Are you ready for the Open Enrollment Period (OEP)?
By attending this meeting, agents will satisfy the 2018 Stride training and certification. The entire process will take approx. 90 minutes (training, then certification).
Contract completion/submission to GarityAdvantage required prior to attending.
If you are not contracted, please download the contract here and return to GarityAdvantage for processing prior to the training.
Please contact me with any questions.
CMS has been taking an increased interest in agent created websites. As a result, many of our carrier partners Compliance Departments have also been very focused on this issue.
United Healthcare’s contract requires all websites owned by contracted agents or agencies to be registered with the company.
Please download and review the Agency Website Check List to see how to register your website, if you haven’t done so yet. Also, on the checklist, you will see guidelines for a compliant website. Please read carefully and make adjustments accordingly.
Don’t hesitate to reach out with questions. You can email questions to our compliance lead, Karla Fennessy at email@example.com.
It’s our shared responsibility to understand and execute compliance best practices in our sales practices. We appreciate and thank you for all that you do to continually serve UnitedHealthcare’s members in a compliant way that best meets their healthcare needs.
Speak up, speak out!
Together, let’s continue to remember we all have an obligation to speak up if we witness what appears to be a violation of policy, law or regulation. Speaking up when we witness a violation is UnitedHealthcare policy and demonstrates UnitedHealthcare’s commitment to integrity.
At UnitedHealthcare we: live the highest form and standard of ethical behavior, speak the truth, deliver on our promises and have the courage to acknowledge mistakes and do whatever is needed to address them. As an agent you are oftentimes the face of UnitedHealthcare to our consumers, we ask that you join us in this commitment to integrity.
Reaffirm your pledge to being compliant, in all that you do, during Corporate Compliance Week, May 4-10, 2014.
But don’t just take it from us – to put it best, check out this video featuring Peter who said it best, “they don’t call compliance our rock for nothing.”
Thank you for your support, continued business, and commitment to helping our members live healthier lives.
To report illegal or unethical conduct, including violations of law, contractual obligations and company policies (including the Principles of Ethics and Integrity), privacy issues or suspected fraud, waste and abuse, please call 1-800-455-4521.
If you have any compliance questions, send an email to firstname.lastname@example.org.
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.
Occasionally, enrollment applications are submitted with:
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 email@example.com. Additional enrollment submission guidelines can be found on our website.
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.
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.
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.
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.
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.
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 firstname.lastname@example.org