub agent’s contracts.
Click here for online contract or to add a carrier to an existing Crowe contract
Adding Medicare to existing agencies
Agencies that already have a successful business may want to add Medicare as an additional revenue stream. In many cases, a good relationship with these clients gives them an opportunity to turn their existing book into a great source for leads. If they have clients nearing age 65 or over, they can easily transition into offering Medicare planning for those clients.
Medicare offers several options for health coverage, including Original Medicare and Medicare Advantage (Part C). Choosing the right plan can be challenging, especially if you’re trying a Medicare Advantage plan for the first time. Fortunately, Medicare provides trial rights that allow beneficiaries to switch back to Original Medicare under specific conditions. Understanding Medicare trial rights helps beneficiaries make informed decisions and avoid being locked into a plan that may not meet your needs.
What are Trial Rights
Medicare trial rights are special protections. They allow beneficiaries to return to Original Medicare if they are dissatisfied with their Medicare Advantage plan. These rights apply in two primary situations:
Those who enroll in a Medicare Advantage plan when first eligible for Medicare and decide within the first 12 months that it’s not the right fit, can return to Original Medicare. You can also enroll in a Medicare Supplement (Medigap) plan without facing medical underwriting restrictions.
Beneficiaries who had a Medigap plan and dropped it to join a Medicare Advantage plan for the first time, can switch back to Original Medicare anytime within the first 12 months. Additionally, they have the right to re-enroll in the same plan they had previously if it is still available. If it is not, they can purchase a different Medigap plan.
Why are Trial Rights important
Medicare Advantage plans may not always work out as expected. They typically have provider networks, may require referrals for specialists, and can come with different costs than Original Medicare. If the beneficiary’s preferred healthcare providers are not in-network, or the coverage does not suit their healthcare needs, trial rights provide a way to switch back without penalty.
Click here to watch a video on what you need to know before a Medicare sale
Understanding how to use a Medicare Trial Right
Those who decide to use the trial right should:
- Contact a Medicare agent, if possible to get the best plan options to fit coverage needs. Those who don’t have an agent; call Medicare at 1-800-MEDICARE or visit Medicare.gov to change their plan back.
- Be sure to apply for a Medigap policy within the 12-month window, if they want supplemental coverage. This helps ensure coverage without going through underwriting.
- Because Original Medicare does not include prescrption drug coverage, it is also important to enroll in a standalone PDP plan.
Things to remember
- Medicare trial rights allow beneficiaries to return to Original Medicare within 12 months of enrolling in a Medicare Advantage plan for the first time.
- Those who switched from a Medigap policy to a Medicare Advantage plan for the first time may be able to reinstate their Medigap policy. If it is not available anymore, they can or get a new one.
- These rights help protect beneficiaries from being stuck in a plan that does not meet their healthcare needs.
Agents who want to see what Crowe has to offer; click here.
Ready to join the team at Crowe; click here for online contracting
It is important to understand the rights of your clients to ensure they have the flexibility to choose the best coverage for their healthcare needs. If a client enrolls in a Medicare Advantage plan for the first time, explain the time available should they want to go back to Original Medicare. To take advantage of these protections, act within the trial period.
For veterans who qualify for both Medicare and VA (Veterans Affairs) benefits, understanding how these two healthcare systems work together is crucial. Although both programs provide coverage, they serve different purposes and operate independently. Coordinating Medicare and VA benefits can help maximize healthcare options and avoid unexpected costs.
Do Veterans need Medicare if they have VA benefits
VA benefits provide healthcare services through VA facilities, but do not cover care veterans receive outside the VA system. This is where a Medicare plan helps. While enrolling in Medicare is not mandatory for veterans, having both Medicare and VA benefits can expand healthcare choices. This helps ensure access to a variety of providers outside the VA network if needed.
Click here to find local VA facilities
How Medicare and VA benefits work together
It is important to note; Medicare and VA benefits do not coordinate directly. This means, one does not cover what the other does not. Instead, each program pays for services independently, depending on where veterans receive care:
VA Facilities
If you receive care at a VA hospital or clinic, only VA benefits cover the cost. Medicare does not pay for services at VA facilities.
Non-VA Providers
If you seek care outside the VA system, Medicare will provide coverage for approved services, but VA benefits will not. Without Medicare, veterans are responsible for the entire cost of care from non-VA providers unless you have other insurance.
How each part of Medicare interacts with VA benefits
Medicare Part A (Hospital Insurance): Covers inpatient hospital care. Many veterans qualify for premium-free Part A, making enrollment a good option even if they normally use VA facilities.
Medicare Part B (Medical Insurance): Covers outpatient care, doctor visits, and preventive services. Those who want access to non-VA doctors or specialists, enrollment in Part B is recommended.
Medicare Part C (Medicare Advantage): Private insurance plans that bundle Parts A and B, often including prescription drug coverage. Some plans offer additional benefits, although some may not work well with VA benefits since VA care providers are separate from Medicare Advantage networks.
Medicare Part D (Prescription Drug Coverage): VA benefits include prescription drug coverage, often with lower costs than Medicare Part D. However, enrolling in Part D can be beneficial for veterans who want access to non-VA pharmacies.
Tricare for Life and VA benefits
Some veterans also qualify for Tricare for Life (TFL), which serves as supplemental coverage for Medicare. In this case:
- Medicare pays first, then TFL covers remaining costs.
- VA benefits still work separately, covering care at VA facilities.
Should veterans enroll in Medicare
- Those who rely solely on VA benefits are limited to VA facilities, which could be problematic if they move or need non-VA care.
- Enrolling in Medicare Part B ensures access to non-VA providers and prevents late enrollment penalties.
- Individuals who plan to use VA prescription drug benefits exclusively can skip Part D enrollment without penalty, as VA drug coverage is considered creditable.
Although VA benefits provide excellent healthcare for eligible veterans, they have limitations, particularly when it comes to non-VA care. Medicare expands healthcare options and ensures comprehensive coverage in case of emergencies or provider preferences.
Veterans should carefully evaluate their healthcare needs and consider Medicare enrollment to maintain flexibility and avoid coverage gaps. A licensed Medicare agent can help go over all the options available and help find the best coverage for each individual.
If a Medicare beneficiary misses a valid enrollment period due to a FEMA emergency, beneficiaries may qualify for a DST SEP. As of April 1, 2025, important Medicare DST SEP changes go into effect. Agents must be aware of this to ensure their clients are able to take advantage of this opportunity too get needed coverage.
What is a Medicare DST SEP
The Medicare DST SEP is an enrollment election period. CMS provides for Medicare beneficiaries who miss a valid election period due to either weather-related emergencies or major FEMA declared disasters.
This SEP is only available in areas where state or local government officials declare an emergency or disaster. DST SEPs begins the date the incident occurs and extends for two months up to a year after it starts or the extension period begins.
The DST SEP election period allows Medicare beneficiaries to either enroll in or disenroll from a Medicare plan. Enrollment in the new coverage goes into effect the first day of the month following the submission of the application.
DST SEP Changes
CMS released a memo on December 3, 2024 announcing the changes to the DST SEP election. The change begins on April 1, 2025.
Please note; as of April1, 2025, beneficiaries using the DST SEP 2025 must submit applications directly through CMS. Beneficiaries call 1-800-MEDICARE or TTY 1-877-486-2048 to submit applications. In other words, brokers cannot submit DST applications. CMS will not accept them.
Applications submitted using any other means will be labeled as using an invalid election period. The plan provider will attempt to contact the enrollee to obtain a valid election period. If a valid election period cannot be verified, the application will be denied and the beneficiary will not receive coverage.
Important: this SEP does not allow (RFIs) Request for Information process for invalid or missing election information. In other words, beneficiaries are not given extra time to respond to correct their election. Additionally, carriers will update applications and disenrollment to remove the DST election.
When to use the DST SEP
Use the DST SEP when a beneficiary resides in an area where a natural disaster (earthquake, flood, hurricane, wildfire or other incident) occurs, resulting in missing a valid election period. Some FEMA emergencies require beneficiaries to leave their homes for safety. This sometimes results in a missed enrollment period.
Some individuals may use the SEP if they rely on a family member or other caregiver who is impacted by a disaster. This can make it impossible for them to receive the assistance they need during an enrollment period.
A few more reasons to use the DST SEP; inability to access Medicare plan information or submit an enrollment due to a FEMA declared disaster. In some instances, beneficiaries may use the SEP if their healthcare provider of facilities are impacted by the disaster. When this happens, the beneficiary may be unable to receive necessary information and make an informed decision.
Eligibility for the Medicare DST SEP
Those who wish to use this SEP, must live in the direct area the disaster occurred in. This must have caused them to miss a valid enrollment period such as; AEP, IEP or OEP.
Click here to learn more about Medicare election periods
Agents who want to join the team at Crowe; click her for online contract.
Important: Beneficiaries cannot use this SEP if; they already made a change during the specified enrollment period.
Beneficiaries must call 1-800-MEDICARE or TTY 1-877-486-2048 to submit an application to avoid missing their window to enroll.
Residents of CT and Medicare agents who offer plans in CT need to be aware of the changes to the CT MSP income limits 2025. The MSP program provides assistance to beneficiaries with limited incomes to help cover their medical costs. Understanding the CT MSP income limits is extremely important for anyone on Medicare and has a limited income. Especially if they depend on financial assistance to access needed healthcare.
What is MSP (Medicare Savings Program)
MSP stands for The Medicare Savings Program. Each state administers this program and provides assistance with medical costs for individuals on Medicare with limited income and resources. It helps pay Medicare premiums, deductibles, coinsurance, and copays.
To participate in the program, you must be eligible for Medicare Part A (hospital insurance) and meet income and asset criteria. In the state of CT, DSS administers the Medicare Savings Program.
CT MSP Income Limits 2025
The MSP in CT provides 3 different levels of help. Each level has a separate income limit that qualifies beneficiaries. Please note; the income limit is adjusted based on household size.
The 2025 income limits for each level of MSP are listed below:
Qualified Medicare Beneficiary (QMB)
Those who qualify for the QMB level recieve the highest level of help. Individuals who qualify for this program, have income of up to 100% of the FPL (Federal Poverty Level). The QMB program pays the Part B Medicare premium, deductibles, coinsurance, and copays.
Individuals with a monthly income of $2,752 for an individual and $3,719 for a couple qualify as QMBs.
Learn about medicare Extra Help
Specified Low-Income Medicare Beneficiary (SLMB)
The SLMB level pays for the Medicare Part B premiums and does not cover deductibles or coinsurnae payments.
Individuals who have an income level of $3,013 per month for an individual or $4,072 a month for a couple. In other words, individuals must have an income level between 100% and 120% of the FPL.
Additional Low-Income Medicare Beneficiary (ALMB)
The ALMB is similar to the SLMB program; it pays the Medicare Part B premium only. It does not cover deductibles or coinsurance payments. It is availabel to those who have income between 120% and 135% of the FPL.
To qualify for this level of help; indivduals must have monthly income of $3,209 for single or $4,336 for a couple.
Please note: This program is subject to available funds and is issued on a first come first served basis
How to Apply for CT MSP
Those who want to apply for CT’s MSP program can do so through the Department of Social Services (DSS).
Individuals must complete a CT state (W-1QMB) application form. There are a few different ways to complete and return the form; online, through the mail, or in-person at a local DSS Regional Office.
Beneficiaries must provide information such as: Medicare enrollment status, income, assets, and other relevant information. DSS provides help with the application for anyone who needs it. Beneficiaries can also have an authorized person complete the application if needed.
Click here for a list of local DSS offices.
To apply online, visit www.connect.ct.gov, click on the ‘Apply for Benefits’ tab and apply as directed.
Those who wish to apply for MSP only; download and complete application below:
Medicare Savings Program Application (W-1QMB)
Formulario de Renovación de programas de ahorro de Medicare (W-1QMBS)
To apply for other assitance programs as well as the MSP program: SNAP (food stamps), Medicaid for Employees with Disabilities (MED-Connect), Medicaid for the Aged/Blind/Disabled (HUSKY C), and/or cash assistance, download the application below.
Click here to apply for Husky C and or Cash assistance program benefits
Haga clic aqui para Husky o asistencia en efective CW-1ES Solicitud de Beneficios
The CT MSP program provides an essential service to qualified individuals. It provides financial assistance to cover Medicare costs.
Agents who want to be part of the team at Crowe – click here for onine contract
Watch a YouTube video and learn about changes for Dual, Partial Dual and LIS SEP changes
For additional information on how to apply, please visit www.ct.gov/dss/apply.
Unfortunately, some beneficiaries incur unexpected penalties (LEPs) because they delay signing up for Medicare Part B or Part D coverage. However, they may have the right to appeal. In this post, we discuss how to appeal a Medicare LEP.
What is Medicare LEP (Late Enrollment Penalty)
Medicare imposes a Late Enrollment Penalty (LEP) when beneficiaries delay enrollment in Medicare Part B or Part D without having other creditable coverage (such as employer-based insurance).
Those who incur a Part B LEP pay a 10% increase in their monthly premium for every 12-month period they were eligible for Part B coverage but neglected to sign up.
The Part D LEP is calculated as 1% of the national base beneficiary premium multiplied by the number of months the beneficiary was not enrolled in a creditable Part D coverage. The provider of their Part D coverage adds this amount to their monthly premium.
Anyone assessed with one of these penalties will end up paying it for life (as long as they have Part B and/or Part D coverage). In other words, it is essential to enroll in coverage in a timely manner and act quickly if the penalty assessment may be an error.
Watch a YouTube video on OEP, SEPs & LEPs
When to appeal an LEP
Those who did not enroll in Medicare Part B and/or Part D but had creditable coverage should appeal the penalty. This happens when individuals have employment-based insurance. If this is the case, ask the employer for a letter proving enrollment and include it with the appeal forms.
In some cases, there could be a mistake and beneficiary was actually enrolled in Part B during part or all of the period in question. When this happens, they can use MSNs showing payment for care as proof of enrollment.
If the beneficiary is enrolled in an MSP plan, they are not charged LEPs.
In some instances, there are extenuating circumstances that prevent individuals from enrolling such as; natural disasters or health conditions. Sometimes individuals receive misinformation from either Medicare or a plan representative that causes them to miss an enrollment period.
How to appeal a Medicare LEP
Step 1: Review the penalty notice
If Medicare applies an LEP, you’ll receive a letter from your plan provider explaining:
- The reason for the penalty
- The amount
- How to appeal
Step 2: Complete the CMS LEP Reconsideration Request Form
Beneficiaries have 60 days from the date on the penalty letter to file an appeal. The LEP reconsideration request form comes with the notice. If you cannot locate one, call the plan provider and request one or use one below.
Click here to download a Part D LEP Reconsideration Request form
Download a copy of the Part B LEP Reconsideration Request Form
Step 3: Gather Supporting Documents
Include any relevant documents, such as:
Proof of prior creditable coverage (letters from past employers or insurers).
Records showing you received misinformation from Medicare or a plan representative.
Medical records or other documentation supporting an extenuating circumstance.
Step 4: Submit Your Appeal to C2C Innovative Solutions
The independent contractor handling Medicare LEP appeals is C2C Innovative Solutions, Inc.
- The address and contact details will be on your penalty notice.
- Send copies, not originals, of supporting documents.
Step 5: Wait for a Decision
C2C will review your appeal and issue a decision within 90 days. If the appeal is approved, the penalty is removed or adjusted. If denied, you may have further appeal rights.
Remember
Act quickly; there is limited time to appeal.
Keep copies of all documents you send.
Check your Medicare records to ensure accuracy.
Avoiding or appealing an LEP can save money in the long run. If there is any doubt that the penalty is justified, don’t hesitate to exercise the right to appeal.
Because Medicare agents have a large number of products to choose from when deciding what to sell, we explain why offer Physicians Mutual dental plans in the post below.
Dental products provide necessary coverage not offered by original Medicare. Because poor dental health can lead to serious health issues, regular dental checkups can help avoid health problems down the road.
There are 4 different dental plan options
Each plan provides coverage for over 400 procedures. The difference between the plans is the premium and the amount the plan pays for each covered service. There are plan choices to fit any budget.
All plans provide 100% coverage for preventive treatment at an in-network dentist. This includes; an exam, x-rays and a cleaning.
Take a look at the CT dental Brochure
Please note; There is a 12 month waiting period on major benefits.
All plans use the Ameritas network of providers. There are more than 5000,000 provider locations for member to access. All these plans are PPOs so members can receive out of network coverage for services, but it is always better to use in network providers for the best value.
Economy
As you have probably guessed; these plans are the lowest cost plans.
The Economy plans pay 25% of the maximum allowable charge for Basic treatments (fillings) and Major benefits, such as root canals or crowns.
Standard
Standard plans are another affordable option for dental coverage. They provide a payment of 40% of the maximum allowable charge for basic and major treatments.
Preferred
Preferred plans are similar to the other plans. The plan cost is a little more and so is the coverage percentage members receive. These plans provide 55% payment of the maximum allowable charges for basic and major benefits.
Premier
The Premier plans are the highest coverage level available at Physicans Mutual. This plan pays 70% of the maximum allowable charge for covered services..
Click here for product availability Map
A few more reasons to offer Physicians Mutual Dental Plans
These plans do not require members to pay a deductible. All preventative benefits are covered at 100% from day 1. One important aspect of this plan is; there is no maximum on cash benefits like other plans. That makes these plans a fantastic value no matter which plan beneficiaries choose.
Watch a video on the Physicians Mutual Dental plans
It is easy for members to add a vision and hearing rider to any plan. Once added members can use any participating provider.
See why you should offer ancillary products to your clients
Eye exams are covered up to $100 per year per member. The vision correction benefit of $150 includes prescription eyeglasses, sunglasses, sports glasses and contact lenses. There is a 3 month waiting period for this benefit. Members use the VSP network of providers to receive a discounted price for eye exams and lenses.
The hearing benefit provides up to $75 per member for covered hearing exams and as much as $500 per hearing aid per ear after a 12 month waiting period.
Click here for online contracting with Crowe
Understanding common Medicare acronyms is important weather you are getting ready to sign up for Medicare or a Medicare agent. As in any business, understanding the terminology is essential to help navigate the system.
General Medicare Terms
- CMS: Centers for Medicare & Medicaid Services
The federal agency that administers the nation’s major healthcare programs, including Medicare and Medicaid. - SSA: Social Security Administration
The government agency responsible for administering Social Security benefits, including the processing of Medicare applications.
Parts of Medicare
- Part A: Hospital insurance covers inpatient hospital stays, skilled nursing facility care, hospice care and some home health services.
- Part B: Medical Insurance covers outpatient care, doctor services, preventative care and DME.
- Part C: Medicare Advantage plans are an alternative to Original Medicare. They provide the same coverage as Original Medicare and often some added benefits. Private insurance companies offer these plans.
- Part D: Prescription Drug Plans provide coverage for approved prescription medications. Private insurers offer these plans.
Medicare Plan Types
- MA: Medicare Advantage also called Part C provide the same benefits as Original Medicare (Part A & Part B).
- MAPD: Medicare Advantage Prescription Drug Plan provide the benefits of Original Medicare as well Part D.
- PDP: Prescription Drug Plan provides stand alone coverage of prescription drugs under Medicare Part D.
- HMO: Health Maintenance Organization is a type of Medicare Advantage plan. These plans require members to use a specific network of providers and referrals for specialists.
- PPO: Preferred Provider Organization is a type of Medicare advantage plan that offers out of network coverage. They are a more flexible option than an HMO.
- PFFS: Private Fee-For-Service is another type of Medicare advantage plan. It allows beneficiaries to see any doctor or hospital that accepts the plan’s terms. The costs and coverage are set by the plan.
- MSA: Medical Savings Account combines a high-deductible Medicare advantage plan and a savings account. The plan deposits money into the account each year to pay healthcare expenses before beneficiaries meet the deductible amount.
Enrollment Periods
- AEP: Annual Enrollment Period occurs from October 15 to December 7 annually. During this time, beneficiaries can enroll in or change their Medicare coverage.
- ICEP: Initial Coverage Election Period is the period when individuals first become eligible for Medicare benefits.
- SEP: Special Enrollment Period occurs outside normal enrollment periods and provides an opportunity to change plans due to a specific event. This includes things like moving or losing employer sponsored health coverage.
Learn more about Medicare enrollment periods
Notices and Forms
- ANOC: Annual Notice of Change
A document sent by Medicare plans outlining any changes in coverage, costs, or service areas for the upcoming year. - EOC: Evidence of Coverage
A document detailing what the plan covers, how much members pay, and other rights and responsibilities. - ABN: Advance Beneficiary Notice of Noncoverage
Is a waiver of liability. A notice given to beneficiaries of Original Medicare when a service or item isn’t expected to be covered, allowing them to decide whether to receive and pay for the service.
Assistance Programs
- LIS: Low-Income Subsidy
Also known as “Extra Help,” this program assists individuals with limited income in paying for prescription drug costs under Part D. - MSP: Medicare Savings Program
State programs that help pay Medicare premiums and, in some cases, deductibles and coinsurance for individuals with limited income.
A few more terms
- DME: Durable Medical Equipment
Medical equipment like wheelchairs, walkers, or hospital beds that are ordered by a doctor for use in the home. - EOB: Explanation of Benefits
A statement from a Medicare plan detailing what was billed, what Medicare paid, and what the beneficiary may owe. - HIPAA: Health Insurance Portability and Accountability Act
A federal law that, among other things, protects the privacy of individuals’ health information.
Being well informed helps ensure that beneficiaries and professionals can navigate the Medicare system effectively.
Individuals getting started in Medicare sales or long time agents may be looking for the best FMO for Medicare agents to grow their business. A good FMO can make all the difference in the world for an agent. They can provide invaluable knowledge, tools and support and expand on the agents value to their community.
Because we offer contracts with all the major carriers as well as many smaller carriers, we ensure the client receives the best coverage to fit their needs. Making sure the clients are happy should the agents top priority. Not only do we work with Medicare products but, we offer ancillary products. This ensures clients can shop for all their coverage in one place. Our ancillary products include dental, vision, final expense and several life insurance options.
Watch a YouTube video to see what we can offer you
When clients get all their coverage needs met in one place, it leads to better retention rates and stronger agent/client relationships. This helps agents maintain their book of business. It also ensures that clients go to the same agent with all their questions.
Click here for online contract and join the team at Crowe
It is easy to get selling with Crowe. There is no need for mountains of paperwork. Just fill out the online contracting kit. You will also need to send copies of your license, E&O , and a void check. The contract has a section for agents to indicate which companies they want to contract with. It is that easy. Agents can easily add carriers to their contract by filling out a link or sending an email to us.
Best FMO for agents – What we have to offer
Agents receive full compensation
Every agent contract we offer is for the maximum allowable commission. Agents receive pay directly from the carriers; we do not take any part of the commission you earn.
Click here for Medicare commissions 2025
Our agents are independent
If you contract with us, you work for yourself and decide what hours you put in. What you put in to your business is what you will get out of it. Because our agents receive their commission directly from the carriers, you own your book of business. If you decide to ask for a release, you take your clients with you. Our job is to provide guidance and support when you need it.
Medicare lead program
Our agents are eligible to receive up to $500 per month as reimbursement for Medicare marketing and lead costs. The only catch is; you must have all your Medicare contracts through Crowe. We do not impose production minimums to start and do not reduce your commission.
Click here to learn about our lead program.
Many ways to enroll a client
Due to the fact that we are partners with Pinnacle Financial Services, we can provide free quoting and enrollment tools. This allows clients to enroll in a plan in a way that is comfortable for them.
Voice signature
We offer many tools to quote and enroll that allow agents to use a voice signature. This includes Connecture, Sunfire and My Medicare Bot.
Click here to learn about My Medicare Bot.
Online enrollment with Connecture or Sunfire
Easily access online enrollment tools for Medicare Advantage, Supplement and Part D plans. All our agents have access to a personalized online enrollment platform. There is no need to meet clients face-to-face if they are not comfortable doing so. This saves valuable time for everyone when necessary. Agents can send prospects a link to compare plans and self enroll from either site.
Find out about the updates in Connecture and Sunfire for 2025
Paper application processing
Because some clients like to use paper applications, Pinnacle is one of the few uplines that still provides our agents application scrubbing & processing.
Additional product quotes
Agents who work with us have free access to Pinnacle’s online quote site. The site not only quotes and compares Medicare Advantage, Medicare supplement and Part D plans but includes; Final Expense, Term, UL, Hospital indemnity, vision and dental plans. Take a look at a site demo.
Turn-key seminar program
We offer agents a Medicare seminar program. This is a great option for agents who enjoy presenting invaluable information to those who need it. Our seminar program allows agents to get out and meet at least 40 to 60 T-65 prospects at each event. Many prospects are more comfortable when they meet an agent face-to-face and this is a great way to do it.
Each agent has access to a personal portal where the seminar registrants’ contact information is stored. This lets you follow up with those who want your help. All invites are sent out for you and all you have to do is book a venue, present your information and close the sale!
Learn the Details of Our Seminar Selling Program
Training webinars
We send out weekly invites to any agent who wants to learn about new products and regulations. All our webinars are available on our YouTube channel so you can view them at your convenience. Our videos cover many topics including: Sales strategies, enrollment and marketing rules, product knowledge, and how to use the sales tools available to our agents.
Take a look at our YouTube channel for some free training videos.
Additionally:
If you want help growing your book or building an agency, we are here for you. Agencies working with us can use our programs and tools to recruit and train agents. This includes our Medicare lead program. This program is a great help to new agents and provides incentive for them to join your agency.
Please note; each carrier has specific requirements for the various agency levels. We are here to help you get to the level you are want to be at. Up-line levels include GA, MGA and SGA levels.
Learn about our discounted E&O coverage; both agents and agencies can purchase our E&O.
Our E&O covers multiple lines of business including; Life, Health, LTC & FE as well as Annuities, both fixed and indexed
More Agency Programs and Benefits – Click here
Life Insurance Basics for Insurance Agents
Life insurance is one of the most essential financial products available, providing financial security and peace of mind for individuals and their families. As an insurance agent, understanding the fundamental aspects of life insurance is crucial for effectively educating and assisting clients. This guide will cover life insurance basics for agents to help you decide if adding these products is right for you.
Life insurance is important financial protection that is paid upon the insured’s death in exchange for premium payments. It is a contract between an individual (policyholder) and an insurance company. This financial protection helps cover funeral costs, outstanding debts, daily living expenses, and future financial needs for the designated beneficiary.
Watch our quick YouTube video on life insurance basics
Types of Life Insurance
There are several types of life insurance policies, each one is designed to meet specific financial needs and objectives.
Term Life Insurance
- Provides coverage for a specific period (e.g., 10, 20, or 30 years).
- Offers a death benefit if the insured passes away within the term.
- More affordable than whole life insurance.
- No cash value accumulation.
Whole Life Insurance
- Provides lifelong coverage as long as premiums are paid.
- Accumulates cash value that policy holder can borrow against or withdraw if necessary.
- Premiums remain level throughout the policyholder’s life.
Universal Life Insurance
- Offers flexible premium payments and death benefits.
- Includes a cash value component that earns interest.
- Policyholders can adjust coverage amounts based on financial needs.
Variable Life Insurance
- Allows policyholders to invest the cash value in various investment options (e.g., stocks, bonds, mutual funds).
- Death benefit and cash value fluctuate based on investment performance.
- Higher risk but potential for higher returns.
See why critical illness insurance may be a good choice for your client
Some things to consider
As an insurance agent, it’s important to assess the clients’ coverage needs, financial situation and goals before suggesting a policy. Here are some things to consider:
- Financial Needs Analysis – Determine how much coverage a client requires based on their income, debts, dependents, and future expenses.
- Affordability – Ensure the client can comfortably afford premium payments without financial strain.
- Policy Features – Explain policy riders, such as accidental death benefits, waiver of premium, or critical illness riders, to enhance coverage.
- Long-Term Goals – Help clients align their life insurance choice with their retirement, estate planning, or wealth transfer strategies.
Are you an agent interested in adding life products; click here for online contract
Educating Clients
Educating clients helps them make informed decisions about life coverage. Be sure they understand all terms in simple language, provide real-life scenarios, and offer personalized recommendations.
Understanding life insurance basics helps insurance agents serve clients effectively. Knowing the types of policies, key features, and client needs, allows agents to provide tailored solutions that offer financial protection and peace of mind.
Selling Medicare plans face-to-face can be very effective, but it requires the right approach to ensure a successful client interaction. Unlike online or phone-based sales, in person meetings allow agents to build trust, address concerns directly, and provide a more personalized experience. Our tips for in person Medicare sales will help agents formulate a sales strategy and expand their book of business.
Do your research
Before meeting a potential client, take the time to understand their specific needs. Having clients fill out a well designed fact finder can provide a roadmap for agents to identify client needs and preferences. Being prepared demonstrates professionalism and allows you to provide relevant options.
Ask questions to help determine the best coverage options
- What are the preferred doctors and hospitals?
- Do they take any prescription medications?
- What is the monthly budget for healthcare expenses?
- Do they travel frequently or spend part of the year in another state?
This goes back to the fact finder suggestion. These insights help tailor recommendations to the unique needs of each individual.
Create a professional first impression
First impressions matter. Dress appropriately, arrive on time, and maintain a friendly yet professional demeanor. Be aware of the client’s needs and preferences and follow all CMS guidelines. Bring all necessary materials, such as brochures, plan comparisons, and enrollment forms, to ensure a smooth meeting.
Form a personal connection
Medicare decisions can be overwhelming for clients. Establish rapport by engaging in friendly conversation and showing genuine interest in their concerns. Building trust makes it more likely they will rely on your guidance and even recommend you to their friends or family.
Learn how to maintain your book of business
Educate rather than sell
Instead of trying to push a specific plan, focus on educating the client about their coverage options. Explain the differences between plan types (Medicare Advantage, Supplement plans, and Part D) in understandable terms. Do not use industry jargon that may confuse clients.
Do not pressure clients to enroll in a plan. Be transparent with all plan benefits and costs. Let prospects consider all information and enroll if they are comfortable. If they choose not to enroll, respect their decision and let them know you are available if they need assistance in the future.
What you need to know before a Medicare sale – Watch a quick YouTube video
Use visual aids and examples
Many clients understand information better when it is presented visually or in a practical context. When possible, use plan comparison charts, benefit breakdowns, and real-life scenarios to illustrate coverage differences and potential costs.
Address concerns
It is very common for clients to have concerns about cost, coverage limitations, or provider networks. Be prepared to address objections with clear explanations of plan benefits, potential cost savings, and alternative options.
Follow all CMS and carrier guidelines
Always adhere to CMS (Centers for Medicare & Medicaid Services) and carrier regulations when discussing plans. Avoid misleading statements, ensure proper documentation, and provide all required disclosures to maintain ethical and legal compliance. This helps protect both the client and the agent in the event questions arise later.
Learn about the Medicare Scope of appointment
Follow Up
A simple follow-up call or email reinforces your commitment to client satisfaction. Check in to see if they have additional questions or need further clarification before making a decision. Agents should also follow up after the enrollment to be sure clients know they are available if any concerns arise later. This helps reinforce the relationship and the client’s confidence in choosing an agent.
Continue learning
Because Medicare plans and regulations change every year, it is important to stay updated on plan details, industry news, and new regulations. This helps you provide the best service to your clients.
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In-person Medicare sales provide agents with the opportunity to build meaningful relationships and offer personalized guidance. By focusing on trust, education, and professionalism, agents can build their book and become valued members of the community.
Are you interested in joining the Crowe team – click here for online contract
Understanding rapid disenrollments and their impact on agents
If you are in Medicare sales, you may hear the term rapid disenrollment. Newer agents may wonder; what are Medicare rapid disenrollments. We explain a little about this term and how it affects agents below.
Although you may have done your best, not every enrollee remains satisfied with their plan choice. When a beneficiary quickly disenrolls from a Medicare Advantage plan, this is known as a rapid disenrollment. While this can be frustrating for the beneficiary, it also has significant repercussions for agents who sell these plans.
What is a rapid disenrollment
A rapid disenrollment occurs when a beneficiary leaves their Medicare Advantage plan within the first three months of enrollment. This happens for a variety of reasons, including dissatisfaction with provider networks, unexpected costs, confusion about benefits, or an agent not properly explaining the plan’s details.
Rapid disenrollments can take place during the Medicare Advantage Open Enrollment Period (January 1 – March 31) or via ann SEP (Special Enrollment Period) if the beneficiary has a qualifying life event.
Why rapid disenrollments matter
For agents, rapid disenrollments can have significant financial and professional consequences:
- Chargebacks – When a beneficiary disenrolls early, agents often face a chargeback, meaning they must repay some or all of their earned commission from that sale. This can significantly impact an agent’s earnings, particularly if multiple rapid disenrollments occur.
- Compliance scrutiny – High disenrollment rates may trigger compliance audits by CMS (Centers for Medicare & Medicaid Services) or plan sponsors. If an agent is found to have misrepresented a plan or failed to properly educate the enrollee, they could face penalties or even be barred from selling Medicare plans.
- Reputation damage – If beneficiaries frequently disenroll from an agent’s recommended plans, it can damage the agent’s reputation in the industry. Clients may leave negative reviews or hesitate to trust the agent in the future.
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Reduce rapid disenrollments
- Conduct thorough needs assessments – Before enrolling a client in a Medicare plan, agents should take the time to understand the client’s healthcare needs, budget, and provider preferences. Making sure the plan chosen aligns with these factors reduces the likelihood of disenrollment.
- Explain all costs and coverage – Unexpected costs, such as high copayments or out-of-network charges, often lead to disenrollment. Agents should clearly explain all costs associated with a plan so beneficiaries can make informed decisions.
- Follow Up with Clients – A simple follow-up call after enrollment can address any concerns early and prevent clients from making hasty disenrollment decisions. Providing ongoing support builds trust and reduces confusion.
- Stay Educated on Plan Changes – Medicare plans change annually. Agents who stay updated on plan benefits, provider networks, and formulary adjustments can better guide their clients toward the most suitable options.
- Ensure CMS Compliance – Agents should always follow CMS marketing guidelines to avoid misleading beneficiaries. This includes proper documentation and full disclosure of plan details.
Watch a quick video on the FCC one to one consent rule
Although disenrollment can sometimes be unavoidable, agents who are well educated, transparent, and ethical can reduce its occurrence. By following the rules and understanding clients’ needs, they can protect their commissions, maintain a good professional reputation, and, most importantly, ensure beneficiaries receive the best possible coverage for their needs.