We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use.
Click "here" to read our Cookie Policy. By clicking "Accept" you agree to the use of cookies. Read less
Read more
Accept
Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Uncategorized Forms
  • Scope Of Sales Appointment Confirmation Form

Get Scope Of Sales Appointment Confirmation Form

This individual may also be paid based on your enrollment in a plan. Signing this form does NOT obligate you to enroll in a plan affect your current enrollment or enroll you in Y00711317305R CMS Approved 06/30/2013 822430 38092WLP Non Model Scope of Appointment SH 06 13 38092WLP Beneficiary or Authorized Representative Signature and Signature Date Signature If you are the authorized representative please sign above and print below Representative .

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the Scope Of Sales Appointment Confirmation Form online

The Scope Of Sales Appointment Confirmation Form is an essential document for agents and Medicare beneficiaries. This guide will provide you with clear instructions on how to effectively complete this form online.

Follow the steps to fill out the form accurately.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. In the section for product discussion, carefully initial beside each type of product you wish the agent to discuss. The options include stand-alone Medicare Prescription Drug Plans (Part D) and Medicare Advantage Plans (Part C).
  3. If you are the beneficiary or an authorized representative, provide your signature and the date you are signing the form.
  4. If you are signing as an authorized representative, print your name and indicate your relationship to the beneficiary in the appropriate spaces.
  5. Next, the agent will complete their section of the form, entering details such as agent name, phone number, beneficiary's name, and optional contact information like phone number and address.
  6. The agent will also fill in the Medicare ID number, indicate the initial method or location of contact, and sign the document.
  7. Finally, review all entered information for accuracy. Once confirmed, save any changes you made, and you can then choose to download, print, or share the completed form as needed.

Complete the Scope Of Sales Appointment Confirmation Form online today for a smoother appointment process.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Get form

Related content

The scope of appointment - HHS.gov
The scope of appointment form is required under the following circumstances:...
Learn more
The University Senate of Michigan Technological...
Dec 9, 2015 — appointment prior to any face-to-face sales meeting to ensure ... A sample...
Learn more
distribution is unlimited. DEPARTMENT OF THE ......
Jan 29, 2014 — Sales of Individual Equipment to Individual ... appointment letter and a...
Learn more

Related links form

Sample Form - Nebraska State Fire Marshal - Sfm Ne Equivalency Concepts - Nebraska State Fire Marshal - Sfm Ne Nebraska Paddlefish Snagging Aplication Form Trial Application Forms - Nebraska Game And Parks Commission - Outdoornebraska Ne

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

The Scope of Appointment form is used to document an in-person appointment with a beneficiary to ensure that no other types of products are discussed outside of what the beneficiary originally requested.

How long are the eSOA links good for? eSOA links do not expire, they are one time use only. Once the link is accessed and the eSOA is completed, the link will no longer be accessible.

SOA is only valid for one completed appointment.

You must fill it out prior to the appointment with your Medicare insurance agent, or a licensed agent must verbally cover the Scope of Appointment with you if you're talking over the phone.

Scope of Appointment (aka SOA) is a form that outlines the specifics of what you will present to a client during a meeting or appointment. This makes sure that potential enrollees will not be sold plans that they did not originally request.

Scopes are effective for 60 days (don't get caught with the AEP exception above). If your scope if over 60 days and you present the plan benefits, you are in violation of CMS rules. Agents are required to keep Scopes for 10 (ten) years. Agents are audited on their Scopes.

For privacy, the eSOA is only valid for 14 days. If you sent an eSOA to your client more than two weeks ago, and your client did not click on the link to view and sign it, then the link expired and will no longer work. If that happens and the client still needs an eSOA, you can send the eSOA again.

The Scope of Appointment form should be completed by the beneficiary and returned prior to the appointment. If it is not feasible for the Scope of Appointment form to be executed prior to the appointment, an agent may have the beneficiary sign the form at the beginning of the marketing appointment.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Get form
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get Scope Of Sales Appointment Confirmation Form
Get form
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232