In 2007, we introduced our Enhanced and Enhance Plus Plans which have very rich benefits. These plans accounted for 40% of all new PFFS sales during our Open Enrollment Period.. Unfortunately the benefit design has resulted in adverse selection and very high loss ratios on this block of business.
The negative financial impact of this business has forced us to make difficult business decisions surrounding these plans. We find it necessary to eliminate commissions on new business with the Private Fee for Service Enhanced and Enhanced Plus plans. This change will be in effect on these plans beginning with effective dates of 8/1/08. This change will not impact your commissions on any other products.
We want to acknowledge WellPoint’s commitment to the Medicare market, and our ongoing partnership with you. We recognize and value the contributions you make to our business, and we remain committed to our partnership.
Facts from letter:
· We introduced Private Fee for Service Enhanced and Enhance Plus Plans with very rich benefits in 2007
· Because of the negative financial impact with the PFFS Enhanced and Enhanced Plus plans we are eliminating commissions for these two products with effective dates of beginning August 1, 2008. .
· These plans accounted for 40% of all new PFFS sales during our Open Enrollment Period and the decision to eliminate commissions was a difficult business decision.
· This change will not impact your commissions on any other products.
· We want to acknowledge your commitment to the Medicare market, and our ongoing partnership with you.
· If you have any additional questions please feel free to contact your regional sales director.
Talking Points
PFFS Enhanced and Enhanced Plus Plans
Q: Why aren’t we going to pay commission on these plans anymore?
A: WellPoint has suffered negative financial impact with the offering of the PFFS Enhanced and Enhanced Plus plans. Unfortunately the benefit design has resulted in a very high loss ratio on this block of business.
Q: How will my commissions be affected on other products?
A: This change will not impact your commissions on any other products.
Q: Why won’t I be able to get commission on the PFFS Enhanced and Enhanced Plus products sold after August 1, 2008?
A: WellPoint made this difficult business decision because of the very high loss ratio for this block business.
Q: Will this have any effect on my current book of business and the commission earned from the book?
A: No, you will continue to receive your current commission on all business written prior to August 1, 2008.
Q: Will these products be offered in 2009?
A: We have filed our benefits with CMS. Once they are approved and CMS allows us to discuss them we will let you know our 2009 offerings.
Q: How does this affect my clients on these products?
A: There is no impact to current members on these products as we are not making any mid-year changes to the benefits.
Q: Can I change my client to another plan offered by Unicare?
A: No. Unless a Special Enrollment Period (SEP) exists for the client/member, you must wait until the 2009 Annual Coordinated Election Period (AEP) beginning November 15, 2008. Please be reminded that Medicare Advantage plans are contracted on an annual basis for the calendar year.
Q: Will my clients experience delays in claims payment?
A: No, we will continue to pay claims in a timely manner.
Q: Will UniCare/Anthem Blue Cross be offering PFFS products in my state for 2009?
A: We have filed our plans for 2009 with CMS for your state, and once we receive approval we will be able to communicate that information to you.
Q: Who may I contact for further questions?
A: If you have additional questions please feel free to contact your regional sales director.
