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Agent Update
Humana Update: Enrollment Reminder
Humana is committed to becoming the most trusted name in health solution. As an industry leader, they expect a high degree of professionalism and integrity from all sales agents that represent them.
Please take a moment and review these important enrollment reminders.
Licensing - All Agents selling Humana plans must be licensed in the state in which the Medicare beneficiary resides, not just where the sale is made and/or where the agent resides. These rules are in accordance with state laws. Agents must also be appointed with Humana in the state in which the enrollee resides.
Certification - Agents can only enroll members in a plan for which the agent is currently certified to sell and solicit.
NOTE: Agents who fail to meet the licensing, appointment and certification requirements will not be paid for any business submitted.
Compensation Disclosure - CMS requires agents to distribute the compensation disclosure in print during any presentation or enrollment.
PFFS Disclosure - CMS requires agents to distribute the two PFFS disclosure documents in print during any presentation or enrollment in PFFS plans.
Sales Presentations - The CMS-approved Humana Sales presentation (MA or PDP) must be used when presenting Humana benefit plans. In addition, enough time should be allotted for each appointment to ensure the presentation is given in its entirety with time for questions and a verification call. Agents should plan on a minimum of one hour.
Changing Enrollment Applications - No changes can be made to paper applications, regardless of the intent.
Creditable Coverage - Agent must always answer question 3b concerning creditable prescription drug coverage. Answering this question incorrectly puts the enrollee at risk for no drug coverage or additional penalties.
BR/GN - Agents should use the proper BR/GN number when using a paper application to enroll to ensure timely application processing.
Enrollees Understanding of Plan - Agents are responsible for assessing, to the best of their ability, the competency of their client so they enroll people who understand and want the Humana plan.
Verification Completion - An inbound verification call must be completed on all MA enrollments whether paper, T-Sig or MAPA applications. The agent writing the application must be part of the call - it can not be delegated to an assistant, etc.
Click here to view Humana's MarketPOINT Compliance Alert with complete details.
Humana, values their members and the agents that serve them. It is as simple as that.
If you have any questions please feel free to contact our office at 1-800-962-4693.
