Purchasers Want Agency Medicare Advertising Guidelines: David Luna


If promoting Medicare plans is a core a part of brokers’ practices, they could be too busy to learn this text till someday after Dec. 7, when the annual enrollment interval for 2024 Medicare Benefit plan protection and Medicare Half D prescription drug plans ends.

As purchasers, at or close to retirement age, search assist with common monetary and retirement planning, they’re getting an unlimited stream of Medicare plan advertising emails, textual content messages and phone calls.

In the event that they activate the tv, they see a Medicare plan advert. In the event that they open a newspaper, they see a Medicare plan advert.

In the event that they pet the cat, the cat in all probability meows one thing about new grocery low cost options.

David Luna is somebody who has dared to enter the stream.

Luna is a licensed Medicare plan agent and the president of Connie Well being, a 4-year-old Brookline, Massachusetts-based startup that goals to make use of synthetic intelligence expertise to assist join shoppers with skilled native Medicare plan brokers who perceive the hospitals and doctor networks within the shoppers’ personal communities.

Luna spent 12 years as a police officer in Glendale, Arizona, then retired from the division and went to work as an insurance coverage agent. He was senior supervisor for presidency applications at Blue Cross Blue Protect of Arizona in 2018, when he left to turn out to be the nationwide director for dealer gross sales at Iora, a Boston-based main care supply agency.

In 2019, he and different Iora veterans began Connie, which now has brokers in Arizona, Florida, Illinois and Texas.

Luna just lately answered questions, through e mail, about new Facilities for Medicare and Medicaid Providers advertising guidelines which have affected the sale of Medicare Benefit plans and Medicare Half D prescription drug plans. The interview has been edited.

THINKADVISOR: What do you concentrate on the entire Medicare plan advertising rule adjustments?

DAVID LUNA: New advertising guidelines are launched yearly to guard Medicare beneficiaries, who’re in a portion of the inhabitants that’s prone to scams and insurance coverage fraud.

Many seniors are extremely overwhelmed whereas choosing a Medicare plan, and that reinforces the worth of the foundations defending seniors.

There are practically 4,000 Medicare plans being provided this yr. Medicare plans can differ vastly from state to state and primarily based on a person’s wants.

Our current annual enrollment interval survey confirmed that:

  • 34% of seniors are uncomfortable about making huge purchases as a result of projected Medicare premium will increase this yr.
  • 33% of seniors haven’t taken benefit of Medicare advantages this yr as a result of they’re involved about added prices.
  • 26% of seniors say they owe $500 to $1,000 in unpaid medical bills.

The Facilities for Medicare and Medicaid Providers has introduced two huge units of selling guidelines. What adjustments apply now?

The CMS advertising guidelines from the 2023 annual enrollment interval season nonetheless apply through the 2024 AEP.

Probably the most notable adjustments to the Medicare AEP advertising guidelines occurs to be a requirement for recording calls.

All gross sales actions must be recorded and saved for a interval of 10 years. If a buyer doesn’t want to be recorded, brokers should finish the decision, which might lead to confusion on the patron facet.

Second, this yr, CMS additionally requires the usage of a third-party advertising group, or TPMO, disclaimer.

Brokers should learn the TPMO disclaimer throughout the first minute of the decision.

The disclaimer states that brokers don’t supply all of the plans, and that the shopper can contact Medicare to get a listing of all their choices. This disclaimer have to be on all communication supplies, akin to emails, advertising supplies, and so forth..

The third huge change is the introduction of the scope of appointment type, or SOA type. This can be a “permission slip” that claims the shopper has agreed to talk to the agent about sure merchandise. It retains the agent from discussing different, unrelated merchandise that aren’t on the SOA.

The SOA was required previously, and brokers needed to wait 48 hours to fulfill with a buyer. This was executed to keep away from high-pressure gross sales.

In 2018, the SOA was nonetheless required, but it surely was not required for brokers to acquire the SOA 48 hours earlier than the appointment, when practicable.


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