Common use of Agent Conduct Clause in Contracts

Agent Conduct. Agent agrees to disclose to any prospective Eligible Medicare Beneficiary prior to or at time of enrollment that the Agent is compensated based on the prospective Eligible Medicare Beneficiary’s enrollment in a plan. Agent further agrees to not engage in the following prohibited sales practices: (a) Making unsolicited home visits; (b) Soliciting Beneficiaries door-to-door prior to receiving an invitation from the Eligible Medicare Beneficiary; (c) Placing outbound calls to prospective or former members, unless the Eligible Medicare Beneficiary requested the call and their solicitation for information is documented; (d) Sending unsolicited emails to a Eligible Medicare Beneficiary unless the Eligible Medicare Beneficiary agrees to receive emails and has provided his/her address to the Agent; (e) Misrepresenting, intimidating, or using high-pressure sales tactics. If Eligible Medicare Beneficiary says he or she is not interested, the conversation must end; (f) Offering Eligible Medicare Beneficiaries a cash payment as an inducement to enroll in a Medicare Advantage Part C or Medicare Advantage Prescription Drug (Part D) plan; (g) Stating that the Agent works for or is contracted with the Social Security Administration (SSA) or the Centers for Medicare & Medicaid Services (CMS); (h) Misrepresenting a product being marketed as an approved Medicare Advantage Prescription (Part D) plan when it is actually a Medigap policy or non-Medicare drug plan; (i) Using an unapproved presentation or material. Agent shall use only those subscription forms, insurance applications, printed materials, and any other sales or marketing materials as are provided by Insurance Company, except as Insurance Company may otherwise approve in writing; (j) Marketing or enrolling other health care lines of business. Additional products that were not identified, agreed upon, and documented in the Scope of Appointment cannot be discussed unless the Eligible Medicare Beneficiary requests this information. A separate Scope of Appointment is required to discuss additional products; (k) Requesting Eligible Medicare Beneficiary identification information such as bank account number, credit card number; (l) Conducting outbound telephone enrollment, which also includes transferring outbound calls to inbound lines for telephone enrollment; (m) Engaging in forgery, including manually assisting Eligible Medicare Beneficiary with the signing of the enrollment application; (n) Engaging in unauthorized language interpretation; (o) Disseminating inaccurate or false enrollment materials; (p) Enrolling Eligible Medicare Beneficiary(s) at educational events, or in healthcare settings (waiting rooms, exam rooms, hospital patient rooms, dialysis center, etc.); (q) Scheduling unauthorized group presentations. Agent must obtain approval from Insurance Company prior to organizing or advertising a group presentation (30) days in advance; and (r) Engaging in any other conduct that CMS prohibits in the future, or which ▇▇▇▇▇▇ deems prohibited in the future, based on interpretation of current or new CMS guidance.

Agent Conduct. Agent agrees to disclose to any prospective Eligible Medicare Beneficiary prior to or at time of enrollment that the Agent is compensated based on the prospective Eligible Medicare Beneficiary’s enrollment in a plan. Agent further agrees to not engage in the following prohibited sales practices: (a) Making unsolicited home visits; (b) Soliciting Beneficiaries door-to-door prior to receiving an invitation from the Eligible Medicare Beneficiary; (c) Placing outbound calls to prospective or former members, unless the Eligible Medicare Beneficiary requested the call and their solicitation for information is documented; (d) Sending unsolicited emails to a Eligible Medicare Beneficiary unless the Eligible Medicare Beneficiary agrees to receive emails and has provided his/her address to the Agent; (e) Misrepresenting, intimidating, or using high-pressure sales tactics. If Eligible Medicare Beneficiary says he or she is not interested, the conversation must end; (f) Offering Eligible Medicare Beneficiaries a cash payment as an inducement to enroll in a Medicare Advantage Part C or Medicare Advantage Prescription Drug (Part D) plan; (g) Stating that the Agent works for or is contracted with the Social Security Administration (SSA) or the Centers for Medicare & Medicaid Services (CMS); (h) Misrepresenting a product being marketed as an approved Medicare Advantage Prescription (Part D) plan when it is actually a Medigap policy or non-Medicare drug plan; (i) Using an unapproved presentation or material. Agent shall use only those subscription forms, insurance applications, printed materials, and any other sales or marketing materials as are provided by Insurance Company, except as Insurance Company may otherwise approve in writing; (j) Marketing or enrolling other health care lines of business. Additional products that were not identified, agreed upon, and documented in the Scope of Appointment cannot be discussed unless the Eligible Medicare Beneficiary requests this information. A separate Scope of Appointment appointment is required to discuss additional productsproducts and a 48 hour "cool off" period must be observed before a second appointment can be scheduled; (k) Requesting Eligible Medicare Beneficiary identification information such as bank account number, credit card number; (l) Conducting outbound telephone enrollment, which also includes transferring outbound calls to inbound lines for telephone enrollment; (m) Engaging in forgery, including manually assisting Eligible Medicare Beneficiary with the signing of the enrollment application; (n) Engaging in unauthorized language interpretation; (o) Disseminating inaccurate or false enrollment materials; (p) Enrolling Eligible Medicare Beneficiary(s) at educational events, or in healthcare settings (waiting rooms, exam rooms, hospital patient rooms, dialysis center, etc.); (q) Scheduling unauthorized group presentations. Agent must obtain approval from Insurance Company prior to organizing or advertising a group presentation (30) days in advance; and (r) Engaging in any other conduct that CMS prohibits in the future, or which ▇▇▇▇▇▇ deems prohibited in the future, based on interpretation of current or new CMS guidance.