Insurance Agent Forum

[HealthResourceAdvisor]

Rumors are Unison Advantage will be lowering their inpatient max OOP to $250 for '09. Pairing that with the dental that includes dentures, hearing that includes hearing aids, generics through the gap, and the available OON rider sounds pretty strong to me. If only they were in more states...

As for the new MIPPA Memo, I think these plans will find a way around some of the commission issues by using bonuses. Also, CMS will probably monitor the 6-year cycle about as well as they monitor the one-time lifetime SEP. The idea is to deter crooked agents from a fast buck, hopefully not to kill the industry as a whole. All the regs are written from the perspective of a senior that's been taken advantage of, and it seems as though there was no thought put into the agent making an honest living in the industry. I look forward to hearing the responses of different plans over the coming weeks...

[scottfree]

I did hear that the Zero premium Humana PFFS plan is going to $20 and $900 per hospital admission from $625 and that their local PPO in my area is staying about the same. Nothing written in stone, just heard through the grapevine.

Two more weeks to know for sure.

[insurance0707]

Premiums and copays going up in my state as well on the MAPD plans

[policy doctor]

My understanding is that no bonuses will be allowed.

[midwestbroker]

The KC market, which has had MA plans for 15+ years, is not changing all that much. Some co-pays are changing and some carriers have raised their premiums, but for the most part it is very similar to last year.

[HealthResourceAdvisor]

I think the tactic plans will use is pay a higher renewal than year 1 commission. CMS's ruling is written with the common understanding that renewal commissions decline after the first year. The only rule was year 1 can't be higher than 200% of 2-6 but it doesnt say anything about how high years 2-6 can be in comparison to year 1. A plan can buy up the marketplace by offering a $600 year 2 renewal so when a beneficiary is in his/her 6-year cycle, that plan will be much more attractive to sell than CMS was banking on...

[GreenSky]

Originally Posted by HealthResourceAdvisor

I think the tactic plans will use is pay a higher renewal than year 1 commission. CMS's ruling is written with the common understanding that renewal commissions decline after the first year. The only rule was year 1 can't be higher than 200% of 2-6 but it doesnt say anything about how high years 2-6 can be in comparison to year 1. A plan can buy up the marketplace by offering a $600 year 2 renewal so when a beneficiary is in his/her 6-year cycle, that plan will be much more attractive to sell than CMS was banking on...

I think I understand you post but the problem is that the renewal commission paid can be no more than what would have been paid under the replaced contract.

So if you replace a WellCare plan which pays $100 renewal with a Coventry plan paying $500 renewal (doubtful), you still only get $100.

Basically CMS has made sure that agents have absolutely no financial benefit from advising seniors. I'm looking at other avenues because I don't believe that this will be a viable market under these rules for more than the next 3-6 months.

Rick

[jdeasy]

Originally Posted by GreenSky

I think I understand you post but the problem is that the renewal commission paid can be no more than what would have been paid under the replaced contract.

So if you replace a WellCare plan which pays $100 renewal with a Coventry plan paying $500 renewal (doubtful), you still only get $100.

Basically CMS has made sure that agents have absolutely no financial benefit from advising seniors. I'm looking at other avenues because I don't believe that this will be a viable market under these rules for more than the next 3-6 months.

Rick

That's the way I read the tea leaves as well. I have a large file of people I am to contact for AEP. Surely that won't run afoul of CMS rules? They are all people that have told me to contact them.

This will be my last AEP/OEP from the looks of things. I had already been moving towards other things. This will just expedite that process.

[HealthResourceAdvisor]

I don't think that is the case. CMS will tell the plan what year of the cycle the beneficiary is in. They are then to pay based off of their plan specific payment schedule. So let's say United is offering $400 for year 1 and $200 for year 2 but Coventry is offering $300 for year 1 and $500 for year 2...if you wrote United in '09 you'd get $400 and Coventry in '10 you'd get $500...