2025 Medical Mutual Sales Compliance Assessment

Enrolling in a Medicare Supplement plan automatically cancels a beneficiary’s enrollment in their Medicare Advantage Plan.

You obtained a Scope of Appointment (SOA) from your client. CMS and Medical Mutual require you to retain this document for your records for 15 years.

You scheduled two sales appointments with clients to discuss Medical Mutual Medicare Advantage products. One appointment was telephonic, and the other was through a virtual setting. Both appointments require you to obtain a Scope of Appointment 48 hours before each appointment.

Compensation will only be paid to appointed and certified agents.

Reporting suspected violations is everyone’s duty. Suppose you suspect a violation has occurred and would like to report it too Medical Mutual. In that case, you can send the report to the MA Sales Compliance team inbox, your sales/account manager, and/ or Medical Mutual Corporate Compliance.

Enrollment applications submitted within an election period of AEP should not be obtained and/or submitted before October 15.

A new regulatory rule requires agents to record only marketing, sales, and enrollment calls with clients.

When an agent changes a client’s plan, they must clearly communicate the impact of this change to their existing coverage.

Email is acceptable for submitting a Medicare Advantage application to Medical Mutual.

Medical Mutual recommends the following best practices to verify providers before enrolling a Medicare beneficiary.

Agent reviewing the Pre-Enrollment checklist with their clients.
Discuss the differences between HMO and PPO plans to ensure clients understand their plan selection and corresponding in-network vs. out-of-network coverage.
Verify that all that requested provider(s) and location(s) are in-network.
If the beneficiary doesn’t provide this information, prompt them to advise of any.
Look up providers using Medical Mutual’s online provider tool, “Find a Provider.”