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  • Do you have a client on an AARP Medicare Supplement?

    Here are some important facts you need to know about them switching from one AARP Medicare Supplement plan to another AARP Medicare Supplement plan with an effective date of July 1, 2017 and later.

    1. Current members with plan effective dates between June 1, 2010 and June 1, 2017
      • Members in this range looking to change from say a Plan F to Plan G, will ignore the rates laid out in the enrollment kit. To get your member an accurate rate, you will need to refer to the plan change rate charts, which you can find here.  Also, for these members their current 10-year enrollment discount structure will be applied to their new plan.
    1. Current members with plan effective dates before June 1, 2010
      • Members with plans effective before this date looking to change from say a Plan F to Plan G will require a new application to be submitted. You will treat these just like a new sale, meaning underwriting and rating rules will apply.
    1. New members looking to get a plan with an effective date of July 1, 2017 or later
      • You will use the new July 1, 2017 enrollment kit and rate pages. Again, underwriting rules will apply and obviously, a new application must be submitted.  Once accepted, these new members will receive the new Enrollment Discount.

    As always, if you have any questions, please feel free to call us at (800)723-5228.

  • Get to Know Your Carriers

    We want you to take a moment and answer a couple questions. (We promise these are easy.)
    1. How many carriers are you appointed with?
    2. How many of their websites have you been to?

    The reason we ask is there is a whole network of information on those carrier websites.
    • Detailed information about their products
    • Live chat
    • Direct phone numbers for Agents Only
    • Material ordering (that sometimes goes straight to your house)
    • Promo ordering
    • Insurance Resources
    • Contact forms
    • Specials/prizes/events

    With AEP right around the corner we think it would be a great time for you to familiarize yourself with the companies that you are appointed with. By doing so, you have all the knowledge you need to give potential clients.

    Need some help finding your carrier website? Type the carrier name in the search bar of your preferred internet search engine and the carrier you are looking for should pop up on the top of your search.

    With that being said, we have another great reference for you to use:

    That’s right. Agent Pit Stop. Did you know that on our webpage you can:
    Click on the CLIENTS tab to see all your clients, plus you can see all upcoming birthdays. Making it easy for you to give them a phone call, send a card, or let them know of plans that may be more suitable to their health needs.

    Under the CONTRACTS tab you can see which documents we have on file and when they are expiring, plus you can request contracting information for carriers you may not be appointed with.

    The RATES tab has a search engine for you to use to better prepare you for your appointments. It helps your clients know the most updated rates that are available.

    The BILLING tab will show any balances you have with Van Berg.

    The COMMISSION STATEMENTS tab will show you exactly that. What date you were paid, the company/companies, and a file to download of the statement for that date.

    The SECURE EMAIL tab is for those who would like to sign up or log in to their secure email page.

    Last, but not least, the BLOG tab. Keep up to date with information about carriers, helpful tips, changes in insurance, and other information that may be pertain to the business.

    As always, if you cannot find what you are looking for here and still need additional help, we have several people in the office to help point you in the right direction. Please do not hesitate to call us at (800) 723-5228.

  • Changes Coming to Medicare Supplements

    The National Association of Insurance Commissioners (NAIC) has released their proposed breakdown of Medicare Supplement plans to take effect in 2020, to comply with new regulations on first dollar coverage passed by congress last year. H.R. 2 eliminates first dollar coverage (discussed further below) as part of Medicare Supplement plans beginning in 2020, along with changing the reimbursement rates for Medicare providers.

    What is first dollar coverage?

    Simply put, first dollar coverage is coverage without any deductibles or coinsurance. The coverage is considered “first dollar” because from the first dollar spent, the coverage pays its share. Medicare Supplement Plan F is an example of first dollar coverage, because the plan pays the Part A and Part B deductibles.

    How does this change Medicare Supplement plans?

    Starting in 2020, plans C and F will only be available to existing Medicare beneficiaries. New Medicare beneficiaries will have their choice of the remaining plans, with Plan G offering the richest benefits. NAIC has also proposed the introduction of a high deductible Plan G to take the place of high deductible Plan F.

    Why are they making this change?

    Many believe that first dollar coverage encourages overuse of services, because beneficiaries have no financial incentive to limit their care to only what’s truly necessary. By passing along a share of cost even to those people who have Medicare Supplement plans, the hope is to lessen the strain on the Medicare program.

    While the new plans won’t take effect for several years, this is sure to significantly change the Medicare Supplement landscape for agents and beneficiaries alike.

  • What to Know About the Knox-Keene Act

    For agents in California, the Knox-Keene Act can be a magic bullet in some tricky situations where a client needs to change to a Medicare Supplement but couldn’t pass underwriting. So how does it work?

    The Knox-Keene Act provides guaranteed issue rights to existing Medicare Advantage plan members if the plan does any of the following:

    1) increases premium by 15% or more
    2) reduces benefits
    3) increases physician, hospital, or drug copayments by 15% or more
    4) discontinues its relationship with a provider who is currently furnishing services to an individual

    Of course there are some restrictions to be aware of.

    GI rights apply to the same carrier’s Medicare Supplement plans first. If the company that offers the Medicare Advantage plan the client is coming off of also offers Medicare Supplement plans, the GI rights only apply to that carrier. If that carrier doesn’t offer Medicare Supplement plans but an affiliated company like a parent or a subsidiary does, then the GI rights only apply to the parent or subsidiary. If none of those companies offer Medicare Supplement plans, then the GI rights extend to any issuer.

    Except in the case of a provider leaving a plan’s network, enrollments using these GI rights must happen during AEP. This isn’t especially restrictive, because the other changes would only be happening effective January 1 and any plan changes would be happening during AEP anyway, but it does mean you can’t just wait and disenroll during the Medicare Advantage Disenrollment Period in January and February and set up the Medicare Supplement then.

    Remember you’ll likely need to submit your client’s Annual Notice of Change or a notice from the plan or their doctor about a network change along with the Medicare Supplement application. It’s a little bit of work to potentially make a client very happy!

  • Quick tips for Submitting a Clean app and Avoiding Kickbacks

    Applications being rejected or kicked back can be frustrating and time consuming. You are not only setting aside time to figure out what plan works best for the client but to also meet with them and help fill out the application as needed. Don’t let your time or your client’s time be wasted because of little mistakes that could have been prevented by taking an extra minute to check over your work.

    Be Thorough – One of the biggest hold ups with processing can be that you’re missing the most basic information on an app. As an agent you are responsible for obtaining information such as a client’s name, phone number, address and Medicare ID and these are very important bits of info. However when you get into the groove of writing apps, especially in group settings or during the annual election period where the process comes at a faster pace, you may move right past a question without answering it. Always scrub your own app before submitting to check for these easy to fill questions.

    Make sure the plan selected actually works for your client – Sometimes a simple mistake of choosing the wrong plan can create a kickback. For instance Blue Shield of California only partially covers Contra Costa County and Care1st has a partial county in Alameda County. Knowing a plans coverage area and double checking zip codes is key to making sure you’re selecting the right plan for your client in situations such as those

    Other possible snags to watch out for are making sure you’ve selected the correct special election period (SEP), whether or not your client is dual eligible, or choosing a plan that helps with a specific health issue such as diabetes or a heart condition.

    Provide the Right Paper Work – At various times extra paper work is needed along with the client’s application. Think ahead and predict what documentation could be needed. For instance, in California, Medicare supplements being written on the birthday rule almost always require proof of prior plan. Having a copy of the client’s previous policy ID card and submitting it with the application could save you time from needing to do so later, while the application sits on hold. When writing an application that has an SEP it’s also very important to include the correct information on why it’s an SEP. If the client has recently moved to a new zip code or state where their plan no longer exists then include a letter from their policy’s provider showing they have moved out of the network.

    Paper work showing Power of Attorney (POA) is particularly important to point out because many agents often forget about including documentation for POA since it doesn’t frequently come up. Although there are a few companies that don’t require documentation, the majority of companies do, which is why it’s a good policy just to always include POA documentation.

    Don’t Dawdle with Corrections – If you do have an issue with an application (like you wrote down the Medicare ID incorrectly or have missing paper work, etc.) make sure to get it to the company ASAP. Providers offer a time frame to get corrections in before they reject applications. Once you miss a deadline it is rare that the company will open that application back up again. This leaves you either having to write an entirely new app if the election period is still open or, worst case scenario, it can leave your client without coverage.

  • Proactive vs Reactive: The Importance of Contracting Before it’s too Late

    During the weeks before Annual Election Period there is a spike in the number of agents contracting with new carriers. But why wait until the busiest time of the year to contract? Why not have the tools you need to insure you’re prepared for each client all year round? Here are just a few reasons to contract now:

    Be Proficient – First off, ask yourself if you are currently confident with all of the products you have to offer a client. Are you prepared if you receive a call from a referral that is in a neighboring town outside your usual area? Don’t be caught without the most competitive plans in not only your direct area, but surrounding areas as well. The most competitive plan in one zip code can be drastically different in the next. When you’re missing something from your “tool bag,” clients can become uneasy about your ability to write the policy that best fits their needs. You might also miss out on referrals that could otherwise help grow your book of business.

    Be Prepared – Having the right materials and information for a company can be crucial to making the right sale. Applications and promotional materials can take a while to arrive. The same goes for properly registering sales events and advertising materials. Contracting early allows you to have these supplies sooner and on hand when needed.

    Stop Losing Sales – Clients often hear of health insurance plans from commercials or through their friends and they’re suddenly set on having that specific product. No other product will do in their minds. This happens more and more often. Advertising is effective and friend’s opinions matter. Just because you personally think that another plan might be better doesn’t mean your client will be set on that product. Offering more options opens up more opportunities.

    Don’t Scramble – Clients need to feel like you have a handle on their insurance needs. Waiting until a client requests a company and then starting the contracting process is an easy way to lose a client. Especially if they’re a new client and don’t have long until their enrollment period ends. You don’t want to have to refer your client to another agent and lose a potential sale.

    Know Your Contract – While keeping everything else listed above in mind, it’s also important to know your limitations or if it’s time to rework your contracts. Know the difference between being a captive agent, career agent and a broker and contract in the way that makes the most sense to you. Captive agents can only sell the products from the company they are employed by, while a career agent can offer other products but only after first offering the products from the company they work with. Brokers, on the other hand, are not chained down. They are able to sell any product that they are successfully appointed and certified with, ensuring they have a wide range of products to cover their client’s needs including unexpected referrals.

    For more information on what companies are available and contracting in general, please visit www.agentpitstop.com or contact contracting at contracting@agentpitstop.com.

  • Medicare Supplement Commissions Cheat Sheet

    Note: Updated with commissions as of 12/1/17

    Agent Pitstop can help you find the best rate for your client through our online rate engine but while you’re writing, it’s nice to know what you’re getting out of it. Especially if there is more than one company in an area with similar rates.

    Here is a Medicare Supplement Commissions Cheat Sheet to help you know what commissions should be coming your way depending on what company you write:

    Click here for a downloadable PDF.

    commission cheat sheet 2017
  • Is Your AARP/UHC Appointment In Jeopardy?

    Most agents maintain appointments for a variety of carriers with whom they rarely write business, either because the carrier serves a specific niche market, the carrier was previously a large player in their region and may become so once again, or simply because they want to maintain as large a variety of options for clients as possible. In most cases this is a smart choice, even if you almost never write any business with certain companies, as long as you’re sure to keep up with your certifications and licensing. The UHC AARP branded products, however, are an important exception.

    AARP/UHC uses what they call the Authorized to Offer (A2O) program. Agents are split into levels based on the amount of business written, both in a given year and a lifetime, and agents who reach the higher level are given certain perks. More importantly for some agents, however, is that AARP/UHC enforces a minimum quota to maintain the ability to write Medicare Supplement business. There are some key things to remember.

    You must write a minimum number of active and paid Medicare Supplement plans to maintain authorization. – If you meet the annual minimum of five active enrollments, you maintain your A2O level one status for that year. If you don’t meet the minimum, you’ll be placed on a temporary deauthorization from selling AARP branded Medicare Supplement plans. You can also maintain your level one authorization, regardless of the amount of new business written in a particular year, if you have minimum of 100 active enrollments on the books. This is good news for anyone who may be transitioning away from AARP but would like to keep it as an option just in case.

    You aren’t completely banned from AARP products during initial deauthorization. – If you don’t write enough business to maintain your level one status, you’ll be temporarily deauthorized. During that period, while you can’t write AARP branded Medicare Supplement business, you can write their MAPDs and PDPs, assuming you’re certified for them. Of course, this business does not count towards meeting your minimum production requirement.

    If you fail to meet the minimum production requirement two years in a row, the deauthorization becomes permanent.  The permanent deauthorization only applies to Medicare Supplement plans, the same as the initial deauthorization.

    If you do get deauthorized, it doesn’t impact commissions on business already on the books. – Any renewal commissions, or commissions on new business under the minimum production requirement, will still be paid even if you’re later deauthorized. It will obviously prevent you from writing new Medicare Supplement business with them, but you’re existing business will continue to earn you ongoing income regardless.

    While there are other carriers who will terminate non-producing agents, it’s rare to see such a specific system of quotas. AARP has a powerful brand draw for many seniors, and is a good choice in some demographics, so it’s important to bear in mind what you need to do to continue to offer their Medicare Supplement plans.

  • Excess Charges – Should Your Medicare Supplement Clients Be Worried?

    Where Medicare Advantage plans have the question of balance billing, Medicare Supplements have excess charges. Medicare Supplement Plan Comparison ChartYou’ve likely noticed in the comparison charts for the different types of Medicare Supplement plans that plans F and G cover what they call “Part B excess charges.”
    For some clients, the idea of these unspecified excess charges can be intimidating, as they bring with them visions of crushing medical bills and the attendant financial ramifications. Even for some agents, it’s difficult to feel comfortable quantifying what excess charges are, how much they can be, and how concerned about them a client should be.

    The important things to remember are as follows:

    – Medicare participating providers are prohibited from billing Medicare beneficiaries for anything outside of their co-insurance or copayment, as determined by standard Medicare coverage rates and whatever Medicare Supplement plan the member may have.

    – Medicare Supplement plans F and G cover excess charges, so members with either plan should never run into excess charges directly, even when seeing non-participating providers.

    96% of providers who offer Medicare-covered services are participating providers. This means that Medicare beneficiaries are statistically unlikely to ever encounter a situation where excess charges are even potentially an issue. You can help members look up providers they may want to see by checking Physician Compare on Medicare.gov

    – Medicare non-participating providers can choose on a per-service basis whether or not to accept assignment, so a member who uses a non-participating provider may not necessarily see excess charges every time.

    – If a non-participating provider is going to bill for excess charges, the member will typically be required to pay for the entire service up front. The provider will then submit a claim to Medicare and the member will receive a reimbursement check for the amount covered by Medicare. The end cost to the member will likely be small, but for some people having to pay up front for the service and wait for reimbursement may be a concern.

    – Excess charges themselves are limited by Medicare. Non-participating providers who are not accepting assignment for a given service can charge up to the Medicare limiting charge of 115% of the non-participating provider reimbursement rate, which is 95% of the Medicare fee schedule amount. This works out to 109.25% of the Medicare fee schedule amount, which means the member would be liable for 9.25% of the Medicare amount, in addition to whatever usual cost-sharing may apply. For example, if the Medicare fee schedule amount for a particular office visit is $175, a non-participating provider can only be reimbursed by Medicare up to $166.25. This makes the Medicare limiting charge 115% of $166.25, or $191.19. A member with a Medicare Supplement plan that covers the cost-sharing for Part B services but does not cover excess charges (Plan A, B, C, D, or M) would be liable to pay the difference between the Medicare limiting charge and the Medicare fee schedule amount, which would be $16.19. Beneficiaries with Medicare Supplement plans that have some share of cost for Part B services and do not cover excess charges (Plan K, L, or N) would pay whatever their usual coinsurance or copayment amount is, plus the excess charges of $16.19. Beneficiaries with Plan F or G would pay nothing.

    – Excess charges only apply to services rendered by non-participating providers, not to services from providers who have completely opted-out of Medicare. Providers who have opted-out enter into a private contract with the individuals they treat, regardless of their Medicare eligibility, and patients must be notified before services are provided that they will be liable for the total cost of any services provided and informed that they may be able to have the same services covered by seeing a different provider.

    In many cases, the potential excess charges will be less than the premium difference between a plan that would cover them and one that wouldn’t. For clients whose doctors are Medicare participating, there’s likely minimal if any benefit to a plan that protects them from potential excess charges. For clients who have a Medicare Supplement plan primarily because of the flexibility it affords them in seeing whatever doctor they want, excess charges may be a more significant consideration, particularly if there’s a provider they would like to see consistently who is non-participating. Understanding the economics of excess charges and how to estimate them can help you and your clients decide how to balance premium cost and the cost of getting care to find a solution that works.