Agents in the Senior Market, MUST PAY ATTENTION TO THIS!! PLEASE PASS THIS ALONG to your fellow agents IMMEDIATELY!! We must get the word out to all Insurance Agents in the Senior Market about this subject. This could affect Medicare Supplement, Medicare Advantage and Medicare Part D marketing and enrollment. Obviously, this could be expanded to more insurance coverages in the future.
CMS is proposing a Demonstration Project which could limit or eliminate the ability of the Medicare Advantage company to conduct Marketing and Enrollment in areas which are classified as “Medicare Enrollment Assistance Demonstration Site(s)”. This could limit or, possibly, eliminate the role of the independent agent in these markets. This could also limit the company’s ability to MARKET THEIR OWN PRODUCTS in these Demonstration sites.
I realize this is a bit complicated, but it is EXTREMELY IMPORTANT TO FOLLOW THIS!!
This Demonstration project would be limited to a couple of states in 2011 (probably 1-2 states) with a Third Party Contractor. This would most likely take the form of a Call Center with Representatives trained to provide one-on-one assistance to beneficiaries to help them understand their coverage options and ENROLL in plans. They would also conduct outreach via direct mail and telephone. The products they would enroll Medicare Beneficiaries in would include: Original Medicare, Medicare Advantage, Medicare Part D Prescription Drug Coverage, Medicare Supplemental Insurance Coverage (Medigap) and Employer coverage. They would also conduct outreach via: Direct Mail, Community and Educational Activities, Sub-Contracting with Community-based organizations, Community-based enrollment centers and processing enrollment applications and submitting enrollment requests to plans.
The Demonstration project would (potentially) mirror the current system of MediCAID enrollment where states use contractors to facilitate this enrollment (no agent involvement).
CMS is also contemplating placing RESTRICTIONS on MARKETING and ENROLLMENT activities in areas which are classified as “Medicare Enrollment Assistance Demonstration site(s)”. Essentially, CMS is posing an open question on what (if any) role the Medicare Advantage company would have in Marketing and Enrolling Medicare Beneficiaries in it’s own products in these demonstration areas. Would the Third Party Contractor be the SOLE source for enrollment and marketing in “Medicare Enrollment Assistance Demonstration Site(s)”??? That’s an open question at this time.
On October 28th, CMS conducted an Open Door Forum to discuss the Demonstation project. HERE IS A LINK TO THE ANNOUNCEMENT.
The Audio Recording of this Conference Call is supposed to be available on MONDAY, NOVEMBER 9th, 2009 and will be available for 30 DAYS! Here is a link on where to get it. I have not heard the Conference Call, but I intend to listen to the call on Monday and download the transcript to learn more about this.
CMS has also established a website for this Demonstration Project. Click here to Access the Medicare Enrollment Demonstration Website. You can also subscribe to get email updates from CMS on this Demonstration Project by clicking here. (I suggest you get the updates!)
PLEASE PASS THIS ALONG TO YOUR FELLOW AGENTS. WE MUST STAY EDUCATED ABOUT WHAT IS GOING ON HERE.
I just wanted to get the initial information out there. In the future, I’m looking to put together some sort of internet based group to keep everyone informed on what’s going on! Check back to the blog for updates.
Craig
[...] I don’t want to repeat what I wrote, so you can find the original blog post here. [...]
This is a sad day for the independent agent and FMO’s who make their living from selling Medigap and Medicare Advantage plans.
A third party merketer could easily get by with a staff of 500 to 1000 “unlicensed agents” and cover the entire US. This will probably account for 50% of sales
They could then partner with or form their own FMO to handle those that want home appointments. The handful of agents that work those layup appointments would probably be paid 15% to 25% of what is currently paid. And since a full calendar could be given out, you wouldn’t need nearly as many agents. This FMO/3rd party would have a monopoly.
This will put hundreds of thousands of agents and staff out of business throughout the country.
And the insurance companies will love it because they will get thousands of policies per year and have no commission to pay.
I can’t understand how the state Insurance commissions are not weighing in as this will eliminate many licensees lowering their budgets.
Steer your ship away from this iceberg or become like the Titanic. We have maybe two to three AEP’s left before we become like the typewriter in this equation.
Sad. Very Sad. I thought I was building a career, but little did I know plans were underfoot to remove a many agents from the equation as possible. Why is CMS at war with independent agents? Who has a bug up their patoot so far that they do everything they can to kill the agent?
Craig – you need to get more active and not just watch and see what develops. By the time you find out – it will be fait accompli and adios to those that are not aligned with the monopolistic 3rd Party Marketer (which will be hundreds of thousands of us).
CMS = Communistic Medicare Services
Robert, I dont think you have to advise Craig to be more pro active in this effort.. He is doing more than just watching to see what developes…..Thanks Craig for all that you are doing to help the independent agent !!!!!
Agreed, I think Craig is very active on as many issues as he can keep on his plate and does a great job at it. He is definitely the Independent Agents friend…
CMS likes to point fingers at companies and agents. Instead, CMS should be pointing a finger at themselves.
We do not need government funded giant phone rooms filled with green horn idiots to explain plan options to medicare beneficiaries.
Independent senior agents with their years of experience are best positioned to help medicare beneficiaries compare plans.
CMS and its myriad of regulations and limitations placed upon agents and plans is responsible for creating much of the confusion for seniors about which plan to select.
CMS attempts to help potential enrollees comparision shop by spreadsheeting some features and benefits on medicare.gov and their goofy “star” rating system. The “Medicare and You” book has a more general and confusing version that is not county specific.
Such spreadsheets are a good concept but should be in a more easy to understand, county specific, printed form.
Annual comparison shopping is important because, as you know, Advantage plans can change significantly from year to year. Last year’s “best” plan might be in the back of the pack this year. Folks sign up for a plan that looks good, then the plan changes These plans also can vary greatly from county to county within the same state.
Independent agents should be able to obtain a supply of easy to understand county specific spreadsheets AND be able to freely distribute and use such spreadsheets when discussing choices with medicare beneficiaries.
Spreadsheets can be a clear, easy to understand quick reference tool to help folks comparison shop all that is available in their particular county. Spreadsheets do not have to be in their current “CMS Approved” hard to decipher mish mash.
CMS likes to make rules. Why not make it a CMS MANDATE that agents HAVE to show these printed county specific spreadsheets to all potential enrollees.
As an Independent agent I want to help seniors comparision shop and be able to offer them the best available plans and value. So what am I doing wrong that CMS wants us to go the way of the dinosaurs?
Has anyone actually heard the recording on this? I got to link and their is no recording, unless I am not doing this right. Please advise or give direct link to recording. Thanks
Joe:
I’ve looked for it the past 2 days and haven’t seen it. I’ll give them another day or 2 and then I’ll send them an e-mail request for it.
Craig
I’ve been saying for years that Medicare seems to trail Medicaid. The lag is 2-3 years.
First open enrollment now auto enrollment.
This became a final reality for medicaid approx 18-20 months ago. From the actions put forth by the gov’t it seems there is no turning back at this point. The inevitable appears to be on the horizon.
This is just one of many things that I see happening in our country that I find disappointing. We are heading down a road that is a slippery slope to an America that is so fundamentally different than our founding father’s vision.
I am not a negative person nor an alarmist. But this is some scary s_ _ t.
Craig,
Thank you for all the work that you are doing. As upsetting as it is, thank you. I’ll start looking for a government job soon.. I’m sure they are hiring being not many other companies are right now. Unless it’s a road crew that is paving a road that was just done a few years ago and now has gotten more money to add another layer.
It will be great to have the nice new roads and nothing to drive on them with. Maybe by then there will be a government drive to take us places as well.
Have a great week Comrades
This is getting scarry. The Federal government is inpinging on every one’s rights.
It’s not just about insurance, what about the good old American way of self reliance and independence? The government wants to think for everyone and spend our money without our consent. Just remember at election time: all incumbents must go. This is no longer a government of the people and by the people!
I was under the impression that CMS was founded on the principles of protecting the public from unscrupulous practices. They dictated what we could and could not do and probably found a few bad apples, so now they have given their blessings to new representatives to take over our duties. Of course, CMS is a typical government run agency full of nitwits and suck-ups and when their new reps screw-up, we won’t hear about it. Kind of like “who visited the White House”.
I feel sorry for all you younger folks in the business today facing all the assinine changes and policies that will be forthcoming. Me, I’m just an “old fart” that has seen some mighty dismall changes in our industry over the years and I guess it’s time for me to “go out to pasture”. It’s rather ironic that I should read this article on the same day the socialistic Health (Pelosi/Obama) Care has been passed.
Larry: I wouldn’t call you an “old fart”. . .you are commenting on a blog!! I think we need to be vigilent about this. I’m concerned about CMS limiting the ability of Insurance Companies to market their own plans (and include the use of independent agents, if they so choose).
What an outrage!
First, rule 151a,
Then, CMS controls commissions’ payments,
Then, “The public Option”, Read – eventual elimination the health insurance system
Now, “Medicare Enrollment Centers” – Read as elimination of agents.
Next come “Cap and tax” – Eliminating Oil conglomerates and the U.S. auto industry. Not to mention the wasted 860 Billion, and misappropriation of bailout money.
These are the most dangerous policies since Germany after WW 1. Look where that got them.
If citizens can’t see the writing on the wall, they must be blind.
BTW, It seems they we be able to make outbound calls those turning 65. What hypocrites.
Where does CMS get the authority to regulate Medicare Supplement programs?
Med Supp exists as separate and apart from official Medicare programs. As such, it is not a federal government program, and is regulated by the states.
Bubba:
The proposed Medicare Enrollment Assistance Demo project would enable the Contractor to enroll Medicare Beneficiaries in Medigap (see #1 on pages 1-2 of the announcement here: http://www.cms.hhs.gov/OpenDoorForums/Downloads/MediEnrollAssistDemo102809.pdf)
#2 (c) Discusses the limitations on Marketing and Enrollment in the Demonstration Site(s). I don’t think these limitations would apply to Medigap. I’m interested in listening to the conference call on Monday to learn more. This is pretty much all I know at this point, but I’m interested in learning more about what this might end up looking like.