In light of the recent response to the ongoing coronavirus situation, we wanted to offer some guidance to our brokers serving seniors during this time.
Given that seniors are among the at-risk population affected by the coronavirus, some of your senior prospects may be hesitant to meet with you in person. Fortunately, during 2020 AEP more than half of the enrollments industry-wide were broker-assisted and facilitated virtually. So it’s clear that virtual appointments and enrollments are possible during this time of precaution.
Currently, policies for conducting virtual presentations and the process for virtual enrollment are defined by each carrier individually. Therefore, there is not an all-encompassing set of compliance guidelines we can share. Nevertheless, here are some general practices to help you stay compliant while conducting business virtually:
1) Get Consent. Brokers must have either an inbound call, written, or virtual request for contact in order to conduct an appointment over the phone. Consent may begin with a Business Reply Card, Inbound Call, or Online Form Fill, but can ultimately be satisfied with an E-Scope process. The ProducerMAX CRM has a free mobile app with E-Scope of Appointment functionality. Visit this page to learn more and download the app.
2) Send Marketing Kit. Provide appropriate sales kit information via email to the client: Benefit Summary, Star Rating Sheet, Abbreviated Formulary, etc. If they don’t have email, you may need to send snail mail to get started.
3) Virtual Appointment. Conduct the appointment as you would in person. Warm-up with the prospect, complete needs analysis, complete Rx Drug search and provider lookup, provide full disclosure, and complete benefits review. It is good practice to record your call or video conference showing your presentation has included all of the compliance measures. You can download presentation compliance guidelines here.
4) Facilitate Enrollment. Virtual enrollment varies by carrier. Use a virtual signature method if available with the chosen carrier or send a paper enrollment form via scan and email, fax, or snail mail if necessary.
Click here to download a complete list of carrier enrollment options. Click here for a list of Med Supp options. Keep reading for a look at carrier tools and resources for virtual appointments and enrollments.
Aetna offers both telephonic Scope of Appointment (SOA) and enrollment.
Click here to review Aetna’s instructions for telephonic SOA.
The Remote Agent Telephonic Enrollment (RATE) tool enables brokers to enroll clients by phone. Brokers must have an iPad to use this tool and will need to complete a short training before receiving their dedicated 1-800 number.
To learn more about completing an enrollment using RATE, view this tutorial.
Last Fall, 60% of Humana enrollments were facilitated virtually, which means brokers contracted with Humana should be equipped to continue business virtually over the coming weeks and months. Here are some of the things you need to know:
Through Humana, there are two ways brokers can virtually obtain a scope-of-appointment signature from the beneficiary before their call.
1) Humana’s IVR Scope of Appointment Line
Humana’s Scope of Appointment IVR phone number is 866-945-4471. The broker and beneficiary must both be on the call together, then the IVR system will prompt you through the call. You can find the full tutorial for using Humana’s IVR Scope of Appointment Line here.
2) ProducerMAX E-scope of Appointment
The ProducerMAX CRM app gives brokers the option to send and receive a signed scope-of-appointment electronically. This SOA is accepted by Humana.
Once you’ve obtained an SOA, you must send the client appropriate Humana marketing kit materials. Here is Humana’s guidelines for distributing marketing material virtually via email.
Finally, Humana’s FastApp enables brokers to complete MA/MAPD, PDP, OSB, and Medicare Supplement plan enrollments without being in-person with the beneficiary. This tool is quick, easy, and secure. It even has built-in compliance checks to keep you compliant. Click here to download a guide to using Humana’s FastApp.
IVR Voice Signatures is available for all Humana plans. To utilize this feature, follow these steps in the enrollment process:
Step 1) Log in to FastApp and complete the enrollment, using the correct Affinity Code and Broker’s email address in designated fields. In order to use the IVR for Voice Signature process through FastApp, under Affinity Partner you will need to select “Field Agent IVR” to utilize the voice signature process. Dual IVR can only be done if clients are both enrolling in the same exact plan. Click IVR sig instead of Electronic Sig.
Step 2) Conference client into the Dedicated IVR line and follow the steps detailed on page 5 of this tutorial.
English Speaking #: 866-730-4014
Spanish Speaking #:800-833-6573
Step 3) Check broker email for status changes and confirmation of successful enrollment.
To maximize efficiency and improve the customer experience of using their Voice Log system, Humana has substantially reduced Voice Log scripts, resulting in significant time savings. Here is a summary:
You can see the complete list of changes here.
In an effort to streamline discussions, ensure consistency and improve the beneficiary experience, Humana has prepared new guidance regarding required elements of disclosure. Humana Compliance Audits will assess compliance using this new guidance as a baseline.
UHC has provided this job aid for virtual selling that a broker can reference to find requirements for telephonic appointments/enrollment, steps to take during the call, and FAQs.
UHC makes LEAN available to producers when face-to-face appointments are not an option.
LEAN can be downloaded as a mobile app from the Apple App Store or Google Play. It can also be accessed from your computer via Jarvis or directly from this link.
Here’s how it works:
1) Scope of Appointment – LEAN gives your prospects the option to sign the SOA form remotely via email. You will need to put both the prospect’s email address and your email address into LEAN along with an access code that you and the prospect agree upon. The prospect will receive an email from DocuSign asking for their signature along with the access code.
2) MA Enrollment Application – LEAN also gives your prospects the option to sign the enrollment application remotely. The process is the same as with the SOA. Therefore, you can complete a presentation and application with the prospect over the phone. You can then email the application for review and signature. The prospect has 24 hours to complete.
You can download the LEAN tutorial here.
WellCare offers PURL, which allows prospects to go directly to a webpage for self-enrollment while giving you credit for the sale. Here’s how it works:
It is now possible to complete electronic enrollment with HealthSun. To do so, visit the Cavulus web portal. The phone number to be used will be the same as the SOA support line: 1-833-258-6452.
Click here to access a complete training guide to getting started with and utilizing Cavulus.
In an effort to reduce the number of in-person visits and slow the spread of COVID-19, many healthcare providers are offering telehealth options. Additionally, many plan carriers are making telehealth accessible for their members. You can see a full list of telehealth options by carrier here.
To help members overcome the challenges of this global pandemic, Allwell is providing assistance and benefits, including: