UPDATED VMO Scorecard beginning 8/1/22

Please see below and attached for some upcoming changes in our VMO scorecard, which will be implemented for our VMO QA audits beginning Monday August 1, 2022.  Based on discussions with a number of our carrier partners recently updates to the overall scorecard were needed in order to address complaint risk and trends within compliance across the board.   These changes help to limit risk for your agency, along with aligning to our ongoing goal of improving our QA scores and lowering the amount of carrier complaints and CTM’s.

 

Below are the highlights of updates being made and we will be discussing these changes and the new scorecard on our upcoming QA/Compliance syncs.

 

We have re-weighted the scorecard to equal 100 points instead of the current 63 points.

• • The scoring goal is still the game of 96% or higher to be considered a PASSING score. So, 96 points attained or higher is a PASS, 95 or below is a FAIL.
  • The metrics being adjusted from a scoring perspective are the ones that our carriers have identified as the ones that most impact compliance.

 

Metric changes/additions/updates:

• The POA (Power of Attorney) metric definition has changed.
  • Each sales call MUST have the agent asking the consumer if they have a POA or someone that makes their decisions for them at some point in the call PRIOR to beginning the application.

 

• The Consent to Enrollment metric definition has changed.
  • The agent MUST get a clear affirmative statement from the consumer that they approve of submitting of a new application for new coverage that will replace their current coverage.
    • This must be done before submission of the application. Humana still requires that the agent “state their name, DOB, and I agree” for the recording prior to submission.

 

• Finally, we have an additional section that will trigger losing points off their score for any egregious activity that takes place.
  • These instances are examples such as enrolling without any consent, submitting an app without an authorized party, steamrolling a customer into a sale, utilizing free look, etc. These are listed in the scorecard definitions.
  • If the agent DOES NOT utilize any of these fraudulent activities, the agent will incur 0 points (thus this will not negatively impact their score). If fraudulent activity does occur, the agent will automatically lose 20 points (auto failing).

 

Overall, these are changes that will greatly improve our ability to limit risk, protect our brand, lower the number of CTM’s and carrier complaints, raise our QA scores, and drive proper agent behaviors. Please let your Account Manager or Zach Harris know if you have any questions.

 

Thanks,

GoHealth VMO

This is neither legal nor accounting advice. If you have questions, please consult a lawyer or accountant. The information included in this post was provided by the entity referenced herein.