FAQS

FAQs

• Q: What SEP should be used when a client’s current Medicare Advantage plan is being terminated in their county?

  A: SEP- TERMINATED/NON-RENEWAL

• Q: What SEP should be used when a client is coming off their employer/group plan or their spouse’s employer/group plan (voluntarily or non-voluntarily)?

  A:  SEP – LEC (Loss of Employer Coverage)

• Q: What do I do if I am unsure of which election to use?

  A: If you are not sure of what election you should be using, please refer to the Election Period Guidelines. If you are still unsure, call or email our enrollment department and we will be happy to assist you. It is never a good idea the “guess” what the election type is. If the wrong election is chosen the application can be denied by the carrier and a new application may be required to proceed.

• Q: What about Scope of Appointment Changes?

  CMS added requirements to the Scope of Appointment (SOA) regulation in 2011.

  In addition to retaining a copy, agents will be required to fax or email a copy of the SOA directly to the Carrier. View SOA Rules.

  
  All agents are required to fill out SOA forms and send them to the carriers prior to meeting with consumers– If it is not feasible for the scope of appointment form to be executed prior to the appointment, an agent may have the beneficiary sign the form at the beginning of the marketing appointment. However, the agent must document why it was not feasible to obtain the scope of appointment prior to the appointment. *Applies to all Scope of Appointment forms.

  The Scope of Appointment Form is required for cancelled appointments, no-shows, appointments not resulting in an enrollment, etc.

• Q: What is the average time for Medicare Supplement enrollments to become active?

  A: Med Supplement applications are mailed into the carriers and it takes up to 10 business days, from the day of receipt of the application at the carrier’s home office, for the processing to be completed.

• Q: How do I submit Medicare and PDP enrollments?

   SEE CHART BELOW 

  If the enrollments are listed as accepted by email or fax this is the preferred method!
  Once you have emailed or faxed an enrollment please DO NOT SEND IN ORIGINALS (this can cause duplication and delay the processing of the first enrollment submitted).

• Q: How do I submit Medicare Supplement enrollments?

  	No Live Check	Live Check	Mail
  All Carriers Except HPHC	Fax or Email	Mail	Y
  HPHC	Fax or Email	N/A*	N

  
  * Please fax or email all your HPHC Medicare Supplement applications directly to our office to be processed. HPHC does not accept collection of first month’s premiums with their Medicare Supplement applications, members are billed after enrollment approval.

• Q: What's NEW for 2019? (UHC)

  UnitedHealthcare Medicare Advantage and PDP applications have an additional agent received date “signature date” that must be completed.