How To Submit An Error Free Application

If you’ve never had a client’s health insurance or Medicare Supplement Plan application get delayed, consider yourself one of the lucky few. It happens to the best of us: you submit an application for your client that isn’t filled out completely or correctly, delaying their coverage – and not only that, but your commission also gets delayed! To avoid any mistakes that lead to these delays, do the following to ensure you submit applications that will not get flagged. 

Take Your Time Filling Each Application Outclock with the time "7:00" on it

If you are submitting an application by hand, make sure you take your time filling it out as neatly as possible. If carriers have an issue reading anything on your application, you can expect it to get kicked back to you. So, make sure it is easy to read, and as straightforward as possible. Then review it with your client to make sure the information is correct, and your handwriting is clear. 

Provide Details

Carriers want the full scoop on your customer before accepting the application. If your lead answers yes to any health questions, but does not provide any further details, the application will be flagged, so make sure to be as detailed as possible when submitting an application.

Be Compliant With SOA Rules

If you’re dealing with a Medicare customer, you will need to complete a Scope of Appointment (SOA) before even meeting up with them. The Center for Medicare and Medicaid Services (CMS) requires that you fill out this form, whether you make a sale or not, so you know exactly what the client wants to discuss with you; if at any point the client wants to talk about something else, like a different product or service, you should fill out another form. This will protect you and your agency, and help the application process go more smoothly. 

Pick A Primary Care Physician

illustration of a faceless doctor
Make sure that you have the primary care physician listed for your applicant.

Some carriers and plans will require your customers to have a Primary Care Physician (PCP) when signing up for a plan so that they can be sure the doctor is in their network. Check to see if the carrier requires this information, and if they do, make sure an in-network PCP is on the application before submitting it, otherwise you can expect the application to be delayed. It is probably best to fill this section out regardless of whether it is needed or not, since getting into this practice can make things simpler.

Don’t Sign for Your Clients 

Maybe you have innocently signed a form for a client at some point to get things moving, or have had others sign something for you when using your card, because you just want the application process to go as quickly as possible. But if you do this, not only will it get flagged, but you could get into serious trouble since it is illegal! You should always have your client sign the application, even if it means waiting a few days.

stop watch with the word deadline and the hand approaching it
Once the application is signed, you have 48 hours to submit it, or you will be penalized.

Submit The Application On Time

No brainer, right? But a lot of agents get so busy gathering all the necessary documents that they miss the deadline. Remember, once you and the client sign the application, the carrier needs to receive it within 48 hours; any later, and you will be penalized by the carrier, and your commission will be delayed. That means you need to get all the necessary documents in order before completing the application. 

Selling insurance is what you do best, but mistakes can happen to anyone, which can mean delayed commissions and clients going without coverage. Whether it is your first time or 200th time filling out an application, make sure to go over the whole application, fill everything out completely and clearly, and have all the required documents ready. Taking your time will prevent any issues and make sure your client gets insured in a timely fashion, and you get your commission.

Do’s and Don’ts Of Medicare Compliance

Before you can begin selling Medicare, you must first get your license to sell Medicare products, followed by certifications from carriers to sell Medicare Supplement Plans. But after all that, there is still one more thing to be aware of before you’re ready to sell. You need to know how to remain compliant with all the rules surrounding Medicare sales. In order to show your commitment to honesty and integrity, as well as to fulfill your legal duty and contractual obligations to sell Medicare, you have to be compliant with the following rules in all of your interactions with customers. Here are some simple do’s and don’ts to help you stay in compliance. 

Medicare Compliance For Selling

When Selling Medicare:

DO:

caucasian man with a white button up sitting down filling out a form
Before contacting a lead, make sure to fill out a Scope of Appointment.
  • Make sure that you have Permission To Contact the prospect. Agents are not allowed to make unsolicited phone calls or send emails to prospects without having an opt-out option. In order to obtain permission to contact, you must use a lead provider like Benepath, who will have prospects/leads sign a form that says they agree to be contacted by an agent.
  • Complete a Scope Of Appointment form before each face-to-face appointment and/or one-on-one phone conversation. These forms outline exactly what you’ll be talking about with your client during a meeting. Per CMS, you must keep these forms on file for at least 10 years, even if your conversation did not end in a sale. 
  • Report any suspected violations to the Medicare Compliance Hotline toll-free at 1-877-211-2290.

DON’T:

  • Engage in door-to-door marketing or sales
  • Use high pressure sales tactics
  • Engage in outbound telemarketing or email campaigns
  • Discuss with prospects any products that are not specified in their Scope of Appointment form
  • Engage in any discriminatory activities, such as conditional enrollment based on a prospect’s mental illness, physical illness, or disability

Medicare Compliance For Marketing

CMS also has regulations in place for marketing, educational events and sales event presentations

DO:

illustration of a man in a suit talking to a group of people sitting down.
When marketing, you can distribute educational materials at an event that are not plan-specific as well as your business cards.
  • Wait until October 1 to begin marketing next year’s plans to potential customers
  • Distribute educational materials that are free of plan-specific information
  • Give out your business card and contact info
  • Collect Scope of Appointment forms
  • Hold your event in a public venue

DON’T: 

  • Attempt to mislead your clients, willingly or unwillingly
  • Use the word free to describe $0 premiums
  • Serve meals at sales events
  • Pressure attendees at events to complete a sign in, it must be optional
  • Distribute plan-specific materials at an educational event (only do this at sales events)
  • Discuss any carrier-specific plans or benefits at educational events (only do this at sales events)
  • Cross-sell or promote health-related products at events

It is important that you follow these rules for Medicare compliance set by CMS, or you risk violations, and you may lose your ability to sell Medicare if you are reported. If you are looking for leads that have given permission to contact, Benepath will provide these leads exclusively to you. We give you exclusive real-time leads when you want them. To find out more information, call 866-368-0377.

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