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WellCare | Temporary Telephonic Enrollment Option

May 15, 2020

Attention Valued Partner:

While more is being done to understand how coronavirus (COVID-19) is transmitted and treated, we are committed to keeping agents, their families, and our communities healthy and safe. Additionally, we are working hard to innovate and provide opportunities to help beneficiaries secure the Medicare plan that fits their needs. We are excited to introduce a temporary way to enroll members into WellCare plans without agents and members being face-to-face.

Telephonic Enrollment Benefits:

  • Is a compliant way to capture the Scope of Appointment and complete an enrollment application without face-to-face contact
  • Ensures that both beneficiary and agent are maintaining social distancing guidelines
  • Allows those that we serve to make healthcare decisions while staying safe
  • Allows agents to continue to serve as a trusted advisor in their communities

Telephonic Enrollment Resources:

Telephonic Enrollment Steps:

Before the Application:

  • Call the Appointment Verification Line (AVL) to capture agreement and a Scope of Appointment (SOA). Calling the AVL does require the beneficiary to be on the line. At the end of the call, you will be provided with an AVL code; be sure to record it, as it is required to conduct the telephonic enrollment process. The AVL code will ensure the agent is credited for the sale and remains the agent of record (AOR).
  • National AVL: 877-780-3920
  • PDP AVL: 877-297-3625
  • The AVL is available 7:00 AM – Midnight, EST.
  • If the member has Medicaid or LIS, be sure to call the SPOP line to verify eligibility.
  • SPOP: 866-211-0544
  • Complete a thorough and compliant sales presentation, including discussing plan premiums, preventive services, hospital, ER, ambulance, supplemental, and Part D drug coverage (if applicable).
  • Gain confirmation that the beneficiary is ready to enroll.

Have the Following Items Ready:

  • AVL Code
  • Plan name
  • Plan effective date
  • Beneficiary’s date of birth
  • Special Election Period (SEP) being used on application
  • Medicare Beneficiary ID# (MBI) (from Medicare’s red, white, blue card)
  • Part A effective date
  • Part B effective date

Taking the Application by Phone:

  1. With the beneficiary on the line, initiate a 3-way call to 844-914-0020.
  2. Remain on the line with the beneficiary and call center representative. You, the agent, will remain the point of contact for any plan or benefit related questions. Note: In most instances, the call center representative is non-licensed and is not permitted to answer any benefit questions.
  3. Field agent will remain the agent of record (AOR) for the sale.
  4. Enrollment is processed and submitted by the call center representative.

Telephonic Enrollment Important Notes:

  • The call center will retain a recording of the enrollment
  • The agent will remain the agent of record (AOR). If the call center representative is not able to enter the agent’s PID, AOR changes will be made at the corporate level. 

If you have any questions please reach out to your DSM.

As always, thank you for all that you do to transform the health of our communities and your dedication to underserved and vulnerable populations. You are making a difference and you are relied upon more than you may realize.

For more information, contact a Pinnacle Financial Services representative today

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

Contact a Pinnacle Representative if you have any questions.

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

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