Humana 2015 mapd compensation

superdave

Expert
54
Florida
Preview of the 2015 Alternate Producer Partnership Plan for Individual Medicare
Dear Agent,

CMS revised the Medicare Marketing Guidelines for 2015 requiring Humana to make changes to the timing and calculation of Medicare Advantage and Prescription Drug Plan commissions.

These changes include but are not limited to:
• Humana may not pay compensation for a future year enrollment until the beginning of the plan year. Payments may not be paid until January 2015 for enrollments effective in 2015. This requirement applies to the compensation, including referral fees, paid to the agent or broker who actually enrolls the beneficiary, whether that agent or broker is paid directly by Humana, or by an intermediate entity, such as a ‘Field Marketing Organization’ (FMO) or similar type entity that has been retained to sell Humana’s Medicare product.
• CMS has clarified the rules when recovering compensation payments (charge-backs): Humana may pay the agent/broker at the initial compensation level during that calendar year but when a beneficiary changes plans during the initial year, Humana must pay a pro-rated amount based upon the number of months the beneficiary is enrolled. For example, an enrollee ages in effective April 1. The enrollee disenrolls effective September 30th of the same year. Humana initially paid a full initial compensation. Since the enrollee disenrolled (not a rapid disenrollment), Humana must recover 6/12ths of the initial compensation (January through March and October through December).
• Humana’s renewal compensation rates must not exceed fifty (50) percent of the current year Fair Market Value (FMV) published by CMS annually. Therefore, Humana must cap all renewal payments made in 2015 at the 2015 Renewal Rate (as defined in the Alternate Producer Partnership Plan). If the renewal rate from any previous year exceeds fifty (50) percent of the current year Fair Market Value (FMV), then renewal compensation will be paid at the current year Renewal Rate.
Humana will incorporate these changes into the 2015 Alternate Producer Partnership Plan for Individual Medicare, Major Medical, Ancillary and Supplemental Products in the next few weeks and will notify you when it is available.
We value your partnership and look forward to our shared success in the future.
:nah:
 

Latest posts

Back
Top