2011 Agent Guide to Submit Electronic Contracting via … · 2017-10-31 · < Coventry uses NMF to...

nomoreforms

An Agent’s guide to submit an electronic contract via nomoreforms

2010 Coventry Health Care Internal Use Medicare Brokers and Agents Only

What is nomoreforms?

< NoMoreForms (NMF) is an online electronic contracting resource.

< Once Brokers have completed certification, they use NMF to submit their contract electronically.

< Upline organizations then use NMF to add additional information to then submit the Broker’s contract to Coventry.

< Coventry uses NMF to manage Broker contracting and to order background information and appointments as necessary.


Nomoreforms topics

< What to expect from this presentation

Steps for logging in as a new or returning user

Tips for resetting passwords

Tips for completing the necessary paperwork

Detailed information for required forms and certain situations

Attaching other files to the contract

Steps to finalize contract submission


Getting Started - Log-in Page

< Two options for logging into NMF

1. Login –

< Used for new users submitting initial contracting

< When submitting an Agency contract –submit the contract using all of the Principal’s information – there will be a section later for adding the Agency information

2. Returning Applicant –

< Used for returning users submitting changes to current contracting

< Forgot password feature – allows users to reset own password


Log-in Page – First Time users

§ Application Type:§ Agent/Producer

§ Agency

§ Name and Social:§ Be sure to enter this information accurately

§ If a contract is submitted using the incorrect SSN or FEIN – Coventry is unable to appoint, contract is rejected, and a new/corrected contract is required.

§ Password:§ Can be any password

§ Be sure to note and retain – will be used in subsequent steps to submit contracting

§ Client Package Code:§ Provided by Upline Organization

§ Used to determine which contract forms to completeClicking Logon To nomoreforms will direct the user

to the Forms page


Log-in Page – Returning users

< SSN/FEIN— Must type in the exact SSN/FEIN used for the initial login

< Password— Enter the password established during initial log in

— What if I forgot my password?

• Click Forgot and a new window will appear – see the next slide for more details

< Client Package Code— Enter the Package Code provided by the Upline Organization

Clicking Logon To nomoreforms will direct the user to the Forms page


Password Reset – First Step

< SSN/FEIN

— Must type in the exact SSN/FEIN used for the initial login

< Last Name

— Type in the Last Name or the Agency name as entered during the initial login

< Click Continue to proceed to next step

< If either field doesn’t match once Continue is clicked – one of two error messages appear:


Password Reset – Second Step

< Key in the new password in the upper box

< Rekey the same password in the lower box

< Tip - retain your password!

< Click Submit


Password Reset – Final Step

< Click Exit to return to the Login window

< Click Logon To nomoreforms to proceed to Forms


Forms – Overview

< The Package code your upline provided dictates which forms will appear for you to fill out.

< Different package codes reveal different forms.

< Forms can be saved as .pdf to your computer for later review

< The following forms are constant and appear for any package code— Contract Information Sheet

— Master Agreement

— Agent Level Addendum (the form name will reflect the agent level)

— Additional Address History

— Acknowledgement and Authorization

— Florida County Selection

— Additional Appointment States

— BA Addendum

< The following forms may appear depending on the package code— Coventry W9

— Marketing Summary Sheet

— LOA Auth Addendum


Forms – Main page

< Status Column:— Forms marked as Incomplete are

REQUIRED

— Forms marked as optional are not required to be completed for submission

— Once a form has been completed, the status is changed to Complete

< Submitted Column:— If a form has not been completed = No

— Once a form has been completed = Yes

The upcoming slides will cover each form you may

encounter…


Forms – Information Sheet page 1

< The Contract Information Sheet is required for contract submission.

< Page 1 appears regardless of Package Code

< Any field with a Red box must be completed.

— (Broker/Agent Name) LAST

— (Broker/Agent Name) FIRST

— Agent Broker SSN

— Birth Date

— Home Telephone Number

— Business Telephone Number

— Email Address

— Home Address

— City, State, and Zip Code

— Commission Statement address Yes/No

— Resident License # and State

— Resident Appointment State dropdown box




< Page 2 appears regardless of Package Code

< Any field with a Red box must be completed.— Background Information – Answer Yes/No for both

questions

— Errors & Omissions Information – Yes/No

— Check box for Certification disclaimer

— Agency Information Yes/No

— Signature

— Date

< If the Agree Button Appears immediately after page 2 – click Agree to submit this form

< Otherwise – continue to Page 3




< This page may not be present in your contracting package depending on the package code provided by your Upline.

< Any field with a Red box must be completed.— Payee Name

• MUST MATCH NAME ON W9

— Preferred Method of Payment – EFT

— Payee’s Tax ID or SSN

• MUST MATCH SSN/TIN ON W9

— Authorized Signature, Title, and Date

< Quick note about payee information

— The information on the EFT form must match the payee information provided on the W9. So if a broker indicates John Doe as the W9 name and SSN of 756756756, the same exact information must be indicated on the EFT form

< Click the Agree button to complete this form


Forms – W9

< The W9 is required for contract submission if included.

< This form may not be present in your contracting package depending on the package code provided by your Upline.

< Any field with a Red box must be completed.— Name (as shown on your income tax return)

— Check appropriate box –

• Individual/Sole Proprietor

• Corporation

• Partnership

• Other – (enter description)

— Address

— City, State, and ZIP code

— SSN or EIN – Enter only ONE depending on Self or Business

— Signature

— Date

< Reminder about payee information— The information on the EFT form must match the payee information

provided on the W9. So if a broker indicates John Doe as the W9 name and SSN of 756756756, the same exact information must be indicated on the EFT form

< Click Save Your Info to submit this form

Disclaimer – This screenshot does not show the entire form

Please be sure to review the ENTIRE documentation provided in your electronic contracting


Forms – Master Agreement

< Review the entire documentation in detail prior to clicking Agree

< This document outlines critical contract information

< This form is required for submission





Forms – Agent Level Addendum Page 1



< Any field with a Red box must be completed.

— By (signature)

— Print name – auto populates with information

— Date

< The title and verbiage of the addendum will vary depending on the package code provided by the upline

< If the Agree Button Appears on page 1 – click Agree to submit this form

< Otherwise, continue to page 2


Forms – Agent Level Addendum Page 2


< This page may not be present in your contracting package depending on the package code provided by your Upline




Forms - LOA Authorization Addendum

< Completed if Agent intends to pay LOA downline agents


< This form is not required for submission.





Forms – Additional Address History

< This form is to be completed if the broker has more than one address in the past seven (7) years.

< This form is not required for submission

< Any field with a Red box must be completed— More than one address in past seven years YES/NO

— First Name, Last name and SSN automatically populate


Disclaimer – This screenshot does not show the entire form 2010 Coventry Health Care Internal Use Medicare Brokers and Agents Only

Forms – Background Authorization

< This document acknowledges that a background investigation is completed on all brokers



< Any field with a Red box must be completed.— Print name – auto populates with information

— Signature

— Date

— SSN auto populates with information

— Home Address (Street, City, State, and Zip Code)

— DL# (Drivers License)

— State (State of current DL)

— DOB (Date of Birth)



Forms – Florida County Selection

< This form is used for brokers that wish to be appointed in Florida

< This form is required if a Florida appointment is requested

< Simply select the box by which counties you wish to market in Florida — Resident – ONE COUNTY ONLY

— Non-Resident – Select any amount of counties



Forms – Additional Appointment States

< This form is used for brokers that wish to be appointed in more states than the Contract Information sheet allowed to be populated.

< This form is not required for submission

< Simply select the state from each dropdown box in which you wish to market



Forms – BA Addendum








Forms – Marketing Summary Sheet

< This Document is required for General Agent level contracting or higher


< This form is required for submission when submitting a GA contract or higher level.

< Any field with a Red box must be completed.— Contract Name— Address – Street, City, State, Zip Code— Primary Phone— What States market in— Number of Agents— Email address— How long in business— How long in senior market

< Click the Save Your Info button to complete this form


Forms – Complete

< Once all the required forms are completed – the Forms page appears with all Complete Statuses with the exception of any optional pages

< A button now appears – Submit Forms

< What if I need to attach other paperwork?— The next slide shows the process to attach

additional files

< E&O Insurance is required to be submitted with the contract. Brokers can either attach a image copy electronically –or Fax to Coventry at 724-741-7285


Attachments

< To add an attachment, first click the “here” link as shown on the left…

This action takes you to a new page…

< Click Browse to locate the file on your computer

< Type in a brief description of the file in the second box

< Click Add Attachment to attach the file to the contracting. Repeat as necessary.

< The next slide shows what appears when the file is added.


Attachments (continued…)

< Click Done once all forms are attached – this returns you to the Forms submission page.


Forms – Submitting completed forms

< Now that the forms are complete and any attachments have been included, you are ready to submit your contract.

< Click Submit Forms to proceed to a few verification stages.


Digital Signature

< On this page, you are required to verify the password you created initially in this process.

< Key in the EXACT password (hopefully you made note of this before)

< Click Submit Forms to proceed.


Confirm Submission

< This page just reviews the forms that were completed, indicates if any attachments were included, and which forms were required or optional

< Click Submit Forms to submit your contract to your upline organization!


Contract has been submitted

< Now that your contract has been submitted – a Submission Confirmation Number is displayed

< This confirmation number can be used as a reference to your contracting for both your upline and to Coventry for future use.

< Your steps are complete!

< Next steps –— Upline completes their steps

— Upline submits contract to Coventry

— Coventry orders Background and Appointments


Questions?

< Do you have questions regarding your contracting or this process?

— Contact your Upline Organization

— Contact the Medicare Broker Services Department

• 1-866-714-9301 Available Monday-Friday 8:00am-6:00pm ET.

• [email protected]


mailto:[email protected]

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2011 Agent Guide to Submit Electronic Contracting via … · 2017-10-31 · < Coventry uses NMF to...

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