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I am a licensed insurance agent in multiple states and have been since the early 90s. Sadly, the last few years of social media and TV advertising lowered our industry standards. The previous oversight in the Medicare sector keeping my lesser peers in check, was all but discarded during the last administration, and abusing the Covid-necessary remote signature options implemented.

 

I am 65 and receive the same mix of calls, emails, and USPS solicitations daily. My callers, ignore my DO NOT CALL list entries, on my home, fax, or business lines – when asked, some even admit their organization doesn’t check the list. I received a call the other day violating Medicare’s Marketing Guidelines when they started talking immediately about Medicare Advantage plans in my area – but didn’t know what state they had called. I decided to play along.

 

The 1st Talker verified my “false name,” “fake date of birth,” and current zip code. Before the hand off, I asked Talker 1 what company he represented, how was his weather? His company, “Scam One,” interestingly not the "State of Maine" showing on my Caller ID. Although, his local weather report identified another State about 1000 miles away.

 

Talker 2 reverified my info given to 1 and asked about my current plan. I used my current plan’s company – a 5 star-rated plan in this market. She quickly changed subjects to the weather, weekend plans, nothing insurance related – keeping me in que for the licensed agent to wrap up another victim. I asked what company she worked, and she replied, “Scam Two.” She replied to my weather question disclosing she was in State 2 across the country from the first guy. She introduced, or tried to, a New Company with a “generous” Giveback benefit – I told her they have a poor provider network, clearing missing my level of product knowledge. She then went on about her weekend plans for another minute before a warm hand off with her “agent.”

 

Talker 3 – a licensed agent – I’ll name Pond Scum, who again verified my info and proceeded to ask what I didn’t like about my plan. I told him the Dental benefit could be better; he claimed to represent my plan. I asked him if he needed my drug list? No. Doctors in multiple states? No. Unfortunately for him, by then, I was looking at his licensing entry page on my state’s bureau of insurance website – he was NOT appointed with my plan. Also, with a few innocent questions on my part admitted he was in State 3 working for another company, Scam 3. Three different states, three different company names.

 

I tried to help him out of his appointment lie with my plan, even noting the insurance department’s webpage, he insisted Scam 3 represents their plans. I again reminded him, while they may, he legally is not appointed; and again, he assured me, he could talk about their products – at this point I informed him that I had detailed notes of the entire call and would happily share their numerous violations with my state’s insurance department, CMS, and both company’s compliance departments. After 30 seconds of dead silence on his end – the call dropped. Within the hour all organizations had my detailed report, including company names, states, and pictures of Caller ID and PDF of his state licensing page.

 

These mega-call centers, celebrity TV ads, are not in business to help you; they are out to make a quick buck. Most have different websites, 800 numbers, and company names each year. A simple form moves their commission from old to new. When the regulators come calling, they don’t know anything about the old company or staff. The CMS Medicare Complaint line has seen a doubling of complaints year over year since these call centers started. They are sophisticated organizations, purposely operating in several states, under different names, using VOIP phone systems to bounce callers all over the country making them impossible to track down and be held accountable by any single state regulator, let alone several.

 

The multi-stepped manipulation to keep you on the call, keep you answering questions, setting you up for YES. And as for your call, they only record the last segment. If, I would have given Pond Scum the opportunity, he would have sold me anything having a better dental benefit. He would read the half-dozen required compliance statements and get my affirmation on each, on the call recording. So, when I complain, the call recording has me saying YES to everything – and he’s off the proverbial hook – I agreed to it! But I can tell you, you will almost assuredly be left without your doctors, drugs, and a hand full of unpaid claims. I see it every week and dozens of my peers do as well. Some advice…

 

Use a LOCAL AGENT recommended by friends or friends of friends. I operate primarily in two states but hold licensure and appointment in five to serve my clients. My business grew from referrals from my clients – a good agent has plenty of client referrals and stays busy helping their clients. A good agent doesn't need to advertise. I know my client's doctors, hospitals, pharmacies, and companies in my two states – and locally where clients live in other states.

 

Agents in the Medicare sector are required to complete annual trainings from one of several national organizations as well as each insurance company’s certification for each of their product families – about two- or three-weeks total training prior to annual enrollment each October. Our local un-licensed volunteers get a few hours covering nearly 60 plans. How can you an be a plan expert in two minutes or less?

 

Finally, a complete compliant sales meeting should take a minimum of an hour for existing clients and likely two hours for couples or new clients; and they should verify every doctor and drug before enrolling you. If your agent doesn’t return your calls, or worse you can’t call them, change agents!

 

The author, co-founder of Image Insurance Group, LLC and Owner of Maine Senior Insurance, LLC. In addition to his insurance practice, he serves on the Board of Directors of NAIFA Maine, an industry advocacy organization.

 

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