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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 .

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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.

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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.

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