A prospect tells a New York agent that she has retiree health coverage and a Medicare supplement policy, but the agent recommends that she buy an additional Medicare supplement policy without reviewing either existing coverage. Under New York's Medicare supplement standards, the agent:

Why D is correct

Under New York's Medicare supplement standards, in recommending the purchase or replacement of a Medicare supplement policy an agent must make reasonable efforts to determine the appropriateness of the recommended purchase or replacement. Recommending an additional policy without reviewing coverage the prospect has already disclosed, a retiree plan and an existing Medicare supplement policy, fails that standard. The rule exists so seniors are not sold duplicate or excessive coverage they do not need.

Why the other options are wrong

• A) Responsibility for the appropriateness determination belongs to the agent who recommends the coverage, not solely to the insurer reviewing the application.
• B) The applicant's disclosure of other coverage is the beginning, not the end, of the agent's duty; the agent must review it before recommending more coverage.
• C) The ability to change policies later under New York's continuous open enrollment does not excuse the agent from determining appropriateness at the time of the recommendation.

Memory hook

Heard 'I already have coverage'? Review it before recommending more.