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Justin Else By Justin Else • January 20, 2017

The Forgotten SEP Code That Every Agent Should Know

Another open enrollment has come and gone.  So selling Medicare plans are over correct?  What if we told you that there is another SEP out there that allows a client to join or switch to a plan that has been awarded the coveted 5 stars by CMS?

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CMS, or Centers for Medicare & Medicaid Services, assigns a star rating to each Medicare plan ranging from 1 star to 5 stars (5 stars being the best). CMS bases this rating on the past performance of the plan in certain categories.  For more information on how CMS calculates plan ratings, click here. The 5-star rating system was first implemented by CMS for MA plans in 2008, serving as a tool to inform the beneficiaries as to the quality of the various plan options and assist the beneficiaries in the plan selection process.

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The star ratings are updated every October and are available on the Medicare Plan Finder as beneficiaries select plans for the upcoming year.  Anyone eligible for Medicare may use the 5-star SEP to switch to any 5-star plan one time each year from December 8th-November 30th.  Even if they are on original Medicare, enrolling into a 5-star plan gives them an SEP to enroll anytime during the year.  Coverage will start the first day of the following month after they enroll.

However, it’s not all roses and sunshine.  The bad news is that there are only a few select plans that have been awarded 5 stars, and they are in select areas.  For example, this year UnitedHealhcare rolled out 5 - five star plans just in Texas alone! Use the Medicare Plan Finder tool at Medicare.gov to see the quality and performance ratings of the plans in your area. 

Now here comes the good news! Using Connecture, our electronic enrollment system for Part C and Part D, allows you to enroll your clients electronically and compliantly in Part C & Part D plans.  This means that even if you are not in an area with a 5-star plan, you can sell these plans electronically to clients in that area.  If you would like more information about Connecture please click on the link: https://thebrokerageinc.com/resources/connecture/.

 

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Please reach out to us and let us help you take advantage of this opportunity to enroll more clients during the “slower” time of the year.  Reach out to your clients if you are fortunate enough to work in one of the 5-star plan areas, or use Connecture to expand your block of business into those areas.  Happy Selling!