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In today’s rapidly evolving landscape of insurance and pharmaceutical sales, compliance is a critical element that guides the actions of sales representatives. One of the central requirements in this regard is the necessity for sales reps to submit paper applications (APs) and maintain a certain level of documentation to comply with industry standards and regulations. This process is crucial not only for ensuring the accuracy of applications but also for safeguarding the integrity of the sales process. In this article, we’ll dive deep into the requirements for submitting paper APs, the materials that must be kept by sales reps, and how various resources help streamline this process.
# Understanding the Requirement: Sales Reps and Paper Applications
For many sales reps in the healthcare and pharmaceutical industries, particularly those working with insurers like Cigna and Aetna, submitting paper APs is not just a procedural formality but a legal and regulatory obligation. These paper applications, which are completed by the representative on behalf of the client, need to be maintained for up to 11 years – the current year plus a decade of records.
Why Maintain Paper APs?
The reason for this extensive retention is tied to compliance and audit requirements. Paper applications serve as legal documents that record the sale, the terms of the insurance policy, and any agreements made between the sales rep and the client. The requirement to keep these forms for 11 years ensures that sales reps are held accountable for their actions, and that a historical record is available for future reference if the need arises.
Additionally, retaining completed applications for this extended period ensures that the insurer is able to verify claims, check for potential fraud, and confirm that all necessary procedures were followed when dealing with clients, particularly those enrolled in government-sponsored programs like Medicare.
# Key Materials to Keep
When it comes to maintaining records, sales representatives are often required to retain various materials. While these can vary slightly depending on the specific company or insurance provider, there are some common elements that apply across the board. These typically include:
1. Completed Suitability Forms
A completed suitability form is one of the essential pieces of documentation that sales representatives must keep. The form is designed to evaluate whether the product being sold is appropriate for the client based on their needs, financial status, and personal preferences. Sales reps are instructed not to submit the form along with the application but must retain it in case of audit or customer dispute.
2. Sales Oversight Materials
Sales reps are often provided with oversight materials to help guide their sales practices. For example, 2017 Sales Oversight guidelines, which outline the steps that should be followed to ensure proper record-keeping and sales processes. These materials, such as the 2025 Cigna Selling with Integrity Flashcards or the 2023 Selling With Integrity Flashcards, are designed to help sales reps maintain ethical and compliant sales practices.
3. Pharmaceutical Marketing FAQs
In addition to general insurance sales, pharmaceutical sales reps must also comply with specific guidelines set out in the Pharmaceutical Marketing FAQs. These FAQs outline best practices for marketing prescription drugs, managing interactions with healthcare providers, and maintaining regulatory compliance. For example, regulations surrounding “scope of appointment” for Medicare sales are carefully defined in these FAQs.
4. State-Specific Sales Rep Laws
Sales reps must also be aware of the Sales Rep Laws State guidelines, which vary from state to state. These laws can cover everything from required disclosures to clients to restrictions on sales practices. Failure to adhere to state-specific regulations could result in hefty fines or even a ban on selling within a state.
5. Certification Flashcards and Training
To ensure that reps are up to date with changing laws and regulations, they must complete periodic certifications. Examples of certification materials include Aetna Individual Core Certification Flashcards. These flashcards focus on important topics such as the ethical selling of insurance, anti-money laundering (AML) policies, and handling sensitive data, among other areas.
6. Scope of Appointment (SOA) Documentation
A crucial aspect of Medicare sales is the Scope of Appointment (SOA) documentation, which ensures that the client understands and agrees to the topics being discussed during the sales appointment. The Medicare Sales & Marketing FAQs often provide clarifications on how to properly complete and maintain this documentation.
# The Role of Sales Reps in Compliance
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sales reps are required to submit paper aps within - 2017 SALES OVERSIGHT