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AI 101 for Insurance Professionals    

AI 101 for Insurance Professionals    

AI 101 for Insurance Professionals    
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Artificial intelligence (AI) is no longer just a buzzword, it’s a transformative force that’s reshaping industries, including Medicare. Did you know that AI can boost marketing efficiency substantially? For Medicare insurance agents, understanding AI is crucial to staying competitive and delivering top-notch service.

Understanding AI: Key AI Terms for Beginners

Here are some key terms that you will run across when learning about AI:

  1. Artificial Intelligence (AI): AI refers to the simulation of human intelligence in machines that are designed to think, learn, and solve problems like humans.
  2. Machine Learning (ML): A subset of AI where algorithms learn from data and improve their performance over time without being explicitly programmed.
  3. Deep Learning: A subset of machine learning that uses neural networks with many layers (hence “deep”) to analyze various levels of data abstractions.
  4. Neural Network: A series of algorithms that attempt to recognize underlying relationships in a set of data through a process that mimics the way the human brain operates.
  5. Model: In machine learning, a model is a mathematical representation of a real-world process. Models are trained on data to make predictions or decisions without human intervention.

Common AI Tools

In the context of Medicare insurance, AI is particularly relevant because it can handle vast amounts of data and automate complex tasks, making business operations and marketing efforts more efficient and precise. Here are some common AI tools that can be used in your business:

  1. ChatGPT: ChatGPT is now on 4.0 and is free to use to a certain degree. You can use ChatGPT to do many things like help write blogs, ideas for content creation, and even to summarize documents.
  2. MidJourney: MidJourney is a prompt-based AI that can generate images based on what you tell the AI you want. This can help with photos for your website or marketing pieces and even logos.
  3. Microsoft Copilot: Microsoft 365 Copilot integrates AI capabilities into office applications like Word, Excel, PowerPoint, Outlook, and Teams.
  4. Adobe Firefly: Adobe Firefly is similar to MidJourney but is integrated into the Adobe suite of products. You can use this AI to generate designs from scratch and even use it to extend out photos or get rid of backgrounds.
  5. Grammarly: Grammarly is a digital AI writing assistant. Grammarly helps with grammar and spell check, punctuation and style suggestions, conciseness and clarity, tone detection, plagiarism detection, and vocabulary enhancement.

Where does Pinnacle Financial Services come in?

Pinnacle Financial Services is a full-service “FMO” dedicated to helping agents across the country grow their book of business. It is essential to be able to implement and adapt to new technologies. We offer the best back-office support in the industry, top-notch technology, and a national agent trainer to help guide you through the certification process. Give us a call today if you’re looking to take your business to the next level!

Looking for more information on AI? Join our webinar later this month Here.

For more information, contact a Pinnacle Financial Services representative today 1 (800) 772-6881 x7731 | sales@pfsinsurance.com
Rob Valincius

Rob Valincius

Author Position

x7701 | rvalincius@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881 support@pfsinsurance.com

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Contact a Pinnacle Financial Service representative today for assistance.

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2025 Medicare Certification

2025 Medicare Certification

2025 Medicare Certification
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2025 Medicare certifications are right around the corner with the launch of AHIP (America’s Health Insurance Plans) and NABIP’s (National Association of Business Insurance Professionals) certifications in a little over a month. Typically, agents won’t begin the process until the major carriers launch their specific training for the 2025 season. This is partly due to the agents receiving a discount on the training from these companies through their portals.

What is AHIP and NABIP?

AHIP stands for American Health Insurance Plans and was established in 2003 through a merger of the Health Insurance Association of America and the American Association of Health Plans. AHIP offers Medicare training that is accepted by CMS (Centers for Medicare and Medicaid Services) and nationally by all Medicare insurance carriers.

NABIP stands for National Association of Business Insurance Professionals and is a non-profit professional association that was established in 1930. NABIP has chapters all over the country organized to promote common business interests to those engaged in the sale of health insurance products and services. A few years ago, NABIP launched its version of AHIP’s Medicare training to compete with other organizations. You can find all the details on that Here.

2025 Medicare Certifications: Current Dates to Remember

In planning for 2025 AEP, it is important to plan out and take all required certifications in a timely fashion. So far, AHIP and a handful of national carriers have announced the dates of when the new training will be available for agents. Here is a list with corresponding dates:

AHIP: June 24th

Devoted: June 24th

Elevance (Anthem): July 2nd

Clover: July 18th

Where does Pinnacle Financial Services come in?

Pinnacle Financial Services is a full-service “FMO” dedicated to helping agents across the country grow their book of business. It is essential to be prepared for the upcoming 2025 Medicare AEP season, and we have the tools here for your success! We offer the best back-office support in the industry, top-notch technology, and a national agent trainer to help guide you through the certification process. Give us a call today to set up a 2025 pre-certification call to ensure you are prepared and ready to go!

Need more guidance? Check out our AEP Toolkit

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Rob Valincius

Rob Valincius

National Director of Agent Training

x7701 | rvalincius@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

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2025 Part D Changes

2025 Part D Changes

2025 Part D Changes
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For the plan year 2025, CMS has announced some massive changes to the Part D program. These changes are in an effort to both streamline and simplify the Part D program for seniors.

Key Changes for 2025

Some of the key changes for 2025 for the part D program include:

  1. Removal of the Donut Hole (Gap Phase) and Initial Coverage Phase- These 2 are being merged together and will be now referred to as the “Standard Coverage Phase.” This condenses the Part D program from 4 phases to 3 (Deductible, Standard, Catastrophic).
  2. The Annual Out of Pocket (OOP) threshold is now $2,000 (changing from the current $8,000) TrOOP.
  3. The sunsetting of the Coverage Gap Discount Program (CGDP) and the establishment of the Manufacturer Discount Program. This will impact what drugs receive discounts, how they are counted towards the $2,000 OOP, and who is responsible for the cost beyond the set amount.

Where does Pinnacle Financial Services come in?

Pinnacle Financial Services is a full-service “FMO” that will always keep you in the know on industry changes. Medicare is always changing yearly and it’s best to understand new rules and regulations. Outside of the industry knowledge, Pinnacle has full-service back office support, top-notch training, and the best technology in the business. Don’t hesitate and call us today about an exclusive opportunity to market an IE-SNP product!

Check out the 2025 CMS Final Rule regulations proposed Here.

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Rob Valincius

Rob Valincius

Author Position

x7701 | rvalincius@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

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Contact a Pinnacle Financial Service representative today for assistance.

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2024 Scope of Appointment

2024 Scope of Appointment

2024 Scope of Appointment
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The 2024 Scope of Appointment rules have changed, yet again, for this year. Due to the 2024 Medicare Final Rule, there have been added regulations put into place regarding the collection of SOAs.

2024 Final Rule SOA Updates

The Centers for Medicare and Medicaid Services (CMS) implements sweeping changes to the Medicare system every year. Changes can impact the agents, carriers and clients alike. Over the past few years, rules and regulations have been aimed at stopping unfair marketing practices with large-scale call centers. Unfortunately, these updates have had a negative impact on individual sales agents as well. Here are the changes to this year’s scope of appointment rules:

  1. 48-Hour waiting period reimplemented. SOAs are required before meeting with a beneficiary to have any discussions that may lead to a sale. Agents must now wait a full 48 hours to conduct a personal marketing appointment. Exceptions to this include the last 4 days of a valid election period and if a beneficiary initiates an unscheduled in-person meeting (walk-in into an office).
  2. SOAs are limited to 12 months from the beneficiary’s signature date or the beneficiary’s request for information.
  3. SOAs are no longer allowed to be collected at educational events. This prohibits agents from setting up future sales appointments while at educational events. However, BRCs (Business Reply Cards) can be made available to collect beneficiary information.

Where does Pinnacle Financial Services come in?

Pinnacle Financial Services is a full service “FMO” that offers the best technology in the business, top-notch back-office support, and on-demand training to ensure you stay 100% compliant. It’s never too late to start. Call us today and ask about our exclusive IE-SNP product!

AEP is here! Check out our AEP Toolkit

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Rob Valincius

Rob Valincius

National Director of Training

x7701 | rvalincius@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

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5-Star Medicare Advantage plans

5-Star Medicare Advantage plans

5-Star Medicare Advantage plans
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5-Star Medicare Advantage plans are a year-round opportunity for both clients and sales agents. Although the 5-star plan designation is scarce throughout the country, there are still various opportunities depending on what state you and your client are in!

What are Star Ratings, and How do They Impact Plans

Medicare star ratings are basically a plan’s overall performance and quality based on data that is provided from the prior year. The scale is numbers 5 to 1, with 5 being excellent and 1 being poor. The 5 categories that the Centers for Medicare and Medicaid Services (CMS) uses to review plan performances are:

  1. Customer Service
  2. Plan Responsiveness
  3. Management of Member Complaints
  4. Preventative Service (Health outcomes of members)
  5. Chronic Condition Management

These ratings impact both the plan sponsor offering them and the clients choosing/staying with them. Plan sponsors benefit from having highly-rated plans by receiving higher rebates and quality bonus payments. This allows them to offer additional supplemental benefits (extras like dental, vision, and hearing), lower to no premiums, and help with future improvements to plan quality. Plans with low stars run the risk of having the contract terminated altogether.

For clients, having a 5-star plan gives them two things. The first is peace of mind. The higher the star rating for a plan, the more confidence they have when choosing that plan. The second is potential special enrollment opportunities. A 5-star Medicare Advantage plan receives a special enrollment period that lasts from December 8th to November 30th every year. This allows the client to make a one-time switch to that plan if it’s available in their service area.

Where does Pinnacle Financial Services come in?

Pinnacle Financial Services is the only “FMO” in the country that has access to a special Institutional-equivalent, 5-star plan available in 30 states across the country. This is an exciting opportunity to market a product that the external distribution channel has never sold. Not to mention, we offer the best technology in the business, back-office support, and training. Don’t hesitate to call us today about how to get set up for this unique opportunity!

AEP is around the corner! Check out our AEP Toolkit

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Rob Valincius

Rob Valincius

Author Position

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881
support@pfsinsurance.com

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

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