events basics 06162016 original - unitedhealth group · events basics 06162016 original page 41 of...

Events Basics 06162016 original Page 1 of 80

Events Basics 06162016 original

1.1 Cover Page

1.2 Introduction

Events Basics 06162016 original Page 2 of 80

1.3 Marco & Phil: Introduction

1.4 Objectives

Events Basics 06162016 original Page 3 of 80

2. Types of Events

2.1 Introduction

2.2 Marco & Phil: Types of Events

Events Basics 06162016 original Page 4 of 80

2.3 Types of Events

educational event (Slide Layer)

Events Basics 06162016 original Page 5 of 80

educational member-only event (Slide Layer)

marketing/sales event (Slide Layer)

Events Basics 06162016 original Page 6 of 80

2.4 Types of Events

2.5 Event Format

Events Basics 06162016 original Page 7 of 80

2.6 Personalized/Individual Marketing Appointments

2.7 Knowledge Check

Events Basics 06162016 original Page 8 of 80

Correct (Slide Layer)

Incorrect (Slide Layer)

Events Basics 06162016 original Page 9 of 80

3. Venue Selection

3.1 Introduction

3.2 Marco & Phil: Venue Selection

Events Basics 06162016 original Page 10 of 80

3.3 Venue Selection Considerations

Best Practice If you are projecting your presentation onto a screen, ensure the consumers have unobstructed views and the text is readable from where they are seated. Best Practice Will the consumer in the back corner of the room or under the air conditioning vent be able to hear your presentation? Will noise levels outside the meeting space vary depending on the time of day? You want each consumer to hear your entire presentation, so be sure to consider factors that might contribute to them not being able to hear your presentation.

Events Basics 06162016 original Page 11 of 80

3.4 ADA Venue Considerations

Be aware... Agents need to be aware of and sensitive to the needs of the Medicare-eligible consumer, including language barriers and physical or cognitive disabilities. Look for indications that a consumer might need accommodations to meet their needs, such as a non-English speaking consumer struggling to understand your presentation in English or a consumer who appears to have difficulty hearing you despite your use of a microphone. There are a number of services and aids available at no cost to the consumer to accommodate their needs. Consumers can request certain Plan materials in alternate languages or formats, utilize the TTY/TDD or State Relay System when calling Telesales or Member Services, and request alternate language translation services or an American Sign Language interpreter at a formal marketing/sales event or personal/individual marketing appointment. Remember that you are only permitted to use authorized individuals to serve as translators or interpreters. Utilizing your family member or friend is not permitted. Let your consumers know of the services and aids available at no cost to them. Venues should have...Entrance doors that open automatically or a resource available to welcome and assist the consumer. Venues should have...Walkways, entrances, and hallways that are clear and dry. Handrails along stairways and/or ramps. Venues should have...Handicap and/or senior parking stalls close to entrances. Venues should have...Handicap accessible restrooms. Venues should have...Ramps and/or elevators as an alternative to stairs.

Events Basics 06162016 original Page 12 of 80

3.5 Additional Venue Considerations

Did you know...? It is acceptable to hold an event in an area completely separate from gambling activities, such as a conference room. Did you know...? Events may be conducted in common areas of healthcare facilities (e.g. conference and recreation rooms.) Did you know...? You will receive an "Unsuccessful Event" infraction (i.e., No-Show) if a shopper/evaluator cannot locate your event. Ensure your consumers will be able to locate you by accurately advertising the venue location, utilizing directional signage, and/or asking venue staff to direct consumers, if allowed by the venue.

Events Basics 06162016 original Page 13 of 80

3.6 Knowledge Check

Correct (Slide Layer)

Events Basics 06162016 original Page 14 of 80

Incorrect 1 (Slide Layer)

Incorrect 2 (Slide Layer)

Events Basics 06162016 original Page 15 of 80

4. Event Reporting

4.1 Introduction

4.2 Marco & Phil: Event Reporting

Events Basics 06162016 original Page 16 of 80

4.3 CMS Reporting Requirement

4.4 UnitedHealthcare Reporting Policy

Did you know? bConnected does not permit entry of an event within 14 calendar days of the date of the event. Because the event cannot be entered in bConnected, it will not be reported to CMS. Conducting an unreported event is prohibited. Did you know...? A single agent could put UnitedHealthcare at risk of receiving a Notice of Non-Compliance from CMS for not meeting event-reporting guidelines. Don’t fall into a mindset that what you do will not impact UnitedHealthcare’s ability to meet or exceed CMS’ expectations. Each agent is individually responsible for, and expected to comply with, event reporting rules for the events he/she is scheduled to conduct.

Events Basics 06162016 original Page 17 of 80

4.5 Reporting Basics

Where (Slide Layer)

Events Basics 06162016 original Page 18 of 80

When (Slide Layer)

Who (Slide Layer)

Events Basics 06162016 original Page 19 of 80

What (Slide Layer)

Products (Slide Layer)

Events Basics 06162016 original Page 20 of 80

Classified (Slide Layer)

4.6 Reporting Basics

Events Basics 06162016 original Page 21 of 80

4.7 Knowledge Check

Hotspot 1-Correct-10th (Slide Layer)

Events Basics 06162016 original Page 22 of 80

Hotspot 2-Incorrect 11th-31st (Slide Layer)

Hotspot 3 - Incorrect - 4-9 (Slide Layer)

Events Basics 06162016 original Page 23 of 80

Hotspot 4 - Incorrect - 1,2,3 (Slide Layer)

4.8 Reporting Changes and Cancellations of Events

Events Basics 06162016 original Page 24 of 80

Q1 (Slide Layer)

Q2 (Slide Layer)

Events Basics 06162016 original Page 25 of 80

Q3 (Slide Layer)

4.9 Cancellation Procedures

Events Basics 06162016 original Page 26 of 80

4.10 Cancellation Procedures

Note! In cases of inclement weather or other extenuating circumstances that result in an unavoidable, last minute cancellation, ask the venue to post a sign making consumers aware of the cancellation.

4.11 Event Reporting-Related Infractions

Events Basics 06162016 original Page 27 of 80

Unreported event (Slide Layer)

Late reported event (Slide Layer)

Events Basics 06162016 original Page 28 of 80

Late reported change/cancellation (Slide Layer)

4.12 Knowledge Check

Events Basics 06162016 original Page 29 of 80

Correct (Slide Layer)

Incorrect (Slide Layer)

Events Basics 06162016 original Page 30 of 80

5. Conducting an Educational Event

5.1 Introduction

5.2 Marco & Phil: Conducting an Educational Event

Events Basics 06162016 original Page 31 of 80

5.3 Educational Events

5.4 Advertising an Educational Event

Events Basics 06162016 original Page 32 of 80

5.5 Materials at an Educational Event

5.6 Meals and Refreshments at an Educational Event

Events Basics 06162016 original Page 33 of 80

5.7 Giveaways at an Educational Event

5.8 Knowledge Check 1

Events Basics 06162016 original Page 34 of 80

Correct (Slide Layer)

Incorrect (Slide Layer)

Events Basics 06162016 original Page 35 of 80

5.9 Knowledge Check 2

Correct (Slide Layer)

Events Basics 06162016 original Page 36 of 80

Incorrect (Slide Layer)

5.10 Prohibited Activities at an Educational Event

Events Basics 06162016 original Page 37 of 80

5.11 Prohibited Activities at an Educational Event (continued)

5.12 Permitted Activities at an Educational Event

Events Basics 06162016 original Page 38 of 80

5.13 Knowledge Check 3

Correct (Slide Layer)

Events Basics 06162016 original Page 39 of 80

Incorrect (Slide Layer)

5.14 Conducting A Member Event

Did you know? If the event will not be explicitly advertised as "educational" or any marketing/sales activities will be conducted, including obtaining names and contact information from non-members, setting future personal/individual marketing appointments with members or non-members, or completing or accepting enrollment applications from members or non-members, the event must be reported to UnitedHealthcare as a marketing/sales event and all guidelines related to conducting a marketing/sales event that are described in the next section apply.

Events Basics 06162016 original Page 40 of 80

6. Conducting a Marketing/Sales Event

6.1 Introduction

6.2 Marco & Phil: Conducting a Marketing/Sales Event

Events Basics 06162016 original Page 41 of 80

6.3 Marketing/Sales Events

6.4 Advertising a Marketing/Sales Event

Note: All products that you will present during the event must be clearly stated (e.g., HMO, PDP, SNP, and MA). Note: If the advertisement or marketing material promotes a drawing, prize, or any promise of a free gift, it must include a written statement indicating that there is no obligation to enroll in the plan. Note: An agent must receive prior approval from UnitedHealthcare to offer a prize, drawing or raffle at any event. Note: The following two disclaimers must appear on any advertising for a marketing/sales event, regardless of the form or media used to advertise or promote the event. Note that upon reasonable request, an American Sign Language interpreter must be made available at a formal marketing/sales event. A request form with instruction is available on the Distribution Portal in the Resource Center tab.

Events Basics 06162016 original Page 42 of 80

6.5 Materials at a Marketing/Sales Event

marketing mat (Slide Layer)

Events Basics 06162016 original Page 43 of 80

visual (Slide Layer)

Did you know? Agents may attach a compliant business card to marketing materials with a single staple or piece of tape, so that content is not obscured. Agents can now order Medicare Advantage (MA) and Prescription Drug Plan (PDP) Enrollment Guides personalized with their name, email address and phone number. This great feature is designed to help you better serve consumers by having your contact information readily available on the back cover. Agents are encouraged to also leave a separate business card with the consumer as part of the enrollment process.

educational (Slide Layer)

Events Basics 06162016 original Page 44 of 80

generic (Slide Layer)

6.6 Meals and Refreshments at a Marketing/Sales Event

Events Basics 06162016 original Page 45 of 80

6.7 Knowledge Check 1

Correct (Slide Layer)

Events Basics 06162016 original Page 46 of 80

Incorrect (Slide Layer)

6.8 Knowledge Check 2

Events Basics 06162016 original Page 47 of 80

Correct (Slide Layer)

Incorrect (Slide Layer)

Events Basics 06162016 original Page 48 of 80

6.9 Giveaways at a Marketing/Sales Event

6.10 Giveaways at a Marketing/Sales Event

Events Basics 06162016 original Page 49 of 80

6.11 Prohibited Activities at a Marketing/Sales Event

6.12 Prohibited Activities at a Marketing/Sales Event

Events Basics 06162016 original Page 50 of 80

6.13 Prohibited Activities at a Marketing/Sales Event

6.14 Permitted Activities at a Marketing/Sales Event

Events Basics 06162016 original Page 51 of 80

6.15 Presenting at a Marketing/Sales Event

Did you know? If you have reported a formal marketing/sales event, but only one consumer attends, you may conduct the event in a less formal manner, such as by sitting at a table with the consumer. However, you must still provide the consumer with the entire presentation just as if there were several consumers present.

Presenter (Slide Layer)

Events Basics 06162016 original Page 52 of 80

Sign-in (Slide Layer)

Marketing (Slide Layer)

Events Basics 06162016 original Page 53 of 80

Enrollment (Slide Layer)

MultiLanguage (Slide Layer)

Events Basics 06162016 original Page 54 of 80

Election periods (Slide Layer)

RX - coverage (Slide Layer)

Events Basics 06162016 original Page 55 of 80

RX - Formularies (Slide Layer)

Disclaimer Phone number is for illustrative purposes only. Consult plan materials for the phone number for the plan you are presenting.

Pharmacy Networks (Slide Layer)

Events Basics 06162016 original Page 56 of 80

Pharmacy Network Risk (Slide Layer)

MA Plans (Slide Layer)

Events Basics 06162016 original Page 57 of 80

MA - Out-of-Network Costs (Slide Layer)

Dual SNP (Slide Layer)

Events Basics 06162016 original Page 58 of 80

Chronic Illness (Slide Layer)

Star Ratings (Slide Layer)

Events Basics 06162016 original Page 59 of 80

Healthcare Refrom (Slide Layer)

6.16 Conducting an Informal Marketing/Sales Event

Events Basics 06162016 original Page 60 of 80

6.17 Permitted Activities at a Marketing/Sales Event

6.18 Staffing a UnitedHealthcare MedicareStore

Events Basics 06162016 original Page 61 of 80

prohibited (Slide Layer)

permitted (Slide Layer)

Events Basics 06162016 original Page 62 of 80

required (Slide Layer)

store-image (Slide Layer)

Events Basics 06162016 original Page 63 of 80

6.19 Enrollment Activities at a Marketing/Sales Event

For example... During a marketing/sales event conducted on October 10, do not solicit and/or accept a completed enrollment application with an election period of AEP (Annual Election Period). However, if a consumer is enrolling in the current year’s plan using an SEP (Special Election Period), you could accept their enrollment application. For example... Phil may decide to host a large formal event with another agent or two present in order to timely assist consumers through the enrollment process following the formal presentation. When multiple agents are working an event, it is the agent who assists in the completion of the enrollment application who signs, dates, and enters their writing number to the application. Agents are not permitted to divide up among themselves the enrollment applications completed during an event. Doing so would result in a compliance infraction and result in corrective and/or disciplinary action.

Events Basics 06162016 original Page 64 of 80

6.20 Knowledge Check 3

Correct (Slide Layer)

Events Basics 06162016 original Page 65 of 80

Incorrect (Slide Layer)

6.21 Knowledge Check 4

Events Basics 06162016 original Page 66 of 80

Correct (Slide Layer)

Incorrect (Slide Layer)

Events Basics 06162016 original Page 67 of 80

6.22 Knowledge Check 5

Correct (Slide Layer)

Events Basics 06162016 original Page 68 of 80

Incorrect (Slide Layer)

6.23 Hosting a Provider at an Educational Event

intro (Slide Layer)

Events Basics 06162016 original Page 69 of 80

6.24 Knowledge Check 6

Events Basics 06162016 original Page 70 of 80

Correct (Slide Layer)

Incorrect (Slide Layer)

Events Basics 06162016 original Page 71 of 80

6.25 Protecting Consumer and Member Information

PII (Slide Layer)

Events Basics 06162016 original Page 72 of 80

PHI (Slide Layer)

6.26 Protecting Consumer and Member Information

Events Basics 06162016 original Page 73 of 80

Must (Slide Layer)

Must not (Slide Layer)

Events Basics 06162016 original Page 74 of 80

6.27 Knowledge Check 7

Correct (Slide Layer)

Events Basics 06162016 original Page 75 of 80

Incorrect (Slide Layer)

7. Introduction to the Event Observation Program

7.1 Introduction

Events Basics 06162016 original Page 76 of 80

7.2 Marco & Phil:The Secret Shopper Program

7.3 Purpose of the Event Observation Program

Events Basics 06162016 original Page 77 of 80

7.4 Primary Areas of Evaluation/Scoring

Event Information

o Could the shopper/evaluator find the event?

o Was the agent on time?

o Was the venue appropriate and accessible to Medicare-eligible consumers? Was it

conducted in a common area if in a health care setting? Was it open to the public?

Agent Information and Products

o Did the agent state their name, company, and specific products that would be presented?

o Was it clear the agent represented UnitedHealthcare and not Medicare or another

government agency?

Contact Information

o Was the agent contact information provided?

o Did the agent make it clear that any sign-in sheet or lead card was completely optional

and that contact information was not used to conduct a drawing or a requirement to receive a gift?

Food and Gifts

o Did the agent provide meals or refreshments in accordance with guidelines based on the

event type?

o Did the value of all gifts and food items stay within the $15-per-person nominal value limit?

o Were gifts and food items available to all consumers with no obligation to enroll?

Materials

o Were materials compliant with guidelines?

o Was an Enrollment Guide available to all who attended?

Presentation Components

o Did the agent appropriately explain the annual election period, disenrollment periods, and

special election periods?

o Did the agent explain network limitations, how to access care, and any financial

implications when using an out-of-network provider?

o Did the agent explain the plan’s Star Rating and how to access additional information?

Make sure you provide the overall Star Rating for the plan you are presenting and indicate the page in the Enrollment Guide where Star Rating information can be found. It is appropriate to mention one to two measures used by CMS in calculating a plan’s Star Rating. Direct the consumer to www.Medicare.gov for additional information.

o Did the agent direct consumers to information in the Enrollment Guide related to

interpreter service, formulary, and other required disclosures?

Events Basics 06162016 original Page 78 of 80

o Did the agent explain step therapy and prior authorization as it relates to prescription drug

coverage?

o When presenting special needs plans, did the agent explain eligibility limitations and the

involuntary disenrollment process if the member loses their eligibility?

Presenter Conduct

o Did the agent proactively approach consumers at an informal event?

o Did the agent appropriately describe the plan’s Star Rating by not emphasizing individual

measures?

o Did the agent make any superlative or absolute statements?

o Did the agent engage in high pressure sales tactics?

o Did the agent disparage the plan, product, competitor, or government program or agency?

8. Conclusion

8.1 Introduction

Events Basics 06162016 original Page 79 of 80

8.2 Marco & Phil: Conclusion

8.3 Summary

Events Basics 06162016 original Page 80 of 80

8.4 Next Steps

8.5 Exit