One of the more common questions agents get asked from their Medicare clients is “what is the Medicare Part D late enrollment penalty?” It is fairly easy to explain that if a Medicare member spends more than 63 consecutive days without having Part D or creditable drug coverage, they will be required to pay a late enrollment penalty should they choose to enroll in a Part D plan in the future. The typical follow-up question is “will I have a late enrollment penalty?” This is also usually pretty easy to answer, assuming the agent asks the proper questions of the client and the client responds with accurate answers about prior coverage.
Statistically, the number of Humana’s MAPD/PDP enrollments that result in an allegation against an agent is just a small fraction of a single percent. The number of allegations that are founded as a result of investigation are just a fraction of allegations themselves, which is outstanding. Here are my root cause reasons for these strong compliance outcomes:
If you’re working through AHIP and carrier specific training currently, you may have noticed the content on Low Performing Plans. CMS plans to “nudge” consumers once again, with a reminder that the plan they’re in, if applicable, has consistently underachieved (less than 3 stars for 3 consecutive years). The beneficiary is directed to a variety of options for reconsideration at the bottom of the letter. Last year there were 525,000 members across 26 plans that were impacted. Letters go out once in October for those on these plans currently, and again in February of 2014 for those who selected a low performing plan this AEP with a 1/1/14 effective date.
Well, I left Orb and Goldensoul off my Superfecta this Derby weekend, so I guess I won’t be retiring anytime soon! Got a chance to speak with a Humana sales leader in Colorado last Friday. We discussed the timing and best strategies for getting an MAPD certification for marketing Humana products, if you do not have one already. As an agent not yet certified for MAPD you should be asking yourself a couple questions: “Is there an opportunity to enroll any beneficiaries into an MAPD plan between now and July?” “Do I plan to represent any of the under 65 major medical products offered through exchanges in the fall?” If you answered yes to either of these questions, now is a good time to get registered for Humana’s MAPD certification training. Here is my logic:
You spend a lot of time and effort during the AEP marketing and enrolling Medicare beneficiaries. Make sure that you also spend the proper time and effort submitting error-free applications. We have identified the six most common errors that cause enrollment applications to pend. They are as follows: