Agents and Brokers should be getting this message from the Insurance Companies they are appointed with for Medicare Advantage very soon (perhaps Monday?).
My Comments on this Memo (reading the tea leaves!)
- I would have preferred to see them reversing their initial guidance with respect to 2009, but the fact that they are suspending the implementation of the former guidance to Health Plans is encouraging. I’m not sure that they would have suspended implementation if they didn’t intend to make a change?!?
- I’m happy to see that CMS is acknowledging the regulatory guidance is clear that for 2010 agents and brokers should be paid an initial fee for enrollments from a PDP to an MA plan. This seems to beg the question, “Why are we handling 2009 differently than 2010?” Generally, the answer has been that CMS didn’t have the administrative capability to instruct the plans on which commission to pay (which led to the whole file issue), however, the first file (the one with “errors”) did have the PDP members included in the file, so I don’t think this is an “administrative” issue any longer. . .
- CMS explicitly states they are examining 2009 guidance and expects to release additional guidance shortly. They go a bit further in instructing the Health Plans to contact their agents and inform them of this. I’d be surprised (but not totally shocked) if they would advise this if they intended to keep 2009 the same. . . That would just be cruel.
Here is a copy of the e-mail which went out to Health Plans late Friday night.
Date: June 26, 2009
Subject: Suspension of implementation of June 5, 2009, HPMS memo on agent/broker compensation; Impending guidance on criteria for paying initial compensation fees in 2009
Suspension of Implementation of June 5, 2009, HPMS Memo on Agent/Broker Compensation
CMS has received feedback concerning the agent and broker compensation requirements in our June 5, 2009, HPMS memorandum titled “2009 Medicare Advantage and Prescription Drug Program Agent and Broker Compensation Refinements and Compensation Rate Adjustment for 2010.” While we evaluate the issues and concerns being raised, we are suspending the implementation of these requirements. We expect to issue clarifying guidance shortly.
Impending Guidance on Criteria for Paying Initial Compensation Fees in 2009
CMS has received feedback about confusion on whether agents and brokers should be paid an initial compensation fee for 2009 enrollments from a PDP to an MA plan. We believe our regulatory guidance is clear that for 2010 agents and brokers should be paid an initial fee for enrollments from a PDP to an MA plan. CMS is examining its guidance pertaining to 2009 enrollments and expects to release additional guidance shortly. Plans should contact their agents and brokers to inform them that CMS is reconsidering its guidance for 2009 and expects to release additional guidance shortly.
Craig,
CMS announced last Friday June 26th they suspended the June 5th guidance on payment of initial commissions. It seems cut and dry with that announcement that they were going to rescind that guidance and pay us the initial commission on members that enrolled in MA with a PDP. Any idea what is taking so long(or should we just expect that with CMS/governmental agency) by now. Hopefully they let us know before the July 4th holiday which begins at the close on business July 3.
Nothing is cut and dry with CMS. They do things the hard way every day.
I know what you mean. Red tape and more Red tape!!! I was in India for a long time and I thought the bureaucracy was bad there. At least there you can bribe government officials to get things done!
Just wanted to thank you Craig, this site is the only way I know what is going on with our social work. I used to be a captive agent with Humana and the pay was great. However, I thought being an independent agent and being able to offer more plans and the ability to sell other products would be more profitable. I was dead wrong. The health insurance market is horrible, the lead companies are profit driven and I’m done with this. I’ve been in Medicare for over 8 years and I’m over it. I’m hopefully getting another job which looks promising. Good luck to all
Just wanted to say a quick “Thank you and/or You’re Welcome” to all those agents who posted positive comments on this blog! I really can’t reply to every comment, but I do try to read as many comments as possible!
Check your Advantra statements. Just got charged back thousands of dollars that were paid out for 01/01/2009 “initial payment”! It looks like Coventry doesn’t have faith that we will be keeping the PDP having clients commissions. CMS is ridiculous. I’m sick of being at their mercy each month that they change rules.
It appears this chargeback is just to reverse the report CMS issued in error on 6/4/2009. There were a few people on my report who were in MAs for years but didn’t have a PDP and went to a PPO this time, which may or may not qualify depending on what their final determination of plan change is.
I would think that they had to reverse those entries (remember if it was manual check, they never sent it yet anyway) to put in the latest guidance. I just hope that they make the right decision and do it quickly and we get everything corrected up to date. Soon we will be in the next busy season or at least preparing for it and we’re still waiting on comps from the last season.
I contacted my FMO’s today that I work with and they have no clue what is going on. I write a lot of business for United Health Care, Coventry, Unison and Highmark and not one them has any idea what is going on.
Craig Ritter is the only FMO I swear that has a clue. If I wasn’t committed to the guy who brought me into the Medicare Advantage business I would move EVERY contract over to Ritter Insurance. They are the best by far.
Many agents are committed to MA contracts from coming in when this all started in 2005, but may not have many Med Supp markets. I would suggest that a great way to show Craig your appreciation since there will be a new block of Med Supp business next year is consider putting any Med Supp markets through Ritters and of course, if you don’t have an MA market that you want to bring on for 2010, also put that through Ritters. Craig Ritter is certainly a friend of the independent insurance agent and shows it through his efforts. I agree, that I have not heard another FMO or company rep really communicate anything on these commission issues except after the fact. I am one of those people that think that an agent/agency based system is the best way to serve the local communities and Medicare Beneficiaries and a proactive, service-oriented FMO makes the whole process work better.
Chris B.
I got the same chargeback today. I think that commission statement which was generated yesterday, 06/28/09 was created BEFORE this past Friday June 26 where CMS was suspending the guidance given to the insurance companies on June 5th. Hopefully CMS’s rules in our favor and everything gets straightened out going back to the beginning of AEP, November 15, 2008..
Lets see if CMS does the right thing!!
Mike:
Exactly correct. See my comment below for more detail on the timing.
I also got thousands chargebacks from Advantra!!!I thought a decision has not been made….Their system of payment is really messed up!!!
Joe:
Advantra was one of the first to pay “initial” commissions based on CMS’s original file. Advantra was told that the file contained errors after they had already paid. Once they got the new file, Advantra started the process of Charging back. This process started a few weeks ago before the most recent word came from CMS this past Friday night. Assuming CMS changes their position (I expect they will, but I’m not betting my life on it), Coventry will need to reverse all these again. Basically, since Advantra was one of the first to pay and one of the last to charge back, you are just seeing this now. I’m sure they will correct the chargebacks quickly once CMS acts on this issue.
Craig,
We all must continue to put PRESSURE on the suits at CMS, so that the agents can receive the commissions that are rightfully there’s.
If they do not do what is right, then and old then, we all must band together and start a class action suit against CMS and to get the media involved about the injustice CMS has done to every agents lives.
Thank you Craig for all that you have done regarding communicating to CMS regading their errors.
I can only hope that someone will also figure out soon that they can not deny commissions beyond the 5th year of MA business as we independent agents of integrity will continue to service out clients for many years to come (or perhaps we needn’t worry about commissions as MA’s will end with the new Marxist regime…..)
Amen!
The good thing is that this can only mean one of two things.
Good News– we have re-evaluated our guidance for 2009 commissions and will pay out for PDP customers.
or
Bad News– we have re-evaluated our guidance for 2009/2010 commission and realized our guidance for 2010 was incorrectly posted and will be re-written to reflect 2009 rules.
niether would surprise me.
Dan,
I would doubt the latter. That would be cruel. I am surprised that that they just didn’t come out and say they will pay initial for people with PDP for 2009. I hope they don’t say going forward they will pay. Who knows. CMS is toying with us and that is cruel regardless whether things in our favor.
Thank you for your work and keeping us informed and leadership.
we have re-evaluated our guidance for 2009 commissions and will not pay out for PDP customers.
“CMS”:
Not funny. Ok, maybe a little? Hmm. . .
Craig