Address Change
Plan Changes
Quality Metrics 2
Enrollments
Delta Updates
100
You have to add a new record and the member will not provide a physical address.  Can you proceed by adding a PO Box in the permanent address field?

Yes.  We should not encourage this, but you can do this for a NM.

100

Can a plan change be denied in states that have underwriting to Accept/Deny?

Yes.

100

There were 8 Disclaimer Errors this month. What is the top trending missed Disclaimer?

If you said Email Opt In, you are wrong!  Great job reducing these errors.

The Answer is: License/Underwriting Statement

Let's discuss why this happens -- anyone want to share why they got an error?

100

If the caller does not agree to completing an enrollment or consent to a follow up DCB, what are you required to review with the caller per Quality Guidelines?

Tell the caller their enrollment options:  Complete on our website or on the phone with an agent.

100

Do we still have to present plans side by side?

Trick Question:

Yes, if we do not help identify and recommend a plan.

No, if we do a thorough needs assessment, and are able to recommend a plan based on their answers.  

200

Sales agents cannot add a temporary or mailing address to the record.  How do we ensure the application and welcome kit gets sent to the preferred mailing address?

Add mailing address to the enrollment.  Breeze will update when the enrollment is processed.

200

The member has Plan G01 and wants to change to N01.  What article do you check to see if an application is required?

Plan Changes from

200

We had 10 Benefit Errors in March. What is the top Trending Benefit Error?

Provide required PPO/DPO required reads (6)

(The rules have changed, is everyone clear with our Plan Options of Coverage work around?)

200

How many points does it cost you if you do not tell the caller their enrollment options?

8 pts!!

(2 errors)


AARP Quality Evaluation Guidelines for Operations

200

What is the new expected time to receive a PR from Delta starting April 1?

2-4 weeks, progress!

(More to come on Welcome Kits)

Note: If there is an email on file, the caller will get both a printed plan guide and an email with a link to the website. If there is no email on file, then only a printed plan guide will be sent.

300

The caller will not provide a physical address and an enrollment is completed.  Can you proceed with the enrollment?

Yes. Ensure the correct zip code is entered for rate. 

300

What is the top trending transactional error we received in March?

Updating Email  

Lets take a look at Step 7: Demographic Changes and Updates - Breeze- Delta

300

How many points is a Benefit Error?

5

(8 errors)

300

When do we have to give the rate guarantee?

When completing an enrollment!

(1 error)

Step 18 of Delta Call Flow:

Agent note: This is often mentioned during the sales discussion as a selling point. Not a required statement unless OLE is completed.

300

With the addition of Propel we are no longer reading the Plan Options of Coverage from Step 10 for the PPO.  However, we still have to present the plan summary.  Where do we find the new language for the PPOs?

Step 12 - Licensed Delta Call Flow

You can choose from three PPO (DPO in TX & NC) plan options with different levels of coverage. Most of the aspects of the plans are identical under two of the three options but there are differences in the waiting periods, co-payment levels, calendar year deductibles, and calendar year maximum benefit amounts.  

400

An enrollment is processed with a PO Box in the permanent address field. What happens when the enrollment is processed?

The enrollment department will contact the member to obtain the permanent address.

400

How many points is a high transactional error?

7!

Does everyone know where to find this? AARP Quality Evaluation Guidelines for Operations  

400

How many Points is a Disclaimer Error?

6!

(10 Errors)

Licensing, Email Opt In, Enrollment Disclosure

400

Are the Enrollment Disclosures required to be verbatim?

Yes!

(0 errors, great job).

400

With the addition of Propel we are no longer reading the Plan Options of Coverage from Step 10 for the PPO. We identified where to read the PPO required reads,  What about the DeltaCare Summary?

This is still located in Step 10 since nothing has changed with the HMO plans.

Remember if both plans are offered we must read both summaries.

500

Do you need to transfer to service after completing an enrollment to add a mailing address to the record?

No, Service agents cannot add a mailing address to a NM either.  The mailing address on the enrollment will update in Breeze. 
500

What are considered high transactional errors?  (Two)

Updating demographics

Verifying mailing or email address when sending fulfillment items.

Seems pretty easy to avoid, don't ya think! ;)




500

What is required for Benefit Review?  (2 things)

Plan Options of Coverage

Read Plan Benefit Table, all items in Bold required start to end.

500

Can I just refer to the new plans as Plus, Propel, and Protect?

Yes, as long as you have said the full plan name ONCE during the call, you can then refer to them in this shortened format.