Frequently asked questions

Overview

What are all of the online systems we use? And what are they used for?


  • Airtable - CRM
  • Zipwhip - texting
  • Cognito Forms - Application
  • Sign Request & Adobe - send/sign documents
  • Healthsherpa - view all applications and see plans (agent version of healthcare.gov)
  • Zywave - group policy information for any company (not just ones we cover)
  • Medicare.gov - plan information (i.e. how much prescriptions cost)
  • Carriers - each carrier has their own site with plan and client information
  • Healthcare.gov - client login to see plan and update their information
  • Burwick - upline for MedicareBrokers
  • Alliance - quote for Life insurance
  • Compass - our upline
  • AHIP - testing for agents
  • GoodRx - prescription discount
  • Plug & Play - task management
  • TWP Employee - timeclock
  • Healthcare Bluebook - cost for procedures with no insurance
  • Zapier - automation
  • Canva - editing pictures
  • Viddyoze - animations for intro videos
  • Unsplash - stock photo
  • Thinkster - auto-send cards (via Zapier)
  • Bear Bones IT - phones
  • FaxBetter - faxes
  • OnceHub - Scheduling software for website
  • Wix - website, LMS




What is a cognito form?


-Secure form processing that was built and owned by Compass -Authorization from the client to do a policy -Lasts for 5 years, unless something “big” happens (i.e. get married) -Not very customizable -Manual process to add contact into Airtable




Who is Compass?


Compass is our upline company. The Executives that we work with are Arthur and Royce




What is the effective date when a baby is added to a plan?


The plan is back dated to birth date




What is some common Insurance lingo?


SEP = Special Enrollment Period FFM = Federal Marketplace YHI = Directly to carrier to make plan




What is SureBridge?


-SureBridge is a carrier that does Indemnity (pay you rather than institution) -Afflack is a similar carrier -Accident Companion: ER and InstaCare visits are treated the same




What is an Effectuation Report?


An Effectuation Report shows what clients have paid (Selecthealth sends report in an Excel spreadsheet) Non Effectuated = no payment




What are examples of length of insurance plans?


Short term - most medical insurance Medium term - i.e. SureBridge Long term - Life insurance




What Life Insurance Carriers provide living benefits?


Midland is the only Carrier that provides living benefits in every plan, other carriers these benefits are an add on that client has to pay for




Cons for Alliance


-Not good for just prescription drug coverage. -Dental doesn’t fully cover preventative, instead it is a Dental savings plan and the carrier covers a % of the preventative costs




What information in a plan is based on income?


-Tax Credits -Premiums




What if someone has pre-existing conditions?


For Marketplace pre-existing conditions don’t matter





Office

How to name a file in the shared Google Drive?


File naming style: Client last name, Client first name, Year of application, company name (optional), Type/Category, Note (optional) i.e. Abbott, Jared 2017 ACA App Example: https://docs.google.com/document/d/1cMU-F2AeH-XKQ1oohHatvjOqnQ6Rd7j_et4jw3WnCKU/edit#





Customer Service

What are typical questions from Clients?


January - Haven’t gotten my ID card (answer: you’ll receive it after your first payment) - New policy information - Subscriber ID (answer: most Carriers provide online) Any time - What’s my premium? (answer: check Airtable or carrier website) - Income change, if it’s $5k-10k+ their plan might change (customer service doesn’t need to do this, pass to Tyler) - Status update (answer: check Airtable) - Is something covered? (answer: typically if it’s preventable, yes) - Client cancelled their plan but still gets charged Open Enrollment - Schedule an appointment (answer: with Tyler over the phone or in person, phone is encouraged right now due to Covid)




When can we adjust a client's plan?


We can add/update a plan any time, not just open enrollment (i.e. add a baby have 60 days from birth day)




What is my basic job description?


Customer Services knows how things work (details), Sales know the different plans (currently only Tyler gives quotes)




What happens if a Client's address changes?


Depends on where they move if plan is still available. If the plan is still available they can continue on it. When we update the address in our system it won't update for the Carrier. Address will only update with Carrier if the plan changes.




What happens if a Client gets married?


If a client gets married they can stay on separate plans for rest of that year (until December 31st) or combine, but the next year they need to be together.




What is the definition of a Year?


Typically a year is Jan 1st - Dec 31st OR whenever client signs up to Dec 31st -Groups: Deductible is Jan 1st - Dec 31st but plan is whenever they signed up (i.e. May 1st - April 30th) -Supplemental (vision/dental): The year depends on the carrier




Can a client have coverage in a different state?


Yes. The process is easy for vision/dental but NOT health




When does Medicaid coverage kick in?


Can take up to 3 months before client receives coverage. Sometimes we will sign client up for a non-Medicaid plan, then cancel once Medicaid kicks in.




When does a policy become active?


Policies are not considered active by the carrier until the first payment has been made.




What carrier provides just Vision insurance?


SureBridge is the only plan just for Vision (EyeMed). All other plans can add Vision.




What qualifies for Special Enrollment?


-If denied Medicaid client can apply for regular insurance -Enrollment after 60 days of loss of job is flexible, can be up to 90 or 120 days




Can we print Insurance Cards?


The Carrier sends out the Insurance Cards (not us), but we can give the client the phone number to call -Exception: we can print/email National General




Blue Cross Blue Shield name


Blue Cross Blue Shield has different names in different states. i.e. Utah is “Regence” and California has 3 different names depending on location (north, central, south)




Phone Basics


-Texting: Reply as if you are Tyler, unless you are initiating a conversation then you can introduce yourself -99% of the calls say “I was looking for Tyler” Ask them if it is something urgent and that you might be able to help them. If not, ask if it’s okay for Tyler to call them back.

  • Tyler has an hour each day (typically 11-12) when he can call people back. Tell the person “Tyler has availability at this time…”. On Tyler’s Google Calendar during the open slot add the persons name, phone and notes so that Tyler has information for the call
  • Tyler can call back 1-3 people during the hour block each day, depending on the type of call
-A lot of times people ask what their status is on their application. If we are still waiting for approval say something like “Your application has been submitted, we are waiting on the government to approve, they typically approve 99% of the time.” -Quote office hours so they are aware. But can say “Tyler will call you on Friday.” This makes the person feel like we are going out of our way to call them back.




How to schedule someone over the phone?


-Scheduling for Advising

  • Pretend agency is bigger than it is, i.e. don’t say Tyler’s name until calendar is pulled up and scheduling the appointment. Say something like “we can schedule you with one of our agents”
  • Ask the Pre-quote questions found on the print out. If the person is busy we can email them the questions to prepare. Say something like “This information is to give to the agent before your appointment.”
  • Write the answers into the person’s Airtable profile
  • Go to the website schedule page
  • Ask the person if they’d like to meet in person, over the phone or screen share
  • Select the option the person chose, then you’ll see the availability
  • Give the person 1-2 options by saying something like “Would you like morning or afternoon?” and then “We are booked up/full until (date)” or “We have a few available times on (date)”
  • Once the person has chosen a date/time select it, hit okay, then fill out the client information. Ask them if it’s okay to send text reminders for the appointment. The “Your Note” section is visible by the client. Don’t put anything rude!! ;)
  • Once the form has been submitted this will add to Tyler’s calendar and send an email to tyler and the client
  • The person will receive auto reminders via email and text (text is just 1 reminder 1 hour before appointment)





Verifications

What information can we push back the due date?


Income is the only one that we are able to push back the due date (up to 3 months)





Applications

Healthcare.gov questions/process


  • Been denied through Medicaid? If you select NO the next page says that if the person is under 18 they need to apply for CHIP. If you know the person would be denied for Medicaid, select YES
  • Next question asks what date the person got denied: put the 15th of the previous month
  • Coverage Info: did anyone apply during (specific dates)? Select NO
  • Coverage Info: Currently covered? Technically yes, but select NO if in the process of switching plans
  • One page on healthcare.gov = one line on Cognito Form
  • There are two forms you can fill out, short form or long form. Short is 5-6 “chunks” of info (this form has only been available for a few years). Long form is 40 pages of information.
  • HeathSherpa has an even shorter form
  • Eligibility Results Notice document: If the Enroll in coverage is blank, need to send in more documents. We typically refer to this document more than the application.
  • Big green button “Pay” takes you to carrier page to pay
  • Cigna does not allow agents to make payments, give info to client to call to make payment. All other Carriers we can set up the first payment.
  • Before done with in healthcare.gov click on “My Plans” (if logged is as the client) and save page




Should I save forms and applications?


Throughout the application process (no matter what carrier) save as many files as you can to refer back to. Add all documents to the drive




Can I change client information on an application?


Agents can edit application information according to the cognito form information




Is there an Application fee?


Yes. Here is the break down. -Waive fee from the 1st-20th of the month -$25 from 20th-25th of the month -$50 from the 25th to the end of the month





Sales


Payments


Public Connections


IT


Leadership


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