September 28, 2009 Latest Compliance Updates
To keep you informed of the Centers for Medicare & Medicaid Services (CMS) and Universal American rules and requirements, we periodically distribute a Compliance News advisory. Please review these advisories carefully and retain them for reference throughout the 2010 selling season. For your convenience, compliance updates will also be available on AgentLink.
Your Outline of Permissible Sales Activities for the "Pre-Selling Season," October 1 - November 14 There are a number of sales-related activities in which you may engage in preparation for the start of the Annual Election Period (AEP) which begins on November 15. The attached memo gives precise information as to what you may and may not do during this pre-selling period. Please read it carefully and contact the Career Sales Department if you have any additional questions. Click for the memo.
2010 Scope of Appointment Requirements Mandatory for Medicare Advantage and Medicare Prescription Drug Plans As established by the MIPPA Marketing rules, agents are required to follow CMS's Scope of Appointment requirements prior to scheduling sales meetings with Medicare beneficiaries. The Scope of Appointment process is a consumer protection designed to prevent Medicare beneficiaries from receiving unwanted product information during a sales call. During the Scope of Appointment process, beneficiaries consent in advance to the product information they wish to discuss with their agent during a scheduled meeting. Agents may not discuss any other forms of coverage with the beneficiary during their scheduled meeting. There are two ways to satisfy the Scope of Appointment requirements: by using the appropriate printed form, or by using our new Scope of Appointment telephone system (our preferred method!). Please keep reading to learn more about each of these methods.
2010 Medicare Advantage Verification Call Procedures New member verification calls are conducted by Universal American in keeping with CMS guidelines. Calls are conducted: - To confirm that the enrollee understands what he or she has purchased.
- To assist the enrollee in better understanding the plan benefits.
- To ensure that the enrollee understands how to access benefits.
Following CMS guidelines, calls must be attempted three times to reach the new member. UAM will attempt a fourth call to ensure a higher rate of completion. The member will also receive an education letter after the first failed attempt. In situations when spouses enroll together, a designated spouse may complete the call on the couple's behalf. During 2010, Verification calls will be handled by a domestic-based call center.
Please click to continue reading. If you have any questions contact the Career Sales Department. For agent use only. Not for distribution to the insurance buying public.
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