seadevil you have bought into the mccain -palin talking points.If you had the time to listen to the 30 minute infomercial by the obama campaign you might look at things from another perspective. Please let's stop the divisiveness
America is bigger than this.I don't want to start a political argument with you I just hope you are willing to give a new perspective a chance. Do you really honestly believe that obama is not a Christian?
First of all a christian doesn't vote for abortion the way he has. (or present).
Second...... how many questionable people does he get a pass on associating with before people say "hmm this is starting to get rediculous. I walked away from a racist at a seminar 2 years ago losing $500 I figure Obama could pick his dinner companions a little better.
Third.... Joe the plumber asks a question and then has his privacy invaded because he doesn't two the democrat line.
I ask anyone here if that is right. You don't agree with someone and they try ruin you?????
3 strikes you are out Obama.
Is it any surprise Rep. Stark who is behind this commission mess is an open Atheist and OH A DEMOCRAT!!
Spread the wealth america, do your part america, bend over america.
Florida Broker, thank you for your comments. I knew when I took a position contrary to conservative right leaning majority on this forum I would receive significant opposition to what I hoped would be a different take on the OBAMA QUESTION. I personally would not choose abortion for my wife or children with a few exceptions. thats my choice, I will not impose my choice on others . does that make me less of a Christian than you are?
I think it is admirable that you walked away from a $500.00 sale because of a racist. We Americans need to find away to
Get beyond this issue.
Joe the Plumber is now a intregal part of the McCain campaign. He appears at the rally's in support of the Senator.
There is nothing wrong with that, however he is now a public figure so what privacy rights are you talking about.
On stark the california congressman ,I betcha I'm more ticked off about him than you are.There are bad politicians on both sides of the political spectrum. This guy does not get a pass from me by any stretch of the imagination. If I lived in his district I would start a recall petition.
is it any surprise Rep. Stark who is behind this commission mess is an open Atheist and OH A DEMOCRAT!!
I resent that you think that being an Atheist means you are anti-commission. It just means (although not in Stark's case) that you are a realist and don't believe in fairy tales.
I guess I shouldn't vote for McCain because he's a Christian?
Take all the offense you want from this, but what a stupid, ignorant statement! You owe me and all Atheists an apology. (Typical fundamental bullshit).
Rick
------------------------------------ ILIAA
Training, Community, Support, and Success Independent Life Insurance Agents Assn rick@iliaa.org
Florida Broker, thank you for your comments. I knew when I took a position contrary to conservative right leaning majority on this forum I would receive significant opposition to what I hoped would be a different take on the OBAMA QUESTION. I personally would not choose abortion for my wife or children with a few exceptions. thats my choice, I will not impose my choice on others . does that make me less of a Christian than you are?
I think it is admirable that you walked away from a $500.00 sale because of a racist. We Americans need to find away to
Get beyond this issue.
Joe the Plumber is now a intregal part of the McCain campaign. He appears at the rally's in support of the Senator.
There is nothing wrong with that, however he is now a public figure so what privacy rights are you talking about.
On stark the california congressman ,I betcha I'm more ticked off about him than you are.There are bad politicians on both sides of the political spectrum. This guy does not get a pass from me by any stretch of the imagination. If I lived in his district I would start a recall petition.
Hunter,
I would never say you are less of a christian and I am not perfect either.
Since I brought this up. I have been called a racist simply because I won't vote for Obama. Now THAT is stupid!!!
As for our despise of Stark. I'll thumb wrestle you for that!!! We are looking to lose a lot of money and professional credibility.
I believe in MA's. Others here seem to think everyone should fork out $200/month and like it.
I was told here one time when I said "make all doctors accept MA's", I was told how would you like being told how to run your business???
Guess what kids...HERE IT US!!!
Except in the doctors case they still get the 100% of medicare and I am getting shafted.
And on that subject...In my scenario the SENIOR wins!!!! Yet that is NEVER discussed.
So as i said in my email to Stark "If you really are interested in helping seniors I respectfully challenge you to call me".
Thank goodness I didn't say i would hold my breath!
All the best to you hunter!!!!!!!!!!!!!!!!!!!!!!!!
In the wake of CMS's Oct. 8 clarification of regulations on Medicare Advantage marketing and commissions, some major MA plans expect to pay basically level commissions to agents ranging from $400 to $500 per member annually over the next several years, Jeff Fox, president of consulting firm Gorman Health Group, LLC, tells MAN. Plans were required to file 2009 commission schedules by Oct. 15 with CMS.
Securities analyst Carl McDonald of Oppenheimer & Co. states in an Oct. 18 note to investors that it appears Humana Inc. will pay a $500 MA commission in the first year, and a renewal commission amounting to $42 per member per month (PMPM), or approximately $500 annually. He says Humana also will pay a $10 annual commission on stand-alone Prescription Drug Plans (PDPs) both in the first year and upon renewal. Coventry Health Care, Inc. also apparently will pay a level commission of $500 per MA member with drug coverage, a level $450 commission for MA-only coverage, and a level $50 commission on PDPs, he says. The latest CMS data show Humana has about 14% and Coventry about 4% of national MA market share.
Smaller local plans, too, including UCare, which covers Minnesota and parts of Wisconsin, tell MAN that they modified their commission structure after CMS's recent clarification. With new enrollment into 2009 MA and Part D products slated to begin Nov. 15, plans now are working in earnest on compliance matters and hoping to avoid failures that could arise from paying agents incorrectly or monitoring sales practices insufficiently, industry consultants tell MAN. But they concede that the selling season is off to a slow start in part because of regulatory challenges. They say the economic downturn is forcing many Medicare organizations to slow down their marketing efforts and any plans for consolidation, encouraging employer groups to move faster on retiree health issues, and compelling consumers to focus hard on product pricing.
For the past several weeks, consultants have reported a high degree of confusion from client plans, especially concerning CMS's interim final rule released last month shifting to a six-year agent compensation structure and limiting the first-year commission to no more than 200% of commissions over each of the next five years. Although the 2009 selling season began Oct. 1, it was not until Oct. 8 that CMS clarified in a memo and an industry conference call that agents will receive only a renewal commission rate for 2009 applications. CMS described this as an effort to avoid financial incentives to shift, or "churn," members into new plans for 2009 in order to get higher first-year commissions.
Earlier this month, Stephen Wood, senior vice president for Ingenix Consulting (formerly known as Reden & Anders), said that early MA marketing seemed sluggish because of commission problems. He asserted that agents won't sell if they don't know how much they're going to get paid or when they're going to get paid, making it likely that MA plans with an internal sales force likely will do better in the short run.
CMS Allows Only Renewal Commissions for '09
In effect, CMS simplified the matter by creating a level commission structure for 2009, allowing only renewal rates, Wood told MAN Oct. 14. But there are "still lots of questions," he said. For example, he asked, "If a person goes from a group MA product to an individual MA product, what is that? Is it a new enrollment?"
"Plans have to start paying commissions immediately, and it's a little challenging," Wood said, again describing the 2009 selling season as off to a slow and confused start. "It's the story of the season — that, and the RAPS [Risk Adjusted Payment System] audit." CMS periodically audits MA plans on their submissions to the RAPS system. The agency looks at the medical records of a sample of the members to ensure that submitted diagnoses are supported by the records.
Abby L. Block, director of CMS's Center for Drug and Health Plan Choice, told MAN in an exclusive interview Oct. 20 that her "guess is things are getting off to a slow start particularly as plans start to implement new rules put in place….We haven't heard of significant marketing yet. It will start to pick up, I think, as we get into November closer to the open-enrollment period."
When asked whether matters appeared to be falling into place regarding commissions and compliance with the new marketing regulations finalized by CMS Sept. 15, she noted that CMS has not had much opportunity to review plans' commission schedules yet. "What we've said is the first year [commission] can't be more than 200% of the renewal commissions," she said, noting that plans had to file a schedule with first-year and renewal commissions with CMS "whether they pay a first-year commission or not….If we allowed a first-year commission in 2009, there'd be enormous incentive for everyone to try to get out there and move beneficiaries."
Block added that CMS had not heard of any MA marketing violations since Oct. 1. "It's really just too soon," she said, adding later: "I have assurances people are playing by the rules…and understand if there are violations we will take them very seriously and take appropriate action."
In its Oct. 8 memo to plans, CMS concludes by stressing to MA organizations and Part D sponsors that they are responsible for the actions of plan representatives, including subcontractors and downstream entities like brokers and agents.
"Health plans want us to come in and audit their [sales] processes, because the execution risk is very high," Gorman Health Group's Fox told MAN Oct. 17. "…The process from today going forward through the annual election period [running from Nov. 15 through Dec. 31] is all about execution risk with these regulations.…CMS says it has tripled its budget for 'secret shopping' and oversight…so plans are nervous and they should be."
In a key component of CMS's recent clarification, Fox noted that federal regulators "left open a window" by deciding to continue to receive comments — during the 60-day public comment period ending Nov. 15 — on whether plans must handle internal sales staff in the same way as independent agents. Initially, CMS said plans had to treat employed agents the same as independent agents, he noted, "but for now, it's status quo with employed staff."
CMS, in its Oct. 8 guidance memo, said that based on public comments and discussions with the industry, the agency realizes that while its current regulations are relevant to the way in which independent agents are compensated, the relationship and compensation arrangements between plan sponsors and employed agents are very different. Until the final regulation is published, CMS said, it won't enforce the compensation provisions for employed agents.
Among numerous provisions, CMS clarified in its recent memo that plans cannot discuss plan-specific premiums and/or benefits at educational events. CMS said that plans also cannot distribute or display business reply cards, scope of appointment forms, or sign-up sheets; set up personal sales appointments or get permission for an outbound call to the beneficiary; or attach business cards or plan/agent contact information to educational materials.
CMS included a "model sales appointment confirmation form" in its Oct. 8 materials that the agency said it is encouraging plans to use. The form asks beneficiaries to initial boxes beside the Medicare plan type(s) they want to discuss with the agent. Beneficiaries are told that by signing this form they are agreeing to a sales meeting with an agent to discuss specific types of products that they initialed. They also are told that signing the form won't affect current coverage.
Fox noted CMS also recently clarified that if a member enrolls in a plan for coverage starting January 2009, and if a plan changes its agents' compensation package for 2010, then the agents still must be paid under 2009 rates. Thus, he says, the execution risk is greater since a plan must keep the agent compensation package for six years if a member stays with that plan.
"The interpretation [of new regulations] still is gray, and with the amount of changes over a short period of time, there's a lot of risk and exposure for the health plan," Fox said. "We have not yet seen health plans just saying, 'Forget it,' but we are hearing about national agencies, FMOs [i.e., field marketing organizations], asking whether it's worth being in this business."
I was told here one time when I said "make all doctors accept MA's", I was told how would you like being told how to run your business???
Guess what kids...HERE IT US!!!
Except in the doctors case they still get the 100% of medicare and I am getting shafted.
And on that subject...In my scenario the SENIOR wins!!!! Yet that is NEVER discussed.
So as i said in my email to Stark "If you really are interested in helping seniors I respectfully challenge you to call me".
I would like to comment about all doctors taking MA's and just to make to clear."All doctors who take Medicare should take MA's." I totally agree and I still belive that to this day. The BS that they can take you and not your friend is crazy.
I would like to comment about all doctors taking MA's and just to make to clear."All doctors who take Medicare should take MA's." I totally agree and I still belive that to this day. The BS that they can take you and not your friend is crazy.
Lets make things as confusing as possible!
I agree that all doctors who are Medicare eligible should be required to accept all MA patients. MAs are part of Medicare.
I do not think this is a "free-market" issue. I do not think doctors should be made to take patients in general... they have their own business to run. But IF they subscribe to Medicare, THEN, since MAs are part C, they should therefore be required to accept them.
If they close their doors due to patient load, fine. If they no longer wish to serve Medicare patients, that's fine, too.... (many are doing this now). But make MAs as acceptable as Original Medicare if they continue their subscription to the program. All or none, baby!
------------------------------------
To be truly independent, an agent should not be dependent on a government bureaucrat for contracts or commissions.
I would like to comment about all doctors taking MA's and just to make to clear."All doctors who take Medicare should take MA's." I totally agree and I still belive that to this day. The BS that they can take you and not your friend is crazy.
Lets make things as confusing as possible!
I agree that things are way out of control and confusion level keeps building and building. I'm so sick of the crap coming down from CMS, not daily anymore but almost hourly.
None of this was even an issue until the PFFS crap hit the fan. I didn't like it when it first started and I dislike it even more.
I do have to disagree with you though. Doctors should not be forced to accept PFFS plans. That is akin to them telling me that I have to sell them. Or, telling me that I cannot sell PFFS plans even though I make a living working in the senior market. I became an independent agent so I can do as I please.
I do understand where you are coming from though and feel your frustration. It is CMS that is flawed. They have come up with a crappy plan and the way they are running it becomes more of a joke and a cluster ah mess daily. I just can't put the blame on the doctors.
------------------------------------
Medicare Supplement Sales Training and Coaching.
"The Perfect Contact Management Program (CMP) for the Insurance Professional" www.YourInsuranceOffice.com
877.633.0808
I agree that things are way out of control and confusion level keeps building and building. I'm so sick of the crap coming down from CMS, not daily anymore but almost hourly.
None of this was even an issue until the PFFS crap hit the fan. I didn't like it when it first started and I dislike it even more.
I do have to disagree with you though. Doctors should not be forced to accept PFFS plans. That is akin to them telling me that I have to sell them. Or, telling me that I cannot sell PFFS plans even though I make a living working in the senior market. I became an independent agent so I can do as I please.
I do understand where you are coming from though and feel your frustration. It is CMS that is flawed. They have come up with a crappy plan and the way they are running it becomes more of a joke and a cluster ah mess daily. I just can't put the blame on the doctors.
Frank, it shouldn't matter to a doctor whether the patient is on a PFFS or a Med Sup. Both are private insurance carriers. The PFFS carrier cuts out the need to deal with Medicare and they bill the carrier directly, so there should be some benefit to them to accept the PFFS.
What got the doctor's panties in a wad last year, was that Congress wanted to take funds originally set aside for their raises and fund expansion of the MA program of which PFFS plans were a part. I don't blame them for getting angry. I would be, too, if I was in their shoes... but that is now history. They got their raise and things have settled down.
The issue with unethical sales agents misrepresenting PFFS plans was a separate issue and really didn't affect the doctors much. It did raise the issue that doctors did not have a contract with the PFFS carrier and therefore were free to turn down a patient. That the beneficiary was mislead into thinking they had to be served was the problem. CMS addressed that problem with a sledge hammer, and now that is resolved, too.
It was just co-incidental that both issues came up at the same time.
It's just this....... If they are so concerned about the senior and pretty much have cart blanche on what they can do......... How would that hurt the senior??
Of course it would benefit them more than anything CMS has ever done!!!
I heard someone on the radio the other day in regards to Pharmacies electing not to dispense the morning after pill.
The caller said they should have to because it was for the greater good of the people and they shouldn't be able to spout their views.
OK...so for the greater good make doctors accept MA's.
And again when the money is the same???
Sorry Frank you need to participate in Bidens america.
It's just this....... If they are so concerned about the senior and pretty much have cart blanche on what they can do......... How would that hurt the senior??
Of course it would benefit them more than anything CMS has ever done!!!
I heard someone on the radio the other day in regards to Pharmacies electing not to dispense the morning after pill.
The caller said they should have to because it was for the greater good of the people and they shouldn't be able to spout their views.
OK...so for the greater good make doctors accept MA's.
And again when the money is the same???
Sorry Frank you need to participate in Bidens america.
I am not speaking for Frank, but your logic escapes me. Somewhere in this discussion you are trying to make a point, but I can't deal with your rationale. Could you re-phrase your argument?
Frank, it shouldn't matter to a doctor whether the patient is on a PFFS or a Med Sup. Both are private insurance carriers. The PFFS carrier cuts out the need to deal with Medicare and they bill the carrier directly, so there should be some benefit to them to accept the PFFS.
Ed,
I don't see that cutting out the necessity of doctors having to deal with Medicare is any kind of a plus for doctors or anyone for that matter. I hear doctors complain about HMO's and PFFS plans but very rarely hear them bitch about having to deal with Medicare. I don't understand the point you were trying to make.
I'm not trying to be argumentative but right now doctors do not have to accept Medicare patients nor do they have to accept Assignment. If you support doctors having to accept all MA plans do you also support them having to accept Medicare and also accept Medicare Assignment?
Right now in metro areas there are doctors who do not accept any of the HMO's. There are reasons why they don't and with some of them it has nothing to do with the amount they get paid.
HMO's to varying degrees will dictate to the doctor what test or procedure the doctor can order. If the HMO says they will not approve it then the doctor's hands are tied in providing what he/she thinks is in the best interest of their patient.
Some doctors feel that their medical training enables them to more of an educated decision regarding their patients well being than an administrator with an MBA who works for an HMO and who is only interested in the "bottom line".
I believe that there are agents who really don't care about that either. Like HMO administrators they are more interested in the amount of money they believe they will be paid when they sign someone up.
We didn't hear anything about this until the advent of the PFFS plans. Both agents and providers appeared to be very happy with the way things were going.
Just a few years ago the professional agents working in the metro areas were offering HMO's and had the ability to help the prospect make a well informed, intelligent decision regarding the type of coverage that was in the best interest of the prospect.
Enter the PFFS plans and the agents who got into the senior market just because they heard that there was a lot of "easy money to be made". That is when the sheit hit the fan. CMS went ballistic, seniors began getting ripped off and doctors got pissed.
We have seen over and over again what happens when the government starts dictating what MUST or cannot be done. That is exactly what is going on with this thread. Agents are up in arms because the government is going to dictate the commissions that will be paid when a PFFS plan is placed. They are afraid that they will no longer be the big windfall that they have been in the past.
You said that doctors should now be happy since they got their raise. Let's assume that is true and there doesn't appear to be a logical reason for them not to agree to accept all MA plans. So Congress makes it mandatory.
Congress now has a huge smile on their face. Know why? Because they can now come back and initiate the cut in what doctors are being paid and the doctors will have no choice but accept it. They won't even be able to decide that they don't want to accept MA patients because it is MANDATORY.
I cannot support any measure that further takes away a business owners right to run their business the way they see fit.
I don't see that cutting out the necessity of doctors having to deal with Medicare is any kind of a plus for doctors or anyone for that matter. I hear doctors complain about HMO's and PFFS plans but very rarely hear them bitch about having to deal with Medicare. I don't understand the point you were trying to make.
-------------------------------------------------------
The fact that they don't have to send a claim to Medicare, wait for it to be approved, then send the balance to the Med Sup carrier to be considered is my thought.... with only one carrier to submit a claim to would seem to be more efficient.... that's all.
I'm not trying to be argumentative but right now doctors do not have to accept Medicare patients nor do they have to accept Assignment. If you support doctors having to accept all MA plans do you also support them having to accept Medicare and also accept Medicare Assignment?
------------------------------------------------------
No, that is not what I said. I said IF they decided to accept a Medicare patient, THEN they should have to accept a MA member.[/quote]
------------------------------------------------------
Originally Posted by Frank Stastny
Right now in metro areas there are doctors who do not accept any of the HMO's. There are reasons why they don't and with some of them it has nothing to do with the amount they get paid.
HMO's to varying degrees will dictate to the doctor what test or procedure the doctor can order. If the HMO says they will not approve it then the doctor's hands are tied in providing what he/she thinks is in the best interest of their patient.
Some doctors feel that their medical training enables them to more of an educated decision regarding their patients well being than an administrator with an MBA who works for an HMO and who is only interested in the "bottom line".
I agree. Always saw it this way... I have been on the butt end of this problem myself years ago when I was a member of KP HMO.
-------------------------------------------------
Originally Posted by Frank Stastny
I believe that there are agents who really don't care about that either. Like HMO administrators they are more interested in the amount of money they believe they will be paid when they sign someone up.
Sad, but true...
-----------------------------------------------------
Originally Posted by Frank Stastny
We didn't hear anything about this until the advent of the PFFS plans. Both agents and providers appeared to be very happy with the way things were going.
Just a few years ago the professional agents working in the metro areas were offering HMO's and had the ability to help the prospect make a well informed, intelligent decision regarding the type of coverage that was in the best interest of the prospect.
Enter the PFFS plans and the agents who got into the senior market just because they heard that there was a lot of "easy money to be made". That is when the sheit hit the fan. CMS went ballistic, seniors began getting ripped off and doctors got pissed.
Yeah, I know... this is where I came in. I got burned bad by an upstart organization headed up by a former UA manager. What a mess...
I have to admit, that I was taken in by this group since I was a brand-new agent and didn't know any better. I did not take me long to come to the realization that I needed out.... quick!
------------------------------------------------------
Originally Posted by Frank Stastny
We have seen over and over again what happens when the government starts dictating what MUST or cannot be done. That is exactly what is going on with this thread. Agents are up in arms because the government is going to dictate the commissions that will be paid when a PFFS plan is placed. They are afraid that they will no longer be the big windfall that they have been in the past.
---------------------------------------------------
Yes, and I can understand to a good degree. Those who saw a good business opportunity, and worked to build a business around it, and those who saw only a quick buck and never had plans to do their due diligence and study to become well-qualified. I have a distaste for the latter.
----------------------------------------------------
Originally Posted by Frank Stastny
You said that doctors should now be happy since they got their raise. Let's assume that is true and there doesn't appear to be a logical reason for them not to agree to accept all MA plans. So Congress makes it mandatory.
Congress now has a huge smile on their face. Know why? Because they can now come back and initiate the cut in what doctors are being paid and the doctors will have no choice but accept it. They won't even be able to decide that they don't want to accept MA patients because it is MANDATORY.
Very good point!
----------------------------------------------------
Originally Posted by Frank Stastny
I cannot support any measure that further takes away a business owners right to run their business the way they see fit.
I agree, up to the point where once a doctor agrees to accept Medicare assignment. At that point he/she should have to take the whole package, and that includes Part C.
(I hope this attempt to multi-quote works... I can't find the directions on the box!)
Re: CMS asked to cap commissions
Linear Mode
