Selling Kaiser Foundation Health Plan of Washington's Medicare Advantage Plans

The Centers for Medicare and Medicaid Services (CMS) requires annual documentation showing that you have achieved threshold test scores on core training that meets CMS Standards for Medicare and Part D plans. This includes the key differences between plans and permissible and prohibited marketing practices. There is a cost associated with the Medicare certification course. You must achieve a score of at least 90% for all tests.

CMS also requires annual Fraud, Waste and Abuse; general compliance; and plan-specific trainings for producers representing the Medicare Advantage plans. To meet the CMS requirement, appointed agents and brokers are required to successfully complete the following two Medicare training courses:

  • 2019 Medicare sales core marketing training: A three to four-hour online course licensed from Gorman/Sentinel that covers marketing requirements for any Medicare plan.
  • Kaiser Permanente 2019 INDIVIDUAL Medicare products & benefits training: A one-hour online course offered by Gorman/Sentinel that covers region-specific Kaiser Permanente Washington Medicare products and benefits for the individual plan segment.

The Medicare Certification period to represent and sell Kaiser Permanente Washington 2019 Medicare Advantage plans ended Sept 30, 2018. Newly appointed producers to existing agencies/houses with a Medicare book of business must request certification training within 30 days of their appointment and will have 30 days to complete that training.

Contact the KPWA Medicare Sales team at 1-800-581-8252 or if you have questions.

Medicare Improvement for Patients and Providers Act (MIPPA) scope of appointment rules prevent producers and agents from selling Medicare plans that were not within the agreed-upon scope of the sales appointment. In brief, the rules require you to:
  • Clearly identify products to your client. Sales representatives and appointed producers must clearly identify the types of products that will be discussed before marketing to a potential enrollee.
  • Get documentation in writing. This documentation can be in writing by having the Medicare beneficiary agree to the scope of the appointment by signing and returning the Scope of Sales Appointment Confirmation Form (PDF) in advance of the sales appointment.
  • Retain the form. MIPPA requires that you retain the Scope of Sales Appointment Confirmation form for 10 years. When applicable, please submit a copy of this form when submitting an election form on behalf of a Medicare Advantage enrollee.

The Scope of Sales Appointment Confirmation form should be used:
  • When a producer meets with a beneficiary at a marketing event for follow-up meetings.
  • When producers unexpectedly find other beneficiaries present for a properly solicited appointment. Additional beneficiaries will need to complete this form prior to conducting the sales discussion.
  • Prior to discussing Medicare Advantage or Part D prescription drug plans. Agents/producers should note on the form if the beneficiary was a walk-in.
  • The form does not apply to these situations:
    • Sales presentations — the scope of products should be indicated in the event advertising.
    • Health plan receipt of enrollment forms from prospective enrollees, or requests to enroll initiated by beneficiaries through means such as inbound calls to plans asking to enroll telephonically.
    • Beneficiary walk-ins to a plan or agent/producer office or similar beneficiary-initiated face-to-face sales event. The form should still be signed before discussing any plan information.
    • Health plans and agents/producers continue to be able to return beneficiary phone calls or messages as these are not unsolicited.

Based on MIPPA regulations, producer compensation will be reviewed annually and may be adjusted based on guidance from The Center for Medicare and Medicaid Services (CMS). For more information call us toll-free at 1-800-337-3196.

2018 Medicare Advantage plans commission supplement (PDF)

2019 Medicare Advantage plans commissions supplement (PDF)

Medicare Forms

Annual Notice of Change - Basic plan (PDF)

Annual Notice of Change - Essential plan (PDF)

Annual Notice of Change - Harbor plan (PDF)

Annual Notice of Change - Optimal plan (PDF)

Annual Notice of Change - Vital plan (PDF)

Annual Notice of Change - Centennial plan (PDF)

Annual Notice of Change - Columbia plan (PDF)

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