UPDATE (3/29) I need to check with the final bill language to verify this. I think this may not have been included in the final version.
UPDATE (3/30) – Language in this blog post has been corrected to reflect the Final Bill (PPACA 2010).
UPDATE (4/20) – See my notes on the 2011 FINAL CMS Call Letter, including enrollment dates.
The relevant sections of the Bill relating to enrollment periods is Section 3204 – Simplification of Annual Beneficiary Election Periods which can be found on page 338. (I’ve copied and pasted the entire section below.)
Here are the changes:
- Changes to the Annual Enrollment Period (formerly 11/15 to 12/31 of each year): The actual language of the Bill was a bit fuzzy (begs the question if anyone read the whole thing, but one would think one person would have caught this error) as to whether this will begin in 2010 (for 2011 plan year) or 2011 (for 2012 plan year). The 2011 CMS Call Letter clarifies that for 2010 (2011 Plan Year), the AEP will run from 11/15/2010 through 12/31/2010. Starting in 2011, the AEP will be changed from 10/15/2011 through 12/7/2011. I blogged about the lack of an AEP in 2010 for 2011 plans here.
- The Open Enrollment Period will be shortened in 2011 to 45 days. The term “Open Enrollment” is a bit of misnomer as now the only options during “Open” “Enrollment” will be to “Disenroll” from a Medicare Advantage plan. Medicare Beneficiaries who disenroll from Medicare Advantage will be allowed to enroll in a Part D plan (Stand alone PDP) during the OEP. A better name might be “Closed Disenrollment Period”, but that’s just my opinion.
As mentioned, here is the text:
SEC. 3204. SIMPLIFICATION OF ANNUAL BENEFICIARY ELECTION PERIODS.
(a) ANNUAL 45-DAY PERIOD FOR DISENROLLMENT FROM MA PLANS TO ELECT TO RECEIVE BENEFITS UNDER THE ORIGINAL MEDICARE FEE-FOR-SERVICE PROGRAM.—
(1) IN GENERAL.—Section 1851(e)(2)(C) of the Social Security Act (42 U.S.C. 1395w–1(e)(2)(C)) is amended to read as follows: ‘‘(C) ANNUAL 45-DAY PERIOD FOR DISENROLLMENT FROM MA PLANS TO ELECT TO RECEIVE BENEFITS UNDER THE ORIGINAL MEDICARE FEE-FOR-SERVICE PROGRAM.—Subject to subparagraph (D), at any time during the first 45 days of a year (beginning with 2011), an individual who is enrolled in a Medicare Advantage plan may change the election under subsection (a)(1), but only with respect to coverage under the original medicare fee-for-service program under parts A and B, and may elect qualified prescription drug coverage in accordance with section 1860D–1.’’.
(2) EFFECTIVE DATE.—The amendment made by paragraph (1) shall apply with respect to 2011 and succeeding years.
(b) TIMING OF THE ANNUAL, COORDINATED ELECTION PERIOD UNDER PARTS C AND D.—Section 1851(e)(3)(B) of the Social Security Act (42 U.S.C. 1395w–1(e)(3)(B)) is amended—
(1) in clause (iii), by striking ‘‘and’’ at the end;
(2) in clause (iv)—(A) by striking ‘‘and succeeding years’’ and inserting ‘‘, 2008, 2009, and 2010’’; and
(B) by striking the period at the end and inserting ‘‘; and’’; and
(3) by adding at the end the following new clause: ‘‘(v) with respect to 2012 and succeeding years, the period beginning on October 15 and ending on December 7 of the year before such year.’’.
Just found this blog, shameful what this has done to the agents in name of protecting the seniors. In reality the MADP hurts the seniors by not letting them into a different MA plan!
As a result of the recent health care legislation there have been siginfigant cuts to the Medicare Advantage program with many of these (subsidies) hitting in 2012. In reviewing some of the plans for 2011 I have noticed very little changes in premiums and/or cost sharing from the 2010 plans. I know you don’t have a crystal ball but you know alott more than most of us and I was wondering what you think might happen come 2012. Will there still be $O premium plans, if so, will many extra benefits be cut like eyeglasses, gym benefits, COMMISSIONS!! Will companies continue to offer Dual and Chronic Special Needs plans? I know many agents(including myself) that sell MA all year round and in particular to the lower income population and we are trying to determine as much as we can if we can continue to expect Medicare Advantage to be and in particular, $0 premium and SNP plans.
If the Republicans take over the Congress and/oWhite House could all these changes enacted in PPCA be changed?
Craig:
Depending on what happens in Congress, it’s possible that the funding for the PPACA bill could be modified. It’s not likely any other changes could be made as they would have to overcome a Presidential Veto. I’m not seeing any commission reductions currently in the MA market.
the membership will become much more stabilized, higher retention rates with the implementation of this legislation.
I can see my health insurance licenses (all 50 of them I have for each individual state) turing into worthless pieces of paper that mean nothing.
Craig,
MA Health Plan Director and Compliance Director just returned from CMS conference in Balitmore this week.
They said that the interim director of CMS clearly defined (to a stunned an hushed crowd) that the AEP for 2011 will be 10/15 – 12/7/2010. Just wanted to pass this along.
Bryan
Bryan:
Thanks for the information! I was going off of the 2011 Call letter! This is big news, I have no idea how they are going to implement this . . .
Craig
If MA companies don’t submit their plan proposals until June, this seems like a tight schedule. And in the past, companies did not send out their ANOC until the end of October. And agents did not attend training on MA plans until October. Seems like there are lots of pieces that will need to be moved around to make this work.
Craig, Anymore update on AEP/OEP for 2011 plan year?
Thanks,
Bryan
Bryan:
The AEP will be the same as last year, however, the OEP will change to a 45 day period to DISENROLL from Medicare Advantage. There will be no opportunity (outside of SEP’s and Initial Enrollments) to enroll in Medicare Advantage for plan year 2011 after 1/1/2011.
Here is a link: http://blog.ritterim.com/2010/04/05/update-on-aep-for-calendar-year-2010-plan-year-2011/
This has been Pelosi’s plan all along. They’ve figured out that MA plans work and can actually turn a profit if managed correctly. They want the money! First they cut commissions and now the slow death part!
Stop telling and start selling.