Sales Oversight & Thoughts on CMS Updated Agent Training Guidelines

As you likely noticed, CMS recently released its updated Guidelines for Agent Broker Training and Testing for CY 2013 on August 21. Our in-house compliance experts have cross-walked the new regulations with the old ones from last year and here’s our take: for the most part, the updated guidelines should be business as usual.  However, it is interesting to take note of where CMS is going to greater lengths to provide additional clarity or requirements.

Here’s our take on a few additions:

• Under the Beneficiary Protections section, new requirements were added on the education of agents on Aggressive Marketing. More specifically, you’ll see requisites on things like what the potential consequences will be for engaging in Aggressive Marketing activities, report requirements, plan disciplinary actions, termination rules, and compensation forfeiture guidelines.  Again, while this isn’t new, it’s now part of the training requirements and necessitates additional preparation, as plans now need to inform the agents about their specific disciplinary process up front.  Agents now need to be educated on scenarios that clearly define, “if agent does X, the penalty is X.”  Plans should take the time to create an offense ranking matrix and a disciplinary scale that escalates based on number of infractions or severity, and educate their agents ahead of time.  Of course there will always be new situations that pop up, but this is not a process that should be created on the go.

• There are quite a few updates focused on “do’s and don’ts”. We saw these added under Marketing for things such as scripts, health screenings, and contact information and again under a new section on Rewards and Incentives.  This is in place to educate agents on what the process should look like in order to help identify any plans that try to get a little too “creative” in some of these areas.

Both of these additions are all about starting to compare processes across some of the (historically) more challenging areas for sales & marketing and compliance departments to manage.  CMS fully encourages plans to forge their own respective path when it comes to agent oversight. They recognize it’s not a one-size-fits-all solution, but with information like this now more accessible, it also allows them to start identifying more instances of what’s working and what’s not.

Stay tuned for the latest analysis on the updated training and testing guidelines.  As always, contact us with questions and be sure to check out the Point — launching in October.