Humana ACA Commissions/New Rates

[FLM2]

Today's webinar informs agents and brokers that the new commission structure will be announced 'within the next month'

They did say you can sell 2013 plans through December 31st and get paid according to the current commission structure-that certainly will be an advantage for anyone outside of the subsidy level.

I have 7 renewal letters from Humana to existing clients in Florida-the new rates, for ACA compliant plans, ranges from a 5% reduction (1 client) to a 60% increase (2 clients).

 

[AllenChicago]

thank you for this information. I will be on the 2 p.m. Central ti hope they have q&a.

 

[taterpeeler]

However..... this has NOT been discussed from the webinar:

Said plans from July31 till end year are going to become ACA compliant....

Next: Plans that elect the renewal strategy will become ACA compliant on 12/31/14 as the renewal process takes them to 12/30/14... that's a strange date and my concern is if a consumer has elected a plan lets say from BCBS on 10/25/14 because it has their doctors, hospitals and formulary medication there will be another election on 12/31/14 as an SEP that will override the prior selection. Now the Humana plan is the selected plan as it was garnered in the SEP for terming plan and also last in and with an SEP on medicare will go into effect 01/01/15.

I cant get hold of my rep as she is working that expo thingy.... but this will be a major problem come 01/01/15 and the client may be locked in with NO WAY OUT until 01/01/16. Client may have a plan that dosent offer their dr/ drugs or in the case of Humana in north Texas no subsidy even if the client was eligible. (they are not doing subsidies in north texas market)

The reason I say SEP is we have been told the AEP will be 10/15-12/07 after 2014

Guys I smell a rat with all the carriers that are offering renewal strategy now... something is just bugging me.

 

[FLM2]

However..... this has NOT been discussed from the webinar:

Said plans from July31 till end year are going to become ACA compliant....

Next: Plans that elect the renewal strategy will become ACA compliant on 12/31/13 as the renewal process takes them to 12/30/13... that's a strange date and my concern is if a consumer has elected a plan lets say from BCBS on 10/25/14 because it has their doctors, hospitals and formulary medication there will be another election on 12/31/14 as an SEP that will override the prior selection. Now the Humana plan is the selected plan as it was garnered in the SEP for terming plan and also last in and with an SEP on medicare will go into effect 01/01/15.

I cant get hold of my rep as she is working that expo thingy.... but this will be a major problem come 01/01/15 and the client may be locked in with NO WAY OUT until 01/01/16. Client may have a plan that dosent offer their dr/ drugs or in the case of Humana in north Texas no subsidy even if the client was eligible. (they are not doing subsidies in north texas market)

The reason I say SEP is we have been told the AEP will be 10/15-12/07 after 2014

Guys I smell a rat with all the carriers that are offering renewal strategy now... something is just bugging me.

I didn't hear or see that on the webinar, I thought they said that anything purchased before December 31st would have the option to be extended until the end of 2014.

The also said that they are waiving the 90 day waiting period to apply for a new plan if you are already a Humana member, I assume that is to give people more options going forward.

It makes no sense to tell people who just got covered they are done at the end of 2013 when everyone else on Humana gets a choice, particularly since the other companies aren't doing that.

 

[Quotebroker]

The reason I say SEP is we have been told the AEP will be 10/15-12/07 after 2014

Guys I smell a rat with all the carriers that are offering renewal strategy now... something is just bugging me.

Off topic: Has anyone seen any traction on changing that AEP? It seems ridiculous for such a tiny window in the first place, much more so when considering the Medicare overlap.

 

[Ann H]

Well, I agree with TaterPeeler. I was sitting in a BCBSAZ seminar a week ago, and had this thought as a fleeting thought, but I didn't think it through to the extent that Peeler has. Here was my thought. If the carriers (Humana and BCBSAZ in this case) are doing us a favor by giving a default option, in case the client doesn't actively choose an option, is that really a favor? This could backfire drastically for the client, and therefore cause liability for us. The carriers absolutely need to have a form, or an option on their letter, which says, "Do NOT issue an ACA compliant plan when my current plan ends. I have chosen a different path." If carriers don't do that, we need to.

Example: John Doe finds out he gets a subsidy, and his Doctor is not in the network for his current carrier's exchange plans. For this example, let's pick on Humana as the current carrier. So John Doe wants Aetna instead. John Doe does his subsidy app, gets his subsidy cert, files his Aetna enrollment form, and you are the agent. Then, on the very last day possible, Humana (the carrier in this fictitiuos example) hits a computer button saying as of December 30th the default option is triggered and the client is moved over to a Humana ACA compliant plan. Now what do you do? Open enrollment is over. If you had filed a form, or a document over the client's signature, stating that you do NOT want the carrier's default option, then you could argue with the exchange for a new SEP. (There is an SEP in case the carrier, or carrier rep, navigator or agent, inappropriately enrolled you in the wrong plan.) But even then, there may be trouble, particularly if the exchange looks at Humana's default option as being an SEP.

We definitely need to push the carriers to give us a clear way of communicating that one of the client's options is NO. I understand that the default option was meant to conserve clients, but there should be a way to say "No". I also understand that some carriers are stating that the agent will be mapped over when these default options are triggered, but that puts us in the position of negating the client's choice of another carrier. So, a way to communicate a "NO" instruction to the carrier is needed.

 

[HealthGuy]

oh lovely
what a mess really!

 

[taterpeeler]

here is just one excerpt from the Humana letter:

never mind, as per the bottom of the email it says we can not discuss this with the public

 

[FLM2]

here is just one excerpt from the Humana letter:

never mind, as per the bottom of the email it says we can not discuss this with the public

I have the Humana letter, I know it references effective dates through July 31st but that wasn't discussed at all on the webinar, they made it sound like all business written through the end of the year would have an option to extend through 12/31/2014, particularly since they are not doing another rate increase for any business that has already been renewed 1X this year.

We'll find out soon enough...

 

[anonymous1]

What happened to sending in a cancelation letter stating please cancel my policy on 12-31-xx Just my thoughts on this.