At Health Plan Markets (HPM), we are committed to maintaining the highest standards of compliance and licensing. As an agent, staying compliant and properly licensed is crucial to your success, and we’re here to guide you every step of the way. Below, we outline our processes and the resources available to ensure you’re always up to date and prepared.
Compliance Overview
Our Compliance Officer, Tom Ryan, is your point of contact for all compliance-related matters. You can reach him at compliance@askhpm.com or by phone at (844) 696-3975. Compliance is the backbone of everything we do, and we make sure our agents are fully informed and supported.
1. Medicare Marketing & Communication Guidelines
Agents must follow the Medicare Marketing and Communication Guidelines, which are updated and posted annually. Any marketing materials you create must be approved before use to ensure compliance.
2. Certifications Required
- Medicare: All agents selling Medicare plans must complete the annual AHIP certification and a test for each carrier they represent.
- Individual & Family Plans (Marketplace): Agents selling on the Marketplace must complete the annual FFM training. This certification is required to represent all carriers offering plans through the Federal Marketplace. No additional carrier recertifications are required for individual and family plans.
3. Keeping You Updated
- We host Monday morning conference calls to keep you up to date on compliance regulations and updates from the Federal government.
- Important updates are sent via email, text, and notifications within HQ, our agent portal.
4. Common Compliance Violations to Avoid
Some common issues agents encounter include:
- Not ensuring that doctors are in-network with a new plan.
- Medications not being covered by the new plan.
- Failing to explain the type of plan (e.g., HMO vs. PPO).
- Not informing clients what happens to their old plan when switching to a new one.
- Not assisting clients with transition-of-care concerns.
5. Complaints and Compliance Process
Each carrier has its own process for handling compliance issues and complaints. Once HPM is notified of an issue, we reach out to you by email and phone to ensure you’re aware and can respond promptly. We request that you copy us on your response so we can guide you in resolving the issue.
Training and Education
While most compliance training is covered in your AHIP certification, we also provide marketing compliance training through our programs. We update agents on compliance during our weekly Monday morning conference calls and continually build out webinars, videos, and training modules in HQ to keep you informed.