Archive for July 2nd, 2008

Effective 8/1/08, United Teacher Associates, a subsidiary of The Great American Companies, is taking the following rate actions in the following states:


Iowa:  8% increase on Plans H, I and J

Kansas:  8% increase on Plan J

Nebraska:  16% increase on Plans A, B, C, D, F and G

Ohio:  8% increase on Plans H, I and J

Oklahoma:  8% increase on Plans H, I and J

South Carolina:  8% increase on Plans H, I and J

Utah:  16% increase on Plans A, B, C, D, F and G; 8% increase on Plans H, I and J

West Virginia:  16% increase on Plans A, B, C, D, F and G; 8% increase on Plans H, I and J.


According to the company, updated rate sheets will not be available until July 18th and they will be will be available on the company’s agent website.  http://agentview.gafri.com


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This is an explanation of the “cooling off period” with respect to Medicare Advantage and other products.  If you intend to present more than one product, you need to advise the client in advance.  Once CMS completes the 2009 Medicare Advantage Marketing rules, I’ll give a detailed description of each rule.

Q: In 2008, is it correct that an agent can present as many MA-PD plans as he wants, or is the protocol to do a needs analysis on the first visit and then go back to present the ONE plan that he thinks best meets the clients needs?

A: There is no restriction on a sales agent presenting more than one MA, MA-PD or PDP plan during a sales presentation for 2008 products.

For 2009 products, CMS is requiring that a sales agent disclose prior to the in-home sales presentation all of the products (e.g. MA, MA-PD, Medigap, PDP) that will be discussed at the in-home sales presentation.

If an agent wishes to discuss a product that is not initially identified, the sales agent must reschedule a separate appointment and such appointment cannot occur until 48 hours has past from the initial appointment – cooling period.

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A representative from American Continental will be in Pennsylvania at various locations throughout the month of July.  If you would like to set up a “one on one” meeting to review their products and services, please e-mail me.

Here are the date and locations:

  • July 8th, Erie, PA
  • July 9th, Pittsburgh, PA
  • July 10th, Altoona, PA
  • July 29th, Harrisburg, PA
  • July 30th, Bethlehem, PA
  • July 31st, Plymouth Meeting, PA

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Here is the actual text of the proposed rule:

422.2274 Broker and agent commissions.
If a Medicare Advantage organization markets through independent brokers or agents—
(a)(1) In paying a commission or other compensation (collectively referred to as ‘‘commission’’) to such agent or representative, the commission the agent would receive for selling or servicing the policy in the first year could not exceed the commission the agent receives for selling or servicing the policy in all subsequent years.
(2) The commission must be the same for all plans and plan product types offered by the MA plan’s parent organization.
This rule is one of a number of “marketing” changes which CMS is proposing.  CMS is looking at this as a way to curb “churning”, so this proposed commission rule change falls under the Marketing umbrella.
Insurance companies have until July 15th to make suggestions before CMS takes all of the information and promulgates its marketing rules for 2009.  This one, in particular, could have a big impact on how Insurance Companies distribute their Medicare Advantage products. 
There are a number of issues that are unclear at this point, for example, although the wording appears to apply to external agents, CMS is interpreting this to include a companies inside sales force.
America’s Health Insurance Plans (AHIP) will be drafting an industry response, which should be available on it’s website soon.  (When I see it, I’ll post.)

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Ritter Insurance Marketing will be closing our office at 1pm EDT on Thursday, July 3rd and will also be closed on Friday, July 4th to celebrate Independence Day with our friends and family.  Our office will return to normal hours on Monday, July 7th.

We hope you enjoy your Fourth of July!

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Here is the latest in the battle over how to pay for the cost of not cutting the Physician’s fee schedule by 10.6%.  From the NAHU website:

The AP (7/2, Yen) reports that “[t]wo powerful health trade groups will begin airing dueling ads this week in their fight over Medicare, hoping to influence Congress as lawmakers face pressure to reverse scheduled cuts in doctor fees.” America’s Health Insurance Plans (AHIP), “a trade group of private insurers, is siding with Senate Republicans and the White House in their standoff with Democrats over” the “measure that would halt the cuts by trimming payments to private insurers.” The American Medical Association (AMA), however, said that “it was airing new television and radio ads in six states through the week that target a group of senators who blocked action on the proposed legislation” to avoid physician payment cuts, which “passed the House, but stalled in the Senate last week amid a veto threat by President Bush.”


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