As you know, staying compliant is important in our industry. Allegations and complaints may result in disciplinary actions ranging from extra training to termination. Should you face a compliance allegation, GarityAdvantage will help you through the process. However, it’s best to be prepared and educated to avoid compliance allegations all together.

Follow these 7 best practice tips to staying compliant at the point-of-sale:

1) Check Your Enrollment Application Quality

Occasionally, enrollment applications are submitted with:

• Missing information
• Inaccurate information or errors
• Illegible handwriting

Your Best Practice is to slow down, and don’t rush the enrollment application process. Double-check all of the information and make sure it’s legible. Submit your enrollments through our office. Our enrollment team is an additional set of eyes catching the errors before they reach the carrier. Submit via Fax to 781-982-1887 or via Email enrollment@garityadvantage.com. Additional enrollment submission guidelines can be found on our website.

2) Don’t “Hold” an Enrollment Application

Example: Sometimes a client will sign the application, but then request it not be submitted until they check with a family member, who is not present at the appointment, that the enrollment is the right decision.

Your Best Practice is to NOT sign the application. All Medicare Advantage and Medicare Supplement applications must be submitted to the carrier within 24 hours of agent receipt. If your client requests a hold on the submission, leave the unsigned application with them and schedule a follow-up appointment or provide the client with instructions to mail to your office for signature and submission to the carrier.

3) Inform Your Consumer about How and When to Withdraw or Cancel the Enrollment

You are required to provide the consumer with the appropriate contact information (e.g., the plan’s customer service phone number or 1-800-Medicare) to request cancellation or withdrawal of the enrollment application or disenrollment from the plan. You must also explain the time frame in which disenrollment and withdrawal is allowed.

Your Best Practice is to have this information at the ready. Make it a regular and consistent part of your presentation. Not only are you staying compliant, but you are gaining your client’s trust by keeping them fully informed about their options.

4) Provide Your Clients with Your Contact information

You can be found out of compliance when you do not provide the client with your contact information or the contact information of customer service for the plan in which they just enrolled.

Your Best Practice is to be prepared! Have business cards made up and always carry several with you. Like the Best Practice above, this good habit has benefits beyond staying compliant. When your client has questions about their plan (maybe they are thinking of switching), they will call you, and you can help them navigate their best options. You should also provide them with the number to the plan’s Customer Service department so they can call the carrier with basic questions.

5) Direct Disenrollment Requests to the Carrier

Sometimes agents get disenrollment or application withdrawal requests directly from the client prior to the effective date. Do not offer to handle this request for the client. If you don’t follow-up appropriately, you will end up with an unwanted enrollment. Remember, agents are expected to act ethically and promptly respond to consumers’ or members’ requests in all situations.

Your Best Practice is to refer your client to the number on the back of their Member ID card. Alternatively, members wishing to disenroll may call Medicare at 1-800-MEDICARE.

6) Always Provide Appropriate Enrollment Materials

You are out of compliance if you fail to provide, or provided your client with incorrect, required marketing/enrollment materials.

Your Best Practice is to always double-check that you have the correct materials prior to your appointment. Most carriers have agent portals on their websites where you can download and/or order the most up-to-date forms and marketing materials. Contact GarityAdvantage if you have having trouble navigating these online portals. We will be happy to walk you through it.

7) Understand Your Client’s Needs in Order to Sell the Most Suitable Plan

Your Best Practice is to Ask and Listen. Ask appropriate questions that will help you fully understanding the consumer’s current and expected needs.  Listen to the answers carefully to be able to suggest the plan that will most suit your client. If you are too focused on making the sale, you put yourself and your client at risk of enrollment in an unsuitable plan. Selling an unsuitable plan to a consumer may lead to a rapid disenrollment and/or an agent misconduct complaint.

GarityAdvantage is committed to keeping you at your best out in the field. If you have any questions about this blog post or any additional questions about compliance, please call or email: 800-234-9488 or info@garityadvantage.com