It looks like it's just the 7 companies, not all PFFS plans. Although the 7 listed were some of the major carriers and probably wrote a good portion of the MA plans. Here's the latest from CMS....
Well, just like the initial announcement, they keep stressing "controls" on marketing these advantage plans. That is good! Means agents will have to call in at point of sale.
Obviously, Pyramid agents , and probably other carriers too, will now have to be re-trained and re-certified. That could be a Pain in the A--. Especially if they demand it now and then again for the 2008 season.
The good news is I know which carrier I don't want.
In a few years, they may squelch these ma plans, so clients can switch under guaranteed issue provision. But the rates will be fun too.
Humana has been focused on creating regional PPO plans. They have had them in place for some time, but people were taking the PFFS plans instead.
Personally, I think that would be a more stable market. Start with what you have in the metros and start to branch out over time, not overnight.
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"Government's view of the economy could be summed up in a few short phrases: If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it." Ronald Reagan
Most clients here in Florida were snowbirds who liked the PFFS because oif flexibility and no good options for PPO's in this county.
Add in the zero premium and part B rebate and you couldn't stop them from signing up.
So putting someone on a med supp who don't have 2 nickles to rub together is not an option.
I know I know...others on this board don't care if seniors don't have money...Thats their fault!!!
Lastly....One of the big reasons for the PFFS demise in this county. The hospital company that owned 3 of the 5 hospitals in the area and largest doctor network....owned their own HMO MA plan!!!!!! BTW, they also told their doctors they were not allowed to take patients from other plans.
P.S> Heard at a meeting last week that Medicare wants to do the issuing of member cards next year for each company...... Seeing as how they are months behind right now without that responsibility, where are they going to be in 2008!!
Most clients here in Florida were snowbirds who liked the PFFS because oif flexibility and no good options for PPO's in this county.
Add in the zero premium and part B rebate and you couldn't stop them from signing up.
So putting someone on a med supp who don't have 2 nickles to rub together is not an option.
I know I know...others on this board don't care if seniors don't have money...Thats their fault!!!
Lastly....One of the big reasons for the PFFS demise in this county. The hospital company that owned 3 of the 5 hospitals in the area and largest doctor network....owned their own HMO MA plan!!!!!! BTW, they also told their doctors they were not allowed to take patients from other plans.
P.S> Heard at a meeting last week that Medicare wants to do the issuing of member cards next year for each company...... Seeing as how they are months behind right now without that responsibility, where are they going to be in 2008!!
Absolutely disgusting!!!
That's the situation here too with one of the counties I work in; exactly the same. On the hospital end and the people not having the $$$$ to afford a supp.
I highly relate.
Relax everyone...these are just growing pains. Most of us were making a fine living without MA just doing med supps...so focus on those for now and wait until this smoothes over. The old cliche, don't put all your eggs in one basket, is most true in the medicare health insurance market...
Insurance agents are going to have some form (separate from the application) that each client needs to sign that states they can go to any provider that accepts Medicare and agrees to the terms and conditions of the PFFS plan.
How else would Medicare go about this? They have no control over what the agent says in the home.
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"Government's view of the economy could be summed up in a few short phrases: If it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it." Ronald Reagan
So the rapid growth of the PFFS plans is the problem? How ridiculous! Remember back to the DNC talking points before the election, they don't like MA period and also want the HSA discontinue, in fact anything Pres. Bush has implemented. This is nothing more then political posturing.
Insurance agents are going to have some form (separate from the application) that each client needs to sign that states they can go to any provider that accepts Medicare and agrees to the terms and conditions of the PFFS plan.
How else would Medicare go about this? They have no control over what the agent says in the home.
Secure Horizons has a form something similar to what you are alluding that states this that MUST be included with your bz. or will not get processed.
I also read that verification calls are going to be implemented. I know Humana does this ( and IMHO I think it is good to do at point of sale, b/c it's mostly to cover an agent). They will also be implementing outbound follow up calls to benefiaries (from what I read) to ensure their satisfactory of the product as well as the agent's disclosure of the product.
This whole system is a mess and more intervention from CMS is not the answer!!
Aggreed. More intervention is definitely not the answer. Hey, how about more money be allocated to education and marketing to the doctors' offices and how about having these broker hotline reps certify too so they all know what the hey is going on and can actually answer a querry accurately when an agent calls in... gee, what a concept.... .
Its nice to see everyone in it for the moneyIts nice to see everyone in it for the money Its nice to see everyone in it for the moneyIts nice to see everyone in it for the money
HUH!?!? Not us man, not us. We work for FREE. Free, you hear! Like you, we work for Free....and give away those commish $$$$$$$$ if they insist on paying us. No Free is the only way...this is not a living, this is charity work. Now let's study your other comment.
I know I know...others on this board don't care if seniors don't have money...Thats their fault!!!
Wrong Again! Since it's logical you only make money from those who have money, and we work for FREE, we avoid people with money. Since we're missionaries like you, we always bring FREE stuff to broke people for FREE. None of this filthy lucre for me, no sirreeeee.
Its nice to see everyone in it for the moneyIts nice to see everyone in it for the money Its nice to see everyone in it for the moneyIts nice to see everyone in it for the money
HUH!?!? Not us man, not us. We work for FREE. Free, you hear! Like you, we work for Free....and give away those commish $$$$$$$$ if they insist on paying us. No Free is the only way...this is not a living, this is charity work. Now let's study your other comment.
I know I know...others on this board don't care if seniors don't have money...Thats their fault!!!
Wrong Again! Since it's logical you only make money from those who have money, and we work for FREE, we avoid people with money. Since we're missionaries like you, we always bring FREE stuff to broke people for FREE. None of this filthy lucre for me, no sirreeeee.
Boys! Boys! Play Nice! This is really a non-event, and everyone is right and no one is right. Floridabroker, I understand where you are coming from, I live in Florida too, where the cheapest UW for a 65yr old non smoker is $165 per month. Yes for us PFFS has allowed us to help people save money. It has broadened our client base, and allowed us to feel good about helping elderly folks who simply can't afford Supplements.
As CMS specified this is a temporary compliance situation, and companies will be re-certified as of 10-01-07. This is a voluntary situation.
The suspensions will apply until a plan demonstrates to CMS that it has the systems and management controls in place to ensure that it can meet all of CMS' requirements. The primary provisions that the plans must meet to have the suspensions lifted (and that all PFFS plans must meet beginning October 1, 2007) include:
All materials (including advertisements, enrollment materials, and materials used at sales presentations) will include the model disclaimer language provided by CMS in its May 25, 2007 guidance.
All representatives selling the product to beneficiaries will pass a written test that demonstrates their thorough familiarity with the Medicare program and the product they are selling.
A provider outreach and education program will be in place to ensure that providers have reasonable access to the plan terms and conditions of payment, and that provider relations staff are readily accessible to assist providers with questions about the plan.
Outbound education and verification calls will be made to all beneficiaries requesting enrollment to ensure that they understand the plan rules.
Lists of planned marketing and sales events provided to CMS will include events sponsored by delegated brokers and agents as well as those sponsored by the plan.
When asked by CMS, plan sponsors will provide a complete list of all representatives marketing a PFFS product and authorize CMS to make the list available to state insurance departments on request.
This is also an impolitic way for Democrats to stop the year round sale of PFFS as it was backdoored into effect by strong support from lobbyists. Please note that no other types of MA's are being so strictly monitored. Yes guys much of the blame lies within our industry, where lack of oversight and greed and plain old lack of ethics has prevailed.
Have the companies and CMS done a poor job of educating doctors regarding PFFS,damn right! Have some agents written inappropriate business, yes. Will having a client talk on the phone with a verification specialist to make sure they know what they are doing be a problem? Well,it won't be a problem for me, it just covers my *ss if other problems come up down the road. As far as I'm concerned all this is a good thing.
I think we are "playing nice". However, his statement that "everyone in it for the money" is pretty specific.
It doesn't say that "some are in it just for the money", it says "everyone". I take that to include me also, and that offends me. If you don't mean "everyone" then you should proof your comments before you post them.
Or should we assume since you said "everyone" that you are also included in that statement?
Florida, how much money have you made writing PFFS plans? I have written a total of three! I may just retire with all the money I have made from those three policies.
I agree, there are agents out there slamming this product based on price. I have stated before that seniors are very susceptible to anything that is "free" or dramatically reduced in price.
It was inevitable that this was going to happen. I'm glad they are finally trying to put a stop to it.
Anyone who has been in this business for more than a few months should have seen this coming.
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I seen this coming last November when the Leader of the Senate, Sen. Ried and the new House Speaker Pelosi (two of the biggest idiots to ever hold such positions) said they would get involved and stop the MA's, well this seems the best they can do. Lucky we don't see any "Tip O'Niel's" coming out of this far left democratic leadership of today.
You are right Frank....I actually meant to say the some who talk about making all the money. I apologize for that!
In the short time I have been here I have seen the salivating posts about making money a few too many times for my liking. Whether meaning to or not it shows bad form and gives our industry the bad reputation it has.
Last year I personally wrote 236.... With at least 150 of those being PFFS. The problem wasn't the plan, and we told people you could go anywhere that would accept the plan payment.
Anyone can right???? But if they would was another question. unfortunately in this county there were plenty of politics to keep the plan from being accepted.
We had doc offices here where the girls didn't even know what a PPO was..... They kept saying "we are not in their network!". There are some dumb people in this world that cannot grasp new ideas.
Now we just lost another HMO last week for this county that was a good plan.
Can I sell Med supps...Yes! The unfortunate part is too many people just can't afford them. very sad!
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