SEP
This SEP is a one-time use for a person with a MA/MAPD to make a change in the 1st Quarter
What is OEP
Sabrina's daughter is POA and helps her mom make her healthcare decisions, even though she can make her own. Can the agent complete the application with the daughter?
What is NO! If Sabrina makes her own decisions then we must complete with her. However, the daughter can be included in the conversation.
MBR calls in and needs dentures. All teeth have been removed already. What plans will give them denture coverage.
What is Hi215, C550 and Dental Savings
Shakira said she did not have an email address. but later in the application she provided one. Where does the email address need to be placed to receive credit for this KPI?
Where is the canvas record?
The agent finished the NEEDs analysis with the consumer and the call drops. Can the application be finished on Outbound call?
What is, yes because the call was dropped due to a system issue. The Agent has till the end of the business day to get the application completed. Afterwards, SOA rules would apply. Pro tip- Get SOA done early in the call.
Beyonce calls in complaining that she did not get her SOB in braille. What SEP can an agent use?
What is none. A member must have not received enrollment materials in alternate format to be able to use SEP-ACC.
Kendrick L. calls in and says he wants a plan the has HOA, transportation and Silver Sneakers. Is this considered a full Needs analysis to the Humana standard?
What is No. The agent needs to determine what he has now and likes about it. Also, the agent should include vision and dental needs befor4e moving on to plan presentation.
Caller needs coverage for a root canal she has scheduled for next week. What plan should she enroll in?
What is the Loyalty Plus Plan?
Cardi B calls in and tells you she is QMB+, which is confirmed in Debut. You check vantage and see she is SLMB. The plan that has the highest HOA benefit requires QMB+. Who do you trust?
What is Vantage?
What past DMS Leader is featured on the Humana Dental commercial?
Who is Alex Calderon.
In June, a DE Member calls in and wants to switch back to their old DE plan with Humana. There has been no recent change to eligibility. What does SEP-DEP allow them to switch to?
What is PDP and Original Medicare only.
Agent Adam Levine asked the consumer for Drs Pharmacy and RX coverage. Has Adam satisfied the call quality expectation for providers?
What is No, He forgot Facilites and Hospitals.
Caller needs a plan for cleanings for her and her husband. What are the plan options for this consumer?
What are the Bright Plus and the Preventative Value Plans?
When reading the last MAF Disclosure related to Marketing, and the client pauses. How do you overcome and explain this disclosure?
How is telling them this is permission for CenterWell Pharmacy to reach out and educate the consumer of savings opportunities?
Agent Tupac received a call from a MBR that wants the part B Giveback Plan. Tupac presents the plan and gets consumer buy-in. He reviews RX Coverage, and the caller shares he has LIS. What should Tupac have done BEFORE presenting the plan?
What is check MARX to confirm MCD/LIS level prior to pitching Part B Giveback plan.
Pro Tip- Reminder if a person is DE, they will not get Part B Giveback.
On April 2nd, Serena (has an MAPD) calls in and mentions a winter storm issue causing her to lose power. Can Agent use SEP-DST?
What is NO, DST is handled by CMS eff April 1st.
Agent Gwen has narrowed down plan options to two plans for a potential customer, but she is unsure which one is the best fit. what should she do next?
What is conduct a more detailed needs analysis to determine the best plan?
Jay-Z calls in and he just retired, and his employer plan is ending. What dental plan should you offer Jay-Z?
What is Complete Dental?
Agents are advised to select this type of provider on 23% of their applications, which can be identified in physician finder by looking for a hyperlinked website.
What is a JOA?
Pro Tip- Common examples include Oak Street, Conviva, and CenterWell.
What JOA offers Transporation to their members to their appointments?
Who is CenterWell PCP?
Drake calls in and has delayed Part B effective this month. What SEP should an Agent use?
What is ICEP? Agents now have 5 months. 3 months before, the month of and one month after.
Caller comes in and advises the want a HOA Card. The agent does not see one available in their area. what is the one phrase you never tell this consumer?
What is NO! We never tell the consumer we do NOT have it or are NOT eligible.
TIP- Confirm the caller is looking for ways to save money. Take time to better understand other ways to build value, like Part B giveback, OTC, Dental and vision benefits, etc.
The Agent just sold Taylor a Med Supp plan; what Dental plans would best fill in her gaps of coverage?
What are Humana Extend 1250, 2500 and 5000.
When positioning the primary care provider on an application, agents are required to share information for this specific type of provider to ensure members receive coordinated and quality care.
What is a Care Highlights Provider? (TPP)
Before becoming a leading health insurance provider, Humana started in 1961 under this original name as a nursing home company.
What is Extendicare?