Why Is There A Compliance Program For The Insurance Industry?
CMS, or Centers for Medicare and Medicaid Services, is a federal agency within the Department of Health and Human Services (HHS) that manages and administers various health insurance programs. The primary purpose of the regulations they make is to ensure consumers, especially those in vulnerable demographics, are protected. To do so, they closely regulate and monitor both agent and carrier activity with a strong checks & balances system – without CMS, there would be no guidelines nor best practice standards.
Let’s go over a few things that, as an insurance agent, you should keep on your radar!
The Rules Are Always Changing
The Centers for Medicare & Medicaid Services are constantly working to find the best ways to protect consumers. As a result, they issue a new final rule every year that contains changes and additions to guidelines and regulations. It can take some time to fully understand the new rules each year.
At Fidelis, we are continually researching these changes (both proposed and final) so that we can keep you informed and give you the most accurate information. Please read through the Compliance Resources in our Agent Hub – we keep all information up-to-date – and if you have questions, reach out at Compliance@fidelisins.com!
It’s Better To Be Safe Than To Be Sorry
In other words, err on the side of caution. Medicare and Medicaid marketing and sales are highly regulated in order to protect a vulnerable demographic. The rules and regulations are not meant to make your job difficult, their purpose is to protect the elderly and disabled and empower them to make the right decisions for their needs.
The regulations require you, as an agent, to be fully transparent with your clients and prove that you are doing so, which means that you are also protecting yourself and your business in the process. If you think you should record a phone call or conversation, record it. If there is a remote need for permission (permission to contact or prior express written consent), obtain consent. It never hurts to be cautious, and your chances of founded compliance allegations decrease dramatically with caution and evidence.
When In Doubt, Ask It Out!
If you have a compliance question or concern, please reach out to your Fidelis Sales Team or Compliance Team. We are here to provide you with the most accurate and up-to-date information, review your communication and marketing materials, and help you make compliant sales presentations. We are your partners in success.
Fidelis Consultants is dedicated to helping you succeed in all aspects of your business. If you need help or want more information about what we can provide, please contact the Fidelis Team!
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