Rebecca Gordon

First, what is the law? PFFS plans as of 2011 must be tied to a network IF THERE ARE TWO OR MORE NETWORK PLANS IN THAT COUNTY AS OF 1/2010. You can easily forecast where a PFFS plan can in effect for 2011. Since there are two major carriers that filed local PPO plans in every county, chances are great that you will not have PFFS unless the carriers can build a network.

Building networks is laborious. It takes a long time and companies won’t want to spend the money to build a PFFS network when CMS prefers PPO and HMO. The only companies that will spend money on PFFS networks are those that don’t already have a large PPO & HMO presence.

My crystal ball tells me there will be one company that has to survive on the strength of its PFFS network. They are working on it and hopefully they are successful. We won’t know until September. The companies have to file their plans in June but it isn’t available to the public. So we wait and wait…

Many agents have dozens or even hundreds of clients on PFFS plan and moving them during AEP can mean losing the chance to bring in new clients or losing clients because there just isn’t enough time during AEP.

Your best bet is to start early! But how can you start early if the plans for 2011 are not made public until September? With a little research, you can see what is likely to happen in your counties. You can assume the big players will have a PPO or HMO if they have one currently. You know what Medicare Supplements will cost this fall and you are ready to start sending letters, emails and holding meetings.

What you cannot do: CMS prohibits agents from disclosing plan information prior to October 1st. So even if you do know with certainty that X will not have a plan in 2011, you still can’t tell your clients that. You can tell clients what is likely to happen and how they can start to plan now for the changes to their coverage and the impact on their budgest. If they go back to a Medicare Supplement it will have a high monthly premium but they can see any doctor and will not have any co-pays.

What you can do now: Show your clients what Medicare Supplements will cost, and a stand alone Part D plan. Now is also the time to take wealthier clients into a Dental, Vision and Hearing plan. Many have enjoyed the added benefits in their MA plans and would like to continue with DVH. AARP is the only Medicare Supplement with a free health club membership included (this varies by state).

Goal #1: Retention. Don’t lose clients because of misinformation they receive from others sources. Be their resource and get information to them no later than July!

Goal #2: Growth. Change is always an opportunity for growth. If you hold meetings, give a giftcard for bringing a friend. If you mail out letters, include a return post card with a list of other products you offer (they never know you sell other things) so they can mail it back if they want a burial plan, dental, indemnity, would like you to speak at their Church or civic group, etc.

Thanks,

Sylvia

I think I represent all insurance agents when I say that this concept of secret shopping is humiliating. The statistics on agent errors and malfeasance bear out that the overwhelming majority of agents abide by the rules. So why punish us all with this type of behavior. It has the smell of the USSR spying on its own citizens.

The most common questions you ask us: will the SS identify herself. NO. If I ask her is she is a SS does she have to admit it? NO. How to do I know if I met her criteria? If your behavior merits a complaint to the FMO, we will contact you immediately for retraining. Do I have to waste time with someone who obviously isn’t a potential client when I have others to wait on? SS won’t put you in that position. They are trained to approach your booth only when you are alone so they don’t disrupt another client conversation, but you must treat them with the same kindness you would any prospect.

Bear with us, they system is far from perfect and these SS are usually easy to identify: 50-ish  woman who says “I really like my current plan but what do you offer.” They were out this week trying to see if agents would disparage their competition. Agents called me and said, my standard response to a client who loves her current plan is, “Great, I recommend you keep it!”

Let’s face it. Only a SS would say “I love my current plan. Period.” Everyone would follow with a “but…it is too expensive, it doesn’t cover my drugs, my doctors are not accepting it, etc. ” Agents would then try to find a plan that would better serve all the clien’ts needs.

Never say: “Humana?! They are a terrible company, Ican tell you horror stories!” While I use Humana merely for example here, you understand my point. There are many companies  you may have had a sour experience with in the past –DO NOT MENTION IT!

When push comes to shove and clients insist on your opionion about XYZ company, I merely say, “I choose to represent the best companies in the market and I feel I do. There are good reasons why I don’t represent XYZ but I’m not allowed to discuss those reasons with clients. “

This gets my point across as well as saying point blank, “That company is terrible!”

It may be easier to say who pays the slowest, that is where all the competition is! Keep in mind that MA commissions are advanced upon approval by CMS.

Pyramid Today’s Options pays daily. No one comes close to paying as fast as TO. Most companies pay weekly but Anthem Blue Cross pays a month after the effective date. This means Anthems commissions for AEP will be paid in February. If this is creates a financial problem for you, please look at other carriers we offer.

As always, you are getting conflicting information from all the MA companies. This time some are saying CMS will not let them pay agents renewals unless they certify annually, other companies are not interpreting the CMS guidelines in that manner.

Be safe, certify with all the companies that you have business on the books with!

Certification has no mercy. If you are not 100% fully certified with each company you sell for, you will not paid commissions. If you are like many agents, you tend to miss one module, which results in NO COMMISSION.

When in doubt, call Gordon Marketing 800-388-8342 and let us check for you!