First year commission cannot exceed 200% of annual renewal so based of a $ 400 commish spread out over 6 years the first year commish cannot exceed $ 133.33 ( 400 over 6 years is 66.66 per year)
Agent/Broker Compensation
Effective date: September 18, 2008 MIPPA required that we establish limits on
Agent and broker compensation that ensure that agents and brokers enroll
Individuals in the Medicare Advantage plan or Medicare Prescription Drug plan
That is intended to best meet their health care needs.
These compensation rules are designed to eliminate inappropriate moves of
Beneficiaries from plan-to-plan. CMS expects that plans will set compensation at
Levels that are reasonable, and reflect fair market value for services
Performed. CMS encourages plans to keep compensation as level as possible across
Plan types, and among agents providing similar services.
If Medicare plans compensate their brokers and agents, under our regulations
Implementing MIPPA, they must pay compensation for the initial year and each of
Five subsequent renewal years (creating a six-year compensation cycle), provided
The member remains enrolled with the MAO or PDP.
The first year of this cycle, for purposes of determining the compensation paid
To an agent, is 2009 - provided that the beneficiary makes an enrollment change
Effective in 2009. The next move of this beneficiary after 2009 would be paid as
A renewal commission. For beneficiaries who do not make an enrollment change in
2009, the first year of the six-year compensation cycle would start the year the
Beneficiary makes his or her first enrollment change after 2009.
An agent’s aggregate first year compensation can not exceed 200 percent of the
Aggregate compensation in each individual subsequent renewal year, of which
There must be a total of five renewal years. (This creates a six-year cycle.)
This means that in the first year, the compensation paid can be no more than 200
Percent of the compensation paid in the second year or any individual subsequent
Renewal year up to a total of five renewal years (six year total compensation
Cycle). The agent will receive renewal compensation for the five year renewal
Period (years two through six) as long as the member remains enrolled in the
Plan or enrolled by the agent in a like replacement plan.
Compensation is earned in months 4 through 12 of the enrollment year as long as
The member is active with the plan. If an enrollee leaves the plan prior to
Month 4, no compensation is earned. If an enrollee leaves the plan after month
3, compensation is paid on a pro-rated basis for the months in which the
Enrollee actually was a member of the plan.
After the 2009 baseline year, no entity may provide, and no agent or broker may
Receive, compensation greater than the renewal compensation payable by the
Replacing plan on renewal policies if an existing policy is replaced with a like
Plan type during the first year and 5 renewal years. “Like plan type” refers to
PDP,
MA or
MA-PD, or Cost plan. Examples of replacements with like plan type
Are—PDP replace with another PDP,
MA or
MA-PD replaced with another
MA or
MA-PD,
And cost plan replaced with another cost plan. If a PDP is added to an
MA-only
Plan, then a new commission is paid for enrollment in the PDP.
Plans must establish a compensation structure for new and replacement
Enrollments and renewals effective in a given plan year. Plans may not alter the
Compensation structure during the given plan year. Compensation structures must
Be in place by the beginning of the plan year marketing period, October 1, and
Must be available upon CMS request including for audits, investigations, and to
Resolve complaints.
Agent/Broker Compensation
Effective date: September 18, 2008 MIPPA required that we establish limits on
Agent and broker compensation that ensure that agents and brokers enroll
Individuals in the Medicare Advantage plan or Medicare Prescription Drug plan
That is intended to best meet their health care needs.
These compensation rules are designed to eliminate inappropriate moves of
Beneficiaries from plan-to-plan. CMS expects that plans will set compensation at
Levels that are reasonable, and reflect fair market value for services
Performed. CMS encourages plans to keep compensation as level as possible across
Plan types, and among agents providing similar services.
If Medicare plans compensate their brokers and agents, under our regulations
Implementing MIPPA, they must pay compensation for the initial year and each of
Five subsequent renewal years (creating a six-year compensation cycle), provided
The member remains enrolled with the MAO or PDP.
The first year of this cycle, for purposes of determining the compensation paid
To an agent, is 2009 - provided that the beneficiary makes an enrollment change
Effective in 2009. The next move of this beneficiary after 2009 would be paid as
A renewal commission. For beneficiaries who do not make an enrollment change in
2009, the first year of the six-year compensation cycle would start the year the
Beneficiary makes his or her first enrollment change after 2009.
An agent’s aggregate first year compensation can not exceed 200 percent of the
Aggregate compensation in each individual subsequent renewal year, of which
There must be a total of five renewal years. (This creates a six-year cycle.)
This means that in the first year, the compensation paid can be no more than 200
Percent of the compensation paid in the second year or any individual subsequent
Renewal year up to a total of five renewal years (six year total compensation
Cycle). The agent will receive renewal compensation for the five year renewal
Period (years two through six) as long as the member remains enrolled in the
Plan or enrolled by the agent in a like replacement plan.
Compensation is earned in months 4 through 12 of the enrollment year as long as
The member is active with the plan. If an enrollee leaves the plan prior to
Month 4, no compensation is earned. If an enrollee leaves the plan after month
3, compensation is paid on a pro-rated basis for the months in which the
Enrollee actually was a member of the plan.
After the 2009 baseline year, no entity may provide, and no agent or broker may
Receive, compensation greater than the renewal compensation payable by the
Replacing plan on renewal policies if an existing policy is replaced with a like
Plan type during the first year and 5 renewal years. “Like plan type” refers to
PDP,
MA or
MA-PD, or Cost plan. Examples of replacements with like plan type
Are—PDP replace with another PDP,
MA or
MA-PD replaced with another
MA or
MA-PD,
And cost plan replaced with another cost plan. If a PDP is added to an
MA-only
Plan, then a new commission is paid for enrollment in the PDP. Agent/Broker
Compensation
Effective date: September 18, 2008 MIPPA required that we establish limits on
Agent and broker compensation that ensure that agents and brokers enroll
Individuals in the Medicare Advantage plan or Medicare Prescription Drug plan
That is intended to best meet their health care needs.
These compensation rules are designed to eliminate inappropriate moves of
Beneficiaries from plan-to-plan. CMS expects that plans will set compensation at
Levels that are reasonable, and reflect fair market value for services
Performed. CMS encourages plans to keep compensation as level as possible across
Plan types, and among agents providing similar services.
If Medicare plans compensate their brokers and agents, under our regulations
Implementing MIPPA, they must pay compensation for the initial year and each of
Five subsequent renewal years (creating a six-year compensation cycle), provided
The member remains enrolled with the MAO or PDP.
The first year of this cycle, for purposes of determining the compensation paid
To an agent, is 2009 - provided that the beneficiary makes an enrollment change
Effective in 2009. The next move of this beneficiary after 2009 would be paid as
A renewal commission. For beneficiaries who do not make an enrollment change in
2009, the first year of the six-year compensation cycle would start the year the
Beneficiary makes his or her first enrollment change after 2009.
An agent’s aggregate first year compensation can not exceed 200 percent of the
Aggregate compensation in each individual subsequent renewal year, of which
There must be a total of five renewal years. (This creates a six-year cycle.)
This means that in the first year, the compensation paid can be no more than 200
Percent of the compensation paid in the second year or any individual subsequent
Renewal year up to a total of five renewal years (six year total compensation
Cycle). The agent will receive renewal compensation for the five year renewal
Period (years two through six) as long as the member remains enrolled in the
Plan or enrolled by the agent in a like replacement plan.
Medicare's New Rules
Re: Medicare's New Rules
WEIRD STUFF!!!
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