It’s official! CMS announced a few hours ago that they will be REVERSING their prior guidance and ALL 2009 enrollments into Medicare Advantage from Original Medicare and a PDP will be paid INITIAL commission.
CMS will be issuing clarification about the implementation and timing of the new files, but the new guidance on 2009 is 100% clear!
Here we go again. CMS loves to toy with us.
Any word on when the files are going to be released? Also I just got in a commission statement from Wellcare with a lot of “Not Taken” thus showing a chargeback on clients that I know are still enrolled in the plan. Anyone else have this happen? I’m about to call and sit on the phone forever to have some idiot in “agent support” give me a line of bull but what else is there to do…
Rose,
I got a statement from WELLCARE that said that also “not taken” on apps I wrote during AEP.
I looked, however, at http://www.wellcarepro.com and those same people that said “not taken” were still showing up as in force. I have a debit balance to Wellcare anyhow so I have no reason to call them anyone. I am just hoping some of the “true ups” come in from deals I wrote during AEP to get my debit balance down.
That happened to me with Coventry. It was from several PFFS plans and several Dual Option plans placed from 2/1/09 to 6/1/2009 – they charged back the months from January to the effective date because with the plans not being renewed for 2010 there will not be a full year in the plan. It should just be for those plans and for those months.
Rose:
I heard a rumor that “corrected” files will come out of CMS by the end of July. For what it’s worth.
Craig
Thanks Craig for passing that along. Did you hear if it will be up to current or not?
MIKE
THANK YOU SO MUCH FOR YOUR INFO ON ADVANTRA FREEDOM . I THINK THAT CMS CALL LETTERS STANDS FOR Can Mess up Stuff … I am so discussed in this industry
it just makes me want to puke… I might quit after 24 yrs of this and just start running moonshine and selling fireworks on the side of the highway.
I might quit after 36yrs!
Can you believe this nightmare started 8 months ago today? And we still have not been paid.
Come on CMS,UHC wheres our $$$$$.
Can you remember the days when Insurance Company’s could be counted on to Do the Right Thing?????
Joe, I don’t think the insurance companies can do anything about this. They can only talk to CMS about the commissions and wait for the file from CMS to pay us. If they paid us without the CMS file and CMS found out – they would be done offering Medicare products and therefore, so would we.
CMS is the only problem here and unless someone at the federal level gets involved and cleans house and gets someone into CMS to clean up all of their administration issues – we continue to suffer.
TO DATE NO TRUE UPS FOR ME…
BUT DID RECEIVE A STATEMENT FROM ADVANTRA WITH ALOT OF CHARGE BACKS FOR NON RENEWAL BIZ IN 2010 …THIS IS SO UNFAIR
Not only do I have a negative balance from chargeback from incorrect CMS files, but I have now lost my commission on 3 new sales to the deficit due to the charge backs. And today I faxed in 2 more applications that I won’t get paid for.
7 months waiting to get paid for business written in 2008 and now I don’t get paid renewals for business written in 2007 or commissions for any new sales because CMS does not seem to have a clue as to what business I have written or what the rules are that they made to pay me for the 1/1/2009 sales.
Funny how quick my new sales commissions have posted since I have a negative balance and no money is being paid.
And who wants to hear that CMS is going to pay us for other months since January, when it all just goes on account and you get nothing until they fix the mess they made and can not seem to fix for January.
And the state workers think they have it bad – they have only been waiting 2 weeks, not 7 months.
Tammy,
I read an article on that also. You must live in Pennsylvania. I thought the same thing about those state workers waiting for their paychecks because the budget hasn’t been passed. I would like to see how they survived if they had to wait 8 months like we do.
Tenn.Tom,
I wrote a lot of business for Advantra this year. According to broker services, they are doing a monthly pro-rated chargeback on all products that they have not renewed for 2010, specifically all of their PFFS business and the special needs plans like Cholesterol, Diabetes and DUAL eligible plans(except in Florida). Whomever it was that I spoke to in broker services said they were doing a monthly pro-rated charge back based on the month you enrolled them but they won’t do the chargeback on the “true-up” amount on those same products. I’m holding my breath for that. So basically if you were receiving $200 on the renewal you would get charge backed $16.66 on each month they will not be on the plan for 2009 since that $200 was based on a 12 month advance.
My company has not recieved notification of the reversal by CMS and would like a copy of ruling. Where can I get this
Has anyone gotten paid their “true up” commissions yet?
I haven’t. Got an email from one of my carriers stating they were waiting on some files from CMS. Then we would get paid.
Anyone gotten paid yet?
Are we going to be paid this pay period or do we have to wait again for CMS to accredit or let the companies know which policyholders are which? This could go on til the enrollment process starts over again.
By the way THANK YOU FOR ALL YOU DO FOR US.
We will be lucky to get our commissions by August or Sept.
Craig,
Now that CMS is paying full initial commission on people coming from OM + PDP I thought of one other question.
Do we get paid the full initial commission in all cases where the applicant is coming from OM. Do we get the full initial commission on all people coming from Original Medicare even if they had a Medicare Advantage say a year ago and subsequently went back to Original Medicare?
I can’t remember if CMS addressed this question specifically. I have met several people that had a Medicare Advantage plan say a year ago or tow and then had network restrictions and consequently when back to Original Medicare. I just wasn’t sure,in that example, if we would be entitled to an intial year commission.
CMS is big problem for the Seniors! Iv’e been blamed by CMS because they didn’t deduct premiums from my clients Soc. Security check! Thank God my clients were given copies of their Application, that showed clearly I marked for it to be deducted from their Soc. Security!
John,
Its not your fault. Social Security is very slow when it comes to doing that. I had customers that had been covered for 8 months and still the premium had not been deducted from their social security check. The insurance company won’t cancel the senior during this period however but may send them a large bill for back months 8 or 9 months after the fact. In 2009 I just made a habit to tell my customers bank draft was the most efficient option to pay their monthly premiums.
Advantage plans are shy on Doctors
Wm, what advantage plans do you sell? Some have good networks and others do not. And with the PFFS’s going away many plans will be looking to increase their networks.
William,
What plans are you selling? Unison? Most plans have excellent provider networks especially with the rise in Medicare Advantage recipients.