Helping a customer is important. A bit of “housekeeping” that is required to achieve before assisting a customer, employer, or employee with financial help or enrolling in an ACA plan, is that you must receive their consent. There is no specific form provided by CMS, but you can use a Broker of Record form administered by an issuer, AOR forms provided by the carrier, or from the State Department of Insurance. The form will need to include what is listed below:
- The name of the customer
- The date consent was given
- Who the consent was given to, including all agents or brokers that were approved by access.
- Consent to have and use their Personally Identifiable Information (PII).
- Point out that the customer may, at any point, dismiss any part of the authorization.
- Limitations that the customer may want to place on behalf of your access.
When guiding a customer over the phone, the consent can be attained via reading a script. The script must include all of the information listed above, but if you feel the need to add more, that is perfectly acceptable as long as the information is of value. Remember, the client may opt out of speaking about personal matters over the phone. You must record, in writing, that the consent was obtained. Getting this information helps with any compensation misunderstandings and satisfies any CMS consent requirements. This process may also be completed via email or mail.
Another way many agents get consent is through outreach events. At these events, you can create sign-up sheets where customers provide their name and contact information. For these sheets, you must inform your clients that by signing up, they are giving you full disclosure to contact them with information about application and enrollment. PII that is received from sign-up sheets should be held in a secure manner, and the only people that should have access to it is staff that needs it for work obligations. Once the customer is contacted once, it is advised for the agent to get a more detailed consent for that is tailored to the customer.
In the case of direct contact with a customer, you are still required to attain consent. You must follow the same procedure for storing the information as well. It is possible to receive a customer’s PII via third party. This happens if you are contacted directly. If you decide to contact the prospective customer, then you will want to get a consent form and follow the same instructions as before when securing the information received.
A consumer can revoke their consent at any time. All consent forms should be secured and kept for at least ten years.
This information is important, especially for new customers/clients. Agents need to know why consent is important and understand that it is required by law to obtain it. Below are some great resources on consent:
- https://www.dwt.com/advisories/CMS_Finally_Issues_Informed_Guidance_on_Informed_Consent_2004_Interpretive_Guidelines_Revised_05_14_2007/
- https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/downloads/SCLetter07-17.pdf
- https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/Downloads/Informed-Consent-Document-Quality-Measure-Public-Comment-Summary-Report.pdf
For questions or comments regarding consent forms, please contact Agent Pipeline at 800-962-4693. One of our providers would be happy to assist you!
