Golden Opportunities

“Buyer beware!” You know that phase – it means “be careful, someone may be out to get you!” But Kaiser Permanente has a different term - “buyer be-Aware!” And today, Carolyn Abraham, Director of Medicare and Marketing for Kaiser, is here to tell us what we should be aware of regarding the solicitation of your medicare business.

Question: I understand there have been some problems with sales of private Medicare plans — a few "bad apples", agents or brokers — using unscrupulous tactics.

Answer: Consumers were registering complaints about the way some agents or brokers were conducting sales of Medicare products.
For example, many consumers truly did not know what they were signing up for. They were somewhat “strong-armed” into purchasing plans – where the agent or broker would receive a large commission - and then, when they had the time to really look at what the plan entailed, realized it wasn’t for them and they would then dis-enroll.
We even had clients call us for help when agents from other businesses wouldn’t leave the customers’ home, they were so insistent on getting a signed contract.

Question: Because there have been salespeople who take advantage of consumers, has the government stepped in?

Answer: Yes, there are now strict federal rules for the marketing and sales practices of Medicare Plans.
First, cold calling is prohibited. You should not receive a phone call from an unknown person giving you a quote/a sales price on a Medicare plan. Beyond that, you must give permission prior to someone calling you; you have to give your clear consent that you want someone to contact you regarding a Medicare plan. This guideline is a step beyond the “do not call” list.

Question: If "cold calls" are not allowed, can someone know on my door to sell a Medicare plan?

Answer: No. Another guideline issued prohibits door to door sales.

Question: I know a lot of our viewers learn about these plans at health fairs. Are they affected by the new rules at all?

Answer: Carriers can still participate in Health Fairs/Screenings, but they can’t distribute or sell any sales plans or benefit plans. However, there still will be Sales events – where a presentation is given – but it must be clarified that it is a sales event.

Question: Let's say I want to buy a plan. Are there guidelines for meeting a representative face to face?

Answer: The Medicare beneficiary, can call a service – like ours at Kaiser Permanente – and request a meeting. And there are new safeguards in place for these as well. Let’s say you would like a representative to come to your home. When you set up the meeting, you and the representative will spell out, very clearly, what you will be discussing in the meeting. This discussion is recorded, if you are on the phone, for verification that the representative has your approval for the home visit. If not on the phone, a signed consent form is required. This is, in effect, putting a ban on cross selling. Sometimes agents or brokers would present the Medicare plan and then go on to lay out other plans – insurance, financial products – and this guideline puts a stop to that.

Question: Instead of coming to my home, can we meet for dinner?

Answer: I’m afraid not. And this is to protect the consumer. Those unscrupulous tactics we referred to earlier included unfairly influencing the beneficiary through “wining and dining.”
And this rule leads to the last rule – beneficiaries cannot be given gifts as an incentive to enroll. Anything over a $15 market value is prohibited.

Question: It's great these new rules are in place, but what if you still think your agent or provider is acting improperly?

Answer: If you have a reason to believe that a plan, agent, broker, or provider is acting improperly – or conducting Medicare fraud – you can report that abuse by calling the center for Medicare and Medicaid Services (CMS) at 1-800-MEDICARE.

Question: Kaiser has its own Medicare plan. How does it work in your company?

Answer: At Kaiser we have our own plan that we sell through our own staff – no independent agents or brokers. And that is a real help to consumers because they will not be pressured.

Wouldn’t it be nice if everyone had our best interests at heart? As Ronald Reagan said “trust but verify.” It’s good to know our rights so we can avoid being “wronged.” My thanks to Carolyn Abraham from Kaiser Permanente. For more information, you can contact Kaiser.