Mapd Commission Payment

[saintstigers]

Question since I'm new to mapd this year.

On my Humana mapd commission statement, for each of my clients it breaks down the $429 payment as:

$214 first year comm
$215 Medicare 2nd half first year comm.

Trying to make sense of "Medicare 2nd half first year comm" ???

 

[sman]

Question since I'm new to mapd this year. On my Humana mapd commission statement, for each of my clients it breaks down the $429 payment as: $214 first year comm $215 Medicare 2nd half first year comm. Trying to make sense of "Medicare 2nd half first year comm" ???

It's also known as the "true up" amount. When a carrier first pays the commission they typically don't know whether the member is new to MAPD or not. So they pay the first amount as if they aren't new to MAPD. Then when Medicare notifies them that the member is new to MAPD they pay the 2nd amount.

 

[saintstigers]

So since I received the full amount of $429 they are new to Medicare Advantage. If I only received $214 for a client then they switched from one Mapd plan to another. Right?

 

[Todd King]

So since I received the full amount of $429 they are new to Medicare Advantage. If I only received $214 for a client then they switched from one Mapd plan to another. Right?

That's exactly right.

 

[Chazm]

So since I received the full amount of $429 they are new to Medicare Advantage. If I only received $214 for a client then they switched from one Mapd plan to another. Right?

And now the new CMS rule that if they never had a MAPD plan but had a part D plan and switch to a MAPD plan, you only get half.

 

[saintstigers]

And now the new CMS rule that if they never had a MAPD plan but had a part D plan and switch to a MAPD plan, you only get half.

That sucks. I guess that went into effect 2016.

Do they still payout the full 1st year if the effective date is a non-January 1 date? For all those T-65ers?

 

[Chazm]

That sucks. I guess that went into effect 2016. Do they still payout the full 1st year if the effective date is a non-January 1 date? For all those T-65ers?

Depends on the company. I know UHC and Humana will pay the full year. I'm in the process of getting away from MA plans myself. Bigger commissions but man AEP is getting to be a big headache.

 

[GreenSky]

And now the new CMS rule that if they never had a MAPD plan but had a part D plan and switch to a MAPD plan, you only get half.

Never heard that. Can you provide a reference?

Rick

 

[Chazm]

Never heard that. Can you provide a reference? Rick

Hmm it was a big discussion a month or so ago. Maybe I was just confused by it. I'll have to look but I thought that's why everyone was upset with UHC?

They said CMS is mandating that Part D clients moving to MA plans are paid prorated. And then every other company sent the same email out.

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I can't copy the thread because I'm on my phone but it's titled "CMS has made it official..."
Again, maybe I don't understand the concept completely. But they are saying in the thread that if you write someone with a SEP from a med supp and part D plan in say Nov 1 effective date. You get $34 and then $17 month starting in Jan.

 

[cadylou]

Hunana enhanced PDP is non commissions me do no $$ for those. Thanks humana!!??

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Hunana enhanced PDP is non commissions me do no $$ for those. Thanks humana!!??

I meant "no money for those " --hate auto correct