2023 AEP Checklist

2023 AEP Checklist

2023 AEP Checklist
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2023 AEP is just right around the corner. There have been many changes this year the biggest being the CMS Final Rule . It is very important to your success that you have all marketing items you need in line and your checklist is complete. Pinnacle Financial Services has the top online enrollment tool systems with voice recording built in. You can pick Sunfire, Connecture, or MyMedicareBot.  The best way to obtain this is to have the right FMO. Pinnacle Financial Services can give you the best technology in the industry to make your Medicare AEP a true success!

AEP Best Practices

Heading into the open enrollment selling season the number one tool you will need to have is Connect4medicare. This Quote, Compare, and Enrollment tool are available to all Pinnacle agents for free!  It allows you to quote enrollment and add drugs all on one platform without having to meet face to face.  It also will have a text-to-enroll feature, along with some other great features including HRA, LIS look-up, and hospital indemnity enrollments. Some of the other things you will want to check off are as follows:

  • Connect4Medicare
  • Supply orders in
  • Leads orders sent out
  • Secure email
  • Generic scope of appointment
  • Sales events filed
  • Certifications completed
  • Quoting software
  • Mobile quoting software
  • Adding new carriers to the market
  • Carrier fax cover sheet
  • Pinnacle enrollment fax cover sheet
  • Walmart training completed

AEP Next Steps

The sales directors here at Pinnacle Financial Services are here to help you complete all the tasks listed above. We are here to give a personal walk-through of Connect4Medicare.com, our quoting software tools, and anything else you may need. Give us a call to make sure you have the most successful AEP yet.

For more information, contact a Pinnacle Financial Services representative today

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

Director of Sales | Health

Contact a Pinnacle Representative if you have any questions.

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

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What is Medigap?

What is Medigap?

What is Medigap?
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Medicare supplemental insurance is administered by private insurance companies to fill the gaps or supplement the costs that original Medicare does not cover. A Medigap policy is different from a Medicare Advantage Plan. Medicare Advantage plans are run by private insurance companies that contract with Medicare to provide Medicare coverage which usually also covers prescription drug benefits. 

Clients pay a monthly premium to the insurance carrier for the Medicare Supplement plan in addition to the monthly Part B premium that they pay to Medicare. A beneficiary cannot have a  Medigap policy if they already have a Medicare Advantage Plan unless they’re switching back to Original Medicare. Any standardized Medigap policy is guaranteed renewable even if they have health problems. This means the insurance company cannot cancel their Medigap policy as long as they continue to pay the premium.

Why Sell Medigap?

Large Market

  • The market size is huge; 10,000 new people become eligible for Medicare every day, 63,964,675 are currently enrolled and eligible for a Medicare supplement, and there will be over 16,000,000 more eligible enrollees in the next 10 years

High-Profit Potential

Competitive Rates

  • Since coverage is standardized across each plan, clients will receive the same benefits no matter which insurance company they choose. The only differences are in premium amounts which tend to vary by carrier.

Easiest Medicare Product to Start Selling – No Red Tape; No Certification

  • Typically there is no certification process required to sell med supps. The exception is United Healthcare.

What do Medigap plans cover?

In the illustration below if a percentage appears, that means the Medigap plan covers that percentage of the benefit, and they must pay the rest. If a box is blank, the plan doesn’t cover that benefit

What’s not covered with a Medicare Supplement?

  • long-term care
  • vision or dental services
  • hearing aids
  • eyeglasses
  • private-duty nursing

Medigap Enrollment

  • First, individuals must have Medicare Part A and Part B. A Medigap policy only covers one person. If they and their spouse both want Medigap coverage, they’ll each have to buy separate policies. Many carriers offer discounts for purchases by both spouses.

WHERE CAN I FIND MORE INFORMATION ON PINNACLE FINANCIAL SERVICES?

Pinnacle Financial Services offers direct contracts with dozens of insurance carriers in the senior market. Whether you are selling Final Expense, Annuities, and/or Medicare, our seasoned sales directors can help you get started and guide you through the contracting process. Call Pinnacle today at 800-772-6881 or visit us online at www.pfsinsurance.com to get started!

For more information, contact a Pinnacle Financial Services representative today

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

Director of Agent Onboarding

Contact a Pinnacle Representative if you have any questions.

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

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Getting Started with Medicare

Getting Started with Medicare

Getting Started with Medicare
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So, you are thinking of getting started with Medicare sales. Like any business, the first steps are always the most challenging.  Where to start? Who to call?  Am I going to do individual sales or have an agency?  In this article, we will take a 30,000-foot view of some critically important items to consider.

Starting a Medicare Business.

As with any business, building a Medicare Business can be difficult. Understand that it is possible to grow a successful Medicare business without Medicare sales experience but there will be a longer learning curve. If you are currently selling annuities, life insurance, or even P&C your sales background will translate over to the Medicare market. The opportunities in Medicare are endless once you make the decision to begin to offer Medicare as the primary or part of your overall practice. Let’s talk about Medicare in general.

The Parts of Medicare

Medicare can be difficult for beneficiaries to understand Consulting with a knowledgeable expert in navigating the Medicare Maze is of utmost importance for clients. If you are going to make Medicare a part of your practice knowing the benefits associated with Medicare is a must.

  • Medicare Part A, Hospital Insurance, helps cover inpatient care in hospitals as well as skilled nursing facilities, hospice, and home health care.
  • Medicare Part B, Medical Insurance, helps cover doctors’ services, outpatient care, and many preventative services such as vaccinations.
  • Medicare Part C, aka Medicare Advantage Plans, are health plan options run by private insurance companies that contract with Medicare covering Medicare Parts A and B and additional benefits such as prescription drugs and possibly dental, vision, and hearing benefits for example.
  • Medicare Part D, prescription drug coverage, is run by private insurance companies approved and under contract with Medicare. Helps cover the cost of prescriptions and may help lower drug costs.
  • Medicare Supplements are standardized by Medicare and cover all or part of the gaps in original Medicare Parts A and B. Clients can choose to purchase a Medigap plan from a private insurance company.

Building a Medicare Agency

If your goal is to build an agency deciding on the payment structure for your Medicare Insurance Agents who are in the field selling is a big decision. In Medicare, there are direct pay agents and what are known as licensed only agents or, loa. So will you have the insurance carriers pay your Medicare agents or do you want all commissions paid to your agency and then you pay the agents?  Some things to consider in making this decision is what other value adds are you providing your agents. Are you giving or co-oping a Medicare Lead Program? Are you allowing them to use your office space for doing business?  Do you want more flexibility in what you are paying your agents? Are you equipped to handle the accounting if you are wanting to pay your agents?

Medicare Agent Training

Training for Medicare agents whether new or seasoned is a key feature of a successful Medicare Agency.  The Medicare industry is ever-changing.  New CMS rules are the norm.  New Medicare carriers are always entering the market.  New technology can be daunting for those without the support and training to stay at the forefront of the Medicare sales industry.

  • Technology in general is something that as a Medicare agency you will need. Keeping your team efficient and successful take dedication and investment in the future. If you are not moving forward you are moving backward.  Technology is a must to grow a successful Medicare business.

A critical decision you need to make is what FMO, field marketing organization, you choose to partner with. Let’s talk about what an FMO can do for your agency’s success.

Medicare FMO

The Medicare market has grown by leaps and bounds over the past several years. Independent insurance agents have plenty of options when searching for the Best Medicare FMO to help them grow their Medicare business.  When searching for your FMO partner you will hear plenty of claims such as, “The Best Medicare FMO”, or “Best IMO” you can find. But what does it take to truly be considered “The Best FMO”?  And what factors do you need to consider when making this decision for your Medicare agency?

Does your FMO provide at no charge all the tools and technology you will ever need?

The decisions you make in steering your Medicare business will make all the difference.  Having key partners can be the difference between living and dying in the early years.

Pinnacle Financial Services prides itself on assisting new and established Medicare agencies take the next step in their business.  Our team of Medicare experts can give you the support and guidance you need to make it in an ever-changing business. 

Contact a Medicare expert at Pinnacle Financial Services today to take the next step in growing your Medicare practice. 1-800-772-6881 or Sales@pfsinsurance.com

For more information, contact a Pinnacle Financial Services representative today

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

Vice President, Marketing

Contact a Pinnacle Representative if you have any questions.

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

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Medicare PDP Commissions

Medicare PDP Commissions

Medicare PDP Commissions
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Medicare PDP commissions are regulated by CMS and typically change each year. Medicare PDP is also called a Part D prescription-drug-plan or stand-alone prescription drug plan. It is one of the ways Medicare beneficiaries can sign up for Medicare coverage for their prescription drugs. A Prescription drug plan can be purchased on top of the Original Medicare coverage as well alongside a Medicare Supplement Plan. Some beneficiaries who have MAPD (Medicare Advantage) plans include part d that covers their prescriptions. In those cases, a stand PDP plan would not need to be purchased.

What are the 2023 PDP COMMISSIONS?

The Centers for Medicare and Medicaid which is also known as CMS has come out and announced the new maximum commissions for 2023 for Medicare Part D plans. With a constant streak of commissions going up year after year, Medicare agents are continuing to see rewards for their work and retaining their beneficiary clients. The 2023 commissions have significantly jumped over five percent year after year in the initial enrollment. CMS has also increased the renewal commissions year after year toward 4.55% annually. In other words, commissions will increase from $87 annually per member to $92 per member annually and the renewals will arrange from $44 per member to $46 per member.

How Can we help you?

Pinnacle Financial Services is a full-service “FMO” that offers you the best technology in the business while giving you options as well. We are the only FMO in the country that offers both electronic enrollment platforms: Connecture and Sunfire. When you are contracted, certified, and ready to sell; both platforms are free of charge for our agents. You will be then able to utilize our tools to check out and then enroll your Medicare beneficiary. You will be able to narrow it down to the best PDP for your client. There are no sales quotas or commitments that you need to make to us as we just want to help you grow your business. We have some of the best opportunities to help agents grow as well as receive individualized attention.

The Pinnacle Medicare team is always available to assist so give us a call!  If you are interested in more information, please do not hesitate to give your sales director a call here. Join us at the top!

For more information, contact a Pinnacle Financial Services representative today

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

Director of Sales | Health

Contact a Pinnacle Representative if you have any questions.

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

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The new CMS Recording Rule (Final Rule)

The new CMS Recording Rule (Final Rule)

The new CMS Recording Rule (Final Rule)
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On April 29, 2022, the Centers for Medicare & Medicaid Services (CMS) released what they call a “final rule that advances CMS’ strategic vision of expanding access to affordable health care and improving health equity in Medicare Advantage (MA) and Part D through lower out-of-pocket prescription drug costs and improved consumer protections.”

  • Marketing and Communication Oversight
  • Lowering Beneficiary Pharmacy Costs
  • Verifying Past Plan Performance
  • Strengthening Network Adequacy
  • Creating Transparency in Medical Loss Ratio
  • Part C and D Quality Rating System
  • Enrollee Input in DSNP Operations
  • Social Determinants of Health and Special Needs Plan Health Risk Assessments
  • Simplified Appeals and Grievance Processes
  • New Pathways to Have Star Ratings Specific to the Performance of the Local D-SNP
  • New Pathways to Simplify D-SNP Enrollee Materials
  • Maximum Out-of-Pocket Policy for Dually Eligible Beneficiaries
  • Technical and Definitional Updates for FIDE SNPs and HIDE SNPs

The latest episode of Connect4Insurance has a more in-depth discussion on the full regulations.

How does the new CMS Recording Rule affect agents?

The National Association of Health Underwriters (NAHU), the leading advocate for health insurance agents, released an update as they continue to fight for change within the rule.  As it currently stands, beginning on October 1st, 2022, all field agents will be required to record all phone calls with beneficiaries.  There is also now a disclaimer that all agents must provide: verbally within the first minute of a sales phone call, electronically when communicating by email or other electronic means, or displayed on any third-party marketing materials or websites.  The disclaimer reads:

“I/We do not offer every plan available in your area. Please contact medicare.gov or 1-800-MEDICARE to get information on all your options”

What can an agent do to prepare or fight the new CMS Recording Rule?

There is a petition founded by Medicare agents trying to reach lawmakers within CMS to explain why the recording rule, while admirable, will negatively affect the wrong people.  According to the Federal Registry for 2022, CMS reported that there were only 39,617 “complaints to Medicare” out of 29,000,000 enrollments.  This equates to 0.0013661% of enrollments.  Most of the complaints were geared toward misleading television ads created by third-party marketing organizations that provide leads to call centers.  Sign the petition and register for your local NAHU chapter to make sure your voice is heard.

If the rule stands as-is, you need to be prepared.  We will have multiple options for recording calls, storing data, and identifying beneficiaries.  This is all provided at no cost.  Schedule a call with our National Sales Trainer, Rob Valincius, for more information on the technology available to you.

Be sure to subscribe to our posts to receive information in real-time.

For more information on Medicare OEP and one-on-one support.

For more information, contact a Pinnacle Financial Services representative today

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

Vice President | Health Sales

Contact a Pinnacle Representative if you have any questions.

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

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What is Medigap?

Medicare Supplement Commissions

Medicare Supplement Commissions
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What is a Medicare Supplement?

A Medicare supplement is an addition to the Original Medicare that fills in some of the gaps, also known as Medigap. A Medicare Supplement policy can help pay for some of the remaining health care costs. Some examples of this would include co-pays, co-insurance, and deductibles. Medicare supplements are sold by private companies. 

Medicare Supplement Commissions:

The average Medicare Supplement commission rate is approximately 22% with a 9 to 12-month advance. The average yearly premium for Medicare Supplement plans is about $1,600 depending on factors such as the client’s agent, smoker/nonsmoker, and what plan option is being selected. Typically, agents can earn renewal commissions for about six years.

Example using 22% commission and 12-month advance:

Even though the average commission on a Medicare Supplement is an average of 20-22% some commissions will vary. They can vary by state, plan, and carrier. You can always check with a sales director here at Pinnacle to see what the commissions are for a particular carrier.

Where does Pinnacle Financial Services come in?

Pinnacle Financial Services is a full service “FMO” that offers you some of the best technology in the business, like our proprietary Connect4Medicare platform, top-notch support service, and personal sales and marketing from the very start. There is no sales quotas or commitments that you need to make to us as we just want to help you grow your business. This is a win-win opportunity for all of us, so what are you waiting for? Join us at the top!

For more information, contact a Pinnacle Financial Services representative today

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

Sales Director

Contact a Pinnacle Representative if you have any questions.

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

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