I would have been in the middle of this before now, but I am having to deal with some health issues myself. Here is what I have written my Congressman, if we bombard congress, maybe someone, somewhere will listed:
Phil,
I am Joe Moore of Morristown. I think you have talked to my son, Greg Moore a few times concerning healthcare in the last few months. My sons and I own an Insurance Marketing Organization (
IMO), known locally as Tennessee Senior Benefits, and nationally as National Senior Benefits (
www.nationalseniorbenefits.com)
We have become very active in the Medicare Advantage and Part-D Markets, offering products locally to Medicare enrollees, and contracting agents nationally to offer the products of companies such as
AARP (United Health Care), Coventry, Blue Cross, etc.
As you may or may not be aware, contracted agents by these companies commissions are basically being controlled by Center for Medicare Services (CMS) and are just the past week getting paid for what CMS is calling a TRUE-UP commission. Agents are in shock as to what is CMS's interpretation of what commissions should be. Most agents (including myself) are looking at about 25% of what we thought it would be.
January 16, 2009, CMS put out the following memo:
CMS requires organizations to pay the renewal rate for all enrollments except those of beneficiaries newly entitled to Medicare or enrolling in an
MA plan, Cost plan or PDP for the first time. This means for example that for 2009
MA plans with an initial year commission amount of $400 will pay a commission of $200 to their agents and brokers, unless the enrollment is for a beneficiary newly entitled to Medicare or enrolling in a
MA plan for the first time.
Emphasis should be placed on the verbiage "enrolling in an
MA plan for the first time". Because CMS has now decided if an enrollee was in a PDP and now newly enrolled in a
MAPD, the agent is only entitled to a "Renewal" Commission.
Agents are contracted with the respective companies, and the contracts all show the earnings as much higher than agents are being paid. By keeping the agent's money they have worked for and earned, it is not saving the government a dime. The companies get to keep the extra money and it goes to their bottom line?
I am looking at this issue as not even being close to fair for the agents. They have already performed the duties they were contracted to do, and now (6 months later) they are getting paid about 1/4th of what they were contracted to be paid. A lot of agents have probably more money invested in the marketing than they will receive back. Ethically, I think CMS appears to have some issues that should have to be addressed.
Also, since when does the US Government control the pay of sub-contractors to get the job done. Agents are sub-contractors to the contracted insurance companies.
The January 16th entire memo can be read at:
http://www.cms.hhs.gov/ManagedCareMa...emo_011609.pdf
Re: Response from Chevell L. Thomas with CMS Regarding Initial MA Payments
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