With the annual enrollment period in full swing, we felt this was a great time to review common causes that lead to a CTM filing. Although there are many reasons a beneficiary would file a CTM, more often than not, during AEP, these complaints stem from an agent: 

•    Not building a rapport with the client
•    Failing to provide all the essential reasons for choosing a particular plan 
•    Missing important cues from the client during a conversation

Sell With Your Ears 
While having a well-prepared sales script is undoubtedly crucial for any enrollment, the true linchpin of a successful sale lies in active listening. Regrettably, at times, agents become overly engrossed in planning their next response, inadvertently missing out on important details shared by their clients. This passive listening approach can potentially result in agents offering inappropriate responses to their clients. It's vital to remain prepared to pause and actively listen throughout your conversation.

Respond To Your Client's Needs 
Listen actively and paraphrase what you hear. This technique works particularly well when your client expresses what benefits they are Looking for. Your paraphrasing confirms for them that you have the same goal in mind and that you are working together to find the best plan. Remember that responding to your client's needs isn't just about offering solutions; it's about demonstrating that you value their concerns, understand their unique situation, and are dedicated to finding the best possible solution for them.

Respond Appropriately 
Respond appropriately when clients share additional information. It's important to recognize that the benefits they seek may not be their only concern. Medicare beneficiaries often undergo significant life changes. Acknowledging these concerns and offering suitable empathy is essential. In some instances, addressing difficult situations like the recent loss of a loved one or a decline in mobility may be necessary. While you don't need to dwell on these topics, offering a few words of sympathy can go a long way in demonstrating your understanding and support.

Be Comfortable With Negative Feedback 
It's possible that your client may express concerns about the plan you've presented. It's crucial not to dismiss or contradict their objection. Rather, acknowledge their concern and engage in a constructive discussion. Offer them ample time to weigh the advantages and disadvantages, demonstrating your collaborative approach to finding the best solution together. The goal is to turn objections into an opportunity for dialogue and mutual problem-solving. This approach not only helps address their concerns effectively but also strengthens your relationship with the client. 

Above all, maintaining ethical sales practices is the cornerstone of Medicare Advantage sales. Always act in the best interest of beneficiaries, providing unbiased information and recommending plans that suit their unique needs. By following these compliance guidelines, you contribute to a positive experience for both beneficiaries and the industry as a whole.

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PSM is your one-stop-shop for all the resources you need to be successful. From an impressive portfolio featuring top industry companies to free enrollment tools and cutting-edge technology to boost your sales, we have everything you need to thrive in todays marketplace. To learn more, request information today, or reach out to our friendly team at (800) 998-7715. Let's explore ways to tailor our services to supercharge your business together.

The Scope of Appointment (SOA) process is a crucial aspect of Medicare marketing and sales activities designed to protect the interests of Medicare beneficiaries and ensure compliance with regulations. The SOA process is primarily associated with Medicare Advantage (Part C) and Medicare Prescription Drug Plans (Part D) but can also apply to other Medicare-related products.

Here's an overview of the Medicare Scope of Appointment process:

Agent Reporting

Coming September 2023... Agent Reporting - a new feature designed to enhance the SunFire Blaze and Blaze Connect experience by providing agents transparency into their individual performance.

Agents will have visibility into their production since January 1, 2023. To access this new function, click the graph icon on the left side of your screen and select the “Performance” tab at the top.

This report will showcase:

• Total number of enrollments submitted across Blaze & Blaze Connect through the instance you are utilizing, broken down by Carrier, Product Type, and Servicing Area.
• Eligible HRA completion rates, identifying enrollments with an HRA still available.
• Eligible Value-Based Care submission rates, identifying enrollments with a VBC Opportunity still available.
• Eligible Mail-Order Pharmacy Consent Form completion rates, identifying enrollments with a Consent Form still available.
• Individual book of business footprint across the country, visualized by heat map.
• Access to a helpful suite of unique SunFire quoting flow features to aid in beneficiary information gathering such as, Customer Look Up, Doctors and Drugs collected and Health Utilization Frequency.
• An enrollment trend algorithm showcasing estimated monthly projections based on current month’s production.
• A drop-down filter allowing you to easily view data on a specific day or within a selected time frame.
  

Preparing for the 2024 Annual Enrollment Period (AEP)

Preparing for the 2024 Annual Enrollment Period (AEP) in the Medicare market requires strategic planning and a proactive approach to effectively meet the needs of beneficiaries. As this critical period approaches, there are several key steps to consider in order to maximize your success and provide valuable services to your clients.

First and foremost, staying updated on changes to Medicare regulations, plan offerings, and industry trends is paramount. The healthcare landscape is constantly evolving, and being well-informed positions you as a reliable source of information for beneficiaries seeking the right coverage. Attend seminars, webinars, and training sessions provided by insurance carriers to ensure you're up-to-date with the latest developments.

Reviewing your marketing and outreach strategies is essential to engage potential clients during the AEP. Refresh your online presence by updating your website, social media profiles, and other digital channels. Consider creating informative content such as blog posts, videos, and downloadable guides that address common questions and concerns about Medicare plans. Tailoring your messaging to highlight the advantages of different plans can help beneficiaries make informed decisions.

Focusing on compliance is also crucial during the AEP. Familiarize yourself with the Medicare Marketing Guidelines issued by the Centers for Medicare & Medicaid Services (CMS). These guidelines outline the dos and don'ts of marketing Medicare plans. Ensuring that your marketing materials are accurate, transparent, and compliant will maintain your reputation and prevent potential legal issues.

Lastly, anticipate the surge in inquiries and be prepared to offer personalized assistance to beneficiaries. Consider implementing systems to manage incoming queries efficiently, whether through your website, email, or phone. Providing clear and concise information, as well as addressing concerns promptly, can set you apart as a trustworthy advisor. By offering exceptional customer service, you'll establish strong relationships with clients that extend beyond the AEP.

By strategically approaching this period, you'll not only serve your clients effectively but also position yourself as a knowledgeable and reliable Medicare advisor.

At PSM, we are committed to providing our agents with a range of resources and support to help them succeed. From personalized marketing materials to interactive sales strategies, our goal is to empower agents with the latest tools, technology and mentorship to achieve new levels of success this AEP.

AEP Resources:

Powerful Partnerships:

We are committed to providing our agents with a range of resources and support to help them succeed: Our powerful partnerships include:

Strong relationships with insurance carriers and industry experts to provide agents with access to the best products, tools, and support.

Capital infusion and acquisition strategies to help agents expand their business and reach their ultimate goals.

Dedicated service and mentorship from experienced professionals to help agents build a successful business.

Proprietary lead, training, marketing and enrollment platforms to streamline your sales process and business practices.

Compliance oversight to ensure agents are meeting regulatory requirements and operating ethically.

Succession planning and agency building support to help agents plan for the future and achieve long-term success.

AEP Helpful Guides:

We are here to support!

As a reminder, We pride ourselves on a "Do the Right Thing" approach and will go above and beyond to service the needs of our agents. We look forward to having a successful AEP and supporting you with products, technology and the personalized service you have come to expect from PSM. We appreciate the opportunity to earn your business and wish you the best!

Effective September 1, 2023, amendments to the Oklahoma Insurance Department (“OID”) Medicare supplement regulations create new enrollment requirements for Medicare supplement issuers.

OAC 365:10-5-129(f)

Amendments to Oklahoma Administrative Code (“OAC”) 365:10-5-129(f) create new enrollment opportunities for Medicare supplement policyholders. The regulation requires Medicare supplement issuers to provide new supplement policies with the same or lesser benefits to current Medicare supplement policyholders—regardless of current issuer—who have had no gap in coverage greater than ninety (90) days since initial enrollment. Previously, these policyholders have had no opportunity after initial enrollment to move to any other Medicare supplement policies or issuers, trapping the policyholders in policies with rising premium costs and no opportunity to search for lower premium rates.

Issuers offering a new (i.e., succeeding) supplement policy shall waive medical underwriting or preexisting exclusions if the new supplement policy offers the same or lesser benefits. Issuers of the current (i.e., prior) policy are required to furnish a statement of benefits or other pertinent information sufficient to permit verification of benefit determination to any new issuer upon request.

OAC 365:10-5-129(g)

Amendments to OAC 365:10-5-129(g) require issuers of Medicare supplement policies to provide notice to individuals under the age of sixty-five (65) enrolled in Medicare by reason of disability of their eligibility for open enrollment to Medicare supplement policies upon reaching the age of sixty-five (65). Issuers must provide this notice sixty (60) to ninety (90) days prior to the first day of the first month in which the individual becomes sixty-five (65) years of age.

Another Year, Another New Rule from CMS…

Yes, we feel your pain.

It seems like every year there’s a new set of compliance rules that agents must follow when selling Medicare Advantage and Part D plans. Some are a minor nuisance; others require scrambling to find and put new systems in place before the deadline (call recording, anybody?).

Remember why CMS does this: They are trying to protect Medicare beneficiaries against misleading and confusing sales and marketing tactics, and make sure these consumers get the right help to end up with the appropriate plan for their needs. This is the same goal that most independent agents have when selling Medicare plans.

While most independent agents focus on providing the best service possible, there are some bad actors. According to CMS, the number of consumer complaints rose from 15,497 in 2020 to 39,617 in 2021.

Medicare Marketing Changes in 2024: New TPMO Disclaimer

There are many resources you can turn to that dive into the changes for 2024. We won’t go over all of them here. But there is one specific rule that directly affects AgentMethods’ customers and the service we provide: the TPMO (Third Party Marketing Organization) Disclaimer.

To make sure it’s clear to customers what companies and plans an agent can offer them, CMS has provided an updated TPMO disclaimer that agents must use in communication and marketing materials such as email, online chat, advertisements, and websites. The new disclaimer is:

“We do not offer every plan available in your area. Currently, we represent [insert number of organizations] organizations which offer [insert number of plans] plans in your area. Please contact Medicare.gov, 1–800–MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.” (source: https://www.ecfr.gov/current/title-42/part-422/subpart-V#p-422.2267(e)(41))

But there’s one tiny problem with the new disclaimer…

The New Disclaimer Doesn’t Work on Websites

While this new disclaimer is helpful for direct mail campaigns and one-on-one communications, it creates a problem when communicating with anonymous website visitors who don’t know their local area. In that case, you aren’t able to provide a correct number for organizations you work with and plans you offer within their area.

We are seeing creative solutions, such as:

• Some agents are simply stating the number of organizations and plans they work with in their area. However, this is often misleading and inaccurate. If you are located in Texas and someone from New York visits your site, you are providing them misleading information that could create the impression that you can offer more plans to them than you actually do.
• Other agents are replacing the “in your area” with “in my area.” While this makes the number accurate, it doesn’t provide useful information to the consumer. Again, this can easily be misread, leading to customer confusion.

We are excited to announce the initial launch of SunFire’s Med Supp Quoting and Enrollment Experience, arriving 10/1! We believe they have created a revolutionary platform that will significantly improve your efficiencies and profitability. As with any new product, their goal is to build a strong foundation with key features and continue to enhance the system over time, including additional carrier integrations.

Features Included in the Initial Launch

• Accurate quoting for 49 carriers with enrollment capabilities for 17 carriers:
  • Full enrollment integration with Aetna, Cigna and Anthem.
  • With MOO, UHC, Humana, and Aflac slated for the new year.
  • Link outs for the other 11 carriers, where the application will be completed within the carriers’ portal.

• A Med Supp specific needs assessment, which captures drug and medical condition data, with the intention of alerting agents to carriers that will be unlikely to pass the applicant through underwriting.
• If our algorithm suggests that Med Supp may not be the best path, the agent can easily transition into the MA/MAPD Quoting and Enrollment flow with all client data staying intact.
• Post enrollment, our new bundling experience creates real agent efficiencies by providing the ability to capture drug and demographic data one time and pass that information to the DVH and PDP applications displayed post sale.
  • The DVH partners currently integrated for quote and enroll include NCD and Aetna with a more robust suite of DVH integrations, including MOO, UHC, Cigna, Humana, Aflac, GTL and others slated for the coming months.
  • PDP plans are available and will be shown to agents who are ready to sell pre-filled, with pricing based on previously captured pharmacy and drug cabinet info.

• Please keep in mind we will only quote plans that are RTS for the agent

As Labor Day approaches, we want to take a moment to express our sincere gratitude for your partnership and trust in us. This special day is a time to celebrate the hard work and dedication that contribute to the prosperity of our nation.

At PSM, we consider ourselves fortunate to work alongside agents who share our commitment to excellence. Your feedback and support have been instrumental in driving our shared success.

Labor Day reminds us of the value of teamwork, persistence, and the pursuit of excellence. Just as your business strives to achieve its goals, we remain dedicated to providing you with the highest level of service and solutions that help you thrive.

As we celebrate this occasion, we also recognize the importance of finding balance in our lives. We encourage you to take some time to relax, enjoy moments with your loved ones.

Thank you for being an integral part of our journey. We look forward to continuing our fruitful partnership and achieving new milestones together.