Date: November 16, 2006
For more information contact: Eileen Mallow, Assistant Deputy Commissioner, (608) 266-7843 or eileen.mallow@wisconsin.gov

OCI cautions seniors about Medicare Part D marketing practices

Madison, WI—The Office of the Commissioner of Insurance (OCI) has been investigating questionable practices some agents have been using to market the Medicare Part D prescription drug program.

Medicare Part D is the optional program designed to help Medicare beneficiaries pay for their outpatient prescription drug costs. The open enrollment period for 2007 began November 15 and runs to December 31, 2006.

Although Medicare Part D is regulated by the federal government, the Wisconsin Office of the Commissioner of Insurance regulates licensed insurance agents and their behavior.

"OCI investigates agents who have been engaged in questionable marketing and sales practices," said Jorge Gomez, Commissioner of Insurance. "It is our job to monitor agent behavior and protect seniors from improper agent activities."

OCI has learned that some agents have been allegedly improperly soliciting for the Medicare Part D program at assisted living facilities where beneficiaries may have some degree of dementia, enrolling some beneficiaries in plans that they apparently did not want, and not being clear about the coverages and covered drugs of certain Medicare Part D prescription drug plans.

"We are concerned that some beneficiaries are confused about what they are being sold and making buying decisions with inaccurate or incomplete information" said Gomez. "Because of this, it is important that there be clear ground rules for what agents can and cannot do in the sale of Medicare Part D prescription drug plans."

Federal and state laws prohibit agents from engaging in the following activities when selling Medicare Part D prescription drug plans. If anyone is aware of the following situations, contact OCI.

• Door-to-door solicitation.
• Cold calls, if not invited to do so, if the person is on the Wisconsin and/or the National Do Not Call Registry. If this occurs notify the Do Not Call Registry.
• Requiring bank account or charge card account numbers.
• Offering rebates or other cash payments of any sort as an inducement for enrolling in a Medicare Part D prescription drug plan.
• Stating that a person must enroll in a Medicare Part D prescription drug plan in order to not lose coverage under Medicare Parts A and B.
• Requiring that other insurance must be purchased in order to get Medicare Part D prescription drug coverage.
• Using scare tactics to get enrollments.
• Destroying existing insurance documents, insurance ID cards or Medicare cards.
• Misrepresenting the prescription drug benefits when marketing the prescription drug plan.
• Refusing to leave a place of residence if requested to do so. If this occurs, 911 should be called immediately.

"The bottom line," said Gomez, "is if you feel uncomfortable or confused, ask that the agent leave the information and return another day. Then review the material with a trusted advisor."

If you or someone in your family is a Medicare beneficiary and you have questions regarding agent activity or wish to file a complaint involving an agent, contact OCI at 1-800-236-8517. Further information and complaint forms are also available at the OCI Web site: oci.wi.gov.

Created by the Legislature in 1871, Wisconsin's Office of the Commissioner of Insurance (OCI) was vested with broad powers to ensure that the insurance industry responsibly and adequately met the insurance needs of Wisconsin citizens. Today, OCI's mission is to lead the way in informing and protecting the public and responding to its insurance needs.