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Home Posts tagged "Medicare contracting"

Resources for new Medicare agents

By Ed Crowe | General Articles | 0 comment | 13 February, 2024 | 0

Resources for new Medicare agents

 Consider joining an experienced upline/FMO

Agents who contract with an experienced upline/FMO have a much easier time getting up and running.  A good FMO provides invaluable resources for new Medicare agents such as contracting, training, tools and guidance they need to be successful in the Medicare field.

Click here to watch a YouTube video on what Crowe has to offer.

Training

One of the most important tools a good FMO provides is training.  Agents not only need to learn the ins and outs of Medicare and how each plan works but they also need to understand the rules and guidelines put in place by CMS and the insurance carriers.  On top of that, they need to know where to get leads and how to make a sale once they have the leads.  As you can see there is a lot of things an agent needs to know before they have a successful Medicare sales business.

Crowe provides our agents multiple ways to get the knowledge they need to succeed including webinars, zoom meetings, in-person training events, one-on-one phone calls with our sales directors, back-office staff or Ed Crowe.  If this is something you would like, we can partner new agents with an experienced agent who can provide guidance.

Learn more about Medicare agent training opportunities.

Visit our events and information page and stay up to date on our upcoming webinars and zoom meetings.

E&O Insurance

Before you contract with the carriers or make a sale, you need to have E& O insurance in place.  E&O protects you in the event you make a mistake in the sale of an insurance product that costs your client a lot of money.  Click here to learn about our discounted E& O Coverage options.

Build an Online Presence

These days everyone is online, that is why it is important to create an online presence.  Once you do, clients can find you easily and see what you have to offer.  An online presence also helps build brand recognition which lends itself to credibility.  There are several ways to do online marketing including, building a website.  Because Crowe and Associates is part of Pinnacle Financial services, our agents have access to their design team who provide free website design help, logo creation, digital marketing or help creating mailers.

there are other ways to create a solid online presence including through a Facebook page, LinkedIn or YouTube just to name a few.

Click here to learn how to create a Facebook business page.

As we mentioned above, the best way to build an online presence is through a website.  Adding a blog to your website is a great way to present helpful tips and information.

Click here to learn how to create a blog.

Quoting and Enrollment

Once you have a good idea of all the rules, regulations and plan details, you will need a quoting and enrollment site you can use to enter each client’s information and show them comparisons of the top plans that fit their needs and budget.  Crowe and Associates provides our agents with free quoting and enrollment tools.

Make sure you fill the application out correctly

We provide the technology that makes quick and accurate comparisons easy. Our quote engines, Sunfire & Connecture provide agents with a built in CRM to store the client’s information including name, address, birthdate, Medicare ID, Medications. pharmacies and doctors.  The CRM makes running a quote quick and easy once you ensure the client’s information is up to date.  Our quote engines also provide agents a PURL (quoting and enrollment link) you can add to your website so clients can run their own quotes and even enroll if they want.

Watch a YouTube video – how to use Sunfire

See how to use Connecture to quote and enroll

Call Recording Rules

All agents need to be aware when CMS’ implements a rule.  You need to be aware of the CMS call recording rule. This rule requires agents to record all sales, marketing, and phone enrollment calls.

Learn the rules for collecting a scope of appointment

Find out about the Medicare sales event guidelines

Both Connecture and Sunfire have call recording capabilities that keep our agents compliant.

Take a look at the 2024 Medicare advantage commissions.

If you are already contracted with Crowe and want to add a carrier, click here

How to find leads

Watch a quick video on ways to generate Medicare leads

Now that you are contracted and ready to sell, you might need some leads so you can start selling.  You can use some of the online lead sources we mentioned in previous paragraphs, but there are many more ways to get Medicare leads.

Click here to learn how to get Medicare referrals

There are numerous companies that offer all different types of leads such as live transfers or mailers.  Whatever lead sources you choose make sure the leads are CMS compliant.

More information for Medicare agents

Visit our events and information page and stay up to date on our upcoming webinars and zoom meetings

Insurance sales training

Insurance sales training

By Ed Crowe | General Articles | 0 comment | 1 February, 2024 | 0

Insurance sales training

Anyone who wants to enter the field of Medicare sales, will need to have insurance agent training before they meet with any potential clients. Crowe and Associates offers Medicare agents access to several types of training tools.  We provide free information on our website, YouTube channel as well as weekly informational webinars and zoom meetings geared for either beginners or experienced agents.

Think about joining an FMO

Getting started in insurance sales can be confusing, especially if you are trying to get it done on your own.  An good FMO provides guidance and support not only to new agents but to experienced agents as well.  Agents receive back office support as well as resources and tools that can make your business run effectively.  it is important to choose an FMO that provides the support you need.  Be sure to ask as many questions as you need to and contact as many as you need.  Agents need to feel comfortable with their upline and secure knowing they will be there to answer your questions when they arise.

See what we offer Medicare agents

Decide what products to offer

We will focus on Medicare products, because that is the largest part of what we offer.  If you are unsure which products you are going to offer clients, your FMO should assist you in choosing a reasonable number of Medicare and ancillary products to get started.  It is best not to overwhelm yourself and get discouraged.   A good FMO will run a quote in the area you plan to sell in and provide you with a few of the top carriers in each product type to et you started.  This is easy to do with a good quote engine and takes only a few minutes.

Join the team at Crowe – click here for online contracting

Contracting and Certifications

After you choose the products and carriers you are going to offer, you must complete contracting.  Your FMO should be able to help get this done.  Once you receive your contracting links, you can complete them along with your carrier certifications(carrier specific training you do to gain knowledge about the products you are offering).   When this is done, you will receive your RTS (ready to sell) and you can now offer that product.

websites and blogs focused on Medicare sales.  Here you will be able to access information regarding all aspects of Medicare sales.  Our recorded webinars will hit on just about every area of Medicare sales.   For those, very new to Medicare sales, be sure to access our Medicare sales quick guide to lean the basics about contracting, certifying and selling.

Because Medicare is a federal program, there are a lot of rules and regulations agents must adhere to. These rules protect the clients as well as the agents and ensure everyone conducts business in a compliant and fair way.  CMS mandates that agents take annual training courses to stay up to ate with all the regulations.  That is why agents need to take and pas the AHIP annually with a score of 90% or higher.

Watch a quick YouTube video for 2024 AHIP test tips

Sales training

New agents often need more guidance to get an idea of how to get started. Comprehensive training programs provide an understanding of things like; eligibility, enrollment and coverage options.  We provide newer agents weekly zoom training to help them feel confident and build their knowledge base.  We are also available for a one on one meeting or phone call.  In some cases agents may have an opportunity to pair up with a local agent and go on sales calls.

Product training

In the Medicare field, clients have soo many types of coverage offered by many carriers to consider. This means agents must be aware of new products and changes in plan products as well  what their client is looking for.  That is why agents complete specific product training, so they can ensure their client receives the coverage they need and can afford.  We provide the opportunity for agents to join one of our weekly zoom meetings or webinars to get updated information and ask questions if they are unsure about anything.

Anyone can find information on our website or YouTube channel.  We update our Events and information page so agents can easily find a webinar or event information on our website, just click on the link below.

Click here to view our updated Events and information post

Access the recorded webinars on various topics on our YouTube channel, just click on the link below:

Subscribe to our YouTube channel and view all our recorded training and informational videos

Learn to use our free quoting and enrollment tools

We provide our agents with a few ways to quote and enroll clients in a CMS complain way. Sunfire and Connecture are two of the tools we offer at no cost to our agents. Both of these tools provide  a CRM as well as the ability to record sales calls and remain compliant.

Take a look at a Sunfire enrollment demonstration

Networking and Business Development Training

Agents require more training once they have a handle on the ins and outs of Medicare and the carrier plans.  Some people require advice to help the design a business plan. They may need a strategy for networking opportunities, leads, and business development.  These tools will establish their place in the community and build a book of business.

Generate Medicare referrals

Medicare lead program

Our agents have an opportunity to participate in our Medicare lead program to.  We provide agents up $500 a month to offset lead and marketing costs.  There are no minimums to start and absolutely no reduction in compensation.

More info on our Free Medicare Lead Program

What does a Medicare agent earn

Each year CMS sets the maximum amount for Medicare commissions.  Click here to see the commission rates for 2024 

Watch a YouTube video to see the CMS proposed changes to agent compensation

 

 

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Connecture vs Sunfire

Connecture vs Sunfire

By Ed Crowe | General Articles | 0 comment | 31 January, 2024 | 0

Connecture vs Sunfire

Because we offer both platforms to our agents at no charge, we will compare the two, Connecture vs Sunfire, to help you choose which one to use based on your personal preferences and not our opinion.  It is tough to decide which platform is better as each provides quoting and enrollment for MAPD, PDP, and Medicare Supplement as well as dental and vision sales.

Both platforms provide browser-based software that does not require agents to download anything on their computer.

Watch a YouTube video on how to use Sunfire and Connecture for enrollments.

Let’s start with Connecture

Here are a few of the features Connecture offers:

  1. This platform provides the user with a built in CRM.  Agents enter client information such as, name address, email, phone number as well as medications, doctors and preferred pharmacy.
  2. There is the option to provide the client’s health status (Generally Healthy, Some Health Needs & Significant Health Needs).  This helps you determine the type of coverage that best suite each individual.
  3. Connecture provides a personal PURL, this is a shopping link that agents can send to clients to self-enroll and credits the agent with the sale.
  4. There is an option to quote and enroll clients in DSNP plans.
  5. This website provides Blue Button functionality, it lets agents enroll clients through a government approved link to the carrier’s enrollment portal.

Learn why you should consider contracting with Crowe

Now we will go over Sunfire

Here are some things that make Sunfire different:

  1. Sunfire offers the ability to select different levels of LIS, this includes approximate premium deductions.
  2. Agents have the option to enter the client’s current plan to provide a side-by-side comparison so clients can make an informed choice.
  3. Enter the client’s health status by choosing Excellent, Good or Fair.
  4. Sunfire gives agents the option to highlight Dental, Vision and Hearing (DVH) benefits if they are included in a plan’s benefits.
  5. Use the enhanced provider search tool and check if a doctor is in network right on the quoting page.  You do not need to use carrier specific tools.

Here’s why they are similar

  1. Each platform provides agents a way to quote and enroll clients over the phone, by sending a link or in-person online.  This can eliminate a face-to-face meeting when it is not possible.
  2. Both platforms provide a basic CRM to save client information, enrollment information and scope of appointment forms.
  3. Connecture and Sunfire both provide the ability to record enrollments and scopes and save them.
  4. Agents can enter the client’s doctors or drug lists and run a plan comparison as well as download a copy to send their clients.
  5. Send clients information through either text or email.
  6. Either system lets agents add plans they are not contracted with in to compare.

Click her to watch a video on the CMS call recording rules

Although both these programs offer similar features, individual agents definitely have their opinions as to which they prefer.  Crowe and Associates agents can access both of these tools through connect4medicare.com.  This is a webpage provided by Pinnacle financial services for use by our agents.  Agents are welcome to use one or both of these tools interchangeably as they choose.  Because the systems are designed differently, each one offers a unique user experience.

 

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Medicare agent sales training

Medicare agent sales training

By Ed Crowe | General Articles | 0 comment | 30 January, 2024 | 0

Medicare agent sales training

As the demand for Medicare coverage continues to grow, the role of Medicare agents becomes increasingly important. For that reason, Medicare agent sales training is crucial. Agents need to be prepared to provide guidance for beneficiaries to ensure they receive the health care coverage that fits their needs and budget.

There are various training programs available to equip agents with the necessary knowledge and skills. Agents need to take in a lot of information including; rules, contracting, benefits, quoting, certs and much more.  We will discuss some of those things below.

Initial Training Programs

Newer Medicare agents require comprehensive initial training programs.  These programs should provide a solid foundation of the Medicare system including eligibility, coverage options and enrollment periods as well as how they work together.  We provide a weekly zoom training for all our newer agents that need the extra time to get up and running.

Product-Specific Training

Because there are so many coverage options for Medicare beneficiaries,  including Original Medicare, Medicare Advantage (Part C), and Medicare Prescription Drug Plans (Part D), agents need product-specific training. This training ensures that agents are well-versed in the details of each plan, allowing them to match individuals with the most suitable coverage.  Each carrier provides it’s agents with product training opportunities.  We also offer training when a new product that shows potential is introduced into an area or if agents show an interest in learning more about a specific product.  Agents can either join one of our weekly zoom meetings or webinars or find information on our website or YouTube channel.  You can find links to this information on our website, just click on the link below.

Click here to view our updated Events and information post

Annual Training and Updates

Given the dynamic nature of  Medicare coverage options, agents must undergo annual training and updates. This ensures that agents stay current with any changes to Medicare regulations, coverage options, and compliance standards.  Agents can get helpful tips on the annual AHIP training on our YouTube channel as well as updated CMS regulations for Medicare sales.

Technology Training

Because technology is always advancing,  agents need updated tools and technology to remain competitive.  That is why we provide both Sunfire and Connecture for quoting and enrollment to our agents at no cost.  We offer one-on-one training and video instruction to agents who want it. These tools offer a built in CRM as well as the opportunity for agents to record their sales calls and remain compliant. Our technological resources enhance the agent’s ability to serve clients effectively.

Visit our YouTube channel and watch some free training videos on any of the above subjects you have questions about

Ethical and Compliance Training

Ethics and compliance are a big concern in the insurance industry. Agents undergo annual training on ethical sales practices and conduct, as well as updated regulatory requirements. This training ensures that agents operate with integrity and in accordance with industry standards.  Our zoom meetings and webinars often focus on updated CMS regulations to ensure our agents maintain their compliance.  All our informational webinars are recorded and put up on our YouTube channel.

If you want to join our team, click here for online contracting

Sales Skills Training

Many agents appreciate training programs that help focus on honing sales skills.  This training teaches agents how to educate clients, address concerns, and facilitate informed decision-making.  Some training programs we offer focus on different types of approaches and opportunities agents can use to generate sales.  Because each agent is an individual, we offer calls or meetings to discuss different approaches agents can use to generate sales.

Networking and Business Development Training

Agents require training programs that go beyond the technical aspects of Medicare.  They need guidance to building a successful business. This includes strategies for networking, lead generation, and business development to help agents establish and grow their client base.  We provide agents with information and guidance on lead programs as well as how to host sales events and much more.

Learn how to generate Medicare referrals

The landscape of Medicare agent training is diverse, this reflects the multifaceted nature of the Medicare business. Whether it’s mastering the benefits of Medicare plans, staying compliant with regulations, or developing essential sales skills, ongoing training is a must for Medicare agents.  This helps ensure they provide high-quality service to their clients.

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Medicare licensed agents

Medicare licensed agents

By Ed Crowe | General Articles | 0 comment | 19 January, 2024 | 0

Medicare licensed agents

Medicare licensed agents provide a valuable service to beneficiaries.  If they stay up-to-date on product offerings and CMS rules, they can provide clients with a number of plan choices that will suite their needs. This is a great career if you are interested in becoming a valued member of your community and providing an important service to it’s members.

Where to start

The first thing you need to do is go onto the state insurance department website for your state.  From there, you can lookup the requirements to earn your health or health and life license.

There are several companies that offer the courses you need to study for your test.  Your states insurance department website will give you the available options. While you are studying for you resident state license, you will start to learn the rules for selling Medicare & other health plans.  Studying also provides valuable information about the different components of Medicare and how they work together.

Each state has different requirements for exam-prep. Some require in-person training while others allow self-study at your own pace.  There are also online options and options to order books if you are more comfortable with that.  There is a test at the end of the course that you must pass before you can take your actual licensing exam.  It is important to note; some states require agents to take a course on life as well as health while other states do not require agents to do both. If you think you may want to offer life products later, you can add the life course and do the testing at once.

Once you pass the exam, CMS reports your results to the National Insurance Producer Registry (NIPR).   Be sure you print and download a copy of your license.  You will find your  National Producer Number (NPN)on your license.  You need your license and NPN to contract with carriers.

Contract with an FMO

An FMO (field marketing organization) is an invaluable tool.  A good FMO not only provides it’s downline agents training, tools and contracting.  They provide continuous, back office support, they will answer your calls and make sure you get answers to your questions. Some of the things FMOs help; they get contracting requests processed, train downline agents on new CMS regulations and carrier products.  Agents need to take time and ask as many questions as you need to to feel comfortable before they choose an FMO.

 Watch a YouTube video on the programs Crowe has to offer

Having an FMO behind you , makes contracting with multiple carriers and products a much smoother process.  They should also provide guidance to new agents to put a plan of action in place and get up and running.  There may also be opportunities for leads, marketing money and other useful tools.

Join the team at Crowe – click here for online contracting

Purchase E&O insurance

In order to do business, carriers require all agents to have E&O insurance.  This insurance protects you in the event you make a mistake when you enroll a client an they take legal action against you to cover any financial loss your misinformation may have caused them.  Your FMO may provide a discounted plan to it’s downline agents.  If they don’t you can purchase a policy through an agent who provides property and casualty insurance.

Click here to learn about our discounted E&O

Complete AHIP

After you get our license, you should take the AHIP.  AHIP stands for America’s Health Insurance Plans.  Most carriers who offer PDP or MA/MAPD plans require agents to take this training and certification course.  Agents must take this test each year and get a 90% to pass.  The cost to take the AHIP course is $175, although many carriers offer a $50 discount if you take it through their portal when you do your carrier certifications(more on those below).

Click here to watch a YouTube video on AHIP test tips for 2024

Get contracted & appointed

Agents must complete carrier contracting before they are appointed to sell their products. In most cases, agents need a copy of their current state health insurance license for each state they plan to sell in.   A copy of their E&O certificate is also necessary.  Your FMO will will help with this process by providing other important information to the carriers.  Once the carrier has all the pertinent information, you must complete the carrier specific training for PDP and MA/MAPD plans.

It is a good idea to request only 4-5 good carriers in your area and get RTS (ready to sell).  With a good FMO, it is easy to add more in as you need them.  You do not want to be overwhelmed from the start. This can discourage anyone.

Find out about how Medicare commissions pay 

Moving forward

It is important to make sure you keep your license active.  This sounds like a no brainer but, some agents forget to renew and that can cause a number of problems with your carrier contracts. up to date.  In order to do this you will need to complete a specific number of CE credits before you can renew your license.  The amount of CE hours you need vary by your resident state.  You can choose any accredited CE course provider you like, again this is based on state specific requirements.

If there are updates with CMS requirements, both your FMO and the carriers you are appointed with should provide them to you.  It is essential that you follow all guidelines when making sales to avoid termination of your contracts.

If you want a career where you provide a valuable service to individuals and truly enjoy helping people, this could be a good fit for you.  In this business, we cannot stress enough how important it is to be organized and well informed to provide the best service to your clients.

Do you need a scope of appointment, click here and learn about the rules

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Starting a Medicare agency

Starting a Medicare agency

By Ed Crowe | General Articles | 0 comment | 31 December, 2023 | 0

Starting a Medicare agency

If you are a licensed Medicare agent and would like to expand your Medicare business into a Medicare agency, here are a few things to do before starting a Medicare agency.

  1. File and register your LLC or Corp with the state that you plan to have your headquarters in.
  2. Go to your state department of insurance to apply for the appropriate license under your LLC or Corp.
  3. Purchase E&O insurance (errors & omissions) for your agency.  This protects business owners from lawsuits connected to insurance sales.
  4. Choose one person to act as the principal of your agency.  This person should be listed on any state license you apply for.  Be sure the individual is licensed in any state you wish to do business in as they will be listed as principal on any license your agency applies for.
  5. Check all CMS compliance laws and be sure that both your agents and agency follow all applicable rules.  The agency principal must complete AHIP annually on behalf of themself and the agency.

Click here to learn the CMS final rule for 2025

Ways to help your agency run smoothly

  1. Hire one or more employees to work your back office and provide support and training for any agents who contract to work with you.  This will help ensure your recruit agent who can successfully sell plans.
  2. Be sure your agents complete annual carrier certifications, AHIP and any necessary CE credits.  Provide guidance for any questions downline agents have and be sure they understand both new as well as existing CMS compliance regulations.
  3. Purchase a CRM, this is a great way to keep all client information as long as it is maintained properly.
  4. Contract your agency with an FMO/NMO that provides your agency with many value added benefits.  More on that point below.
  5. Make sure you track all commissions and pay them to downline agents in a timely manner if they are LOA.

Watch some of our free training videos on YouTube

Important

If you plan to run a successful Medicare agency, it is imperative that you educate your downline agents.  If you do not support your agents, they will find another upline to work with the provides the guidance they need to be successful in this business. There are plenty of other up-lines looking to sign agents out there.  Make sure your agency is competitive.

Click here to see what a competitive agency has to offer 

A good upline offers many different programs to agents so they can find one that best suits their style of selling.  Quoting and enrollment platforms, such as Sunfire and Connecture are invaluable tools that have many benefits such as; saving client information like prescription lists (this saves time each year to run quotes), built in call recording capabilities (for compliance) and 10-year storage capability.

Learn more about Connecture and Sunfire

Back-office support helps answer any questions regarding marketing or product-specific training in a timely manner and your agents feel confident when they have a personal relationship with actual people who support their efforts day to day.

Contracting with the right upline makes all the difference.

Contracting your agency with an FMO/NMO can really boost your over-all success.  These organizations provide many valuable connections to carriers.  This can make cross selling easier.  They also have the capability to process carrier contracts quickly and smoothly.  Many provide free access to quoting tools like Sunfire and Connecture to downline agents.  There are many other benefits like keeping your agents up to date on the latest rules and regulations of the industry and application processing help.  The best upline can help agents develop a good marketing strategy.  There are many other benefits to joining an FMO/NMO.

Let Crowe and Asociates help guide your agency – click here for online contracting

There is quite a bit to consider if you want to start a profitable, successful Medicare agency.  Forming the right partnerships can really help you get it done right.  and be As you can see there are a lot of moving parts that need to be running in synchronization to have a successful Medicare Agency.

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Medicare scope of appointment rules

Medicare scope of appointment rules

By Ed Crowe | General Articles | 0 comment | 3 December, 2023 | 0

Medicare scope of appointment rules

The Medicare scope of appointment rules are put in place by CMS.  The SOA (scope of appointment) is a form that clients or potential clients as well as their agent must complete before meeting to discuss Medicare plan options. The scope is mandatory if you are discussing either a Medicare Advantage or Part D prescription drug plan. Although, it is a good idea to collect a SOA before any client meeting to protect both the agent and the client.  The SOA form should be kept no less than 10 years and may be collected either physically, verbally or electronically.

Watch a quick video on the scope of appointment rules for 2024

Verbal scope of appointment

When the pandemic began, it was not advisable to host in-person meetings to discuss coverage options.  Because of this, many appointments took place over the phone.  That lead to the use of verbal scope of appointments which are recorded and saved.  Many carriers offer this option as well as quoting/enrollment tools such as Sunfire and Connecture.

Click here to watch a Sunfire enrollment demonstration on YouTube 

General information about a verbal SOA

  • If the client calls the agent (inbound call), the 48-hour rule does not apply.
  • The scope is good for 12 months from the date it is signed.  You must complete the appointment within that time or obtain a new scope. The scope is still good if the call drops and the same agent calls the client back.
  • If additional benefits are added to the discussion, a new scope is necessary.

How long is a SOA good for

As we mentioned above, a scope of appointment is good for 12 months from the date it is signed. It is important that you discuss only products that were agreed to and included in the scope.  If additional products are added, the beneficiary needs to sign a new scope.

If the client asks about Medicare Advantage plans during the 48-hour waiting period and they had not included them on the original scope, you will need to have them sign a new scope before your discussion.  This will restart the 48-hour waiting period and may move your meeting date out further.  This rule applies to any product regulated by CMS.

Need a SOA – Click here

CMS guidelines

In order to be complaint with CMS, agents need to have their clients complete a Medicare Scope of Appointment form. The 2024 CMS final rule went into effect September 30. 2023 and has added some changes to how agents obtain the SOA.

The SOA rules apply to agents and brokers who discuss Medicare coverage options and plans.  The 48-hour rule was put in place so beneficiaries could avoid the high-pressure sales tactics some agents use.  The 48-hour period provides beneficiaries time to consult friends, relatives or anyone they like to research their options. This time also provides agents time to prepare for the discussion.

Agents are able to contact the beneficiary once the SOA is completed for up to 12 months. It is essentially permission to contact until the meeting takes place.  The beneficiary has the option to opt out annually.

Please note, if the beneficiary does not select a coverage option on the SOA, Medicare requires the agent to avoid discussing that option without a new SOA where the option is clearly selected.

Find out about the proposed CMS rule 4205-P, see how it could affect agents!

Exceptions to the 48-hour rule

If the beneficiary is in the last four days of a valid election period, agents may collect a same-day SOA.

When the beneficiary walks into your office and initiates a conversation about coverage options, agents can take a same-day SOA.  This same rule applies to inbound call initiated by the beneficiary to the agent requesting advice.

How long do you need to keep a SOA

Agents must be able to access the SOA form for ten years. Clients have the right to request a copy anytime within that time frame without any issues.  The SOA can provide help in the event that an issue or dispute occurs.  The Scope is in place to protect the consumer, but it can also protect the agent.

 

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Medicare enrollment periods

Medicare enrollment periods

By Ed Crowe | General Articles | 0 comment | 26 November, 2023 | 0

Medicare enrollment periods

In order for agents to sell Medicare plans, one of the first things they need to understand are the Medicare enrollment periods.  There are many different enrollment periods available to beneficiaries. Each one depends on their personal circumstances.

If a beneficiary already receives Social Security benefits, they will automatically be enrolled in Original Medicare.  In other words, they do not need to sing themselves up for Medicare Part A or Part B.  Beneficiaries who do not qualify for automatic enrollment should enroll during the Initial enrollment period.

There are three enrollment periods available for Original Medicare

  1. The first and most commonly used is the IEP or initial enrollment period.
  2. Second is the AEP or annual enrollment period which can be used for a number of different reasons.
  3. Third is the GEP or general election period that beneficiaries use to enroll in Original Medicare if they missed their IEP for some reason.

Medicare IEP (Initial Enrollment Period)

The Medicare IEP (Initial Enrollment Period) is a seven-month window available to beneficiaries to enroll in Medicare Part A & Part B.  The IEP is based on either your 65th birthday or once a qualified beneficiary receives their 24th Social Security disability payment. This enrollment period starts 3 months before the qualifying event and continues through the month of the event.  The IEP ends 3 months after the month of the qualifying event.  If the beneficiary’s birthday falls on the first of the month, The IEP begins 4 months before the 65th birthday of the beneficiary and ends 2 months after the beneficiary’s birth month.

Coverage for beneficiaries who enroll in the months before their birthday begins the first day of their birth month.  If they enroll either during or after their birth month, coverage begins the first day of the month after they enroll.

During the IEP, beneficiaries can choose to either enroll in both parts of Original Medicare or they may choose to delay enrollment in Part B if they have other credible coverage such as from their own or a spouse’s employment.

Medicare AEP (Annual Enrollment Period)

The AEP starts each year on October 15 and runs until December 7.  AEP is an opportunity for anyone on Medicare to make changes to their Part C or Part D coverage.  Please note: changes made during this enrollment period will go into effect January 1 of the following year.

Click here to learn more about the AEP

Medicare GEP (General Enrollment Period)

If a beneficiary neglects to enroll during their IEP and does not have other credible coverage, they may need to use the GEP to enroll in Medicare.  The GEP starts January 1 and runs through March 31 each year. During the GEP, coverage begins the first day of the month after you enroll.  Beneficiaries who enroll during the GEP may have to pay a late enrollment penalty depending how long they have gone without credible coverage.

Other Enrollment Periods

There are still more enrollment periods available.  There are the Medicare Advantage Open Enrollment Period as well as the Medicare Supplement Open Enrollment Period. Each if these enrollment periods apply to the specified type of coverage.  Although some individuals qualify for one of the many SEPs (Special Enrollment Periods).

Medicare Supplement Open Enrollment Period

The Medicare Supplement Open Enrollment Period starts the day their Medicare Part B is effective and runs for 6 months. This enrollment period gives beneficiaries guaranteed issue right to enroll in any Medigap plan available to them. Several supplement carriers let beneficiaries apply for a plan up to 6 months before their Part B start date.  The supplement will not start until the day Part B benefits are in place.  If the beneficiary misses their Medicare supplement open enrollment period, they can apply for a Medicare supplement plan any time of year.  Keep in mind, they may have to go through underwriting and can be denied coverage.

Medicare Advantage Open Enrollment Period

When a beneficiary first enrolls in Medicare Part A and Part B during their IEP, they are eligible to enroll in a Medicare Advantage plan.  If they do not choose to enroll at that time, they have to wait until the AEP (Annual Enrollment Period) unless they have an SEP available to them.

There is a specific Medicare Advantage Open Enrollment Period available to those who are already enrolled in a Medicare Advantage change their coverage.  This enrollment period runs from January 1 through March 31 each year.

To learn more about the Medicare Advantage OEP, click here

Special Enrollment Periods for Medicare

The most difficult to understand enrollment period may be the Special Enrollment Period. This enrollment period can apply to several different circumstances and does not apply to all Medicare beneficiaries. SEPs may require the beneficiary to provide proof of eligibility.

The most common reason for enrolling during an SEP is loss of employer coverage due to the fact that many benficiares choose not to enroll in Medicare PArt B because they have employer coverage.

Find out the rules for SEPs

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What's the Medicare GEP

What’s the Medicare GEP

By Ed Crowe | General Articles | 0 comment | 25 November, 2023 | 0

What’s the Medicare GEP

The Medicare GEP (general enrollment period) is a chance for eligible individuals to enroll in Medicare Part A and Medicare Part B.  The GEP runs each year starting January 1st and ending March 31st.  In years when the GEP ends on Saturday or Sunday, Social Security allows individuals to enroll the following Monday in one of their local offices.  If they receive a written request for enrollment with a stamp dated by the last day of the GEP, Social Security will honor it.

Who can enroll during the GEP

If individual is eligible for Medicare benefits and has to pay a Medicare Part A premium, they can use the GEP to enroll in Medicare.  If they are like most people and do not have to pay a Part A premium, they can enroll in Medicare Part A anytime.  Eligible individuals who did not enroll in Part B during either their IEP or an SEP can use the GEP to enroll in Medicare Part B.

Is there a penalty for enrolling during the Medicare GEP

Eligible beneficiaries who went a year or more without Part B or Part A, if they have to pay a premium for it, may pay a late enrollment penalty when they use the Medicare GEP to enroll. Penalties for Part A and Part B differ.  See below for details:

The penalty for Part A only applies to individuals who are not eligible for premium free Part A benefits.  If a penalty applies, 10% is added to the premium cost. The penalty lasts for twice the number of years the enrollee delays Part A enrollment.  For example, (If enrollment was delayed for 2 years, a penalty applies for 4 years).

Part B penalties add an additional 10% to the Part B premium each year the beneficiary delays Part B enrollment.  An example is (a delay of 2 years will equal a 20% penalty).  The Part B penalty lasts for as long as they have part B coverage.

Please note:

Those who did not enroll in Medicare Part B because they had insurance coverage through theirs or a spouse’s employment, do not pay an LEP.  There is also no penalty for beneficiaries who qualify for an MSP (Medicare Savings Program).

Before 2023, no matter what date beneficiaries enrolled in Medicare during the GEP, their coverage would start July 1.  Since the CMS rule change that began is 2023, there are no longer delays in Medicare effective dates for beneficiaries who enroll during the GEP.  In other words, coverage begins the first day of the month following the enrollment.

Our YouTube channel has many important guidelines and updated rules for Medicare sales – subscribe to our channel and take a look.

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Medicare sales cross selling

Medicare sales and cross selling

By Ed Crowe | General Articles | 0 comment | 24 November, 2023 | 0

Medicare sales and cross selling

If you are selling Medicare, you should think about how to meet all the coverage needs of your clients. That is why Medicare sales and cross selling go hand in hand.  Before you try and do this, be sure you have the necessary product knowledge on anything you intend to offer.

A great way to get insight into your client’s potential needs is with a client needs assessment.  Each agent should tailor the assessment to include the applicable product lines they are licensed to sell and have a good knowledge of.

If your client understands that you are able to offer them coverage for all their personal insurance needs, they will be inclined to call you when they decide to add to their current coverage.  It is best to take care of their most urgent concerns before talking about additional items.

Watch our quick YouTube video on cross selling during AEP

Medicare sales cross selling – be aware of underlying health issues

If you conduct a needs assessment or spend enough time speaking with your client, you will probably find out if your client has any illnesses that will prevent them for obtaining some types of coverage that they will not qualify for.  If you ask about any recent claims they have had, this may be an indicator if they are a good candidate for some types of coverage.

Some other things to find out from your client

Is the client or their spouse presently working?  If the answer is yes, do they have any employer benefits and if so, what are they?

Have they ever served in the military (are they a veteran)?  Sometimes veterans receive benefits.  You need to find out if they do and what those are.

Medicare sales cross selling – Cancer, Heart attack and Stroke coverage

Because many people have a family history of either cancer, heart attack or stroke, this product is not difficult to sell. This product is sometimes called critical illness insurance.  Be sure you understand the client’s budget before you show them quotes from companies that will fill their coverage need.

Cross selling – Long Term Care Insurance

Most people do not have long term care coverage. Although LTC has changed over the years, there are still some good coverage options available.  There are some short-term care policy options that include home health coverage.  There are also some life policies that include an optional LTC rider.  You can ask your client if anyone in the family has needed home health or nursing home care. If they have, ask them if they know how it was paid for. Do they have a way to pay for it if they need it?

Cross selling – Life Insurance

Life insurance is not like LTC coverage because many clients have at least some life insurance coverage.  If you want to start a discussion about life insurance, you need to find out if the client already has coverage and if so, how much.  Once you get the answer, you can ask questions to determine if they have enough to cover what they need it for.

Here are some reasons people purchase life insurance:

To replace income lost due to the death of a family’s financial provider.

If they want to cover their final expenses.  If they have a policy in place, it may not be enough to cover their final expenses.  This means they may want to consider purchasing a policy that provides a bigger benefit amount.

Policies can help pay any outstanding debts owed by the policy holder.

In some cases, the policy holder wants to leave a financial gift to their chosen beneficiary.

If they do not have a policy, you may be able to help them decide if a policy could benefit their loved ones.

Cross selling – Final Expense

Final expense insurance is a kind of life insurance.  If the client does not have life insurance in place, this type of policy can help family members pay for their final expenses and avoid leaving them with a large bill after you are gone.

Cross selling – Annuities

These days many people want a safe place to invest their savings due to low interest rates at banks and stock market volatility. Simply ask your client if they are happy with their current rate of return on investments. Let them know a fixed indexed annuity can provide a dependable place to invest savings and a better return rate than many CDs.  In many cases, you can offer them an annuity product that will provide a better return that what they currently have.

Now that we have given you a few products to consider adding to your portfolio, it is up to you to decide what will be the best value add.

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