The Centers for Medicare and Medicaid Services (CMS) requires that the Scope of Appointment (SOA) must be agreed to by the Medicare beneficiary prior to any face-to-face personal/individual marketing appointment for a Medicare Advantage or Prescription Drug Plan. An SOA is not required for Medicare Supplement Plan presentations. Agents can document the SOA in writing via an SOA form. If the SOA is being documented by recording a phone call in advance of the appointment, the call should be placed by the plan sponsor and not the agent. Agents shall only discuss during that appointment those products that have been agreed upon by the beneficiary during that appointment. If the client requests to discuss a product outside of the original SOA form, the agent must complete a new SOA form and schedule a second appointment no sooner than 48 hours. Agents shall comply with each plan sponsor’s requirements for submission of the SOA form and retain a copy of the form for at least 10 years. An SOA form cannot be used for more than one appointment; each appointment requires a separate completed SOA form.
Policy and Procedures for Leads and Scope of Appointment
Unsolicited Contact, Lead Management and Lead Referral Process Policy and Procedures
The Centers for Medicare & Medicaid Services (CMS) prohibits making unsolicited contact with consumers. Consumers must grant permission for agents to reach out to them with regard to Medicare Advantage (MA) or Prescription Drug Plans (PDP). Some examples of unsolicited contact include, but are not limited to, door-to-door solicitation and telephonic or e-mail solicitation without permission to contact. Agents shall not contact consumers about MA or PDP without procuring a permission to contact.
Agents are responsible for ensuring that if they use a lead generation company, the leads are obtained in a manner that is compliant with CMS regulations and respective plan sponsor(s) policies. Agents may not accept MA or PDP leads resulting from an unsolicited contact made by a third party to a consumer. Agents are responsible to ensure MA or PDP leads purchased have the required permission to call documented.
Agents may not ask a beneficiary for referrals. Agents, however, may give their business card to a beneficiary if the beneficiary would like to refer a friend or relative to the agent. In all cases, a referred individual needs to contact the agent directly.
Since joining TMS 4 years ago, I have not only expanded my Medicare knowledge but also my flexibility of contracting with multiple companies. The support I get is fundamental to having access to contracts, product knowledge and meeting many other agents with the different companies I represent. TMS has helped me become better educated and prepared for the different obstacles in dealing with the whole range of issues that are part of the Medicare plans!
I’m happy to be a TMS agent because through my career TMS has given me the most support . TMS ensures all possible resources and tools are available to me to ensure success. Furthermore, we are an agency that cares about the clients first. That philosophy ensures our continuing growth. I’m proud to be a part of such wonderful team.
“Excellence at it’s finest” – when we came to TMS our sales were dismal with no FMO Support to speak of. TMS helped us make the tough and right decisions for our company, resulting in the most successful turnaround, all within a year.
Working with TMS has been an incredible experience because of the support I receive. I’ve never felt alone, in fact, I feel like I am part of a family which is so important in this business.
When you’re searching for an FMO or a general agency, you want to know that you are being supported. Here are just a few of the things you can expect from TMS.
Our group E&O program offers the lowest rates we’ve seen for non-captive agents. Protect your business with this value-added program from TMS.
Our contracting team is here to support you in getting contracted and appointed with our many carriers. You will not feel alone.
Medicare Insurance Direct
Your FREE personalized consumer-facing quoting and enrollment URL.
We have an exclusive 10 hour self study training program as well as several hours of videos to help you become an expert on Medicare.
We do regular webinars to keep our agents engaged and to make sure that you are writing as much business as you would like to be.
Quoting and Enrollment Website
We give you access to our online quoting and enrollment tools. You can quote several companies and enroll clients, all from one website.