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Topic: Agent Oversight
CMS has released a notice seeking comments on their plans for training and certifying sales agents who could enroll persons into the federally facilitated exchanges. To be exact, the notice is about collection of data about the sales agents who are trained and certified for selling coverage offered by qualified health plans on the exchange. It just so happens that the vehicle for doing the collection is the training and certification program that is mandated by the law and the final regulations published last March. So, CMS does not want comments about the requirement to be trained and certified but they do want comments about what information is collected and maintained about individual sales agents.
In a Federal Register notice out yesterday CMS officials are projecting 254,095 health insurance agents and brokers will sign up to sell the “metal plans” in the new federal health insurance exchange (HIX) system. Quarter. Million. Agents. OMG. And the scary part: they face a fraction of the regulatory requirements Medicare sales agents do.
Most plans are in the process of onboarding their agents and preparing them to sell. Meanwhile, they’ve invested marketing dollars across various channels and different media. Now it’s time to turn marketing dollars into members. With another AEP just around the corner, here are a few GHG best practice tips to keep in mind this season to help get the most bang for your buck out of those incoming leads. Read more
As you likely noticed, CMS recently released its updated Guidelines for Agent Broker Training and Testing for CY 2013 on August 21. Our in-house compliance experts have cross-walked the new regulations with the old ones from last year and here’s our take: for the most part, the updated guidelines should be business as usual. However, it is interesting to take note of where CMS is going to greater lengths to provide additional clarity or requirements.
Selling season is nearly upon us, so with that in mind, here are some thoughts to help plans prepare. In this post, I’ll detail some sales oversight and reporting best practices we’ve seen applied with success in a number of plans.
“Lean and Clean” is Key to Survival for Medicare Plans — Join the exclusive GHG Compliance Forum November 2-4 in Las Vegas
New regs every other week. 500 HPMS notices a year. RADV audits and Star Ratings surveys. Intermediate sanctions and the threat of termination for poor Stars performance. And now a new, uncoordinated CMS Central Office/Regional Office audit approach that could result in multiple government reviews in a calendar year. “Lean and clean” must define a cultural and management revolution among Medicare plans. If you aren’t on the compliance train in these next several years, you’re going to be under it.