AEP 2027
The enrollment period when Medicare members can change their health plan choices.
What is the Annual Enrollment Period (AEP)?
The skill of recognizing and responding appropriately when a member expresses frustration, concern, or confusion.
What is empathy?
The question agents should ask before ending the call.
What is "Is there anything else I can assist you with today?"
The timeframe in which a caller should be greeted after the call is presented.
What is within 10 seconds?
A recap of the actions taken during the call.
What is a call summary?
This enrollment period is available annually from January 1 through March 31.
What is the Medicare Advantage Open Enrollment Period (MA OEP)?
The communication style agents should avoid because it makes interactions feel impersonal.
What is sounding robotic?
Name three sources used to determine SSBCI eligibility.
What are Health Risk Assessments (HRA), Annual Wellness Visits (AWV), and Claims Data?
The process of reviewing actions taken during the call
What is summarization?
Information that should be included in a summary.
What are actions taken, outcomes, and next steps?
Members who qualify for LIS or Dual Eligibility may use this SEP how often while they remain eligible?
What is once per month?
The customer service skill that prevents callers from unnecessarily repeating information.
What is active listening?
This method is no longer allowed for either new or existing members to qualify for SSBCI in 2027.
What is self-attestation?
The question agents should ask before ending the call?
What is "Is there anything else I can help you with today?"
The reason call summaries are important.
What is confirming member understanding?
A member action allowed during AEP.
What is enrolling in, switching, or dropping a Medicare plan?
The language agents should use instead of jargon or internal Aetna terminology and provide an example.
What is plain language?
True or False :
Existing members can self-attest for SSBCI eligibility.
What is False?
The information agents must provide before placing a caller on hold.
What is the business reason and estimated hold time?
What is the maximum amount of silence allowed before it becomes Dead Air?
What is longer than 45 seconds?
For 2027, members must meet how many eligibility requirements to qualify for SSBCI benefits?
What are three eligibility requirements?
When a customer says, "Sorry, I'm just really frustrated," what is an appropriate response?
What is"No need to apologize. I understand how frustrating this can be. Let's take this one step at a time together."?
If a member is upset about losing their SSBCI benefit but is not requesting a determination review, the CSR should file this.
What is a Grievance?
The action agents should take when they need additional research time while on hold.
What is returning within the quoted timeframe and asking permission to continue holding?
What should a CSR say while researching an issue to avoid Dead Air?
What is "I’m still researching this for you" or "Thank you for your patience while I review your account"?