Insurance agents are talking about reports that some Medicare helplines may absorb agents' clients.

The concern has popped up recently on message boards for members of the National Association of Health Underwriters and Health Agents for America.

Bryan Wampler, a Mississippi-based agent, started one recent online conversation about the topic.

One of his Medicare supplement insurance clients lacked basic Medicare B physician and outpatient services coverage. The client called what seemed to be a state-sponsored Medicare call center, to get help with ironing out the Part B coverage problem. The helpline worker resolved the client's Medicare Part B program, then asked, "What are your plans for Medicare supplement insurance coverage?"

The client told the helpline worker what Wampler had recommended. The helpline worker transferred the client to a Medicare assistance center that signed the client up for the coverage Wampler had recommended.

"I was completely bypassed out of the entire process," Wampler wrote in the online conversation, which he shared with ThinkAdvisor Life/Health. "Even worse, not only did the Medicare agent intercept on the Medicare side, the Medicare representative went further and even accessed into the group medical insurance side, which I also handle."

Other agents told Wampler that they had heard of similar problems cropping up all over the country, and, in some cases, of insurers' own call center reps absorbing agents' business.

Quentin Ledford, a Tennessee-based agent, spotted Wampler's report and shared it with HAFA. Ledford said in an email interview that he believes some cases of helpline client absorption, such as the one in which the helpline worker got into Wampler's client's group heath file, may raise compliance questions.

"This kind of access, without the express written consent of either the client or the employer, is definitely a violation of privacy and confidentiality laws," Ledford said.

Other trends may have made agents more conscious of the activities of insurance helplines, ombudsman programs, and other government-sponsored and nonprofit organization consumer support programs.

In recent years, agents have been watching Affordable Care Act public exchange program Navigators and other nonprofit exchange helpers, such as certified application counselors, move closer toward what agents' think of us their domain.

In August, for example, CMS offered nonprofit ACA exchange helpers a webinar that included a presentation on how to help exchange plan enrollees sign up for Medicare.

CMS officials saw the webinar as a way to mobilize ACA exchange helpers to ease older consumers' shift into Medicare.

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B. Ronnell Nolan, the president of Health Agents for America, said in an email interview that many HAFA members have concerns about the idea of the Navigators helping consumers with Medicare enrollment.

"Our issue is that they do not have a license and should not be helping anyone enroll in Medicare," Nolan said. "Also, on the same webinar, Navigators were instructed how to evaluate group health insurance. Why on God's green earth would a Navigator receive instruction on something that a licensed agent works many years to understand? It appears [to be] just another way to cut out the agent/broker by using government folks."

If government officials or Navigators want to enroll people in Medicare, or help employers with group coverage, they should get licensed as agents or brokers, Nolan said.

The Centers for Medicare and Medicaid Services, the agency that oversees Medicare, declined to comment.

Wampler, Ledford and other agents interviewed view email said they are not certain whether cases of Medicare helplines absorbing agents' clients are more common now than it used to be, how common the problem really is now, or whether the call centers absorbing the clients are really part of the federally funded State Health Insurance Assistance Program or any other specific program.

Ledford, for example, said he thinks he has been safe from any sticky Medicare helpline problem so far because of the nature of his clients.

"Most of my folks will call me before they do anything," Ledford said. "Most really do not trust anything they are told from government sources without verifying it."

Wampler said any cases of helplines competing with agents are a concern, because so many agents have been shifting into the Medicare plan market in recent years.

"Not much good if this comes under assault as well," Wampler said.

Instant Insights /

Are Medicare helpline representatives stealing agents' clients?

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