SEP SPOT
Compliance Corner
STATS
LIS
Dispositions
100
NAME THAT ENROLLMENT PERIOD:
A consumer get a second enrollment period?
2nd initial enrollment period
100
When should the scope of appt be read to the consumers?
ON EVERY CALL
100
What affects your ROC percentage?
Anytime your not in READY
100
Do we have to warm transfer to the LIS Team?
Yes
100
Ineligible-No SEP- In what instance do we dispo the call as this?
No Sale due to consumer not having a valid election period
200
What SEP is appropriate for this situation?
Consumer had Union group coverage and is now losing it?
Loss of employer coverage
200
Is this an auto fail?
Not informing the consumer of their part D penalty
Yes
200
What is the freshman conversion goal for this month?
20%
200
After choosing conference call, what is the next step to complete, when transferring a consumer to the LIS team?
Step 2:Type in 138 or LIS and select the LIS speed dial option that appears. If needed, switch Type to Cold
200
CST Evaluation Needed-- When is it appropriate to utilize this disposition?
Consumer intended to purchase something other than health insurance and this lead should be used as a coaching opportunity for Tier 1 agents
300
What SEP should be used in this situation?
Consumers zipcode considered disaster area. Disaster related to weather?
disaster-weather related SEP ( marketplace should notify you when this SEP is available
300
Can we sell on the free look period?
NO
300
How long are you allowed to stay in ACW(after call work) after your call with the consumer has concluded?
2-3 minutes to finish adding notes
300
What is the income level for a signal individual to qualify for LIS?
Monthly:
$1,581
Annual:
$18,972
300
Ineligible-Health Condition-- When should this disposition be used?
No sale due to consumer having a disqualifying health condition or prescription drug history
400
What is the enrollment time frame for:
Loss of special needs status-loss of subsidy-loss or loosing SNP
3 months after expiration of status
400
Is saying "ok" or "sure" acceptable for the consumers to say when agreeing to the disclosures?
No- this constitutes a autofail
400
What are the freshman sales goals for this month?
1.65 ( 2 sales) daily
400
What is the income threshold for a married couple to be eligible for LIS?
Monthly: $2,134
Annual: $25,608
400
When should No Sale-Best Plan be utilized?
No sale due to the consumer already enrolled in the best plan available in their zip code
No sale due to there being no Advantage plans available in the consumer’s zip code
500
When is it appropriate to utilize the following SEP:
Trail right 2
When the consumer dropped Medigap to try MA and wants to return to medigap
500
What is an "unacceptable" QA fail?
Under 80%
500
What is the schedule adherence goal?
80%
500
What forms of income should be considered when determining whether a person should be sent over to LIS team
include all income (Social Security, Retirement, Pension, etc. BEFORE deductions
500
When should 065-LIS Referral be used?
An LIS referral has been submitted for review. This lead should be returned to the Agent that submitted the LIS referral.