By Next Monday we’ll know if overrides ,marketing money and Hra’s gone . I found it interesting yesterday wellcare sent out email lowering Hra’s from $225 to $150 on dsnps and no more money on non dsnp Hra’s . Also wellcare was paying hra fee’s immediately like Aetna before the plan went in effect . That’s gone .Now they pay on effective date . They mentioned persistency. Basically agents were gaming the system on dsnps . They’d write on March 1st get the $225 and rewrite on March 18th new carrier for April 1 effective date
Countdown to cms final ruling
- Thread starter DonP
- Start date
Special Agent
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This would go in effect now or 1/1/25?
I saw one person complaining that they were going to basically get rid of overrides and pay $35 more per app. [Update: it was $31, not $35]
I was like - YES!!!!!!!!!!
That's where the money belongs - those who WRITE BUSINESS.
(This person obviously has a business based on overrides. Sorry ... Go write some business and you'll be just fine)
I was like - YES!!!!!!!!!!
That's where the money belongs - those who WRITE BUSINESS.
(This person obviously has a business based on overrides. Sorry ... Go write some business and you'll be just fine)
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- Thread starter
- #4
No that $35 is supposedly for the fmo I believe . It’s for overrides . But your correct . The overrides are obscene in mapd . Fmo’s, mga’s , GA’s making 6-7 figs for doing little . You got Ifg mga’s making $1-$5 mil a yr in mapd overrides . This is govt money funding these overrides .
Are you sure?
www.bassberry.com
It reads (to me) like broker comp goes up - i.e. you and me - the people actually talking to Mildred about her Ozempic tier level - are the ones getting the extra $31
(Note it was $31 not $35)
Especially if that $31 is renewal (or $15.50) - I'm 100% good with this.
I'll pay for CSG again...
New 2025 Medicare Advantage Proposed Rule Further Scrutinizes Marketing Practices, Expands Behavioral Health, and Promotes Health Equity
On November 15, CMS published a proposed rule, which, as currently written, has potentially significant implications for Medicare Advantage (MA) plans and Medicare Prescription Drug Benefit Program (PDP) plans in Contract Year (CY) 2025 with a limited number of provisions to be applicable...
www.bassberry.com
It reads (to me) like broker comp goes up - i.e. you and me - the people actually talking to Mildred about her Ozempic tier level - are the ones getting the extra $31
(Note it was $31 not $35)
Especially if that $31 is renewal (or $15.50) - I'm 100% good with this.
I'll pay for CSG again...
- Thread starter
- #6
Are you sure?
New 2025 Medicare Advantage Proposed Rule Further Scrutinizes Marketing Practices, Expands Behavioral Health, and Promotes Health Equity
On November 15, CMS published a proposed rule, which, as currently written, has potentially significant implications for Medicare Advantage (MA) plans and Medicare Prescription Drug Benefit Program (PDP) plans in Contract Year (CY) 2025 with a limited number of provisions to be applicable...
It reads (to me) like broker comp goes up - i.e. you and me - the people actually talking to Mildred about her Ozempic tier level - are the ones getting the extra $31
(Note it was $31 not $35)
Especially if that $31 is renewal (or $15.50) - I'm 100% good with this.
I'll pay for CSG again...
Carriers could easily cut broker comp 30% plus and give that to fmo’s . I put nothing past anything . I’m sure you noticed a huge change in fmo’s and carriers emails the past 3 months . Carriers like Humana hardly mention mapd anymore in their mail outs . It’s all med sups and dental now. This started last yr with them pivoting hard to diversify . Humana’s the most vunerable of all carriers as they’re 90% mapd. Aetna and United both are very diversified with large med sup and big group business . Fmo mail outs are spamming the hell out of med sups the past 4 months . I’m getting emails like “ Is your business diversified “. They smell the coming override pain with mapd .
Humana's Med Supp underwriting is ridiculous. I've had several declined with Humana that have been approved elsewhere. Just had a client who takes a cholesterol med, BP med and thyroid med declined by Humana. She was on the same meds 3 years ago when she was approved with another carrier.
Was it stated somewhere that it will be released by next Monday?
lol i miss those days. two UW questions on the app, that was it
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