MLR Senate/House Momentum - NAHU

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Arizona
Got this email from NAHU, and another from LifeHealthPro:

Healthcare Issues Dominate NAHU Meeting | LifeHealthPro
John Greene, NAHU vice president of congressional affairs, said the Senate bill will have several changes from the legislation exempting agent commissions from the MLR as introduced in the House as H.R. 1206.
One removes a provision in the House bill providing exempting commissions on waivers provided through PPACA.
Another limits the carve-out from the PPACA MLR provision to health premiums for individual and small groups, which is the market served by NAHU members, Greene said.
In other words, commissions sold on large groups would not be exempt, he said. “The small group and individual market is where the action is,” Greene said.
Moreover, the revised bill will not exempt bonuses paid by insurance companies to agents from the MLR, Greene said.
Regarding the latter provision, Greene said, “We never intended bonuses to be exempt from normal administrative or marketing costs,” he said.




Breaking News: Senate Complement to H.R. 1206 Coming Soon
Today, at NAHU’s 22nd Annual Capitol Conference, NAHU CEO Janet Trautwein announced that at least three bipartisan senators, Mary Landrieu (D-LA), Johnny Isakson (D-GA) and Ben Nelson (D-NE) will introduce legislation to help protect health insurance agent and broker jobs by excluding independent health insurance producer compensation from the medical loss ratio (MLR) requirements contained in the Patient Protection and Affordable Care Act (PPACA). The new bill will be officially filed within the next week, and will be a strong complement to H.R. 1206, currently pending in the House.
The new legislation will not be identical to H.R. 1206, but instead will include minor targeted improvements based on the market’s response to the MLR requirements over the past year. The lead co-sponsors of H.R. 1206, Congressmen Mike Rogers (R-MI) and John Barrow (D-GA), have indicated their support for the updated Senate measure.
The announcement was extremely well timed, as during the same meeting the Director of the Center for Consumer Information and Insurance Oversight at the Centers for Medicare and Medicaid Services (CMS), Steve Larsen, announced that the agency has concluded that there is no legal way that it could provide regulatory relief to agents and brokers on the MLR. However, he went on to tell meeting attendees that HHS believes “the success of exchanges depends on a strong and active role from agents and brokers.”
NAHU has always believed that a legislative solution would the most permanent and effective way of solving the economic problems that the MLR is causing for both insurance agents and brokers and health insurance consumers nationwide. We are thrilled that we will have bipartisan bills in both chambers of Congress in the near-term future, and we look forward towards their expedient passage.
Before the start of Capitol Conference, H.R. 1206 had 151 bipartisan co-sponsors. Due to the amazing work NAHU members did pounding the pavement and visiting Capitol Hill offices this week, we believe we will soon add at least 20 more. We also believe that our members will convince many more senators to support the Senate complement to H.R. 1206 from the get-go. If you would like to help, please contact your representative and senators today. Ask your representatives to sign on to H.R. 1206 if they haven’t already, and ask your senators to express their support for the efforts of Senators Landrieu, Isakson and Nelson by becoming original co-sponsors to their measure.
Thank you for your continued support of NAHU and your industry. If you have any questions about our legislative efforts, please contact us at [email protected].
 
Looks like bonuses will still be in the 20% MLR. Maybe comp will rise instead of taking this MLR hit.

Senate MLR Bill Aims to Give Agents Some Relief | LifeHealthPro
S. 2068 makes some slight modifications to H.R. 1206 based on the MLR experience over the past year, as the National Association of Health Underwriters (NAHU) pointed out. Representatives Rogers and Barrow support these changes, NAHU said.
They include limiting the MLR exclusion to the individual and small-group health insurance markets, where the problem is most severe; clarifying that any bonuses agents may receive remain a carrier administrative expense; and striking language expanding the state MLR adjustments, as the majority of states that applied have already received their determination from HHS. Under S. 2068, the waiver process will remain as is.
 
The NAIC already formally recommended to HHS that agent comp be left out of the MLR calculations. The response was "thank you, but no." This bill, IMHO, is going nowhere but I admire the effort.
 
Bill, if agent comp is removed from MLR would you feel comfortable with full disclosure to your clients and allowing the carrier to add your fee on to the premium?
 
The main question is ......will the pricing be different without a broker. If the same, it won't be hard to justify value as it is now. If different pricing, start thinking about a fee based model, or a flat fee offset by commissions received (AZ presumably allows). But, as I said before, I don't like what NAHU doing, it opens up more uncertainty. Some carriers may attempt to eliminate us. By the time anything gets voted on and changed, we'll be so close to 2014, that we'll be looking at what state exchanges, and private exchanges offer agents (or not). Advice will be needed, at a cost.

My market: Every person making over $44k, any family making more than 90k, anyone who makes money under the table, any immigrant who has a life here, anyone who wants to avoid the IRS, any company's under 50 ee's, or someone driving a mercedes whose behind in child support payments, there will be lots of reasons for people not to not sign up for the state govt run exchanges.

Add to the list..............
 
My market: Every person making over $44k, any family making more than 90k, anyone who makes money under the table, any immigrant who has a life here, anyone who wants to avoid the IRS, any company's under 50 ee's, or someone driving a mercedes whose behind in child support payments,

Interesting market niche.
 
Looks like bonuses will still be in the 20% MLR. Maybe comp will rise instead of taking this MLR hit.

Senate MLR Bill Aims to Give Agents Some Relief | LifeHealthPro
S. 2068 makes some slight modifications to H.R. 1206 based on the MLR experience over the past year, as the National Association of Health Underwriters (NAHU) pointed out. Representatives Rogers and Barrow support these changes, NAHU said.
They include limiting the MLR exclusion to the individual and small-group health insurance markets, where the problem is most severe; clarifying that any bonuses agents may receive remain a carrier administrative expense; and striking language expanding the state MLR adjustments, as the majority of states that applied have already received their determination from HHS. Under S. 2068, the waiver process will remain as is.


gimme a fair first year commission ( 18-20 %) and I dont need no stinking bonuses. I'm currently averaging 18-20 percent FYC and quite happy. Seems the carriers are playing games with the recent bonus schedules and I really dont care for it. I can tell you that I'm feeling more confident about the future because these bonuses mean Carriers like Aetna and UHC are meeting the MLR and have cash to spare.

My .02
 
Interesting market niche.

A little cheat sheet tells me that Georgia requires a separate "fee based counselor" license to charge fees. Same in Indiana, and Texas supposedly. AZ, FL, PA, TN, OH, IL don't require additional licensing, nor is there a law against it. Check with your own DOI.
 
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