1.Does this guidance apply to just paper enrollment applications, or does it also apply to telephonic and online applications?
This guidance applies to all enrollment applications received (paper, telephonic, online) regardless of medium.
2. How would I hold onto a telephonic or online enrollment application that is received prior to AEP?
The short answer is you cannot. However, you can do a full presentation from the 1st of OTC to the 14th and ask the beneficiary if it would be ok to pre-fill a client profile in your SUNFIRE Enrollment tool where it would be easier to submit their application when AEP begins on the 15th. Let them know that you will be calling them or meeting with them once more to confirm the plan selection, answer any remaining questions and when they are willing to submit the application for enrollment, you will give them a few options to do so. (if you are in-person, then simply obtain the signature) Here are the electronic signature options.
- Provide your client your SUNFIRE PURL link to the plan they wish to enroll in. Your client will fill out the application 100% on their own via the link and sign and submit themselves. This is considered a self-enrollment and that portion of the process does not need to be recorded.
- Instruct your client to call you back on your recorded line preferably through Agent Boost’s Rocket CRM tool. (note.. this number will be your CRM number that will forward to your cell or other line you have indicated to receive calls on from clients) Advise them that you will go through the application process and have 3 methods to obtain a signature.
Method 1: Send a TEXT message signature link
Method 2: Send an Email signature link
Method 3: Since this is an inbound recorded call, you are able to read the enrollment confirmation script on the application signature page verbatim and obtain verbal consent to enroll the customer in the plan. Here is a basic script for obtaining such permission.
Ok Mrs. Customer, please listen as I read the required disclosure in order to enroll you into the AARP Medicare Advantage Plan 1 for an effective date of January 1, 2023… “”Read disclosures verbatim”” Now that I have read this, may I have your permission to affix your name to this application for enrollment into the AARP Medicare Advantage Plan 1 for an effective date of January 1, 2023? If so, please state your Name, Date of Birth and say YES I AGREE… Great thank you so much for that. Here is what will happen next….. (explain next steps.. HRA, Id cards, timeframes, how to get ahold of you etc.).
3. If a beneficiary calls me (prior to AEP) to submit an enrollment application, can I take the information over the phone and submit it on the 15th
If you are using a carrier enrollment portal and the portal allows you to “save”
the application for a future submission, then the application can be held this way.
If the portal does not allow you to save the application and it must be submitted the same
day or it will be timed out, then you should advise the beneficiary to call you back on
AEP and start the enrollment process then. If you are using SUNFIRE during Pre-AEP, then the compliant act of saving applications does not exist because the “ENROLL” button is not clickable prior to the 15th. You can only create client profiles and simply bring that profile up on the 15th and beyond to enroll into a plan for AEP.
4. How is “unsolicited” defined? Examples of “unsolicited” may include:
- You meet with a member on 10/1 and provide information about plan options for 2023, including a paper enrollment application. You advised the member that AEP starts on 10/15. On 10/4, you received an application in the mail. Because you did not encourage the member to enroll early, this is considered an unsolicited application.
- You meet with a member on 10/1 and provide information about plan options for 2023, including a paper enrollment application. You advised the member that AEP starts on 10/15. The member tells you that she will be out for several weeks during AEP and she does not want to miss out on enrolling. She asks you if it would be acceptable if she can send in the application right away before she leaves town. On 10/4 you received an application in the mail. Because you did not encourage the member to enroll early, this is considered an unsolicited application.
Examples of solicited may include:
• You meet with a member on 10/1 and provide information about plan options for 2023, including a paper enrollment application. You advised the member that while AEP starts on 10/15, it may be a good idea for the member to send in the application earlier to beat the rush and avoid any delays. On 10/4, you received an application in the mail. This type of solicitation would not be appropriate.