2015 Mapd Changes

[RickT]

I have now heard from two different sources that the renewal pay for 2015 AEP will not wait 13 months before you collect it. This is what I have been told.

You sell MAPD 10/1/14 for 1/1/15 effective date. You will get paid the $200/$400 commission after January 7th, 2015. However, you will ALSO get the $17 per month per member starting January 2015. (no longer waiting for the 13th month)

This sounds way too good to be true, but I have been told by two different sources this is a change for 2015. It will not apply for mid year, but it will apply for AEP this year.

Is anyone else hearing this? I would love to see documentation supporting this. Right now I am just being "told" these are changes.

 

[Chazm]

Not sure if I understand it. Then we'll be 12 months ahead of payments. That would cause more chargebacks. Not less. Doesn't make sense

 

[WCMason]

I have now heard from two different sources that the renewal pay for 2015 AEP will not wait 13 months before you collect it. This is what I have been told. You sell MAPD 10/1/14 for 1/1/15 effective date. You will get paid the $200/$400 commission after January 7th, 2015. However, you will ALSO get the $17 per month per member starting January 2015. (no longer waiting for the 13th month) This sounds way too good to be true, but I have been told by two different sources this is a change for 2015. It will not apply for mid year, but it will apply for AEP this year. Is anyone else hearing this? I would love to see documentation supporting this. Right now I am just being "told" these are changes.

Close. But the eff date would have to be no later than 12/1 for renewals to start in Jan.

 

[RickT]

I understand how the system is now. I am being told it is changing. They are removing the 13 month rule, so you get per member per month starting the same plan year as the effective date for this AEP.

Would not cause any more or less chargebacks. If a member dies/quits/changes, you stop getting your monthly money for that member. It is not 12 months ahead. It is being changed.

Again, this is what I have been told. It sounds like no one else is hearing the same thing, so it could be a croc of poo.

I know in 2014 you get paid $200/$400 and on the 13th month you get your $17 per month. I am being told in 2015... this will be different.

1/1/15 effective date. Sold in AEP, you get the full amount $200/$400 advanced (around Jan 7th) , and still get $17 per month immediately starting in January 2015.

I'm not asking about this year... I would like to know if anyone else has heard about these changes.

Thank you!

 

[sman]

I understand how the system is now. I am being told it is changing. They are removing the 13 month rule, so you get per member per month starting the same plan year as the effective date for this AEP. Would not cause any more or less chargebacks. If a member dies/quits/changes, you stop getting your monthly money for that member. It is not 12 months ahead. It is being changed. Again, this is what I have been told. It sounds like no one else is hearing the same thing, so it could be a croc of poo. I know in 2014 you get paid $200/$400 and on the 13th month you get your $17 per month. I am being told in 2015... this will be different. 1/1/15 effective date. Sold in AEP, you get the full amount $200/$400 advanced (around Jan 7th) , and still get $17 per month immediately starting in January 2015. I'm not asking about this year... I would like to know if anyone else has heard about these changes. Thank you!

Think about this logically. You enroll someone during AEP with a 1/1/15 effective date. Let's just say this person isn't new to MA. The carrier pays you the 2015 advance of $200. And according to your sources, the carrier will also pay you $17 per month starting January 2015. Which means you'd get paid $400 in 2015 for someone who should have only paid you $200.

Does that sound logical to you? Why would a carrier do that?

 

[RickT]

It does not sound logical at all. This is why I am asking. It was told at a delegated meeting and also told to me by another "manager".

They seem pretty darn sure it's the case. I don't think they are lying, just wrong.

Nobody else has heard about this "change"?

 

[jbage007]

"delegated meeting"
sounds very Humanaish
that would explain a lot right there (sorry, but those folks at Humana just are not the sharpest tools in the kit by any means)

If you were to get $400 Jan 7 on a 1/1/ enrollment, then immediately start collecting !7/month, you'd end up getting paid 600 first year, which of course EXCEEDS CMS guidelines by 50%. Max comp first year is $400. So the renewals are going to start 1/1/16 for 1/1/15 eff. dates.

Where you'll see the difference is mid-year enrollments. Let's say it is a June 1 2016 eff. date. You'll get paid the rest of the FIRST year commissions at the most (7 months x 17). Then you'll start getting "renewals" as of Jan. 1 2016.

This new CMS rule reflects the fact that all plan years run Jan 1 to Dec 31. Renewals are meant to start in plan year #2, which is not the same as in month 13 (except for the 1/1/xx eff. dates).

Rule of thumb: Never take at face value anything you hear from a Humana person.

 

[WCMason]

"delegated meeting" sounds very Humanaish that would explain a lot right there (sorry, but those folks at Humana just are not the sharpest tools in the kit by any means)...Never take at face value anything you hear from a Humana person.

Could not have said it better myself. There is a wide range of rules that you can't trust their reps to give you correct information about.

 

[RickT]

I appreciate the heads up. Thank you.

 

[Piece Of The Pie]

I understand how the system is now. I am being told it is changing. They are removing the 13 month rule, so you get per member per month starting the same plan year as the effective date for this AEP.

Would not cause any more or less chargebacks. If a member dies/quits/changes, you stop getting your monthly money for that member. It is not 12 months ahead. It is being changed.

Again, this is what I have been told. It sounds like no one else is hearing the same thing, so it could be a croc of poo.

I know in 2014 you get paid $200/$400 and on the 13th month you get your $17 per month. I am being told in 2015... this will be different.

1/1/15 effective date. Sold in AEP, you get the full amount $200/$400 advanced (around Jan 7th) , and still get $17 per month immediately starting in January 2015.

I'm not asking about this year... I would like to know if anyone else has heard about these changes.

Thank you!

Almost correct. (See WCMason's post) I was told something similar. It's for effective dates 12/1 or earlier. NOT AEP. I stated that in your similar thread you started called "Pmpm Changes???". Nothing in writing though.