CMS Final Rule for MA/part D overrides

Sorry. My point is, most FMOs do more than just MAPD.

I’m thinking more about my direct upline, not the FMO. She has invested a lot of time and $ into what she does just to have the rug pulled out from under her.
But, she actually did plan. She has about 12 rental houses and counting.
 
Many individuals with Medicare rely on agents and brokers to help navigate complex Medicare choices as they comparison shop for coverage options. The Medicare statute requires that CMS must establish guidelines to ensure that the use of compensation creates incentives for agents and brokers to enroll individuals in the Medicare Advantage or Part D plan intended to best meet the prospective enrollee’s health care needs. However, excessive compensation, and other bonus arrangements, offered by plans to agents and brokers can result in individuals being steered to some Medicare Advantage and Part D plans over others based on the agent or broker’s financial interests, rather than the prospective enrollee’s health care needs.

CMS is cracking down on that. Specifically, CMS is finalizing requirements that redefine “compensation” to set a clear, fixed amount that agents and brokers can be paid regardless of the plan the individual enrolls in, addressing loopholes that result in commissions above this amount that create anti-competitive and anti-consumer steering incentives. The provisions of this final rule, which are applicable beginning with the upcoming Annual Enrollment Period, ensure that agent and broker compensation reflect only the legitimate activities required of agents and brokers, by broadening the scope of the regulatory definition of “compensation,” so that it is inclusive of all activities associated with the sales to/enrollment of an individual into a Medicare Advantage or Part D plan. In response to feedback from stakeholders, CMS is increasing the final national agent/broker fixed compensation amount for initial enrollments into a Medicare Advantage or Part D plan by $100, which is an amount higher than what was proposed ($31). CMS believes this increase will provide agents and brokers with sufficient funds to serve individuals with Medicare. This increase will eliminate variability in payments and improve the predictability of compensation for agents and brokers. This increase will be added to agent and broker compensation payments for the Annual Election Period in Fall 2024 and applied to all enrollments effective in CY2025 and future contract years.
I agree with everything stated here. Blue Cross MN shorts agent compensation until the agent reaches 50 MAPD clients with them. Only then does the agent receive full compensation. Wouldn't that be a violation of the new ruling? For example, let's say an agent has 49 BCBS-MN MAPD clients and a new client is trying to decide between Blue Cross and a competitor. The agent would have the additional compensation from Blue Cross hanging over him or her during the presentation.
 
Blue Cross of MN has 4 pay out levels. Elite, Premier, Select and Non-Partners. To be an Elite agent, you have to be in the top 1-3% of all agents. I have around 750 members with them and I'm a Select agent. I'm taking a $16 per member hair cut. Will this be legal in 2025? Doubtful. Will they pay the full renewal commission? I hope so.... I could use the $12,000.
 
Back
Top