With the start of AEP, it’s good to remind all agents and agency owners that getting busy and stressed out to make the AEP deadlines is not an excuse to cut any corners.  Every year I hear of agents being terminated for sharing their agent ID.

Scenario: Agent didn’t misrepresent the plans, but…

Agent Bob has a friend how sells Humana MAPD and is well versed in MAPD plans, but neglected to certify for Aetna. He does the presentation (which was compliant) and take the application (from a client who truly wants the plan) and gives the application to Bob to sign and submit. What harm could there be? The policy is suitable, the client is happy and no one was harmed, right? Just like you can’t practice medicine or law without a license, you can’t represent an insurance company without an appointment. In the scenario above, Bob not only was terminated from the carrier but he lost 8 years of renewals and is barred from re contracting for life. Plus, the humiliation of losing his job at his agency and all his clients.

Scenario: HIPPA violation enrages clients

Mary sells over 100 cases a year for Cigna MAPD but she isn’t licensed in Alabama, where some of her clients have just relocated. She does the presentation, and send the applications to Jeff to submit without even telling her clients. How could anyone find out? When the clients found out that a stranger, Jeff, had their application and all their private information (bank routing numbers!) they filed a complaint. Mary thinks that the company will make an exception because she is such a large producer, surely they won’t want to lose her?! But they terminate her PER CMS GUIDELINES and she will never be eligible to recontract.

Scenario: Agent manager trains new agents and is just trying to help, but…

Todd coudn’t get contract because of his credit, but he’s been an agent for 20 years and really knows his material. He has an agency and he takes agents into the field to train. While in the house, he does most of the sale presentation, then has the trainee sign the application. Todd can’t lose his contract or renewals as he isn’t contracted! He thinks he is above the law and in this case, he wasn’t punished but the agent he was training was terminated for cause–which means he can never recontract! If you are not able to give a complete, compliant presentation and need assistance from another agent, it’s better for you to just watch the other agent do the complete presentation and wait until you are ready to work alone.

Unlike many other types of insurance products where agents can work together and split commissions (Medicare Supplements, life and annuities), it is not permissible for agents to jointly serve a MAPD or PDP client. Splitting commissions is prohibited by CMS.