Berwick Insurance Group was started in 1996 by Jim and David Berwick specializing in the sales of Health and Life insurance products. In 2004, Berwick Insurance Group added Medicare products to their portfolio. Berwick expanded to recruit agents nationally in 2009, and within three years Berwick became one of the top producing brokerage firms in the country. The Berwick Insurance team is comprised of motivated, ambitious, fun-loving individuals who truly enjoy their work! The motto “work hard play hard” is in full swing at Berwick Insurance.
At Berwick Insurance we live by the saying, “Give a man a fish he eats for a day. Teach him to fish and he eats for a lifetime!” The promise of free leads is often used by organizations as a recruitment ruse and it rarely delivers. We want you to be in this business for a long time, and by teaching you how to market your business and build a leads pipeline, you will have an advantage over those agents waiting for someone else to send them a free lead. Learn More...
Leads come from many sources and with over 10,000 people a day turning 65, there is no shortage of individuals in need of your expertise and assistance. At Berwick Insurance, we teach you how to access those leads in a credible and compliant manner. Our marketing and training programs are extensive and FREE! As our partner, we make sure you understand the whole business. Honesty is the best policy here at Berwick.
If you are new to this industry the acronyms can be a bit confusing at first. Every carrier has a slightly different designation for the various contract levels they offer. Berwick Insurance is proud to hold National Marketing Organization (NMO) or Field Marketing Organization (FMO) status with our national carriers. In most instances the NMO/FMO status is the highest contract level available. UnitedHealthcare designates a select group of top-producing brokers as National Marketing Alliance (NMA) partners. Berwick Insurance is proud to be among this elite group. Contact Us for more information.
The Berwick brothers built the business on old-fashioned values combined with current-day innovative technology. Be honest, be accessible, be ethical; these are standards we take seriously! We do what we say we are going to do and make sure our agents have the tools, training and support they need to succeed. We provide one-on-one assistance and strive for excellence every day. We do what we love and love what we do! Learn more About Us.
With approximately 50 million people enrolled in Medicare, AEP is indeed a busy time of year. During AEP, every Medicare eligible person can change plans, which makes it a perfect time for you to pick up new clients. AEP is only 7 weeks long, so depending on your level of involvement with Medicare, you can be very busy.
Most definitely! Agents sell all year because of the amount of people turning 65 every day! The commissions are the highest for new-to-Medicare plans and many pay life-time renewals. Selling Medicare all year will provide a steady and lucrative income stream now and in the future! Check out the chart to see how you can Make a Million in Medicare!
Absolutely nothing! Berwick Insurance does not charge any fees or take any of your commissions. Our services and training are designed to help you achieve your business goals. We are compensated by the carriers when you sell a plan. You receive 100% of the commission you earn. And if you don’t sell anything we don’t get paid either, so we offer a multitude of services to ensure you have what you need to succeed.
Berwick Insurance is proud to represent the most reputable Medicare carriers in the industry. We strive to offer quality products to our agents and clients; and work with carriers that share similar values. We provide contracts with national, regional and even a few carefully selected state carriers. At Berwick Insurance, we constantly evaluate the market to determine if there are additional carriers we should add to our portfolio.
That is not a problem. Berwick Insurance does not hold our agents captive to sell only our contracted carriers. We realize there may be carriers in your market that are essential to your success and we encourage you to get any contracts that you feel you need. We are happy to provide you with any insight we may have about the carrier prior to you contracting. We believe agents do NOT need every carrier in their market to be successful, so we normally generally advise agents to only contract with the most reputable carriers in their market. These carriers are the most stable and typically have the fewest plan changes.
Berwick Insurance Group is licensed and contracted in all 50 states and the District of Columbia.
Absolutely, and we have a very large group of agents that are independent and successful. By utilizing our expertise and training in the Medicare market, you will quickly learn the best way to build your business.
Contact one of our team members and let us help you determine what is the best way to contract. We process an incredible number of contracts each year and can assist you in determining the best contract for your agency. Whether you are a local agency or a large regional or national organization, we have the tools and people in place to ensure your success and/or to assist in the growth of your agent base.
We prefer that you be paid directly by the carriers and we set it up this way whenever it is possible. There are some organizations that require agents to assign their commissions to their company; and then the company pays the agent’s commissions. This is not the Berwick Insurance way.
| Term | Definition |
|---|---|
| AARP® | AARP (formerly known as the American Association of Retired |
| Agent | A global term to refer to any licensed, certified, and appointed individual soliciting and selling UnitedHealthcare regulated insurance products. |
| Appointment (Agent) | A procedure required by most states that grants limited authority to an individual, the privilege to sell a company line of products within the state. An individual is required to have an appointment in their resident state before appointments can be submitted to non-resident states. An appointment is required before an agent can sell the Company’s product. |
| Authorized Representative | A person authorized under applicable law or identified in writing by the individual to act on behalf of the individual in making health care and related decisions for an enrollee. Same as Responsible Party. |
| Term | Definition |
|---|---|
| Beneficiary | Also Medicare Beneficiary. A person who is entitled to Medicare according to the Centers for Medicare & Medicaid Services definition. |
| Book of Business | The collection of leads, contacts, and/or transactions assigned to a particular agent. |
| Term | Definition |
|---|---|
| Call Monitoring | A quality assurance function used to evaluate inbound and outbound calls either side-by-side or remotely; for the purposes of compliance and training (to identify areas of opportunity), while ensuring an agent’s accountability as a representative of the UnitedHealth is compliant as it pertains to CMS regulations and guidelines and Company rules, policies, and procedures. |
| Centers for Medicare and Medicaid Services (CMS) | The federal agency responsible for administering Medicare. CMS communicates guidance and regulatory requirements and provides oversight to Medicare Advantage Organizations. |
| Cold Calling | The act of cold calling, including but not limited to; telephone calls, emailing, text messaging and leaving voice mail are all prohibited. The Centers for Medicare & Medicaid Services (CMS) has specific Regulations in relation to marketing through unsolicited contacts. Agents may not engage in any direct unsolicited contact with consumers, including consumers who are aging-in. (See also Unsolicited Contact) |
| Community | See Sales Event. All Community Events/Meetings are ‘Formal Marketing/Sales Events’ |
| Complaint | A written grievance received from a consumer or member, or any person or organization acting on a consumer or member’s behalf, including written grievances from any Department of Insurance or other regulatory or governmental agency. |
| Consumer | An individual who may be eligible for UnitedHealthcare products (e.g. Medicare consumer, customer, client). |
| Coordinated Care | In Part C, the health care plans that coordinate a consumer’s care by the physicians and hospitals visited. These plans may have some restrictions on the physicians and hospitals used for care. These plans are also referred to as “managed care” plans. PFFS and MSA Plans are not coordinated care plans |
| Copayment | An amount the member may be required to pay as their share of the cost for a medical service or supply, like a physician’s visit or a prescription. A copayment is usually a set amount, rather than a percentage. |
| Cost-Sharing | The amounts that a member has to pay when drugs or services are received. The most common types of cost-sharing are coinsurance, copayments and deductibles. |
| Coverage Gap | Most Medicare prescription drug plans have a coverage gap. This means that after the member and plan have spent a certain amount of money for covered drugs, the member has to pay all costs out-of-pocket for their drugs up to a limit. The member’s yearly deductible, coinsurance or copayments, and what they pay in the coverage gap all count toward this out-of-pocket limit. The limit does not include the drug plan’s premium. There are plans that offer some coverage in the gap. However, plans with coverage in the gap may charge a higher monthly premium. Check with the plan first, to see if the consumer’s drugs would be covered in the gap. |
| Credentialing | Process of contracting, appointment, certification, and approval for an agent to sell any UnitedHealthcare products. |
| Cross-Selling | CMS regulations and guidelines prohibit marketing non-health related products (e.g. annuities, life insurance, disability) to consumers during any Medicare Advantage or Part D sales activity or presentation. This activity is prohibited. |
| Term | Definition |
|---|---|
| Deductible | The amount a member must pay for health care services or prescriptions, before Original Medicare, their prescription drug plan, or other insurance coverage begins to pay |
| Deemed Provider | A Medicare-eligible provider who agrees to accept the plan’s terms and conditions of payment for a specific member visit by virtue of the fact that the provider is aware, in advance, that the patient is a PFFS member and the provider has reasonable access to the plan’s terms and conditions of payment. Members must inform providers of PFFS Plan membership and present their ID card prior to receiving covered services. If the provider does not agree to be deemed, the PFFS member must find another provider. Providers agree to bill the plan and will not balance bill the member. A provider must agree to be deemed each time a member seeks covered medical services. The provider can decide whether or not to accept the plan’s terms and conditions of payment each time they see a PFFS member. A decision to treat one plan member does not obligate the provider to treat other PFFS members, nor does it obligate providers to accept the same member for treatment at a subsequent visit. |
| Deeming | A provider is deemed by law to have a contract with the plan when all of the following four criteria are met:
|
| Disciplinary Action Committee (DAC) | A committee whose purpose is to consider recommendations for suspension or terminations of appointments of agents. |
| Door-to-Door | Direct, unsolicited, in-person contact with a consumer. May include actual door-to-door solicitation or unauthorized in-person contact with a consumer in any public place, e.g. parking lot, senior center, etc. |
| Down-Line | A term used to describe agents within an FMO hierarchy that are below the management/reporting level of a specific agent/agency |
| Dual-Eligible | Consumers and/or members receiving benefits from both Medicare and Medicaid. |
| Term | Definition |
|---|---|
| Errors and Omissions (E&O) Insurance | Errors and Omissions insurance covers UnitedHealthcare’s contracted agents and solicitors in the event they misrepresent a plan and its benefits to a consumer |
| Educational Event | Educational events are events designed to inform Medicare consumers about MA, Prescription Drug or other Medicare programs but do not steer, or attempt to steer consumers toward a specific plan or limited number of plans. Educational events may not include any sales activities such as the distribution of marketing materials or the distribution or collection of Enrollment Applications. Educational Events must be advertised as educational; otherwise they are considered marketing/sales events. Educational events are held in public venues and do not extend to personal/individual appointments. (See also Sales Event) |
| End-Stage Renal Disease (ESRD) | Permanent kidney failure requiring dialysis or a kidney transplant. |
| Term | Definition |
|---|---|
| Field Marketing Organization (FMO) | An independent marketing organization that has contracted with UnitedHealthcare to solicit and sell identified UnitedHealthcare Medicare Solutions products through its network of agencies and licensed, certified, and appointed agents. They are not employed by UnitedHealthcare. |
| Formulary | A list of medications covered within the benefit plan; often represents the level of cost-sharing associated with various groupings of medications (Generics, Preferred Brand, Non-Preferred Brands). The formulary is often published to the web or in a written document. However the document may only reference the preferred medications. (Often referred to as Preferred Drug List or PDL). |
| Term | Definition |
|---|---|
| Generic Drugs | A consumer who is Medicare eligible, retired from his/her previous employer and is looking to continue health care and/or prescription coverage with their previous employer. Employer Groups contract with health plans which allow them the opportunity to offer products and administer benefits through contractual agreements and arrangements. With subsidized plans, the employer contributes to the premium, but with endorsed plans the employer does not. |
| Term | Definition |
|---|---|
| Health Fairs | Health Fairs are defined by the venue, the room design, and the way in which the event is advertised to the consumer. These events are typically comprised of booths that are manned by staff to answer questions and hand out materials. |
| Hierarchy | The management structure of an FMO and/or the management structure defined as part of the contracting process. |
| HMO | Health Maintenance Organization |
| Term | Definition |
|---|---|
| In-Home Appointment | A scheduled one-on-one sales presentation that takes place in a consumer’s residence. Includes a nursing home/facility resident’s room. Requires a Scope of Appointment form. |
| Initial CoverageElection Period (ICEP) | The ICEP is the period during which a consumer newly eligible for Medicare may make an initial enrollment request to enroll in an MA plan. This period begins three months immediately before the consumer’s first entitlement to both Medicare Part A and Part B and ends on the later of:
|
| Currently no "J" terms. |
| Currently no "K" terms. |
| Term | Definition |
|---|---|
| Late-Enrollment Penalty (LEP) | An amount added to a consumer’s monthly premium for Medicare Part A and/or Part B, or for a Medicare drug plan (Part D), if they do not elect to join when they are first eligible. Consumers pay this higher amount as long as they have Medicare. There are some exceptions |
| Lead | A consumer who, by their actions, has demonstrated an interest in a UnitedHealthcare Medicare Solutions product (includes current members). |
| License | A certificate giving proof of formal permission from a governmental authority to an agent to sell insurance products within a state. |
| Term | Definition |
|---|---|
| Marketing/Sales Event Formal and Informal | Are defined both by the range of information provided and the way in which the content is presented. In addition, Marketing/Sales events are defined by the Plan’s ability to collect Enrollment Applications and enroll Medicare consumers during the event. A Marketing/Sales event is designed to steer, or attempt to steer, consumers toward a plan or limited set of plans. A Formal Sales Event is structured in an audience/presenter style with sales personal or plan representative formally providing specific sponsor information via a presentation on the products being offered. An Informal Sales Event are conducted with a less structured presentation or in a less formal environment like a retail booth, kiosk, table, recreational vehicle or food banks where an agent can discuss plan information when approached by a consumer. |
| Master General Agent (MGA) | An independent contractor, with a direct contract with UnitedHealthcare at the MGA level that is part of the FMO hierarchy. May refer agents and solicitors for certification and appointment. The specific hierarchy level is based upon the production of contracted agents and solicitors; they are not employed by UnitedHealthcare. |
| Medicaid | A program that pays for medical assistance for certain individuals and families with low incomes and resources. Medicaid is jointly funded by the Federal and State governments to assist states in providing assistance to people who meet certain eligibility criteria. Medigap cannot be sold to consumers who receive assistance from Medicaid unless assistance is limited to help with Part B premiums, or Medicaid buys the Medigap Plan for the individual. |
| Medicare | A federal government health insurance program for:
|
| Medicare Advantage Disenrollment Period- MADP | January 1 – February 14 The 45-day period when Medicare Advantage members may disenroll from their current plan, but only return to Original Medicare (they may also select a PDP for Part D coverage). |
| Medicare Advantage Plan – MA Only | A Medicare Advantage Plan with only medical coverage. It does not have an integrated Part D prescription medication benefit. |
| Medicare Advantage | A Medicare Advantage Plan that integrates Part D prescription drug benefits with the medical coverage |
| Medicare Part A | The part of Medicare that provides help with the cost of hospital stays, skilled nursing services following a hospital stay, and some other kinds of skilled care. |
| Medicare Part B | The part of Medicare that provides help with the cost of physician visits and other medical services. |
| Medicare Part B Premium | The premium amount deducted from a Medicare consumer’s Social Security check. The Part B Premium varies from year to year. |
| Medicare Part C | Medicare Part C Plans are referred to as Medicare Advantage Plans.
|
| Medicare Part D | Known as Medicare Prescription Drug Plans. The part of Medicare that provides coverage for outpatient prescription medications. These plans are offered by insurance companies and other private companies approved by Medicare. Consumers can get Part D coverage as part of a Medicare Advantage Plan (if offered where a consumer lives), or as a Stand-alone Prescription Drug Plan. |
| Medicare Private Fee-For-Service Plan (PFFS) | Medicare Advantage Plans offered by private insurance companies that allow members to go to any Medicare eligible provider who agrees to accept the PFFS Plan’s terms and conditions of payment rates. The PFFS Plan pays instead of Original Medicare. PFFS Plans may or may not offer Part D coverage. |
| Medigap Policy | Medicare Supplement insurance sold by private insurance companies to fill “gaps” (deductibles, coinsurance, copayments) in Original Medicare. A Medigap Policy cannot be sold to a Medicare Advantage member unless the member is switching to Original Medicare. A Medigap Policy can be sold to members in Part D (not MA-PD) Plans. |
| Term | Definition |
|---|---|
| Network | Group of physicians, hospitals and pharmacies who have contracts with a health insurance plan to provide care/services to the plan’s members. The Part D prescription drug plan’s network of pharmacies may help members save money on medications. |
| NIPR | National Insurance Producer Registry. NIPR developed and implemented the Producer Database (PDB) which provides the following benefits: Financial/Time savings, reduction in paperwork, real time information, verify license and status in all participating states, ease of access via the internet, and single source of data vs. multiple Websites. |
| National Marketing Alliance FMO (NMA) | NMA is a higher level contract given to a select group of FMO’s. These companies must adhere to comprehensive compliance, marketing and recruiting goals. |
| Term | Definition |
|---|---|
| Outbound Enrollment Verification Call (OEV) | An outbound call to recent enrollees which evaluates agent performance in making full benefit and network disclosures and benefit descriptions. |
| Original Medicare | An outbound call to recent consumers who enrolled in a Medicare Advantage plan which evaluates agent performance in making full benefit and network disclosures and benefit descriptions. |
| Out-of-Network Provider | A licensed physician or hospital that is not contracted with a Plan to provide medical services to its members. With Medicare Advantage PPO and POS plans, members can access out-of-network providers for covered services, generally at a higher cost than with in-network providers |
| Out-of-Pocket Maximum | An annual limit that some plans set on the amount of money a member will have to spend out of their own pocket for benefits |
| Term | Definition |
|---|---|
| Party ID | A number assigned by Agent On-Boarding that provides primary identification of an agent. All writing numbers assigned to the agent are tied to their Party ID |
| Pledge of Compliance | A document signed (electronically) annually by agents pledging compliance with Center for Medicare and Medicaid Services (CMS) regulations. |
| Point-of-Service (POS) | An HMO option that lets members use physicians and hospitals outside the plan’s contracted provider network subjected to increased cost sharing, POS benefits are available for selected benefits. |
| Preferred Provider Organization (PPO) | A type of Medicare Advantage Plan in which the member can use either preferred physicians or hospitals, or go to non-preferred physicians and hospitals. If the member uses non-preferred providers, they will usually pay a larger share of the cost of their care. |
| Prescription Drug Plan (PDP) | A stand-alone plan that offers Part D prescription medication coverage only. |
| Primary Care Physician (PCP) | A physician seen first for most health problems. The PCP may also coordinate a member’s care with other physicians and health care providers. In some Medicare Advantage Plans, members must see their PCP before seeing any other health care provider. |
| Provider | Any individual who is engaged in the delivery of health care services in a State and is licensed or certified by the State to engage in that activity, and any entity that is engaged in the delivery of health care services in a State and is licensed or certified to deliver those services if such licensing or certification is required by State law or regulation |
| Currently no "Q" terms |
| Term | Definition |
|---|---|
| Regional Preferred Provider Organization (RPPO) | A type of Medicare Advantage Plan. Regional PPO plans were introduced in an effort to expand the reach of Medicare managed care to Medicare consumers, including those in rural areas. The RPPOs can only be offered in an MA Region which is defined by CMS |
| Resident Agent | An agent who is licensed to sell in their state of primary residency. |
| Responsible Party | A person authorized under applicable law or identified in writing by the individual to act on behalf of the individual in making health care and related decisions for a consumer. Also known as ‘Authorized Representative’. |
| Term | Definition |
|---|---|
| Sales Event | Any sales or marketing activity and/or event that can be used to market to consumers and steer them toward specific plans, but does not include scheduled face-to-face individual/personal sales presentations. All sales events must be reported in accordance with CMS reporting regulations and guidelines. CMS also outlines specific regulations and guidelines in regard to the marketing, facilitation, and cancellation of sales events. |
| Scope of Appointment | A document or recorded agreement, received prior to the related scheduled appointment, which specifies the products the consumer has agreed that the sales agent may present at the one-on-one sales presentation. |
| Service Area | The geographic area approved by CMS within which an eligible consumer may enroll in a certain plan |
| Service Request | The documentation of all inbound and outbound contacts between the PHD and the producer community |
| Solicitor | A licensed, certified, and appointed independent contractor who sells any one of the UnitedHealth products through a contract with an agency (FMO, SGA, MGA and GA), but does not have a direct contract with UnitedHealth Group. |
| Special Election Period (SEP) | A period when a Medicare consumer may sign up or make changes to their Medicare coverage outside of a general enrollment period. These periods are available under specified circumstances defined by Medicare. |
| Super General Agent (SGA) | An independent contractor, with a direct contract with UnitedHealthcare at the SGA level that is part of the FMO hierarchy. May refer agents and solicitors for certification and appointment. The specific hierarchy level is based upon the production of contracted agents and solicitors. They are not employed by UnitedHealthcare. |
| Term | Definition |
|---|---|
| Telemarketer/ing | A firm or individual who contacts consumers, via the telephone, on behalf of UnitedHealthcare for the purpose of soliciting or selling any of the products listed above. Telemarketing activities may include lead generation, appointment setting, and/or product marketing. |
| Tier | Covered medications have various levels of associated member cost-sharing. Example: Tier One (primarily Generics); Tier Two (primarily Preferred Branded Medications); Tier Three (primarily Non-Preferred Branded Medications); Tier Four (Specialized High Cost Medications). |
| Term | Definition |
|---|---|
| Unsolicited Contact | Unsolicited contact includes, but is not limited to: door-to-door solicitation, email solicitation, text message solicitation and cold-calling (telephone solicitation). Products affected are Medicare Advantage (MA), Prescription Drug Plan (PDP) and any UnitedHealthcare product that carries the AARP name. If the consumer asks to no longer receive calls, you must discontinue contact and update your book of business in regards to MA/PDP and all products carrying the AARP name |
| Up-Line | Agents within an FMO hierarchy that are above the management/reporting level of a specific agent/agency |
| Currently no "V" terms. |
| Term | Definition |
|---|---|
| Writing ID number | A Company generated number, assigned to a contracted, licensed, and appointed agent used for submitting business, to track commissions, and other agent-specific sales statistics. |
| Currently no "X" terms. |
| Currently no "Y" terms. |
| Currently no "Z" terms. |