Address Change
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.
Can a plan change be denied in states that have underwriting to Accept/Deny?
Yes.
What article can you use to determine if a plan has lesser or higher benefits?
Go to article Equal to or Less than Medicare Supplement Plan Benefits Listing - UHC
A member calls with interest in enrolling for her and he husband. When should you complete regulatory for the spouse?
At the start of the call. This is a sales discussion for two enrollees and we should create the opportunity and do Regulatory at the start.
Note: If you do not authenticate, update record, open opportunity, and complete regulatory for both at the start of the call, you leave yourself open to error.
A third party calls on behalf of an IM. How do you know what information can be released?
Releasing Information To An Unauthorized Person - UHC
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.
The member has Plan G01 and wants to change to N01. What article do you check to see if an application is required?
Plan Change Rules From Existing Legal Entity Modernized Medicare Supplement Plans
What article has a listing of states that have a Birthday Enrollment Period and the related article with specific information.
Birthday Rule state listing - UHC
Regulatory identifies Medical UW is required. If it is a same day callback, does the UW Decision Tree have to be reviewed again?
Yes, they must do them again because of the transfer of the data from Underwriting Decision Tree to the application.
A wife calls to enroll and says I want to enroll in the same plan as my husband. She verifies his name and DOB. Can we confirm his coverage?
No, unless she is an authorized party.
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. Once processed enrollments will contact the member to verify physical location.
The member has plan J and wants to change to G. What article do you need to review?
Plan Change Rules From Standardized and Pre-Standardized Medicare Supplement Plans
What article lists the plans an applicant can change to without UW in MD? Name two articles.
Maryland Medicare Supplement Plan Change Specifics - UHC
Plan Change Rules fore ELE
What tool do we use to identify plans available for plan changes?
The Optional Decision Tree --
You can also use Knowledge, State Product Availability and the new Birthday Rule article
An account populates but is not authenticated. We can clearly see the name and address matches but the DOB does not and they do not have their membership number. What do you do?
Create a new record.
Where do you add a temporary or mailing address for a NM?
Where do you add it for an Insured Member?
Trick Question. You cannot!
Once insured, only service can add to the record.
What two states now require applications for Plan Changes to Plan N?
MD and Utah
What article just got released and includes better options for Under 65 applicants with ESRD or ALS?
Texas Open Enrollment Period with ESRD or ALS (50-64) UHC.
A POA calls for his father, but the caller does not enroll the person and says "Can you call me back later today when my wife (who is also a POA) is home from work... Can you call the POA?
Trick Question: yes and no.
You may not callback a POA for MS but you can for Medicare Plans -- see Diary Callback Scenarios.
You can call back the original caller, but you may not call and ask for his wife.
A potential enrollee wants to change the HH address but cannot identify the other HH member on the record. Can you change the address? They are not insured.
No. IM/Um/NM rules are the same. Create a new record for the member and completed a mailed application. Have them add their membership number to the application and once returned it will join up with the newly created record. NO VS!
see Incorrect Contact In A Household - UHC
Do you need to transfer to service after completing an enrollment to add a mailing address to the record?
Is a plan change required when an NLE plan holder moves into a state that does not have NLE plans?
No. Check out NLE New Legal Entity Talking Points
Can you name the article that was just released with changes to how we add an apt number to the address field?
Apartment/Suite/Unit Address Standardizing - All Staff
Always check for Breeze Home page Alerts and News Releases!
A wife calls for her herself and husband and we review the UW tree with her for both. Later the husband comes to the phone to do the VS. Do we have to do UW questions again?
Yes, his voice is his signature and he did not answer those questions himself.
Note: You could do a Third Party VS and use the wife's responses though!
A third party calls and is not authorized on the IM account, but does authenticate the record. Can I renew their membership?
Yes, AARP is not HIPPA protected. We still must authenticate a record per our policy but once authenticated CAN review membership expiration and due dates.