Santa is coming to town
What brings Frosty the Snowman to life?
A magical hat
An agent's plan had an original effective date of 01/01/2010. In September 2022, the client put in an application with another carrier that went through. The agent just received a chargeback for 3 months in the Dec 2023 statement. Is this valid?
Yes - if the agent did not receive the chargeback when the client first went inactive
Will an agent be paid for the HA for non-SNP policies?
If the member is enrolled into a UHC non-SNP plan from another carrier the agent will receive an HA payment for a successful HA submission.
However, if the member does a plan change from a UHC plan (MA/DSNP/CSNP/etc) to a UHC non-SNP plan the agent will NOT receive an HA payment for all 1/1/2024 and later effective dates.
An agent signs a current UHC member into a new non-SNP MAPD and complete the HA (in 2024). Is this commissionable?
No, Non-SNP to Non-SNP plan changes Health assessments are not commissionable.
An agent is upset and calling in because they are not getting an option to complete the HA for an application they recently submitted.
No, you will verify to see if the plan is a MAPD and when/how the app was submitted.
If you do find they should have the option you will escalate to LEAN Tier 2
In 2021, what percentage of U.S. adults intended to celebrate Christmas, Hanukkah or Kwanzaa?
According to the National Retail Federation, 90% of adults planned to celebrate the holidays.
A MGA is confused why they did not receive the New to UHC override amount for a PDP.
PDP are not included in the New to UHC Program
Will HA’s pay for non-commissionable plans?
No. The following plan types are excluded from HA payments:
Non-Commissionable
Group Plans
ISNP
UHC plan changes to non-SNP plans
An eAlliance solicitor's client calls into DTC and DTC enrolls with them into a new plan. With the eAlliance Solicitor remain as AOR?
No, as of 9/1/2023 eAlliance agents/agencies are not eligible for AOR retention
An agent calls in on Jan 8th because they have not received their HA payment for a 12/01 ED. Can we escalate?
No, it should process with the MAPD/PDP renewals on 01/22
How long is the average growing time for a Christmas tree?
7 Years
Agent received a chargeback on this months statement for a MAPD client that they swear changed their plan in 2020 but has remained active on the same plan since. Would this be valid?
No, it is outside of the Statute of Limitations so the chargeback should not have processed if so. You will need to research, most likely the client moved plans in 2022.
When a client enrolls effective 10/1, 11/1 or 12/1 and uses AEP to change plans for an effective date of 1/1
Q4 Term
An agent enrolls one of their active clients into another carrier plan for 01/01. During OEP, the client calls into Telesales and switches back to their original plan for 02/01. Will the original agent be retained?
No as there was one month gap in coverage.
ICM is showing AOR Retention IND = Yes but GPS is not showing the correct AOR.
No, these updates happen every Monday unless there is a holiday then it will fall on the next Monday.
What ad campaign popularized Santa’s red suit?
Coca-Cola’s 1931 ad campaign
A MGA is confused as to why they received $125 instead of the $20 for overrides for an Agent level agent's member who was active on another carriers MAPD but switched to UHC during AEP.
New to UHC Overrides and there is no GA in between the MGA and Agent so they received for both.
How can an agent submit an HA?
HAs will only be accepted if they are submitted via LEAN or a third party approved system, Connecture, MyMedicareBot, or Sunfire
If a non-SNP client receives Medicaid within the first month of enrolling into their plan and is now eligible for a SNP plan and enrolls for the following month. Will there be a full chargeback for the first plan?
There is an Rapid Disenrollment exception
•Additional RDE
•Becoming LIS or dually eligible for Medicare or Medicaid
•Death
•Due to an auto, facilitated, or passive enrollment
•Moving out of the service area
Qualifying for another plan based on special needs (logic added to ICM
Agent's client moved to a state the agent is not credentialed in and the Agent would like to be removed as AOR.
No, agent must request this in writing so should email into PHD this request.
What was the first Christmas movie ever made?
Santa Claus (1898)
An eAlliance upline is confused to to why the received a full chargeback for one of their agent's New to Medicare clients overrides. The client was active on the plan for 5 months and voluntarily termed.
•eAlliance agencies, upline payment for both New to UHC and New to Medicare programs will be charged back at 100% of year-one override commission if the member terms before the end of the calendar year (involuntary term exceptions will be prorated months-on-plan).
If the plan results in a rapid disenrollment, will the HA be charged back?
Yes. HA payments are subject to rapid disenrollment rules for enrollments with application effective dates on or after January 1, 2024. If a policy is a rapid disenrollment the HA payment will also be charged back.
An agent enrolls a client for a 12/01 ED, the client then decides to switch to a new plan for a 02/01 ED
There will be no exception due to the new plan not having a 01/01 ED
A Servicing agent calls confused in 2024 because one of their client is missing. The client moved towns and called into DTC to update their plan. Can we escalate to update AOR?
No, starting for 2024 Servicing agents no longer qualify for AOR retention as their are not active agents