2013 PPO 65 (GROUP) Employee application
2013 Application employee or retiree must complete to enroll in a Group sponsored Personal Choice 65 plan. Group rates are also required and both should be sent to your account manager 30 days in advance of effective date.
Scope of Sales Appointment Confirmation form
*Required for Group or Ind installation. Form to be completed by Medicare eligible in order for a certified agent to be able to discuss Medicare Advantage and Medicare Prescription Drug plans with a Medicare beneficiary.
CMS Secret Shopper Checklist
CMS on occassion will have a secret shopper act as an interested Medicare Beneficiary at your group marketing/sales events. This checklist for your review, providing you a glimpse at what they will look for you as an agent to be compliant on.
2012 Non-Group PPO 65 Change form
2012 change form to be completed by Medicare beneficiary to change products within Individual PPO Medicare. AEP is from 10/15/11 thru 12/7/11. For Disenrollment or SEP, ask your Account Manager.