BY MARGARET STEDT
Preparing for Annual Open Enrollment Period (AEP)
Annual Enrollment Period (AEP) continues to provide the biggest opportunity for growth of the Medicare focused agent’s business,
for the retention of their book of business. It’s also the greatest challenge for time management and for their health and sanity!
This is the time that the people covered by Medicare Advantage can enroll or move to another Medicare Advantage Plan (MA/MAPD). Or, if certain criteria are met, they can apply for a Medicare Supplement Plan on
a Guaranteed Issue basis. It is also the time that covered persons can enroll into or change their Stand-Alone Prescription Drug Plans.
To be your best, make sure to complete your certifications and product trainings, finalize your marketing plan for new acquisitions, prepare and send letters to your existing clients and schedule meetings
Now is the time to complete your certification trainings. Depending on the companies you are contracted with, make sure to complete your AHIP, NAHU or company certifications and then move onto each companies’ product’s training. The trainings continue to be offered online with a few companies starting to open up to face-to-face trainings.
Review the plans carefully and note any additions and changes, withdrawals and additions of plans in your targeted sales areas. This is especially important to your retention efforts. AEP is the opportunity for covered individuals
to move from a Medicare Advantage Plan to a Medicare Supplement Plan. Creating a grid of the plans for my own use has been a helpful tool to note the highlights of each plan. (Note that these are never to be used with the clients as it is not an approved marketing piece.)
There are many marketing approaches to use for AEP for the acquisition of new clients. These can include mailers, the use of social media outreach, advertising on radio or TV outlets and in circulars or local newspapers. In person events are very effective as things open up, such as holding community meetings, “camping“ at provider offices to provide information and enrollment opportunities, hosting booths at community fairs, senior centers, and local pharmacies.
As there can be substantial costs involved, explore programs with the companies and with your Field Marketing Organization (FMO) or General Agency (GA).
Many provide marketing dollars and lead programs on a shared cost basis or dedicated product basis. They may require the submission of a marketing plan and a financial commitment especially for focused mailings. You may want to
use their giveaways or order your own. Create a budget and stick to it!
Make sure to follow the Medicare Marketing guidelines for meetings and materials.
- Remember to always file your sales meetings with the respective companies for the
products you will be representing.
- For your mailers, presentations and collateral, most agents use the companies’ or the FMO’s Medicare approved
- If you want to use your own design, remember these must be filed and approved by Medicare and there is a lead time for the approval
- Check with the companies’ sales executives and your FMO/GA for opportunities and
Meetings may be scheduled in person or using a virtual platform such as Zoom.
Strive to create long term relationships with local independent pharmacies, physicians and senior centers. You may also want to reach out to faith-based communities and organizations such as VFW’s, the American Legion and American Veterans. Many of your clients have community contacts and may be
involved in organizations and would be willing to assist you to reach the right people to arrange for your involvement and marketing efforts.
Reach out to your clients during this important enrollment period to help them determine if they wish to remain on their current plan or consider changing. Marcello Castro, an agent in Orange County with a substantial book of business, recommends doing two mailings. The first is to reach out to all clients to remind them of AEP as well as their options. He asks them to contact him if they have had any changes in their health, prescription drugs, provider relationships or have other concerns.
The second mailers are plan specific which provide guidance and recommendation for consultation regarding their specific plan’s changes for the coming year. Marcello says, “I find this approach proactive and provides confidence and an annual routine for my clients. It helps me to manage and retain almost all of my clients. In addition, I receive many, many referrals not only during AEP but throughout the year!”
The review of the prescription drug coverage and plans are handled differently by agents. Many prefer to assist their clients with the plan changes and review the coverage with their clients and prospects. There are some agents that prefer to refer the clients to the Medicare or company’s website. You need to determine what is best for your clients and your business model.
Changes from Medicare Advantage to Medicare Supplement plans
There are a number of Guarantee Issue (GI) situations that apply during AEP. Make sure to review the Medicare Supplement company’s GI outline to specifically see:
- which Medicare Supplement plans may be offered
- what is required to qualify
- what must be submitted for proof of prior coverage such a copy of the specific change from the MA/ MAPD Plan’s Annual Notice of Change or a print out from the Medicare Plan finder
- A copy of their current Plan ID Card and a signed Replacement form must also be submitted with the Medicare Supplement
The two most used Guaranteed Issue situations during this period are:
Trial Period: The MAPD covered person is within the first year of joining the plan and was first eligible for Medicare when they joined the plan, or they dropped a Medicare Supplement plan to join a MA/MAPD plan.
Medicare Advantage Plan Change: There are two scenarios that can qualify a person for the change to a Medicare Supplement Plan:
- The covered person may change from their company’s MA/MAPD plan to their company’s Medicare Supplement Plan if the MA/MAPD plan increased the premium, copayments, reduced the benefits or terminated its relationship with their medical provider for reasons other than good cause relating to the quality of care.
- If the company offering the MA/MAPD plan does not sell Medicare Supplement plans and one of the following criteria have been met
- increased premiums or copayments by 15% or more
- reduced the benefits or
- terminated its relationship with their medical provider for reasons other than good cause relating to the quality of
Note that the individual must disenroll from their MA/MAPD plan by contacting the company or enrolling in a Stand-Alone Drug plan. For prescription drug coverage they should enroll in a Stand-Alone Drug plan during AEP.
BIRTHDAY RULE: Many agents are confused by the Medicare Supplement Birthday Rule. Remember it only applies to the persons covered by Medicare Supplement plans and not to any changes from MA/MAPD Plans.
SELF CARE is a MUST
Lastly, during Annual Enrollment Period take care of yourself. It is a grueling and challenging period for seven weeks and the weeks leading up to and following. Make sure to plan well, to get rest, and take snacks and beverages with you if you are out on the road. We have had agents wind up in the hospital from dehydration/ exhaustion or suffered heart attacks during this period. Your family and your clients need you! Don’t be afraid to hire help or to partner with other agents and your FMO.
With planning, study and commit- ment you should have a successful AEP and feel confident that you have done the best you can for your clients, your business and your family. Good Selling!
MAGGIE STEDT is an independent agent that has specialized in the Medicare market for the past 21 years. She is currently president of California Association Health Underwriters (CAHU) and is a past president of her local Orange County Health Underwriters Association (OCAHU) chapter. Reach her at firstname.lastname@example.org.