Agility partner Humana has graciously shared the results of Humana’s internal secret shopper survey from the last Medicare Annual Enrollment Period, which was completed on Dec. 7.
The findings from the shopping are listed below. Agility thanks Humana for this invaluable information, as we all need to maintain compliance with Centers for Medicare and Medicaid Services (CMS) guidelines.
Specifically, the survey found that FMO agents failed to do the following at formal marketing events:
- Advise that the Medicare Part B premium must still be paid when enrolled in a Medicare Advantage plan.
- Advise members that they may be subject to a Late Enrollment Penalty.
- Explain Step Therapy.
- Explain Low-Income Subsidy.
- Explain enrollment and disenrollment periods.
- Discuss the Plan Star Ratings for the plan(s) being discussed.
- Explain that preventative benefits are provided at no cost.
- Explain the plan’s formulary regarding specific prescription drug coverage.
- They did not use a sign-in sheet at the in-person event, and nominal gifts/food were given.
All Medicare agents must do each of these items at formal marketing events to maintain compliance with CMS selling guidelines. Agility wants to remind agents that CMS Secret Shoppers are active year-round at these events.
The Low-Income Subsidy is an important tool to inform Medicare clients about, as it can save them considerable money if they qualify. If you have questions about the Low-Income Subsidy or how you compliantly present the other requirements listed above, email the Agility Compliance team at [email protected] for assistance.
