Updates to Rules of Engagement

Effective October 1, 2024.

Cigna Healthcare has released an updated version of our Rules of Engagement. Please read below for a full list of updates and take some time to review the Rules of Engagement prior to AEP.

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Sales distribution management

• Page 8 – Updated engagement level criteria for field distribution and call center agencies.

Calendar year at a glance

• Page 11 – Added existing Medicare Advantage (MA) member renewal compensation payments to each month and full year advance for existing PDP member renewal compensation in February.

Recruitment and Onboarding

• Page 16 – Added that Topline Approved Releases are only valid for 60 days from the signature date.

• Page 17 – Added an additional limitation to changing hierarchies. When an Agency is terminated, all direct pay Downline Agents and Agencies will roll up to the next active agency in the hierarchy.

• Page 18 – Added a note that Agency level upgrade submissions will be sent for internal approval prior to processing. SGA2 and above cannot be submitted via e-vite.

• Page 22 – Added language that Cigna Healthcare and its associates may communicate with you via auto-dialed or prerecorded calls. Message and data rates may apply. You can opt-out at any time.

FDR Oversight Guide

• Page 32 – Updated FDR Performance Tracking metrics.

Call Center Guidelines

• Page 40 – Added Licensing, Certification, and Training language stating that for agencies that submit via bulk, it is the Topline Agency’s responsibility to verify submissions and readiness status via the Agent Status report.

Oversight

• Page 42 – Added tips on how to minimize sales complaints.

• Page 44 – Updated the Sales Integrity Quality Review and Audit section.

• Page 45 –Added a new section for Plan Reporting Requirements; added links to each TPMO Reporting Template.

• Page 47 – Updated disclaimer language for TPMO marketing materials.

• Page 48 – Added a note that only materials that include the Medicare card image need to be approved (graphic images that do not include the Medicare card do not need to be approved); updated Cigna Healthcare Branded Materials section; added that the elements noted in the Pre-enrollment Checklist must also be reviewed with the customer.

Operational Requirements

• Page 51 – Updated BRC Guidance.

• Page 53 – Added Distribution of Personal Beneficiary Data by TPMOs section; added Member Non-Payment Agent Outreach section.

• Page 54 – Added note that Cigna Healthcare will electronically deliver enrollment materials when you complete an online or phone application; added note for agents to contact the IVR phone number to confirm receipt of faxed PDP application; added note that PDP applications do not require a fax Cover Sheet.

• Page 56 – Added note that PDP applications require an Agent signature date.

• Page 57 – Updated Additional Application Requirements section.

Compensation Rules

• Page 63 – Updated Initial Year Agent Commission Examples; added note on the second commissions example table to specify it shows Cigna Healthcare PDP Extra Plans only; added note that in 2025, Cigna Healthcare Extra and Saver plans will be commissionable.

• Page 64 – Added notes to Payment for Facilitating VBE HRA section.

• Page 65 – Added note that payment for the VBE program is for digitally submitted applications only; added note that the VBE program may be discontinued, and payment amounts may change at any time.

• Page 67 – Added note that effective 10/1/24, Cigna Healthcare does not allow an Agent of Record (AOR) change for a current active member if they remain on the same plan. AOR and compensation remains with the AOR who wrote the original policy unless it falls under one of the approved plan change scenarios.

• Page 68 – Added note that if a plan change is performed by the Plan Change Unit or an internal Cigna Healthcare agent, the current AOR will be retained unless the agent is currently in Terminated or Servicing status

• Page 71 – Added language that Cigna Healthcare will not compensate an agent/agency when fraud and/or intentional non-compliant activities are committed.

• Page 77 – Added an example for when a book of business (BOB) transfer request cannot be approved.

• Page 79 – Added section to Servicing Status – Agents.

• Page 80 – Added section to Servicing Status – Agencies.

• Page 81 – Added that proof of legal authority to act on behalf of the deceased agent must be provided for review within 60 days of the agent’s passing; added note that it is recommended to verify if a BOB transfer can be approved before completing purchase.

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