Issue with Humana anyone Else?

jason5436

Expert
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This is a Atlanta thing but maybe other cities are the same. I am new and just feel like this may be a new thing. Is this something I should be concerned with or just a thing that happens in the business?

Humana MAPD plan in 2015 - H4141-001. It still is $0 but they raised the MOOP, the PCP and the drug deductible.

Humana MAPD H1H1-015 was created this year. Same plan except the MOOP is cheaper, the PDP is cheaper and the drug ded is cheaper.

One of my clients read the letter to me. It reads like Humana wants the clients to call Humana direct so they can not pay the agent. Maybe its just me but I feel like that is very dirty but why? What does Humana get out of this. A pissed off agent who doesn't want to write for them?

CMS pays them a lot of money why would they cut an agent out for $200 bucks a year. Doesn't make sense to me.

So this is a question for you seasoned vets in the biz? Will this happen all the time or is this just a new thing with Humana because of the merger with Aetna. It almost seems like Aetna set this up. They came out with a better plan than Humana and maybe are hoping to push the business to Aetna. Seems like a big game.

It just frustrating to me because now I have to switch a bunch of people for no reason. Its hard to explain to a client. Well client Human wants me to get a signature from you because well they changed plans. That doesn't make sense to a consumer. But what the hell I guess its just the MAPD market. Any feedback?
 
Must be fairly new to the business? Not just a Humana thing, all insurance company's send out letter's to mine and your clients with the corporate phone number on them. Some of these letter's and advertisement's say call us or your agent, some don't. Get used to it and give your client a reason to deal directly with you. You could start by telling them you answer the phone.
 
This is a Atlanta thing but maybe other cities are the same. I am new and just feel like this may be a new thing. Is this something I should be concerned with or just a thing that happens in the business? Humana MAPD plan in 2015 - H4141-001. It still is $0 but they raised the MOOP, the PCP and the drug deductible. Humana MAPD H1H1-015 was created this year. Same plan except the MOOP is cheaper, the PDP is cheaper and the drug ded is cheaper. One of my clients read the letter to me. It reads like Humana wants the clients to call Humana direct so they can not pay the agent. Maybe its just me but I feel like that is very dirty but why? What does Humana get out of this. A pissed off agent who doesn't want to write for them? CMS pays them a lot of money why would they cut an agent out for $200 bucks a year. Doesn't make sense to me. So this is a question for you seasoned vets in the biz? Will this happen all the time or is this just a new thing with Humana because of the merger with Aetna. It almost seems like Aetna set this up. They came out with a better plan than Humana and maybe are hoping to push the business to Aetna. Seems like a big game. It just frustrating to me because now I have to switch a bunch of people for no reason. Its hard to explain to a client. Well client Human wants me to get a signature from you because well they changed plans. That doesn't make sense to a consumer. But what the hell I guess its just the MAPD market. Any feedback?

With Humana, if they change plans with the same network type (HMO to different HMO) the original selling agent still gets the commission even if a different agent switched them.

If the go from an HMO to PPO (or any change in network) the new agent gets the commission.
 
With Humana, if they change plans with the same network type (HMO to different HMO) the original selling agent still gets the commission even if a different agent switched them.

If the go from an HMO to PPO (or any change in network) the new agent gets the commission.

In my areas, we have a Humana Chronic plan for diabetics (HMO TO HMO). Agent changes when prospect is enrolled on regular plan or Diabetic. It's a sword that cuts both ways. I try my darnedest to get them on Diab HMO if I know they're diabetics.

You just got me thinking , however. We've had the SAME Humana plan contract numbers for MANY YEARS. (H4510). For some reason, they are now calling it H6649. Not sure why. However, I should check on this.
 
With Humana, if they change plans with the same network type (HMO to different HMO) the original selling agent still gets the commission even if a different agent switched them.

If the go from an HMO to PPO (or any change in network) the new agent gets the commission.

That is not always the case. We have an HMO here that was $0 premium in 2014 that has a premium for 2015. Humana brought in another HMO for 2015 with a $0 premium for 2015. It has the same provider network and formulary and is structured the same with several of the co pays just a little bit less.

It has a different plan number than the old plan so it was an HMO to HMO change. If a client called Humana or signed with another agent the original agent lost them. I know this from personal experience.
 
That is not always the case. We have an HMO here that was $0 premium in 2014 that has a premium for 2015. Humana brought in another HMO for 2015 with a $0 premium for 2015. It has the same provider network and formulary and is structured the same with several of the co pays just a little bit less.

It has a different plan number than the old plan so it was an HMO to HMO change. If a client called Humana or signed with another agent the original agent lost them. I know this from personal experience.

That would be the same as in my example where one changes from a "regular" plan to a Diabetic plan. Regular plan in San Antonio is H4510-015. If said diabetic mb enrolls with another agent into H4510-030, new agent receives the commish.
 
Whatever you do, figure fit out on your own. The Humana AEP crew has arrived, and they will make you wish you never called them.
 
With Humana, if they change plans with the same network type (HMO to different HMO) the original selling agent still gets the commission even if a different agent switched them.

If the go from an HMO to PPO (or any change in network) the new agent gets the commission.
That's good to know. thanks

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Must be fairly new to the business? Not just a Humana thing, all insurance company's send out letter's to mine and your clients with the corporate phone number on them. Some of these letter's and advertisement's say call us or your agent, some don't. Get used to it and give your client a reason to deal directly with you. You could start by telling them you answer the phone.
yes end of 2nd year. I figured I would have to deal with this a lot. I called all my clients to check in last week. I can imagine it gets tough when you get into your 5 year when you have a ton of clients. But I guess I will just have to keep in touch how ever I need too.
 
I can tell you from experience that even captive agents can get caught up in this. If they respond to the mailer or whatever and an agent is sent out, the member tends to assume it will be the original agent again. But that's not necessarily the case depending on the circumstances. Then the member will call you about what the other agent said or did.
 
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